Aquatic Therapy Anyone?

Posted on June 29th, 2013 by Denise | No Comments

Aquatic Therapy Anyone?


Denise Koonce OTR

“She wore an itsy bitsy teeny weenie yellow polka dot bikini that she wore for the first time today!”  The lyrics of Brian Hyland remind me of the glorious pool days of summer.  Summer time is here and one quintessential part of summer is playing and spending time in the pool.  Our household has already racked up numerous hours this summer in various pools.  Children generally love playing in water whether it is with a sprinkler, water balloons, or spending time in a pool.  Here in the south, where it is so hot during the summer, the day is simply made bearable by spending some time in the water.  My family recently took a trip to see family and while there we turned the backyard into a mini water fun land.  We had a child’s slip and slide, two kiddy pools, and a recycled billboard canvas, which when dish soap is added, turns into a massive slip and slide.  The kids loved it!  The kid’s shrills and laughter became so infectious that eventually the adults had to join in and were taking their turn sliding.  It was hilarious to watch.  Everyone used muscles that they didn’t typically use and were therefore sore the next day.    Water play is fun for the young and young at heart, yet beneficial to all at the same time.  Ancient civilizations, including the Greeks and Romans, recognized the healing and therapeutic value of water.  The prominence of water in future civilizations ebbed and flowed, changing over the centuries from viewing it simply to more complex, with the European countries finally creating the initial basis of what we now refer to as, aquatic therapy. 

What are the benefits of aquatic therapy in the pediatric population?  The water elicits the motivation for the child to enter the pool and once they are in the pool, the aquatic environment provides the stage for fun, therapeutic activities.  Positive effects, of time spent in the water, can be observed in multiple systems throughout the body including the cardio vascular, pulmonary, musculoskeletal, neuromuscular and sensory systems.  By using the inherent properties of water, an advantageous therapeutic environment is created for the patient and therapist to work.  The properties of water are relative density, buoyancy, hydrostatic pressure, viscosity, cohesion, adhesion, surface tension, refraction and thermodynamics.  These properties provide a more supportive, forgiving environment for increasing range of motion, motor learning, strengthening, activity tolerance, and improved breath control, than is offered with land based therapy.  The same goals you try to achieve on land based therapy are what you seek to achieve in aquatic based therapy.   However, aquatic based therapies or exercises are not intended to replace land based therapy only to complement them. 

There are different therapeutic water based treatment approaches including Bad Ragaz Ring Method, Halliwick Method, Watsu, Ai Chi, Aquatic PNF, and Neuro-Developmental Treatment Based Therapeutic Aquatics.  Most of the treatment approaches require a hands-on approach from the therapist and for the patient to be an active participant, but not all.  Those which require the patient to be active use the water’s properties to support, assist, or resist during the movement or exercise.  Aquatic therapy is also generally performed in a heated pool set for temperatures between 87-94 degrees.  The warm temperature aids in increasing body warmth and blood flow, decreasing inflammation and edema, and muscle relaxation.  Individuals that may benefit from aquatic therapy include those diagnosed with cerebral palsy, autism, Down syndrome, sensory integrative disorders, multiple sclerosis, muscular dystrophy, and arthritis, just to name a few.  There are some inherent contraindications or situations which would prevent someone from participating in aquatic therapy including open wounds, patients with tracheotomies, fever, diarrhea, ear infections and/or a history of reoccurring ear infections, chronic skin diseases, yeast infections, hypo/hyperthermia, and acute rheumatoid episodes.  Some conditions thought to be a contraindication but are not include a g-tube placement or a Mic-Key button.

Summer is not the only time for aquatic therapy, as most therapeutic pools are indoors and functioning year round, but it brings the memories of fun time spent in a pool.  Summer also provides more time for children to participate in complementary therapies since they are out of school.  Aquatic therapy is a powerful, motivating choice for the pediatric population to jump-start new motor learning, move forward past a difficult skill you have not obtained with purely land based therapy, increase strength or range of motion, or gain momentum in a new developmental skill.  If you have had positive experiences or outcomes from the results of aquatic therapy please share them with us.  Until then splish, splash, your way through summer!



Becker, BE, Aquatic therapy: Scientific Foundations and Clinical Rehabilitation application; American Academy of Physical Medicine and Rehabilitation; Vol 1, 859-872, September, 2009

Muenks, S; Thillet-Bice, F, Aquatic Therapy In-service at Reach Therapy Center, Oct. 2010

Styer-Acevedo, J, Neuro-Developmental Treatment Based Therapeutic Aquatics for Pediatrics, Continuing Education Course given at Reach Therapy Center, July, 2008.

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