Tuesday, 12 April 2016
Centuries ago, the Greek physicist Archimedes declared, "Any object, wholly or partially immersed in a fluid, is buoyed up by a force equal to the weight of the fluid displaced by the object." Today, health care professionals are applying this theory of buoyancy in physical therapy with marked results, particularly among the aging population. As patients engage in aquatic therapy, the buoyancy of the water reduces the effect of body weight, which in turn reduces the stresses to muscles and joints. Thus aquatic therapy is a viable option among older adults for several reasons:
1) Aquatic therapy reduces the risk of falls during exercise.
Exercising can be hazardous based on the patient's physical abilities. While gyms offer many amenities such as weights, ellipticals, and treadmills, these can clearly present a danger if not used correctly or if the individual's body is not ready for strenuous activities. For the senior adult, navigating exercise equipment can seem especially daunting, as the chance of falling is a greater risk. Physical therapist Mike Studer describes how aquatic therapy is a good choice with senior adults: "The patients can lose their balance and know they aren't going to fall immediately [and injure themselves]" (1). He describes the success of aquatic therapy with an 80-year-old patient in his Oregon clinic who has had a history of falls. "He has painful arthritic joints, limiting his ability to engage in therapy, but he walks in the water. It doesn't hurt because of the buoyancy. And he knows that if he loses balance, he'll just make a splash and not fall on the ground, so he can regain his balance in a non-threatening environment." (1)
2) Aquatic therapy improves balance and strength while relieving pain.
Exercising in water can be useful for many ailments in the elderly such as weakness, staggering gait, arthritis, plantar fasciitis, or more generalized conditions such as knee, shoulder, or hip pain. Aquatic therapy can be used to treat all of these by providing gait training, which normalizes movements that seem abnormal, and by strengthening the patient's lower and upper extremities. Physical therapists often recommend resistance training for seniors, and aquatic therapy has proven to an effective way to provide the much-needed improvements in muscle tone and strength among that age group, as water provides natural resistance without the need for weights (2). Regarding the patient's body weight, the reduction of it that water provides is significant in treating patients with injury and pain, as a patient in waist-high water has reduced his or her body weight by 50%. A good example is a fractured pelvis injury. While it could take several weeks for such a patient to be able to support their body weight, water therapy takes the weight off and allows strength and gait training, as well as range-of-motion exercises, much sooner (3). Another success story involving aquatic therapy is that of a patient in New Jersey who had a total knee replacement. Three days after his surgery, he had poor balance and needed a roller walker to get around as his active range of motion (AROM) was -10 to 75 degrees, according to his therapist, Leonard Hardy. It was critical that he heal quickly, since he had several steps to climb at his home. By adding aquatic therapy to his exercise regimen, the patient's balance improved, his AROM increased to O to 97 degrees, he no longer needed the walker, and he could go up and down stairs safely within just two weeks (1).