HYDROTHERAP Y

Anna Ria R. Balaladia, PTRP

Introduction/History

5th Century B.C. = AESLEPIUS (god of healing) Hippocrates = cold water warms, warm water cools Bernard Baruch = used effects of hydrotherapy in treating mental pxs and drug addicts Charles Lawman = 1st employ underwater exercises on spastic pxs Franklin Delano Roosevelt = established Georgia Warm Springs Foundation or National Infantile Paralysis Foundation

Hydrotherapy

External use of water in the treatment of disease Water = medium for hydrotherapy

Physiologic Effects of Heat & Cold

Hypothalamus Anterior Hypothalamus Heat Loss Center prevent T rise Acts as a terminal receptor organ for T Posterior Hypothalamus Heat Maintenance Center prevent cooling Functions as a synaptic relaying activity from thermoreceptors in the skin

Physiologic Effects of Heat & Cold

Hunting Response of Lewis Vasoconstriction Reflex vasodilation Erythema 43C - 45C (109F - 113F) = skin tolerance to HEAT 15C (59CF) = skin tolerance to COLD

Factors that affect responses of human body to Heat & Cold Application:
1. 2. 3.

4.

Dose & Intensity Nature of heating energy Extent & Duration of Application Degree of interference offered by the body

Factors Affecting Perception of Heat or Cold

1.

2. 3. 4.

Density of thermal receptors stimulated Degree of T produced Size of area heated Rate of T change

Skin = cold receptors (Krauses endbulbs) > heat receptors (Ruffinis corpuscles) = 11.3/cm2 : 3.3/cm2

Controlling Factors: Heat regulation - T of skin T sensation rate of skin T change

Responses to Thermal Sensory Experiences

Thermal Shock Reactions to Heat/Cold

Mild Analgesia
Fear/Pain

Moderate Stimulating
(invigorating)

Extreme Fight/Flight
Responses ( eye dilation,, BP, PR, facial color

(Gen. Relaxation, Decrease pain, Muscle spasm) changes)

HEAT

Erythema ( increase blood to area)

Sweating

COLD

Skin Blanch or Cyanotic (decrease blood to area)

Piloerection

Physiologic Effects of Systemic Application of Heat

1.

2.
3.

4. 5.

Cutaneous vasodilation 25-35% increase in resting metabolism Increase blood flow, blood volume, & cardiac output Increase osmotic pressure of body cells BP changes

Physiologic Effects of Systemic Application of Heat

6. Heat in abdominal wall decrease GI activity Ingestion of hot H2O increase gastric motility External applied heat decrease intestinal blood flow, activity, & acid secretion in stomach 7. Decrease urinary output 8. Decrease gamma spindle firing

Physiologic Effects of Local Application of Heat

1.

2.
3. 4. 5.

Increase blood flow Decrease blood viscosity Increase metabolic rate Analgesic Consensual heat vasodilation

*43-44C (109-111F) = pain

Physiologic Response to Heat Application

METABOLIC RESPONSE

Increase Metabolic Rate

Increase Phagocytosis

Arteriolar Dilatation

Physiologic Effects of Systemic & Local Application of Cold

1.
2.

3.

Effects are opposite of the effects of heat Decrease metabolism Arteriolar vasoconstriction, due to: 1. Decrease formation of metabolites 2. Local effect of cold on small blood vessels on skin 3. Reflex vasoconstriction by the hypothalamus Decrease edema formation & lymph production

Physiologic Effects of Systemic & Local Application of Cold

4. Increase arterial BP due to muscular contraction & vasodilation 5. Decrease muscle tone 6. Decrease pain, due to decrease muscle spasm & slowing in nerve impulses 7. Weakness & decrease ease, precision of movements

LOCAL COOLING is used to:

1.

2. 3. 4. 5.

Decrease extravasation of fluid following acute soft tissue trauma Decrease pain & muscle spasm Better control of spasticity Preserve viability of parts Retard development of gangrene

HEAT VERSUS COLD

FACTORS MUSCLE SPASM Decrease HEAT Decrease COLD

SPASTICITY

Cause only transient/short decrease

Relieves pain Decrease

Very effective in decreasing spasticity

Relieves pain Increase

PAIN CAPABILITY TO SUSTAIN MUSCLE CONTRACTION STRENGTH OF MUSCLE CONTRACTION TISSUE METABOLISM

Slight increase strength

Slight cooling will increase strength Decrease

Increase

BLOOD FLOW

Increase blood flow & tendency to bleed

Decrease blood flow & tendency to bleed

HEAT VERSUS COLD

FACTORS EDEMA JOINT STIFFNESS SKILLED MOVEMENTS ORTHOSTATIC HYPOTENSION HEAT Tend to produced edema Decrease Does not impair
Readily produce orthostatic hypotension with total or large body exposure Used in late stage of inflammatory rxn/injury to assist in their resolution

COLD Prevents further edema Increase Impair Decrease due to vasoconstriction

STAGE OF CONDITION

Used in acute inflammatory rxn/injuries to prevent aggravation

EFFECT ON FROSTBITE OR BURNS

Can reduce effect of frostbite if the parts is warmed quickly

Can alleviate burns if applied immediately