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At least 19 recordsLinked to original sources
PubMedDate not supplied

North American survey of hydrotherapy in modern burn care.

To investigate the role of hydrotherapy in the treatment of patients with burns, a survey was conducted of the use of hydrotherapy in Canada and the United States as part of an intensive investigation into the causes of Pseudomonas aeruginosa infections in burn injury. Results of the survey conducted indicate that hydrotherapy continues to be an important part of burn wound care in most (94.8%) burn centers in North America. Of the burn centers that use hydrotherapy, 81.4% continue to immerse patients, 82.8% perform hydrotherapy on all patients with burns regardless of total body surface area, and 86.9% continue with hydrotherapy throughout the entire phase of the patient's hospitalization. Routine culturing of the hydrotherapy equipment is standard procedure in 49.7% of the units surveyed, and culturing of the water supply to the equipment on a regular basis is done in only 18.6% of those burn units regularly using hydrotherapy. Pseudomonas aeruginosa was identified as the most common, major cause of sepsis in 52.9% of the burn units surveyed, Staphylococcus aureus in 25.5%, and Candida albicans in 5.2%. This survey demonstrates the extensive use of hydrotherapy in North American burn units and the concern for serious infections in patients with burns from gram-negative organisms such as Pseudomonas species. With the increasing number of reports of Pseudomonas infections related to the use of hydrotherapy equipment, the importance for further investigation into burn wound care with and without hydrotherapy, infection rates, and cost analysis appears to be indicated.

Burn Units↗
PubMed1998

Low airloss hydrotherapy versus standard care for incontinent hospitalized patients.

OBJECTIVE: To determine whether low airloss hydrotherapy reduces the incidence of new skin lesions associated with incontinence in hospitalized patients and results in more rapid healing of existing pressure sores compared with standard care. To assess subjectively patient and nursing satisfaction related to using low airloss hydrotherapy beds. DESIGN: Randomized, prospective, unblinded study. SETTING: Acute and chronic hospital wards. PARTICIPANTS: A total of 116 newly admitted, incontinent, hospitalized patients with and without existing pressure sores. INTERVENTION: Low airloss hydrotherapy compared with treatment on hospital beds and mattresses ordered by the patient's attending physician. MEASUREMENTS: Incidence rates of new skin lesion development, e.g., pressure sores, candidiasis, and chemical irritation; improvement in existing pressure sore size, volume, and status; subjective assessment of patient and nursing satisfaction. RESULTS: Possible hypothermia was identified in two patients during the first week of the study, and patient and nursing dissatisfaction with low airloss hydrotherapy remained high throughout the first months of the study. Therefore, two major modifications in the initial protocol were made: (1) increased patient temperature monitoring for hypothermia was initiated in Week 2 of the study and (2) increased staff resources for in-service training on bed use began in Week 18 of the study. After the latter change, 58 subjects were randomized to low airloss hydrotherapy and 58 to standard care. Subjects were old (median age > or = 80 years), and almost all were bedbound or nonambulatory. The median (range) length of follow-up for subjects in the treatment group was significantly shorter than for those in the control group (4 (1-60) days versus 6 (1-62) days, respectively, P = .017) because there were more dropouts from the treatment group (24 (36%) of 58 versus 2 (3%) of 58, P = .0001). The major reasons dropout occurred were patient or family dissatisfaction (12 (21%)), new or worsened skin lesions thought to be related to bed use (4 (7%)), and hypothermia < 97 degrees F (4 (7%)). The total cumulative incidence of new truncal skin lesions within 9 days of enrollment was greater in the treatment than in the control group (48% versus 14%, respectively, P < 0.01). Too few patients with existing pressure sores were treated for too short a period of time to assess the effect of low airloss hydrotherapy on pressure sore healing. Because only 10 patients treated on low airloss hydrotherapy beds were able to complete satisfaction surveys meaningfully, interpretation of these data is difficult. Only nine (21%) of 44 nurses subjectively reported overall satisfaction using the low airloss hydrotherapy bed. CONCLUSIONS: This study shows the value of a rigorously designed clinically based evaluation of a new product developed for older patients. The results of the study led to re-engineering of the prototype low airloss hydrotherapy bed as well as a change in marketing strategy. Studies of products targeted to the prevention and treatment of pressure sores in older patients should be undertaken before generalized marketing begins.

