Hydrotherapy on Movable Platform - Power of Versatility in Clinical Application
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1 Hydrotherapy on Movable Platform - Power of Versatility in Clinical Application Ms. Rosana Lam, SPT UNITED CHRISTIAN HOSPITAL HYDROTHERAPY WORKING GROUP, PTCOC 8 MAY 2014
2 Water Power of Versatility Fall Risk Strain on joints Muscle Hypertone Hyper-reflexia Oedema Weight bearing Gait facilitation Proprioceptive & Exteroceptive feedback Pain Balance restoration Soft tissue suppleness Relief therapist MHO loading Warm Water is Ideal Therapy Environment
3 Hydrotherapy Chronic Disease Soft Tissue Injuries Sport Injuries Pathologies Paediatric Pathologies Obesity Neurological Pathologies Degenerative Disease Reference: Becker (2009) Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications. American Academy of Physical Medicine and Rehabilitation 1:
4 Quality & Effective Patient Service Pool Design Equipment Safety measures Physiotherapist skills PTCOC Hydrotherapy WG H 2 O Unique physical properties
5 Water Unique Physical Properties
6 Physical Properties of Water Viscosity Drag Force Buoyancy Thermodynamics Hydrostatic Pressure Density Specific gravity Turbulence Velocity Surface tension
7 Body weight off-loaded with increasing immersion depth
8 Hydrostatic Pressure Neck 0 mmhg The water braces my back and knees so I can stand upright in the Pool!!! Waist 36 mmhg Ankle 110 mmhg
9 Hydrostatic pressure Central Blood Volume & Cardiac Output Upright Standing Upright standing in water
10 Hydrostatic pressure Central Blood Volume & Cardiac Output Upright Standing Upright standing in water
11 Hydrostatic pressure Central Blood Volume & Cardiac Output Upright Standing Upright standing in water
12 Turbulent & Drag Force
13 Physiological Effect of Hydrotherapy Exteroceptive & Proprioceptive feedback Pain Sensation Blood Flow to Muscles Patient Blood Pressure Heart Rate Cardiac Output Efficiency Breathing Workload
14 Quality & Effective Patient Service Physiotherapist skills Pool Design Equipment Safety measures PTCOC Hydrotherapy WG H 2 O Unique physical properties
15 Overseas Corporate Scholarship Program for Physiotherapists in Hydrotherapy 13-16/8/2013: Las Vegas Conference & Workshop USA 17-28/8/2013: Minneapolis 5 Structured modules
16 Variety of Hydrotherapy Techniques BackHab Water Ai Chi Aqua Soft tissue Stretch Task Typed Activites Joint Mobilization Stretching Progression of Rx Water Yoga
17 Aqua Soft Tissue Stretch
18 Water Yoga
19 Water Ai Chi POH AHNH
20 4 Wall concept Progression of Rx
21 Stretching of Tight Tissues Adductors Back Hip Rotators Stretch Hamstrings
22 Joint Mobilization Neck Neck Extension Neck Rotation
23 Thoracic Spine Joint Mobilization
24 Task Typed Activities (Functional Training) Put on Clothes
25 Task Typed Activities (Functional Training) Carry a weighted cup / Bucket
26 BackHab
27 BackHab UCH Study Proposal: Use of BackHab in Rx of simple Low Back Pain (LBP) Inclusion Criteria: At least 10 min. LBP free each day Exclusion Criteria: Contraindication No neurology Red / Yellow flag Unable to follow command Poor adherance to program Injury on duty(iod)
28 Course: 8 sessions Rx frequency: twice weekly UCH LBP patient Baseline Ax Hydro Group Land Rx Group Final Ax (Post 4/52) Evaluation (Post 4/52)
29 Variety of Hydrotherapy Techniques Cardio- Vascular Fitness Circuit Training Plyometric Training Controlled Weight Bearing Training Deep Water Running Respiratory Muscle Training Towel Dance
30 Plyometric Training
31 Respiratory Muscle Training
32 Towel Dance Sea Snake Spaghetti Wraps Cursive Writing Flag Shaking
33 Cardiovascular Training Side Step / Side Jump with a Box
34 Circuit Training
35 Deep Water Running
36 Hydrotherapy Session for NWB PWB Ambulation UCH
37 Variety of Hydrotherapy Techniques Vestibular Training Halliwick Spatial Orientation Sensory Integration Motor Planning Muscle Tone Modulation Watsu Bad Ragaz
38 Vestibular Training Sensory Stimulation
39 Sensory Integration Approach Tactile Stimulation Tactile Stimulation & Education of Shape / Colour
40 Sensory Integration Approach Motor Planning Spatial Orientation & Bilateral Hand Coordination
41 Sensory Integration Approach Spatial Orientation & Bilateral Hand Coordination
42 Modulation of Muscle Tone
43 Relaxation by Watsu Dance
44 Clinical Application of Skills
45 Clinical Application of Skills
46 Clinical Application of Skills Paediatrics Sensory Integration Approach Halliwick Respiratory Muscle Training Cardiovascular Fitness Training Deep Water Running BackHab Water Ai Chi Functional training Plyometric training Water Yoga
47 Quality & Effective Patient Service Pool Design Equipment Safety measures Physiotherapist skills PTCOC Hydrotherapy WG H 2 O Unique physical properties
48 Equipment Augmentative Communication Household Toys
49
50
51
52
53 Polyspot turbulence in Water Ai Chi
54 Pool Design driven by Clinical Need Very frail balance patients Using weight-bearing programs e.g. post-op Wide range of heights: infants to children to adults Facilitate therapist using various Rx techniques Wide range of pathologies: Ortho, Rheum, Sport, Neuro, Paed, Cardiac rehab, Pulmonary rehab
55 Modernized Pool Design Feature Depth vary: 40 cm to 180 cm Sufficient horizontal surface for Group activites 9 m x 7 m surface area Sloping part for axial load variation Moving belt on floor to challenge the cardiovascular function in joint unload environment
56 Modernized Pool Design Feature Movable Working Platform in both Vertical axis Horizontal axis Pool with adjustable floor height with underwater Treadmill
57 Modernized Pool Design Feature
58 Modernized Pool Design Feature
59 Quality & Effective Patient Service Pool Design Equipment Safety measures Physiotherapist skills PTCOC Hydrotherapy WG H 2 O Unique physical properties
60 HA PT I/C HKWC Mr. Louis TSOI, PT I, MMRC HKEC Mr. Eric TONG, PTI, PYNEH Hydrotherapy Working Group Members KCC Mr. Man CHUNG, SPT, QEH KEC Ms. Rosana LAM, SPT, UCH KWC Mr. Jimmy YUEN, SPT, PMH NTWC Ms. Angela LEE, PT I, POH NTEC Mr. Johnson PANG, PT I, PWH Established since 21 Nov 2013
61 Terms of Reference Way ahead Since 21 Nov 2013 Develop & review hydrotherapy service guidelines and protocols Develop & review operational & facility standard Recommend training and development program of PT to support the hydrotherapy service Facilitate knowledge & experience sharing to raise PT competence Review Hydrotherapy Management Guidelines (PTCOC 2006) Establish communication channel between PTCOC, HAHO and hydrotherapy service providers on hardware and service outcome Conduct sharing sessions PT Staff forum, CCTP, HA Convention Recommend training program(s) to IAAHS & T&D, PTCOC
62 Key Messages to Optimize Versatility of hydrotherapy Knowledge Skill Practice Appropriate Pool Equipment HA Support CQI
63 THANK YOU
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