Hydrotherapy for Children with Cerebral Palsy: Difference between revisions

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<h2> Description<br />  </h2>
== Description<br>  ==
<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 />  
 
</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 <ref>Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;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>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>  
<h2> Indication<br />  </h2>
 
<p>Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is:&nbsp;  
== Indication<br>  ==
</p>
 
<ul><li>Provides resistance  
Hydrotherapy is indicated in children with cererbal palsy. The main aim of aquatic therapy is:&nbsp;  
</li><li>Encourages a wider range of movement and opposition  
 
</li><li>Alleviates stress and tension  
*Provides resistance  
</li><li>Reduces pain and tension in muscles and joints  
*Encourages a wider range of movement and opposition  
</li><li>Protects against injury  
*Alleviates stress and tension  
</li><li>Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
*Reduces pain and tension in muscles and joints  
</li><li>Decreases post exercise discomfort
*Protects against injury  
</li></ul>
*Improves cardiovascular conditioning since the heart pumps more blood per beat when body is submerged in water  
<h2> Safety Considerations and Outcome Measures  </h2>
*Decreases post exercise discomfort
<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>  
 
</p>
== Safety Considerations and Outcome Measures  ==
<ul><li>Acute vomiting / diarrhoea  
 
</li><li>Medical instability  
Absolute Contra-indications&nbsp;<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</ref>  
</li><li>Chlorine / Bromine allergy  
 
</li><li>Resting angina  
*Acute vomiting / diarrhoea  
</li><li>Shortness of breath at rest  
*Medical instability  
</li><li>Uncontrolled cardiac failure  
*Chlorine / Bromine allergy  
</li><li>High BMI limiting exit from pool
*Resting angina  
</li></ul>
*Shortness of breath at rest  
<p><br />  
*Uncontrolled cardiac failure  
</p><p>Relative Contra-indications  
*High BMI limiting exit from pool
</p>
 
<ul><li>Acute illness  
<br>  
</li><li>Irradiated skin  
 
</li><li>Known aneurysm  
Relative Contra-indications  
</li><li>Open infected wounds  
 
</li><li>Poorly controlled epilepsy  
*Acute illness  
</li><li>Unstable diabetes  
*Irradiated skin  
</li><li>Exercise dependent O2 demand increases
*Known aneurysm  
</li></ul>
*Open infected wounds  
<p><br />  
*Poorly controlled epilepsy  
</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>.  
*Unstable diabetes  
</p><p><br />  
*Exercise dependent O2 demand increases
</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>
<br>  
<ul><li>Gross Motor Function Measure (GMFM)&nbsp;  
 
</li><li>Paediatric Evaluation of Disability Inventory - functional skills  
Outcomes should be meaured in dimensions outlined by the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY)&nbsp;<ref>World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.</ref>.  
</li><li>Dynamometer - muscle strength  
 
</li><li>Energy Expenditure Index (EEI) - energy efficiency  
<br>  
</li><li>3/5/6 minute walk tests  
 
</li><li>Timed up and Go (TUG)  
Common motor function meaures utilised in Aquatic Therapy research:&nbsp;<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.</ref>  
</li><li>Vital Capacity  
 
</li><li>Goniometry - range of movement  
*Gross Motor Function Measure (GMFM)&nbsp;  
</li><li>Ashworth Scale - spasticity
*Paediatric Evaluation of Disability Inventory - functional skills  
</li></ul>
*Dynamometer - muscle strength  
<p><br />  
*Energy Expenditure Index (EEI) - energy efficiency  
</p><p>Swimming based measures:  
*3/5/6 minute walk tests  
</p>
*Timed up and Go (TUG)  
<ul><li>Aquatics Independence Measure  
*Vital Capacity  
</li><li>Water Orientation Test-Alyn 2 (WOTA)
*Goniometry - range of movement  
</li></ul>
*Ashworth Scale - spasticity
<p><br />  
 
