Hydrotherapy : A therapeutic healing agent

Introduction

A Hydrotherapy is ancient technique which is also the cheapest and the safest mode of treatment has been used for treating paralysis, diseases like rheumatoid, cerebral palsy, osteoarthritis, ankylosing spondylitis, muscle soreness, fatigue and mainly beneficial for injuries. Hydrotherapy is used in the form of pool therapy, aquatic therapy and balneotherapy.

Image/Google

DEFINITION

Hydrotherapy is the use of water to prevent, maintain, restore and accelerate healing of various musculoskeletal and neurological ailments. It is one of the oldest methods of treatment used in the natural medicine called aquatic therapy, pool therapy and balneotherapy. For its healing effects, water as a physical agent has been used since ancient times.

When the part of the body is immersed in water which gives a physiological effects produced on the body. The buoyant force give rise to the against the gravity helps to reduces load on the weight bearing joints such as hip joint and knee joints. When the load is reduced on the joints reduces pain and increase the mobility of the patient to perform exercises in the pool. Water exerts pressure all over the extremities and enhances venous return and lymphatic drainage from the extremities towards the heart and lymph nodes. This physical properties of the of water is beneficial for use in the problems such as cardiovascular and lymphatic disorders.

Physical Properties Of Water

It is depend upon the mechanical characteristics :-

• Hydrostatic Pressure:- According to Pascal’s law, when a body part is immersed in water, a pressure is exerted equally in a horizontal direction. Hydrostatic pressure is the pressure exerted by the water on any object. This pressure exerted by water on all surfaces of the object when it is at rest at a given depth. Density of the water increases with the depth. Hence when a patient is standing or walking in water which plays a beneficial role in reduction of edema. The pressure supports the body all around to an equal degree in the horizontal direction, while buoyancy maintains the vertical position.
• Buoyancy:- There is upward thrust produced by the water which works against the gravity. This upward thrust generated by water against the gravity is based on Archimedes Principle, which states that if any object totally or partially immersed in a fluid will experiences an upward, buoyant force equal to the weight of the volume of fluid displaced by that object.
• Hydrodynamic Pressure:- It is the pressure caused by movement of either the object or water. When the person walks in water, resistance is encountered and demand is placed on the walking muscles. The faster you walk, the more demands are placed on the walking muscles. This pressure offers resistance against the movements of limbs; therefore, water resistance can be used for strengthening the muscles.
• Turbulence:- It is defined as “the velocity at a given point that varies erratically in magnitude and direction”. The movements of limbs in water cause circular patterns of water and create small whirlpools or eddy currents and turbulence. Movement through turbulent water or against the current than through calm water encounters greater resistance which requires more muscular effort. The circular patterns caused by movement of the legs, arms and body of the patient are also known as drag force. The drag force is exerted by water on a submerged and moving object or body segment.
• Thermal Conductivity:-Thermal conductivity is the property of a material to conduct heat. It is evaluated primarily in terms of Fourier’s Law for heat conduction. The higher the thermal conductivity value of the substance, the better the substance performs as a heat conductor. Thermal conductivity value of water at 15°C. Thermal conductivity of water is 2.5 times more faster than paraffin wax.
• Density:- Various materials usually have different densities, and density may be relevant to buoyancy and molecular packing. The more compactly arranged molecules, the denser the substance. The density of water decreases as the temperature of water increases. In hydrotherapy, the temperature of water is maintained at a higher range for some inflammatory conditions. The higher temperature decreases the viscosity, and density not only of water but also of body fluid, and enhances the venous return.

PHYSIOLOGICAL EFFECTS Of HYDROTHERAPY

Using water in various forms and at various temperatures can produce different effects on the body. Water is a good conductor of heat and electricity. If the temperature of water is higher than the body temperature produces several physiological changes in the body such as increased blood circulation, increased metabolism rate, improved local edema, nerve conduction velocity (NCV) and reduced muscle spasm. The normal temperature of the skin and the subcutaneous tissues is 33°C (depending on the weather conditions), whereas the internal temperature of the body is maintained at 37°C.