Aged↗
PubMed2003

Hydrotherapy for Rett syndrome.

OBJECTIVE: The effects of hydrotherapy on an 11-year-old girl with stage III Rett syndrome were investigated. METHODS: The Halliwick method was used to apply hydrotherapy in a swimming pool twice a week for 8 weeks. The girl's physical abilities were assessed 3 times: before and 5 minutes after a single hydrotherapy session and after 8 weeks of hydrotherapy. The tests included analysis of stereotypical movements, functional hand use, hand skills, gait and balance, hyperactive behaviour, communication and social interaction. RESULTS: Immediately after hydrotherapy, stereotypical movements decreased and this decrease continued during the following 8 weeks. The girl's feeding activities and hand skills increased markedly. After 8 weeks of hydrotherapy, her walking balance was improved, interaction with her environment increased and hyperactive behaviour and anxiety decreased. CONCLUSION: In conclusion, after the application of hydrotherapy, stereotypical hand movements had decreased and purposeful hand functions and feeding skills increased in this case. Whether hydrotherapy has a positive effect on the functional use of the hand in Rett syndrome should be investigated using more subjects.

Adolescent↗
PubMed1996

A randomized and controlled trial of hydrotherapy in rheumatoid arthritis.

OBJECTIVE: The aim of this study was to evaluate the therapeutic effects of hydrotherapy which combines elements of warm water immersion and exercise. It was predicted that hydrotherapy would result in a greater therapeutic benefit than either of these components separately. METHODS: One hundred thirty-nine patients with chronic rheumatoid arthritis were randomly assigned to hydrotherapy, seated immersion, land exercise, or progressive relaxation. Patients attended 30-minute sessions twice weekly for 4 weeks. Physical and psychological measures were completed before and after intervention, and at a 3-month followup. RESULTS: All patients improved physically and emotionally, as assessed by the Arthritis Impact Measurement Scales 2 questionnaire. Belief that pain was controlled by chance happenings decreased, signifying improvement. In addition, hydrotherapy patients showed significantly greater improvement in joint tenderness and in knee range of movement (women only). At followup, hydrotherapy patients maintained the improvement in emotional and psychological state. CONCLUSIONS: Although all patients experienced some benefit, hydrotherapy produced the greatest improvements. This study, therefore, provides some justification for the continued use of hydrotherapy.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Objective assessment of results of special hydrotherapy in inpatient rehabilitation following knee prosthesis implantation].

AIM: Based on our own previous surface EMG investigations (EMG mapping), it has been shown that disturbances in coordination, proprioception and strength measured before and after implantation of a total knee arthroplasty (TKA) can be treated successfully with standard physical therapy during in-patient rehabilitation. The objective of the present study was to evaluate the therapeutic effect of a special type of hydrotherapy. METHOD: 25 patients with TKA were treated for 3 weeks with a standardized hydrotherapy training during in-patient rehabilitation. Several diagnostic methods (EMG mapping, Isokinetics, Ultrasound) were applied to objectify and quantify changes in muscular coordination and strength at 4, 7, and 26 weeks postoperative. These results were compared with the results of 38 TKA patients treated with a "standard rehabilitation program" and with the results of 20 healthy persons. RESULTS: EMG mapping as well as isokinetics and ultrasound permitted an objective characterization of the results. Patients treated with the special hydrotherapy showed greater improvements in the investigated items of coordination and strength than patients treated with the "standard rehabilitation program". For example, in the hydrotherapy group a significantly better contraction capacity of the M. vastus intermedius was measured. The intensive hydrotherapy was tolerated by all patients and reached good acceptance. CONCLUSION: The investigated hydrotherapy technique leads to better muscular coordination and strength, which can provoke a better stabilization of the knee joint. Therefore, the early and intensive application of hydrotherapy for improving coordination and strength in the rehabilitation of patients with total knee arthroplasty is advisable.

Aged↗
PubMed2002

Hydrotherapy in labor.

