Definition of Aquatic Exercise

Definition of Aquatic Exercise:
Aquatic exerciserefers to the use of water (in multidepth immersion

pools or tanks) that facilitates the application of established therapeutic
interventions, including stretching, strengthening, joint mobilization,
balance and gait training, and endurance training.
Aquatic exercise - specific goals:
■Facilitate range of motion (ROM) exercise

■Initiate resistance training
■Facilitate weight-bearing activities
■Enhance delivery of manual techniques
■Provide three-dimensional access to the patient
■Facilitate cardiovascular exercise
■Initiate functional activity replication
■Minimize risk of injury or re-injury during rehabilitation
■Enhance patient relaxation.
Precautions and Contraindications to Aquatic Exercise:

Fear of Water
Fear of water can limit the effectiveness of any immersed activity.

Fearful patients often experience increased symptoms during and after
immersion because of muscle guarding, stress response, and improper
form with exercise. Often patients require an orientation period
designed to provide instruction regarding the effects of immersion on
balance, control of the immersed body,and proper use of flotation
devices.
Neurological Disorders
Ataxic patients may experience increased difficulty controlling

purposeful movements. Patients with heat-intolerant multiple sclerosis
may fatigue with immersion in temperatures greater than 33°C.Patients
with controlled epilepsy require close monitoring during immersed
treatment and must be compliant with medication prior to treatment.
Respiratory Disorders
Water immersion may adversely affect the breathing of the patient with
a respiratory disorder. Lung expansion tends to be inhibited due to
hydrostatic pressure against the chest wall. Additionally, increased
circulation in the chest cavity may further inhibit lung expansion due to
increased circulation to the centre of the body. Maximal oxygen uptake
is lower during most forms of water exercise than during land exercise.
Cardiac Dysfunction
Patients with angina, abnormal blood pressure, heart disease, or

compromised pump mechanisms also require close monitoring.
Cider and colleagues demonstrated significant increases in work rate,

VO2peakand walking capacity, and muscle function in patients with
congestive heart failure and type 2 diabetes mellitus. Teffaha and
colleagues demonstrated similar results of increased VO2peak in
patients with chronic heart failure or coronary artery disease with
normal left ventricular function.
Small, Open Wounds and Lines
Small, open wounds and tracheotomies may be covered by waterproof

dressings. Patients with intravenous lines, Hickman lines, and other
open lines require proper clamping and fixation.
Precautions should also be exercised with patients having G-tubes and

suprapubic appliances. Observation for adverse reactions to aquatic
therapy is essential.
Contraindications
Contraindications to aquatic therapy include any situation creating the

potential for adverse effects to either the patient or the water
environment.
Such factors include:
■Incipient cardiac failure and unstable angina
■Respiratory dysfunction, vital capacity of less than 1 liter
■Severe peripheral vascular disease
■Danger of bleeding or hemorrhage
■Severe kidney disease (patients are unable to adjust to fluid loss during
immersion)
■Open wounds without occlusive dressings, colostomy, and skin

infections, such as tinea pedis and ringworm
■Uncontrolled bowel or bladder (bowel accidents require pool

evacuation, chemical treatment, and possibly drainage)
■Menstruation without internal protection
■Water and airborne infections or diseases (examples include influenza,

gastrointestinal infections, typhoid, cholera, and poliomyelitis)
■Uncontrolled seizures during the last year (they create a safety issue for
both clinician and patient if immediate removal from the pool is
necessary).
Properties of Water:
To utilize aquatics efficiently, practitioners must have a basic

understanding of the clinical significance of the static and dynamic
properties of water as they affect human immersion and exercise

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Definition of Aquatic Exercise

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Definition of Aquatic Exercise:

Aquatic exerciserefers to the use of water (in multidepth immersion

Aquatic exercise - specific goals:

■Facilitate range of motion (ROM) exercise

Precautions and Contraindications to Aquatic Exercise:

Fear of water can limit the effectiveness of any immersed activity.

Ataxic patients may experience increased difficulty controlling

Patients with angina, abnormal blood pressure, heart disease, or

Cider and colleagues demonstrated significant increases in work rate,

Small, Open Wounds and Lines

Small, open wounds and tracheotomies may be covered by waterproof

Precautions should also be exercised with patients having G-tubes and

Contraindications to aquatic therapy include any situation creating the

Such factors include:

■Incipient cardiac failure and unstable angina

■Respiratory dysfunction, vital capacity of less than 1 liter

■Severe peripheral vascular disease

■Danger of bleeding or hemorrhage

■Open wounds without occlusive dressings, colostomy, and skin

■Uncontrolled bowel or bladder (bowel accidents require pool

■Menstruation without internal protection

■Water and airborne infections or diseases (examples include influenza,

To utilize aquatics efficiently, practitioners must have a basic

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