Hydrotherapy for Children with Cerebral Palsy: Difference between revisions

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== Description<br>  ==
<h2> Description<br />  </h2>
 
<p>'Hydrotherapy' also known as 'Aquatic Therapy' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydorstatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change <span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Becker 2009">Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;amp;amp;amp;R; 2009,1;9:859-72</span>. The bouyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="Morris DM">Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.</span>.&nbsp;<br />  
'Hydrotherapy' also known as 'Aquatic Therapy' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydorstatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change <ref name="Becker 2009">Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;amp;R; 2009,1;9:859-72</ref>. The bouyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training&nbsp;<ref name="Morris DM">Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.</ref>.&nbsp;<br>  
</p>
 
<h2> Indication<br />  </h2>
== Indication<br>  ==
<p>Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is:&nbsp;  
 
</p>
Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is:&nbsp;  
<ul><li>Provides resistance  
 
</li><li>Encourages a wider range of movement and opposition  
*Provides resistance  
</li><li>Alleviates stress and tension  
*Encourages a wider range of movement and opposition  
</li><li>Reduces pain and tension in muscles and joints  
*Alleviates stress and tension  
</li><li>Protects against injury  
*Reduces pain and tension in muscles and joints  
</li><li>Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
*Protects against injury  
</li><li>Decreases post exercise discomfort
*Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
</li></ul>
*Decreases post exercise discomfort
<h2> Safety Considerations and Outcome Measures </h2>
 
<p>Absolute Contra-indications&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015</span>  
<h2> Safety Considerations and Outcome Measures </h2>
<p>Absolute Contra-indications&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="ATACP">Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015</span>
</p>
</p>
<ul><li>Acute vomiting / diarrhoea
<ul><li>Acute vomiting / diarrhoea  
</li><li>Medical instability
</li><li>Medical instability  
</li><li>Chlorine / Bromine allergy
</li><li>Chlorine / Bromine allergy  
</li><li>Resting angina
</li><li>Resting angina  
</li><li>Shortness of breath at rest
</li><li>Shortness of breath at rest  
</li><li>Uncontrolled cardiac failure
</li><li>Uncontrolled cardiac failure  
</li><li>High BMI limiting exit from pool
</li><li>High BMI limiting exit from pool
</li></ul>
</li></ul>
<p><br />
<p><br />  
</p><p>Relative Contra-indications
</p><p>Relative Contra-indications  
</p>
</p>
<ul><li>Acute illness
<ul><li>Acute illness  
</li><li>Irradiated skin
</li><li>Irradiated skin  
</li><li>Known aneurysm
</li><li>Known aneurysm  
</li><li>Open infected wounds
</li><li>Open infected wounds  
</li><li>Poorly controlled epilepsy
</li><li>Poorly controlled epilepsy  
</li><li>Unstable diabetes
</li><li>Unstable diabetes  
</li><li>Exercise dependent O2 demand increases
</li><li>Exercise dependent O2 demand increases
</li></ul>
</li></ul>
<p><br />
<p><br />  
</p><p>Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref" name="WHO - ICF-CY">World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.</span>.
</p><p>Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.</span>.  
</p><p><br />
</p><p><br />  
</p><p>Common motor function meaures utilised in Aquatic Therapy research:&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.</span>
</p><p>Common motor function meaures utilised in Aquatic Therapy research:&nbsp;<span class="fck_mw_ref" _fck_mw_customtag="true" _fck_mw_tagname="ref">Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.</span>  
</p>
</p>
<ul><li>Gross Motor Function Measure (GMFM)&nbsp;
<ul><li>Gross Motor Function Measure (GMFM)&nbsp;  
</li><li>Paediatric Evaluation of Disability Inventory - functional skills
</li><li>Paediatric Evaluation of Disability Inventory - functional skills  
</li><li>Dynamometer - muscle strength
</li><li>Dynamometer - muscle strength  
</li><li>Energy Expenditure Index (EEI) - energy efficiency
</li><li>Energy Expenditure Index (EEI) - energy efficiency  
</li><li>3/5/6 minute walk tests
</li><li>3/5/6 minute walk tests  
</li><li>Timed up and Go (TUG)
</li><li>Timed up and Go (TUG)  
</li><li>Vital Capacity
</li><li>Vital Capacity  
</li><li>Goniometry - range of movement
</li><li>Goniometry - range of movement  
</li><li>Ashworth Scale - spasticity
</li><li>Ashworth Scale - spasticity
</li></ul>
</li></ul>
<p><br />
<p><br />  
</p><p>Swimming based measures:
</p><p>Swimming based measures:  
</p>
</p>
<ul><li>Aquatics Independence Measure
<ul><li>Aquatics Independence Measure  
</li><li>Water Orientation Test-Alyn 2 (WOTA)
</li><li>Water Orientation Test-Alyn 2 (WOTA)
</li></ul>
</li></ul>
<p><br />
<p><br />  
</p><p>Social function measures:
</p><p>Social function measures:  
</p>
</p>
<ul><li>PEDI - social function domain
<ul><li>PEDI - social function domain  
</li><li>Pictoral scale of perceived competence
</li><li>Pictoral scale of perceived competence  
</li><li>Canadian Occupational Performance Measure
</li><li>Canadian Occupational Performance Measure
</li></ul>
</li></ul>
 
<h2> Key Evidence  </h2>
== Key Evidence  ==
<p>Administered correctly, aquatic therapy can:  
 