PURPOSE: To review the literature on hydrotherapy in labor to direct prescription of the intervention and design studies to test its effectiveness. METHODS: Studies of hydrotherapy were identified via searching literature and electronic databases. FINDINGS: A primary effect of immersion is a central blood volume bolus, which occurs almost immediately after bathing begins. Subjective maternal responses to bathing in labor have been favorable. No maternal or infant infections have been attributed to bathing by parturients with either intact or ruptured membranes. Maternal bathing in labor does not appear to affect infant Apgar scores or stress hormones at birth. No clear evidence exists to indicate that hydrotherapy increases cervical dilation, increases fetal descent, reduces uterine dyskinesia, shortens labor, decreases use of epidurals or analgesia, or decreases rates of operative delivery or hemorrhage. CONCLUSIONS: Study findings indicate support for using hydrotherapy for relief of rapid pain and anxiety in labor. A methodical approach must be taken to determine for whom and under what circumstances intervention with hydrotherapy in labor is efficacious. Studies of the maternal and fetal effects of hydrotherapy in labor, including mechanisms of action, as well as large, prospective, randomized clinical outcome trials with control for intervening variables, are needed to help practitioners decide whether to prescribe hydrotherapy.

Adult↗
PubMedDate not supplied

[Methodological reflections on 20 randomized clinical hydrotherapy trials in rheumatology].

The aim of this study was to estimate the level of scientific evidence contributed by randomized clinical trials in rheumatologic indication of spa therapy. A literature search was made of computer data banks, with analysis of 20 randomized hydrotherapy trials. On the 20 identified randomized hydrotherapy trials, four were carried out double-blind; nine included a comparison of inter-groups evolution. The indications assessed are chronic low back pain, osteoarthritis of the knee and hip joints, osteoarthritis of fingers, fibromyalgia, rheumatoid arthritis and psoriasis arthritis. The results suggest durable, persisting improvement several months after balneological care, in accordance with the following evaluation criteria: pain, handicap, quality of life, consumption of analgesics and of nonsteroidal anti-inflammatory drugs (NSAIDs). It was concluded that randomized evaluations, demonstrating a beneficial and prolonged clinical effect of balneologic treatments, exist in respect of the main indications for rheumatologic hydrotherapy. These results acknowledge the medical help given by hydrotherapy within the aforesaid parameters, to which may be added a reduction of the adverse gastrointestinal events of NSAIDs. Evaluation needs to be continued to clarify the medical benefit offered by rheumatologic hydrotherapy.

Double-Blind Method↗
PubMed2003

The effect of hydrotherapy on the incidence of common cold episodes in children: a randomised clinical trial.

UNLABELLED: Few interventions have proved to be effective in the prevention and treatment of common colds. Anecdotal reports suggest the possible beneficial effect of hydrotherapy (stimulation of the body surface with warm and cold water). This study's objective was to evaluate the clinical effect of hydrotherapy on common colds in children. Children aged 3-7 years with six or more common cold episodes during the preceding 12 months were randomised to receive either daily inhalation of normal saline in the control group or daily inhalation plus daily hydrotherapy in the experimental group for 12 months. The main outcome measurements were incidence, duration and severity of common cold episodes as reported by the children's parents in a daily symptom diary. Groups did not differ at baseline with regard to age, gender, or number of cold episodes in the year before the study. Diaries were available from 81 patients in the control group and 65 patients in the experimental group. In the study period, there were no significant differences in the incidence of colds (control vs. experimental group, mean +/- SD, 4.8+/-3.5 vs. 4.1+/-3.3 episodes) or the average duration of episodes (7.7+/-3.5 vs. 7.6+/-3.8 days). CONCLUSION: This study does not demonstrate any beneficial effect of hydrotherapy on preschool children with frequent common colds.

Administration, Inhalation↗
PubMed2003

Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool.

