Milestone Pediatric Therapy is so EXCITED to announce that Dr. McIntyre will now be offering and performing aquatic physical therapy in addition to all her other clinical services! This blog introduces you to what aquatic therapy is, what the benefits are, and what types of kids make great gains in the water!
What is aquatic therapy?
Aquatic Therapy is defined as a “practice of physical therapy with therapeutic intent toward the rehabilitation or attainment of specific physical and functional goals of individuals using the medium of water” (G-R et al.)
Aquatic therapy is basically physical therapy (sometimes occupational therapy) performed in water. Aquatic therapy uses the following principles to it’s advantage to effect each client toward his/her goals.
Buoyancy
Relative Density
Viscosity
Resistance
Hydrostatic pressure
Turbulence
Flow
Without getting into the nitty-gritty of the physics of it all, the physical therapist uses these principles to work on a multitude of PT goals such a strengthening, stretching, weight bearing, gait training, vestibular training, and some sensory/behavioral interventions. Water offers multiple sensory stimuli through water temperature, weight relief, and vestibular input. (Mortimer et al) Traditionally performed in a therapeutic pool with a typical temperature of 90degrees F- aquatic therapy can be performed in any community pool setting depending on therapeutic goals.
Here at Milestone we are perform aquatic therapy in the indoor Jim Barnett Pool in Winchester, VA. Jim Barnett Pool offers a 86-88d temperature, shallow stairs to help with entering the pool as well as therapeutic exercise, and a large shallow section for Dr. McIntyre to work with her clients in a one-on-one setting.
So what are the benefits of aquatic therapy compared to land therapy?
There has slowly been an increase in available research and articles on the benefits of aquatic therapy in different pediatric populations. There is still not a lot of clinical trial research out there but there are a lot of case studies and anecdotal evidence of the positive impact of water when combined with land therapy.
Using the properties of water, aquatic therapy can assist with anti-gravity movements in children who struggle to move against gravity and conversely the resistance the water provides can help strengthen those same muscles depending on the therapeutic intervention being performed. Water can help support positive postural positioning allowing a child to work on standing, walking, or other fundamental motor skills in a safe supported environment. Water will also have an un-weighting effect that will improve a child’s ability to weight bear independently and perform these same critical skills.
With a warmed pool and deep pressure, spastic muscles have the potential to be promoted to relax and allow for greater stretching and better alignment. Water can also promote improved circulation as well as challenge the cardiovascular system promoting increased activity tolerance and endurance.
Aquatic therapy has been shown to have a positive influence on activity participation, motor skills, and social interaction/behavior in many different pediatric populations including autism and cerebral palsy. The pool provides a great opportunity for social interaction which can facilitate language development, improve self esteem, self-awareness, and a sense of accomplishment. (Mortimer et al)
Recent research looking at a combination of aquatic therapy and land therapy in the early intervention population (0-3years of age) showed greater gains in parent satisfaction and gross motor attainment with pool therapy. Another study demonstrated increased walking speed after implementation of aquatic therapy. Something all the studies who looked at a long term follow up (6-20 weeks post-intervention) showed was the excellent retainment of improvements and progress seen at the conclusion of the aquatic therapy treatment sessions.
So what kind of child benefits from this type of therapy?
Several different patient populations can benefit from aquatic therapy and your therapist will help determine whether or not aquatic therapy is right for you and your child. The following are some examples of patient populations studied in the research:
Aquatic therapy is just as fun as land therapy…and depending on the child you talk to maybe even more FUN!
Picture From Gillette Children’s Hospital.
Neuro-developmental (peripheral and central): this includes children with cerebral palsy, stroke, and spina bifida
Genetic Conditions: including Down Syndrome, Triple X, and Muscular Dystrophy
Autism Spectrum: Research has shown that there is an increase in positive social interaction and decrease in hostile/antisocial interaction in this patient population with aquatic therapy.
Psychomotor delay: slowing of physical movement in an individual, typically associated with depression
Musculoskeletal disorder: orthopedic injuries or surgery that might need a period of decreased weight bearing. Aquatic therapy excels at allowing for rehab to occur in a protected way while not breaking protocol.
Ideal Treatment:
There is a some studies on what is recommended for the best gains utilizing aquatic therapy to reach therapeutic goals. Most studies looked at 60 min sessions in the pool once or twice a week. However, a study that showed the best gains in gross motor skills, combined one land therapy and one aquatic therapy session throughout the week. After synthesizing the research Dr. McIntyre recommends the following treatment protocol depending on client goals and tolerance:
Once weekly aquatic therapy session x 30-45 minutes combined with once weekly land sessions x 60 minutes
This will help produce the greatest gains utilizing aquatic therapy. The client will be able to work in the pool then carry over their gains into a land session to work on more critical independence in full weight bearing.
Interested in Aquatic Therapy?!
Aquatic therapy is a great way to train and develop a multitude of body systems within a single therapy session not to mention it is great FUN and super motivating for the child participating in the session. Dr. McIntyre is excited to be able to offer this awesome services to the Winchester area.
If you are interested in aquatic therapy for your child please reach out to Milestone Pediatric Therapy to schedule a complimentary consultation or your initial evaluation today.
P: 540-724-1757
Or contact us through our online portal!
Resources:
Academy of Pediatric Physical Therapy: Aquatic Therapy Fact Sheet. 2017.
Declerck et al. Benefits and Enjoyment of a Swimming Intervention for Youth With Cerebral Palsy: An RCT Study. Journal of Pediatric Physical Therapy. 2016.
Fragala-Pinkham et al. An Aquatic Physical Therapy Program at a Pediatric Rehabilitation Hospital: A Case Series. Journal of Pediatric Physical Therapy. 2009.
Güeita-Rodríguez et al. Identification of intervention categories for aquatic physical therapy in pediatrics using the International Classification of Functioning, Disability and Health-Children and Youth: a global expert survey. Journal of Brazilian Physical Therapy. 2016.
McManus et al. The Effect of Aquatic Therapy on Functional Mobility of Infants and Toddlers in Early Intervention. Journal of Pediatric Physical Therapy. 2007.
McManus et al. THE EFFECT OF AQUATIC THERAPY ON PARENT SATISFACTION WITH EARLY INTERVENTION SERVICES AND CHILDREN’S GROSS MOTOR SKILLS.Abstracts of Platform and Poster Presentations for the 2005 Combined Sections Meeting. 2005.
Mortimer et al. The effectiveness of hydrotherapy in the treatment of social and behavioral aspects of children with autism spectrum disorders: a systematic review. Journal of Multidisciplinary Healthcare. Feb 2014.