</p>
Administered correctly, aquatic therapy can:  
<ul><li>Improve muscle tone  
 
</li><li>Increase core strength  
*Improve muscle tone  
</li><li>Enhance circulation  
*Increase core strength  
</li><li>Improve cardiovascular functioning  
*Enhance circulation  
</li><li>Improve flexibility  
*Improve cardiovascular functioning  
</li><li>Increase endurance  
*Improve flexibility  
</li><li>Extend range of motion  
*Increase endurance  
</li><li>Reduce muscle spasticity  
*Extend range of motion  
</li><li>Elevate metabolism  
*Reduce muscle spasticity  
</li><li>Reduce sleep disturbances  
*Elevate metabolism  
</li><li>Relieve joint stress  
*Reduce sleep disturbances  
</li><li>Improve muscle tone  
*Relieve joint stress  
</li><li>Increase stability  
*Improve muscle tone  
</li><li>Decrease pain and discomfort
*Increase stability  
</li></ul>
*Decrease pain and discomfort
<h2> Resources  </h2>
 
<p><br /><span class="fck_mw_template">{{#ev:youtube|lvIufSb9dYk}}</span>
== Resources  ==
</p>
 
<h2> Case Studies  </h2>
<br>{{#ev:youtube|lvIufSb9dYk}}  
<p>add links to case studies here (case studies should be added on new pages using the <a href="Template:Case Study">case study template</a>)<br />  
 
</p>
== Case Studies  ==
<h2> Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)  </h2>
 
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>  
 
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
<div class="researchbox">
<div class="researchbox">
<br>  
<p><br />
</p>
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== References ==
<h2> References  </h2>
 
<p><span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /><br />  
<references /><br>
</p><p>&nbsp;<br />
 
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Revision as of 22:34, 21 October 2016

 

Original Editor - Your name will be added here if you created the original content for this page.

Top Contributors - Eoin McNamee, Sweta Christian, Candace Goh, 127.0.0.1, Naomi O'Reilly, WikiSysop, Kim Jackson, Amanda Ager, Chelsea Mclene and Ines Musabyemariya  

Description

'Hydrotherapy' also known as 'Aquatic Therapy' involves therapeutically immersing the body in water where the physical properties of altered density and gravity, hydorstatic pressure, buoyancy, viscosity and thermodynamics can be used to promote physiological change Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;amp;amp;R; 2009,1;9:859-72. The bouyancy and turbulence of water facilitates weight relief and ease of movement during rehabilitation to promote safe movement exploration, strengthening, and functional activity training Morris DM, Aquatic Rehabilitation for the Treatment of Neurologic Disorders .In: Cole AJ and Becker BE. Comprehensive Aquatic Therapy. 2nd edition. Philadephia: Butterworth Heinemann, 2004. p151-175.. 

Indication

Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is: 

  • Provides resistance
  • Encourages a wider range of movement and opposition
  • Alleviates stress and tension
  • Reduces pain and tension in muscles and joints
  • Protects against injury
  • Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water
  • Decreases post exercise discomfort

Safety Considerations and Outcome Measures

Absolute Contra-indications Aquatic Therapy Association of Chartered Physiotherapists. Guidance on Good Practice in Aquatic Physiotherapy. United Kingdom: Aquatic Therapy Association of Chartered Physiotherapists; 2015. Available from: http://atacp.csp.org.uk/guidance-good-practice-aquatic-physiotherapy-2015

  • Acute vomiting / diarrhoea
  • Medical instability
  • Chlorine / Bromine allergy
  • Resting angina
  • Shortness of breath at rest
  • Uncontrolled cardiac failure
  • High BMI limiting exit from pool


Relative Contra-indications

  • Acute illness
  • Irradiated skin
  • Known aneurysm
  • Open infected wounds
  • Poorly controlled epilepsy
  • Unstable diabetes
  • Exercise dependent O2 demand increases


Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007..


Common motor function meaures utilised in Aquatic Therapy research: Jorgić B, Dimitrijević L, Lambeck J, Aleksandrović M, Okičić T, Madić D. EFFECTS OF AQUATIC PROGRAMS IN CHILDREN AND ADOLESCENTS WITH CEREBRAL PALSY: SYSTEMATIC REVIEW. Sports Science. 2013 [cited 2016 Oct 21];5(2):49–56. Available from: http://www.sposci.com/PDFS/BR0502/SVEE/04%20CL%2009%20BJ.pdf.

  • Gross Motor Function Measure (GMFM) 
  • Paediatric Evaluation of Disability Inventory - functional skills
  • Dynamometer - muscle strength
  • Energy Expenditure Index (EEI) - energy efficiency
  • 3/5/6 minute walk tests
  • Timed up and Go (TUG)
  • Vital Capacity
  • Goniometry - range of movement
  • Ashworth Scale - spasticity


Swimming based measures:

  • Aquatics Independence Measure
  • Water Orientation Test-Alyn 2 (WOTA)


Social function measures:

  • PEDI - social function domain
  • Pictoral scale of perceived competence
  • Canadian Occupational Performance Measure

Key Evidence

Administered correctly, aquatic therapy can:

  • Improve muscle tone
  • Increase core strength
  • Enhance circulation
  • Improve cardiovascular functioning
  • Improve flexibility
  • Increase endurance
  • Extend range of motion
  • Reduce muscle spasticity
  • Elevate metabolism
  • Reduce sleep disturbances
  • Relieve joint stress
  • Improve muscle tone
  • Increase stability
  • Decrease pain and discomfort

Resources


Case Studies

add links to case studies here (case studies should be added on new pages using the <a href="Template:Case Study">case study template</a>)

Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)


References


 

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