Renee Kinder

One of my grandfather’s favorite stories to tell about my stubborn childhood antics revolves around the first summer they opened their pool. 

Spoiler alert, I couldn’t swim.

I somehow, however, managed to convince him that it was a good idea to place my floaties on my ankles before I jumped into the pool. 

As you can imagine, 5-year-old Renee went totally topsy-turvy, feet in the air and head submerged under the water. He of course had to jump in and save me. He would always roar with laughter while repeating this story for decades to come. However, what I remember was after this event, I never saw him in the pool again, claiming this traumatizing event as the reason. 

The next summer I jumped off the top of a slide at their home and broke my arm, but that is a story for another day.

My grandmother, on the other hand, was never tired of the water and long raved about how much better she felt after her evening laps. So many of my summer memories of her revolve around watching her swim back and forth and back and forth, alternating her stroke under the light of the moon.

Nothing better than a summer night swim. Nothing. 

In numerous ways, our summer seasons are defined by time in the water. From neighborhood and community pools that open Memorial Day, indicating the start, to their dreaded closure following Labor Day, many of our first stroke, dive in headfirst, “Marco Polo” memories are limited to a brief May-to-September window. 

Summer is coming to an end. However, I am here today to share that for many therapy teams, that doesn’t mean that time in the pool must conclude!

Patient populations who may benefit from the use of therapy provided in an aquatic setting include those with rheumatic disease, neurological disorders, arthritis, cardiovascular disease and post bariatric surgery; individuals with chronic conditions such as COPD and diabetes; and persons with balance issues, fibromyalgia and musculoskeletal impairments. 

Aquatic therapy is a skilled intervention provided by many occupational and physical therapy teams, which use the principles of water to cause physiologic changes. Specifically, aquatic therapy services include the use of hydrodynamics such as buoyancy, density, viscosity, thermodynamics and hydrostatic pressure, which are collectively known as hydrodynamics.

These principles provide the rehab patient with a unique sensory experience by which to facilitate range of motion, functional strength and balance and decrease edema and pain to promote improved physical function and enhance quality of life.

What could indications for use of aquatic therapy include, you ask?

  • Facilitate weight-bearing activities
  • Facilitate range of motion exercises
  • Provide three-dimensional access to the patient
  • Apply resistance training
  • Deliver manual techniques
  • Facilitate cardiovascular exercise
  • Replicate functional activity
  • Minimize risk of injury during rehabilitation
  • Enhance patient relaxation

Furthermore, individuals can benefit from water’s properties during the intervention in the following ways:

  • Moving through water to develop bone and muscle strength as well as cardiovascular and muscular endurance
  • Using viscosity, which allows for an increased time of response, so that reaction time can be trained more functionally
  • Using immersion of the body to increase the work of breathing and change the respiratory dynamics
  • Using water to affect the sensory receptors, improve proprioceptive input, improve sensory integration, and reduce tone and spasticity
  • Using hydrostatic pressure to reduce edema
  • Using buoyancy to unload the body to assist with ease of movement
  • Using sensory overflow while in water to reduce pain

Following a hands-on evaluation from a registered physical or occupational therapist, patients may receive intervention with goals aimed at reducing tone and spasm reduction, increasing range of motion and flexibility, improving strength, reducing pain, improving trunk alignment and stability, restoring normal patterns of upper and lower extremity movement, and training functional capacity of the body as a whole.

Additional long-range benefits are also noted in research, from improved digestion, sleep patterns and healing to decreased pain and anxiety.

So, yes, summer is ending, the fall leaves are starting to turn here in Kentucky, but that doesn’t mean the feelings associated with summer also have to go.

Think this form of intervention isn’t a potential due to not having an onsite pool? Think again. Many communities partner with local YMCAs or other venues to accommodate the needs of those they serve.

Consider stepping into aquatics therapy, feet first, of course, and leave those silly floaties at home.

*Note use of an aquatics-based program must include adequate assessments of risks and contraindications for certain patient populations. Consult with your physician provider and rehab professionals for guidance. 

Renee Kinder, MS, CCC-SLP, RAC-CT, is Executive Vice President of Clinical Services for Broad River Rehab and a 2019 APEX Award of Excellence winner in the Writing–Regular Departments & Columns category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty and is an advisor to the American Medical Association’s Current Procedural Terminology CPT® Editorial Panel. She can be reached at [email protected].

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.