HYDROTHERAPY
Review on the effectiveness of it's application in physiotherapy and occupational therapy.
by Dr. Craig W.Martin, Senior Medical Advisor Kukuh Noertjojo, Health Care Analyst.
(May 2004)
I came across this review online and I was intrigued to find out what the benefits were for patients in this rehabilitation process. My new job role is in Orthopaedics and hydrotherapy, so more knowledge into this role will be extremely valuable to me.
The beginning of the review states that many practitioners believe that water has many curative properties that are not harmful or toxic. Current rehabilitation professionals define hydrotherapy as a pool therapy program specifically designed for an individual in an attempt to improve neuromuscular and skeletal function.
The therapy is conducted and supervised by appropriately qualified personnel ( physiotherapists and therapy assistants), ideally in a purpose-built hydrotherapy pool. The use of hydrotherapy as a rehabilitation tool was first described by Hippocrates (c.450-375 BC) and is now commonly used by physiotherapists and occupational therapists.
It lists how hydrotherapy is applied in numerous rehabilitation programs for:
By looking at the list of different rehabilitation programmes, I can see that hydrotherapy can cater to many different health problems, and also orthopaedic injuries such as knee and ankle which are common in dancers.
The review then addresses previous literature results that have shown the high level evidence on the effectiveness of hydrotherapy.
One example is: "Hydrotherapy and rehabilitation of patients with anterior cruciate ligament disruption."
Thomson et al conducted a Cochrane systematic review on the effectiveness of physiotherapist-led programs and interventions for rehabilitation of anterior cruciate ligament (ACL), medial collateral ligament (MCL) and meniscal injuries (M) of the knee in adults.
The authors found 31 previous trials, and only 2 of these 31 trials involved the application of hydrotherapy vs land-based rehabilitation program among patients.
The trial consisted of McClintock et al randomizing 20 post ACL reconstructive surgery patients into 2 rehabilitation programs: 10 days 'standard' home program followed by 7 hydrotherapy sessions and 10 days 'standard' home program followed by 7 land based therapy sessions. The hydrotherapy based and land-based programs were not similar or equivalent. Both rehabilitation programs took 28 days. The knee was measured pre operation, 10 days post operation and pre and post therapy sessions ( 7 measurements in all up to 28 days follow-up).
However, the authors did report that patients in the hydrotherapy program demonstrated significantly greater pain in mean flexion and range of motion at four weeks. The authors also reported that hydrotherapy based patients showed a significantly faster rate of return to pre-operative values of knee extension. In summary of this trail, there was evidence that post op hydrotherapy may be more effective than a land-based rehabilitation program for those patients undergoing ACL reconstructive surgery.
The final summary of this review stated that:
In conclusion, the summary of this review is a good example of when I carry out my inquiry in module 3. I cannot be biased, only stating my opinion that supports the argument- I have to acknowledge there may be risks too, and I should be prepared to list the positive and negatives to ultimately deliver a fair and true report of my inquiry.
Review on the effectiveness of it's application in physiotherapy and occupational therapy.
by Dr. Craig W.Martin, Senior Medical Advisor Kukuh Noertjojo, Health Care Analyst.
(May 2004)
I came across this review online and I was intrigued to find out what the benefits were for patients in this rehabilitation process. My new job role is in Orthopaedics and hydrotherapy, so more knowledge into this role will be extremely valuable to me.
The beginning of the review states that many practitioners believe that water has many curative properties that are not harmful or toxic. Current rehabilitation professionals define hydrotherapy as a pool therapy program specifically designed for an individual in an attempt to improve neuromuscular and skeletal function.
The therapy is conducted and supervised by appropriately qualified personnel ( physiotherapists and therapy assistants), ideally in a purpose-built hydrotherapy pool. The use of hydrotherapy as a rehabilitation tool was first described by Hippocrates (c.450-375 BC) and is now commonly used by physiotherapists and occupational therapists.