• Metabolic activity :- Metabolic activities increases as the temperature increases and decrease with fall in temperature. An appropriate rise in temperature increases all the activities of the cells including cell motility and synthesis, and release of chemical mediators. If the temperature of body rises by 1°C, it increases metabolic activities by 13%.
• Viscosity:- As the temperature rises, blood vessels get dilated and the viscosity of fluid also decreases. Resistance to the flow of blood decreases, and blood circulation increases.
• Collagen tissue extensibility:- Collagen tissue extensibility increases as the temperature increases.
• Respiratory System:- The hydrostatic pressure on the body in standing position increases compression of the thorax with an increase in intrathoracic blood volume. There is increased work of breathing and decreased respiratory reserve volume.
• Renal System:- The hydrostatic pressure forces the fluid from the distal extremities to the central. The central hyperemia resulting from the hydrostatic pressure, increases renal blood circulation, decreases antidiuretic hormone (ADH) and aldosterone production. All these result in increased sodium and potassium excretion and consequent diuresis.

CLINICAL USES Of HYDROTHERAPY

Hydrotherapy, the use of water as a physical modality for health promotion and treatment of various diseases:-

• Cerebral Palsy:- Hydrotherapy is highly effective form of treatment for cerebral palsy children and adolescents. The buoyant effect of water relieves load on the lower extremities, whereas the optimal temperature of water reduces the spasticity. These effects of water facilitate the voluntary movements. Water offers resistance against the movements during the gait training that further facilitates the voluntary control and balance of the patient. The study also reported increase in lower-extremity muscle strength and balance and promote better respiratory function and reduced spasticity in adolescents.
• Osteoarthritis:- The buoyancy of water works against gravity and exerts a force towards the surface. The weight of the body is proportionally decreased as the depth of the water increases. The load on the joints is reduced to 40% of the total body weight at the chest level water in erect standing. Decreased weight bearing on the joint reduces pain and allows the patient to walk in the water which is usually difficult on the land.
• Inflammatory Arthritis:- Balneotherapy reduces pain and improves physical activity, reduces tiredness and improves sleep quality functional activities in patients with ankylosing spondylitis disease.
• Hydrotherapy:- is highly recommended for the patients having rheumatoid arthritis who were treated with 30-min session per week. They reported feeling much better than those treated with surface exercises.
• Muscle Soreness :- Leg immersion in warm water with temperature of 43 ± 1°C for 45 minutes before stretching or short exercise of muscles can significantly reduce exercise-induced muscle damage, including muscle soreness, creatine kinase activity in the blood, maximal voluntary contraction force, and jump height. Immersion of extremities in water potentially improves of physical recovery immediately after immersion with reduction in delayed onset muscle soreness compared with Passive stretching.

Application procedure

• First of all explain the procedure to the patient.
• Then, prepare the patient for the further procedure.
• Patient should be examined thoroughly for contraindications especially for contagious diseases.
• Ask the patient about their meals timing before performing any procedure because treatment should not be given immediately after meals.
• Patient should be asked to empty his or her bladder before immersion, since a warm bath often has diuretic action.
• Patient should be asked to put on shorts or in the case of female patients, a proper bathing suit should be give n by the therapist.
• Before entering into the pool, patient should be asked to take a bath.
• Non-ambulatory patients are transferred into the pool with assistance of electrically or hydraulically operated hoist.
• Ambulatory patients may walk down the steps if the pool is below ground. If the pool is raised above the ground, all patients can be transferred by hydraulically or electrically operated hoist.
• Adjustable floor should be available as it provide direct access to the pool.
• The temperature of the pool should be as per the condition of the patient.
• The treatment should not exceed the appropriate time.
• After completing session, the patient should be transferred to the changing room immediately.
• The patient should be given plenty of water after the treatment procedure.

Contraindications of Hydrotherapy

• Fever
• Acute bleeding
• Vomiting
• Diarrhea
• Chemotherapy
• Cardiac insufficiency
• Wound infection
• Deep Vein Thrombosis (DVT)
• Pulmonary embolism
• Stress incontinence
• Shortness of breath
• Epilepsy

To understand more about Hydrotherapy watch video given below:-

Video/Youtube

To learn and understand more about Laser Therapy click the given link https://physiocontent.com/laser-therapy-lllt-physiological-effects/

To learn and understand more about Microwave Diathermy click the given link https://physiocontent.com/microwave-diathermy-mwd-2/

To learn and understand more about Shortwave Diathermy click the given link https://physiocontent.com/shortwave-diathermy-swd/