</p><p>Social function measures:  
<br>  
</p>
 
<ul><li>PEDI - social function domain  
Swimming based measures:  
</li><li>Pictoral scale of perceived competence  
 
</li><li>Canadian Occupational Performance Measure
*Aquatics Independence Measure  
</li></ul>
*Water Orientation Test-Alyn 2 (WOTA)
<h2> Key Evidence  </h2>
 
<p>Administered correctly, aquatic therapy can:  
<br>  
</p>
 
<ul><li>Improve muscle tone  
Social function measures:  
</li><li>Increase core strength  
 
</li><li>Enhance circulation  
*PEDI - social function domain  
</li><li>Improve cardiovascular functioning  
*Pictoral scale of perceived competence  
</li><li>Improve flexibility  
*Canadian Occupational Performance Measure
</li><li>Increase endurance  
 
</li><li>Extend range of motion  
== Key Evidence  ==
</li><li>Reduce muscle spasticity  
 
</li><li>Elevate metabolism  
Administered correctly, aquatic therapy can:  
</li><li>Reduce sleep disturbances  
 
</li><li>Relieve joint stress  
*Improve muscle tone  
</li><li>Improve muscle tone  
*Increase core strength  
</li><li>Increase stability  
*Enhance circulation  
</li><li>Decrease pain and discomfort
*Improve cardiovascular functioning  
</li></ul>
*Improve flexibility  
<h2> Resources  </h2>
*Increase endurance  
<p><br /><span class="fck_mw_template">{{#ev:youtube|lvIufSb9dYk}}</span>  
*Extend range of motion  
</p>
*Reduce muscle spasticity  
<h2> Case Studies  </h2>
*Elevate metabolism  
<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 />  
*Reduce sleep disturbances  
</p>
*Relieve joint stress  
<h2> Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)  </h2>
*Improve muscle tone  
<div class="researchbox">
*Increase stability  
<p><br />
*Decrease pain and discomfort
</p>
 
</div>  
== Resources  ==
<h2> References  </h2>
 
<p><span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /><br />  
<br><img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="0" _fck_mw_template="true">  
</p><p>&nbsp;<br />
 
</p>
== Case Studies  ==
 
add links to case studies here (case studies should be added on new pages using the &lt;a href="Template:Case Study"&gt;case study template&lt;/a&gt;)<br>  
 
== Recent Related Research (from &lt;a href="http://www.ncbi.nlm.nih.gov/pubmed/"&gt;Pubmed&lt;/a&gt;)  ==
<div class="researchbox"><rss>https://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1P5hUf9EVi7DANk4JXRqG5VfmzggAukOPUREM057eulao1egH0|charset=UTF-8|short|max=10</rss></div>  
== References  ==
 
&lt;span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /&gt;<br>  
 
&nbsp;<br>

Revision as of 22:48, 21 October 2016

 

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Description
[edit | edit source]

'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 [1]. 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 [2]. 

Indication
[edit | edit source]

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[edit | edit source]

Absolute Contra-indications [3]

  • 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) [4].


Common motor function meaures utilised in Aquatic Therapy research: [5]

  • 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[edit | edit source]

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[edit | edit source]


<img class="FCK__MWTemplate" src="http://www.physio-pedia.com/extensions/FCKeditor/fckeditor/editor/images/spacer.gif" _fckfakelement="true" _fckrealelement="0" _fck_mw_template="true">

Case Studies[edit | edit source]

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>)[edit | edit source]

Failed to load RSS feed from https://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1P5hUf9EVi7DANk4JXRqG5VfmzggAukOPUREM057eulao1egH0|charset=UTF-8|short|max=10: There was a problem during the HTTP request: 422 Unprocessable Entity

References[edit | edit source]

<span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" />

 

  1. ↑ Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.PM&amp;amp;amp;amp;R; 2009,1;9:859-72
  2. ↑ 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.
  3. ↑ 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
  4. ↑ World Health Organisation. The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY), 2007.
  5. ↑ 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.
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