As an Occupational Therapy professional working in a Level 1 Trauma Hospital for over 26 years, I've always enjoyed aquatic therapy as a therapeutic intervention to promote independence with activities of daily living and community integration. Simply said, I love water and being mostly water myself makes it pretty essential. Personally to keep myself fit, I've enjoyed snorkeling the most but of course cross training using swimming or simply playing with the kids in the water is fun too. Kayaking and other types of boating activities have always been fun.
Here I am riding some waves at the Great Wolf Lodge in Williamsburg Virginia. This was much harder than it looked!
Here I am coming out of the swimming portion of the Raleigh 70.3 Ironman
I started teaching aquatics simply by accident. I had taken several of my patients in the water and learned many interventions at that time from Donna Mooneyham RT and Susan Callis RT. At the time Janice Blatt OT was teaching an aquatic class to Occupational Therapy students but one year she was unable to teach due to other plans. She gave me her current lecture notes and the rest is history as she soon resigned and moved away. Not only did I teach that year, I am still teaching that course with lots of added features and an aquatic lab in a therapeutic pool to reinforce the lecture portion. Once I even taught a land course at the NC OT State Conference and I've actually taught this course virtually due to the 2020 Covid19 situation. How crazy life is that one decision creates a career or life change? Later I would attend other aquatic certification courses including but not limited to an Advanced Halliwick course by Johan Lambeck, PT, Aquatic Therapy by Donna Mooneyham RT, and a National Aquatic Arthritis Foundation Community Class Instructor Course. Currently, I teach mandatory aquatic guest lectures for Pitt Community College's Occupational Therapy Program, optional East Carolina OT's program SOTA club, and Occupational Therapy, Physical Therapy, and Recreational Therapy staff at Vidant Medical Center formerly Pitt County Memorial Hospital in Greenville NC. This blog was prompted when a Webex I did on aquatics was a near epic fail as some videos worked and some didn't regardless of being from one of my YouTube Links or simply from a file. I figured this would be a good back up and who knows? Maybe some others out there may enjoy the information too. Keep in mind, I'm no expert but simply a Jack of many things... so take everything in with a grain of salt or two. I'll also try to add more clarifying information that I would discuss in an open lecture as I gradually do updates.
Benefits and Goals of Aquatic Therapy
Contact Isolation with Open, Draining or oozing Wounds that cannot be covered with occlusive dressings (i.e. Tegaderm)
Unstable Vital Signs
Uncontrolled Incontinence of Bowels
Urinary Tract Infections
Contagious Skin Rashes
Premature Rupture of Membranes in Pregnancy
Therapist can provide a fixed stable point while the patient moves toward or away from the body. The client is the one who determines the resistance by how fast they move in the water. This is good for strengthening the extremities. Note that the therapist positions their hand on only the side of the extremity that the person needs to push against. The therapist provides proprioceptive feedback for the patient to help the patient motor plan the movement directed to do. In the picture above, the person is performing shoulder abduction as he moves his arm away from his body toward me. Typically, a fixed speed of the exercise is determined but can be changed by facilitation of the therapist and ultimately determined by the individual performing the exercise. A good way to remember is to break down the term isokinetic to "same speed". Obviously Aquatic therapy is a bit tricky to maintain the same speed.
In the picture above notice that now the hands are on the medial aspect of the extremity. Now the patient is adducting their leg as he brings his leg toward his opposite leg. Note that I am not moving. I am a fixed point. He is controlling the speed and therefore the resistance of the movement.
Ai-Chi is like Tai Chi except it is performed in the water. It combines a series of gentle stretches and breathing exercises. I would also recommend other martial arts but simply do them in the water.
Primary Goals of Ai-Chi