Introducing aqua hydrotherapy treatment in KL | Synapse

Physical properties of water 

Water possesses various physical characteristics: encompassing mass, weight, density, relative density, buoyancy, hydrostatic pressure, surface tension, refraction, and reflection.The following are the physical properties laws of water that the physiotherapist should understand: 

Buoyancy 

Buoyancy is the upward force encountered, acting in opposition to gravity. In water, a submerged body undergoes the influence of two conflicting forces. Stable equilibrium is achieved when the weight of the floating body matches the weight of the displaced liquid, and the centers of buoyancy and gravity align in the same vertical line. 

Hydrostatic pressure 

According to Pascal’s law, when a fluid is at rest, its pressure is evenly distributed on all parts of an immersed body at a specific depth. This pressure correlates with the fluid’s density and depth, leading to increased pressure. Consequently, exercises conducted beneath the water’s surface, where heightened pressure can be utilised, are more effective in reducing swelling.

The hydrostatic pressure exerted externally induces a peripheral decrease in Blood Pressure (BP) and a rise in BP in and around the heart. This dynamic can pose challenges for individuals with conditions such as Chronic Heart Failure (CHF) and Coronary Artery Disease (CAD), necessitating careful consideration. The depth of immersion directly influences the extent of changes in the mentioned factors. 

Surface tension

When under tension, the surface of the fluid acts as a membrane. The key significance of this characteristic lies in its close correlation with the size of the object. Consequently, exerting force to move an object or body part above the water demands more effort compared to moving it below the surface. Devices such as floaters can be employed to facilitate these movements 

Viscosity

Viscosity refers to the resistance to flow resulting from friction between the molecules of a liquid. This resistance is directly influenced by the viscosity of the liquid through which the movement occurs. Consequently, the crucial observation here is that resistance increases proportionally with the velocity of movement, as well as with the surface area of the item or body part in motion. 

Benefit 

Hydrotherapy creates a gravity-eliminated environment that enhances joint range of motion, further augmented by the stimulating effects of water flow providing sensory input.

Traditionally considered as a supplementary approach to exercise, hydrotherapy has gained broad acceptance in the treatment of acute painful conditions such as rheumatoid arthritis, complex regional pain syndrome, and postoperative pain.

The advantages of water exercises encompass the elimination of gravity, the positive influence of buoyancy, increased muscle relaxation, and reduced joint compression. The buoyancy of water decreases the effective weight of the patient proportionally with increasing depth. An example would be standing in chest-deep water reduces weight-bearing loads to 40% of total body weight. By eliminating the effects of gravity through floating, water exercises may gradually introduce increased tissue loads by adjusting the therapy depth. Water viscosity provides resistance equal to the force exerted by the patient, with resistance varying according to the speed of movement.

Clinically, patients report reduced pain levels during passive and active range of motion, as well as strengthening exercises in water. Water exercises allow for closed kinetic chain activities when pain or weight-bearing precautions limit land-based therapy. Additionally, water exercise is often perceived as less strenuous compared to the same exercises performed on land. Studies have demonstrated sustained benefits, showing a reduction in pain and improved function in patients participating in hydrotherapy for up to three months after therapy initiation.

 Hydrostatic forces also have been demonstrated to enhance venous return, improve stroke volume and cardiac output, and induce reflexive bradycardia (Stanos et al.). 

Contraindication

Hydrotherapy is contraindicated in the presence of the following conditions: severe organic deficiency, severe brain impairment, senile deterioration, individuals with multiple sclerosis, open wounds, active infection, altered sensation, hydrophobia, heat or cold intolerance, and poor balance.

Techniques in hydrotherapy 

WATSU method 

Also known as ‘water Shiatsu,’ WATSU® is a fusion of Aquatherapy and Shiatsu. It involves stretching the body in the comforting and buoyant environment of warm water. Beyond its physical benefits, WATSU® places significant emphasis on the mental aspect of therapy. This method induces a profound sense of relaxation and tranquility, alleviating muscle tension and promoting the stimulation of all body systems and organs by enhancing the flow of energy 

Bad Ragaz Ring method 

The Bad Ragaz Ring technique is an aquatic treatment approach rooted in proprioceptive neuromuscular facilitation. Employing floating rings positioned at the neck, pelvis, knees, and/or ankles, this method supports the patient in a vertical supine position. Utilising water at a temperature of 33 degrees Celsius, the Bad Ragaz Ring technique involves resistive exercises that enhance both strength and mobility. It is essential for the patient not to exert significant force, allowing the therapist to apply the necessary pressure. For optimal results, the Bad Ragaz Ring technique should be integrated with complementary strategies aimed at enhancing engagement and exertion. One such approach is the Halliwick method. 

Feldenkrais Method

This method promotes teaching individuals about the quality of their movements and how to move effortlessly with ease and efficiency. 

Burdenko Method 

It is an integrated land-water therapy approach that develops balance, coordination, flexibility, endurance, speed, and strength using the same methods as professional athletes. The water-based therapy uses buoyant equipment to challenge the center of buoyancy in vertical positions, exercising with movement in multiple directions, and at multiple speeds ranging from slow to fast 

Who needs aqua therapy?  

Hydrotherapy, the therapeutic use of water, offers a range of benefits that cater to various individuals. People grappling with musculoskeletal conditions, such as arthritis or joint pain, often find relief in the buoyancy of water, which reduces impact on joints during exercises. Rehabilitation patients recovering from surgery or injury can benefit from hydrotherapy, leveraging water’s support and resistance for a gradual and effective recovery of strength and mobility. Those dealing with chronic pain, including conditions like fibromyalgia or lower back pain, may experience alleviation as the warmth of water relaxes muscles. Athletes incorporate hydrotherapy, including ice baths and warm water immersion, for post-exercise muscle recovery and inflammation reduction. Hydrotherapy’s relaxing effects make it valuable for managing stress and anxiety. Individuals with circulatory problems may find improvement through contrast baths, while those with respiratory conditions can benefit from steam baths or saunas. Prenatal water activities and warm baths are recommended for pregnant women seeking relief, and elderly individuals appreciate the gentleness of hydrotherapy on aging joints