Water Immersion Therapy Dr Mark Abelson History Benefits

Water Immersion Therapy Dr Mark Abelson

History • Benefits extolled by ancient Greeks and Romans • Spas very popular in 18 th century England Europe • Treat paralysis, gout, rheumatics, leprosy

Benefits of cold water therapy/swimming • Improves immune function • Boosts mood – endorphin release • Burns calories – brown fat • Improves sex life – increases test.

Cold water therapy for athletes • Muscle recovery post exercise – quicker • Reduces inflammation and muscle injury

Hydrotherapy • Popular amongst physiotherapist • Used to treat wide variety of conditions • Immersion in warm water – promotes muscle relaxation, pain relief, assist joint movements

Water based cardiac rehab therapy

Head Out Water Immersion (HOWI) • Upright, seated • 35 degree Celsius water to the sternal notch 4 feet of water 22 mm. Hg of pressure /foot under water

Water temperature and Heart Rate response to exercise – lower temp keeps body cooler

Effects of water pressure on circulation • Hydrostatic pressure pushes fluid pooling in lower limbs into blood vessels • Approximately 700 ml in normal person • Increased blood volume returned to the heart and circulation • Cardiac output increases (35 -50%). Heart rate drops • Due to vaso-dilatation BP remains unchanged • BP = CO x SVR

Effects of raised blood volume and cardiac output • Diuretic response – decreased levels of ADH • Natriuretic response – increase levels of ANP • Beneficial for patients with heart failure and fluid retention • Avoid dehydration – drink fluids

Water based therapy • “Hydrotherapy is an alternative method of exercising since the buoyancy effect reduces loading. Exercises to improve mobility, strength, as well as cardiovascular fitness can easily be provided in water” (Schmid et al. , 2007). • Stretching, walking, jogging, strength and balance training • Swimming

Advantages of water based therapy • Warm (32 -34*) comfortable environment • Non-weight bearing - morbid obesity - arthritis and other orthopaedic and muscular limitations • Less effort to maintain correct posture • More strenuous – water higher resistance than air • Beneficial effects of improved cardiac output allows for more strenuous and longer exercise classes

Benefits of water exercise on BP

Beneficial effects of water exercise on strength

Benefits of water exercise on exercise capacity

Benefits of water exercise in Heart Failure

Are these benefits water specific? • Some are – lower heart, improved cardiac output • But land based exercise similarly good effects • However – warm water based exercise allows for better improved ability to exercise