OBJECTIVE: To investigate the efficacy of using ratings of perceived exertion (RPEs) to regulate exercise intensity for patients with chronic back pain while they undergo hydrotherapy. DESIGN: Experimental study. SETTING: Hydrotherapy pool in the United Kingdom. PARTICIPANTS: Twenty-six patients (16 women, 10 men) with chronic low back pain of more than 12 months in duration. All were referred for hydrotherapy after attending a back pain triage clinic. INTERVENTIONS: Not applicable. Main outcome measures Borg Ratings of Perceived Exertion Scale; heart rate expressed as a percentage of age-predicted maximum heart rate, computed from readings using heart rate monitors; Oswestry Disability Questionnaire; and pain score from a visual analog scale. RESULTS: At workloads below 55% of age-predicted maximum heart rate, great variability was found in the relation between RPE and exercise intensity. However, for workloads between 55% and 85% of age-predicted maximum heart rate, RPE had a strong correlation with relative exercise intensity during hydrotherapy. CONCLUSIONS: At workloads sufficient to induce an aerobic training response, and yet be safe for patients with chronic back pain, RPE was an accurate predictor of exercise intensity. At lower intensities, back and leg pain may exert a mediating influence. Further investigation is needed to determine the exact relation between back pain, exercise type, and RPE at low exercise intensities.

Adult↗
PubMed2003

Hydrotherapy--a new approach to improve function in the older patient with chronic heart failure.

AIMS: Hydrotherapy, i.e. exercise in warm water, as a rehabilitation program has been considered potentially dangerous in patients with chronic heart failure (CHF) due to the increased venous return caused by the hydrostatic pressure. However, hydrotherapy has advantages compared to conventional training. We studied the applicability of an exercise programme in a temperature-controlled swimming pool, with specific reference to exercise capacity, muscle function, quality of life and safety. METHODS AND RESULTS: Twenty-five patients with CHF (NYHA II-III, age 72.1+/-6.1) were randomised into either 8 weeks of hydrotherapy (n=15), or into a control group (n=10). The training program was well tolerated with no adverse events. Patients in the hydrotherapy group improved their maximal exercise capacity (+6.5 vs.-5.9 W, P=0.001), isometric endurance in knee extension (+4 vs.-9 s, P=0.01) together with an improvement in the performance of heel-lift (+4 vs. -3 n.o., P=<0.01), shoulder abduction (+12 vs. -8 s, P=0.01) and shoulder flexion (+6 vs. +4, P=0.01) in comparison to patients in the control group. CONCLUSION: Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in patients with CHF. This new approach broadens the variety of training regimes for older patients with CHF.

Aged↗
PubMed1982

Hospital hydrotherapy pools treated with ultra violet light: bad bacteriological quality and presence of thermophilic Naegleria.

The microbiological quality of eight halogenated and two u.v.-treated hydrotherapy pools in hospitals was investigated. The microbiological quality of halogenated hydrotherapy pools was comparable to halogenated public swimming pools, although in some Pseudomonas aeruginosa and faecal pollution indicators were more frequent due to bad management. On the other hand u.v.-treated hydrotherapy pools had very bad microbiological quality. Apart from faecal pollution indicators, P. aeruginosa was present in very high numbers. Halogenated hydrotherapy pools were not highly contaminated with amoebae, and Naegleria spp. were never detected. On the other hand u.v.-treated pools contained very high numbers of thermophilic Naegleria. The Naegleria isolated were identified as N. lovaniensis, a species commonly found in association with N. fowleri. Isoenzyme analysis showed a different type of N. lovaniensis was present in each of two u.v.-treated pools.

Amoeba↗
PubMedDate not supplied

Is there a need for state health department sanitary codes for public hydrotherapy and swimming pools?

The Board of Health of the Commonwealth of Virginia has an outdated sanitary code for its public hydrotherapy and swimming pools. The code is restricted to pools in hotels and other lodging places. The absence of modern regulations for public hydrotherapy and swimming pools has permitted serious deficiencies in pool maintenance, which are highlighted in this report. The most notable of these deficiencies was the presence of high levels of bacterial contamination that could predispose to infect in the water of one public hot tub. The results of this study indicate that the Virginia Board of Health sanitary code for pool water must be revised immediately and should include all public hydrotherapy and swimming pools. Other states and communities may want to assess their codes for swimming pools and hydrotherapy tubs to avoid deficiencies that could be detrimental to public health.

Bacteria↗
PubMedDate not supplied

Hydrotherapy during labor. An example of developing a practice policy.

Warm water has been used for centuries to treat many painful ailments. In perinatal clinical practice, hydrotherapy is being used to increase relaxation and decrease pain during labor. This article summarizes clinical studies evaluating hydrotherapy during labor, describing the current evidence which supports hydrotherapy as an effective method for managing intrapartal pain. The article also describes the process by which an institution established an evidence-based practice policy for the use of hydrotherapy in labor.