It lists how hydrotherapy is applied in numerous rehabilitation programs for:
- Improving muscular and cardiopulmonary endurance in the elderly
- Pulmonary rehabilitation in patients with severe asthma
- Ventilated patients with Guillan-Barre Syndrome
- Sports injuries
- Osteoarthritis and rheumatoid arthritis
- Various dermatological conditions
- Rett syndrome
- Chronic heart failure
- Reducing spasticity in severe traumatic brain injury patients
- Burns and wound healing
- Ankylosing spondylitis
- Fibromyalgia
- Lower back pain
- Rehabilitation post anterior cruciate ligament surgery
- Colles' fracture and total femur replacement
- Pressure ulcer
- Children with complex regional pain syndrome
- Rehabilitation of patients with supraspinatus muscle tears
- Rehabilitation of patients with spinal muscular atrophy
- Rehabilitation of ankle sprains grade 1 and 2
- Improving functional mobility in patients with incomplete c-6 spinal cord lesion
- Venous stasis/insufficiency, including haemorrhoids
- Common colds
- Urolithiasis
- Various psychiatric conditions, including hysteria.
By looking at the list of different rehabilitation programmes, I can see that hydrotherapy can cater to many different health problems, and also orthopaedic injuries such as knee and ankle which are common in dancers.
The review then addresses previous literature results that have shown the high level evidence on the effectiveness of hydrotherapy.
One example is: "Hydrotherapy and rehabilitation of patients with anterior cruciate ligament disruption."
Thomson et al conducted a Cochrane systematic review on the effectiveness of physiotherapist-led programs and interventions for rehabilitation of anterior cruciate ligament (ACL), medial collateral ligament (MCL) and meniscal injuries (M) of the knee in adults.
The authors found 31 previous trials, and only 2 of these 31 trials involved the application of hydrotherapy vs land-based rehabilitation program among patients.
The trial consisted of McClintock et al randomizing 20 post ACL reconstructive surgery patients into 2 rehabilitation programs: 10 days 'standard' home program followed by 7 hydrotherapy sessions and 10 days 'standard' home program followed by 7 land based therapy sessions. The hydrotherapy based and land-based programs were not similar or equivalent. Both rehabilitation programs took 28 days. The knee was measured pre operation, 10 days post operation and pre and post therapy sessions ( 7 measurements in all up to 28 days follow-up).
However, the authors did report that patients in the hydrotherapy program demonstrated significantly greater pain in mean flexion and range of motion at four weeks. The authors also reported that hydrotherapy based patients showed a significantly faster rate of return to pre-operative values of knee extension. In summary of this trail, there was evidence that post op hydrotherapy may be more effective than a land-based rehabilitation program for those patients undergoing ACL reconstructive surgery.
The final summary of this review stated that:
- The application of water to treat disease has been used throughout history. It is known that Hippocates (460-375 BC) used hot and cold water in the treatment of multiple disease states. At present, hydrotherapy is applied to treat a myriad of diseases, including musculoskeletal problems. The majority of the evidence on the effectiveness of hydrotherapy to treat the described disease states and 'conditions' comes from small case series/reports and subsequent low level evidence (level 4).
- The higher level evidence that was reviewed does not suggest hydrotherapy is effective in treating osteoarthritis, rheumatoid arthritis, chronic low back pain, fibromyalgia or pressure ulcers. There were 2 papers that did suggest that post ACL reconstructive surgery patients may have better outcomes than those undertaking land based exercises alone.
- The application of hydrotherapy is not always without risk. There are reports in the literature regarding legionella infections, burn, folliculitis and hypersensitivity pneumonitis which were directly related to the hydrotherapy.
In conclusion, the summary of this review is a good example of when I carry out my inquiry in module 3. I cannot be biased, only stating my opinion that supports the argument- I have to acknowledge there may be risks too, and I should be prepared to list the positive and negatives to ultimately deliver a fair and true report of my inquiry.
Hi Katrina,
ReplyDeleteNice to meet you in person today! How was the rest of the session? I hope you had a good journey back.
I can relate to what you say about picking out bits of the literature that support your opinions. I find that I do this often - it's what I'm drawn to and I tend to skim over other parts!
Lisa x
Hey Lisa sorry I haven't replied it's been such a busy week! Nice to meet you too!
ReplyDeleteThe rest of the session was good, we divided ourselves up into our module groups & had a good chat about how we were feeling so far and what our inquiries are about. That really helped for me, talking to others that are going through the same thing and feeling that you're not on your own! I'm going to come up again in a few weeks too and meet up with some of the other girls in my module to do a study day at middle sex.
Katrina xx
Katrina - using data form other research will be important in your work-based inquiry. This research was conducted on clinical issues - scientific research - but the data is useful when you are looking at practice in a more exploratory way for BAPP.
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