Aquatic Therapy

**Geriatrics**
Wiki: Aquatic Therapy

**Purpose:**

Aquatic therapy (AT) has been shown to
be a viable exercise option for all patients, and it can have additional
benefit from specific population such as older adults.1,2 The
purpose of this page is to highlight the benefits of AT in the older adult,
demonstrate

**Objectives:**

Introduce
some specific indications for AT in the older adult

Introduce
some interventions to address strength and endurance

Follow
up with some suggested outcome measures to assess the effectiveness of AT for
some of the common conditions

Introduction
to balneotherapy

**Indications:**

·
Fibromyalgia:
AT decreases pain in this population allowing for increased endurance, improved
compliance, and improved sleep quality.3

·
Osteoarthritis:
Unweighting the joints that are having pain caused by osteoarthritis allows
from more pain-free movement.4

·
Frequent
falls: AT may provide a safer medium for balance training for older adults that
struggle with land-based balance exercises. AT is equal to land-based programs
for improving balance score on the Berg Balance Scale.5

o
This
can also be applied to a large variety of neurological conditions that have
balance and gait deficits.

·
Back
pain: Unloading the spine in the pool often can alleviate some of the low pain
patients have making it less painful to exercise.

·
Obesity:
Performing exercises on land may be too challenging for this population due to
their higher body weight, however the buoyancy in the pool can make it much
easier to exercise.

These are just a few of
the more common applications of AT, however there are countless other
conditions AT can benefit. The water temperature is also important to monitor
for some conditions.

**Contraindications:**6

·
Incontinence

·
Open
wounds

·
Excessive
fear of water

·
Infectious
diseases

·
Severe
weakness, decreased range of motion, or lack of endurance that could be a
safety hazard

**Example**
Exercises:

·
Forward/backward
walking and jogging

·
Side
steps

·
Leaps

·
Kicks

·
Arm
curls, pushes, and pulls

·
Single
leg balance

·
Marching
and deep-water bicycle

All of these exercises can be made easier (by
moving slower) or harder (by moving quicker or by adding webbing/water weights)

**Outcome**
Measures:

Fibromyalgia Impact Questionnaire[1]

Berg Balance[2]

Oswestry Disability Index[3]

**Balneotherapy:**7,8,9

Balneotherapy is the use of natural mineral
waters, natural peloids and mud, and natural sources of certain gases for
medicinal purposes. The evidence is somewhat conflicting on the effectiveness
of this treatment for musculoskeletal conditions. While it is suggested to
improve lower back pain, osteoarthritis pain, and chronic inflammatory pelvic
diseases, balneotherapy should only be used as an alternative therapy used in
addition to other interventions.

**Additional**
Resources:

Aquatic Therapy Guide[4]

Aquatic Therapy Book[5]

Top 10 Pool Exercises[6]

Aquatic Physical Therapy[7]

Balneotherapy[8]

Chase
NL, Sui X, Blair SN. Comparison of the health aspects of swimming with other
types of physical activity and sedentary lifestyle. *Int J Aquatic Res Educ* 2008;2:151-161.

Batterham
SI, Heywood S, Keating JL. Systematic review and meta-analysis comparing land
and aquatic exercise for people with hip or knee arthritis on function,
mobility and other health outcomes. *BMC Musculoskelet Disord*.
2011;12(1):123. doi:10.1186/1471-2474-12-123

Munguía-Izquierdo
D, Legaz-Arrese A. Assessment of the Effects of Aquatic Therapy on Global
Symptomatology in Patients With Fibromyalgia Syndrome: A Randomized Controlled
Trial. *Arch Phys Med Rehabil*. 2008;89(12):2250-2257.
doi:10.1016/j.apmr.2008.03.026.

Wyatt,
Frank & Milam, Stacie & Manske, Robert & Deere, Randall. The
Effects of Aquatic and Traditional Exercise Programs on Persons With Knee
Osteoarthritis. *Journal of strength and*
conditioning research / National Strength & Conditioning Association*.*
2001;15:337-40.

Douris
P, Southard V. The Effect of Land and Aquatic Exercise on Balance Scores in Older
Adults. *Journal of Geriatric Physical*
Therapy *Vol. 26;1:03.*

Cole
AJ, Becker BE. *Comprehensive Aquatic Therapy*. Butterworth Heinemann;
https://books.google.com/books?hl=en&lr=&id=vovrDRkuthcC&oi=fnd&pg=PR7&dq=contraindications+of+aquatic+therapy&ots=3GmtIi9b5o&sig=dnzPAqEjKLP4smDajtT-7T1YKPs#v=onepage&q=contraindications
of aquatic therapy&f=false. Accessed July 12, 2018.

Bender
T, Bálint G, Prohászka Z, Géher P, Tefner IK. Evidence-based hydro- and
balneotherapy in Hungary—a systematic review and meta-analysis. Int J
Biometeorol. 2014;58(3):311-323. doi:10.1007/s00484-013-0667-6.

Kamioka
H, Tsutani K, Okuizumi H, et al. Effectiveness of Aquatic Exercise and
Balneotherapy: A Summary of Systematic Reviews Based on Randomized Controlled
Trials of Water Immersion Therapies. J Epidemiol. 2010;20(1):2-12.
doi:10.2188/jea.JE20090030.

Verhagen
AP, Cardoso JR, Bierma-Zeinstra SMA. Aquatic exercise &amp; balneotherapy
in musculoskeletal conditions. Best Pract Res Clin Rheumatol.
2012;26(3):335-343. doi:10.1016/J.BERH.2012.05.008.