Adult↗
PubMed2002

Incidence of Pseudomonas aeruginosa in recreational and hydrotherapy pools.

Pseudomonas aeruginosa remains an important agent of opportunistic infection in patients, particularly those with respiratory complications and burns. One natural niche of this organism is water and water-associated facilities, hence the aim of this study was to examine specimens from recreational and hydrotherapy pools in Northern Ireland over a two-year period. Water specimens (n = 3,510) were obtained from three amenity categories, namely, 13 hydrotherapy pools (specimen number [n] = 323), 51 Jacuzzis/spas (n = 1,397) and 68 swimming pools (n = 1,790). Specimens (100 ml) were filtered through a cellulose acetate (0.45 micron pore size) gridded filter and the membrane was placed on Pseudomonas CFC agar (Oxoid CM559 + SR103) and incubated at 37 degrees C for 48 +/- 2 h. Colonies that clearly showed pyocyanin production or met other identification criteria were considered P. aeruginosa. Of the amenities examined 4/13 hydrotherapy pools (30.8%), 37/51 Jacuzzis/spas (72.5%) and 26/68 swimming pools (38.2%) were positive for P. aeruginosa. The most heavily contaminated amenity category was the Jacuzzi/spa, where 34.7% and 12% of private and public sites respectively were positive for P. aeruginosa at a level of greater than 1,000 cfu 100 ml-1. Approximately twice as many samples were positive in private Jacuzzis/spas compared to publicly operated facilities. There was a similar trend with respect to public and private hydrotherapy pools, though bacterial counts did not exceed 1,000 cfu 100 ml-1. Recreational and therapeutic amenities involving the use of water may be a potential source of P. aeruginosa for susceptible patient groups, including patients with cystic fibrosis and bronchiectasis. This may vary depending on amenity type and public/private ownership of such amenities.

Humans↗
PubMed1999

Hydrotherapy use during labor: an integrative review.

Hydrotherapy is an effective, alternative intervention that can be used by care providers to provide a nonpharmacological method to assist low risk, laboring women cope with labor. This article provides a synthesis of the state of the science on the effects of hydrotherapy with labor and delivery. The indications, physiologic mechanism, benefits, practice implications, and needed research are discussed. The data-based articles support numerous benefits such as increased relaxation, increased satisfaction, lower blood pressure, and increased diuresis with women who bathe during labor. These studies found that there was no difference in maternal and neonatal morbidity such as infections between bathers and nonbathers. Additionally, there was no difference in maternal and neonatal infection rates between women with intact or ruptured membranes. The use of hydrotherapy during established labor increases cervical dilation while bathing although there is no difference in the total length of labor between bathers and nonbathers. Researchers conclude that hydrotherapy is a safe, nonpharmacological alternative for women to use during labor and delivery.

Journal Article↗
PubMed2003

Implementation of the Vienna Hydrotherapy Group for Laryngectomees--a pilot study.

GOALS: Laryngectomy involves several problems for the individual, such as the need to cope with a stoma, adjustment to tracheostomal breathing, and the formation of a voice. Contact with water, resulting in aspiration, may prove fatal for laryngectomized patients in the absence of appropriate aids. The aim of this pilot study was to conduct a hydrotherapy group for laryngectomized patients and to evaluate its feasibility and outcome in relation to the goals of therapy. PATIENTS AND METHODS: Six male patients who had undergone laryngectomy were included in a pilot study. The patients underwent a structured hydrotherapy rehabilitation program (three times a week for 8 weeks), using a special underwater therapy device. The patients' posture was controlled by posturography and their endurance capacity by standard ergometry and the 6-min walk. The parameters of fatigue, expectoration, mobility, elasticity/flexibility, postural control/coordination, and general well being were registered on a visual analog scale (VAS). Quality of life was assessed by having the patients fill out the German version of the SF-36 Health Survey. MAIN RESULTS: Posturograpy findings showed an improvement of two subtests ( p<0.028). Exercise testing showed an improved endurance capacity ( p<0.028). The patients were able to walk a greater distance in the 6-min walking test ( p<0.028). The VAS also showed an improvement of endurance capacity ( p<0.028), fatigue ( p<0.028), expectoration ( p<0.043), mobility of the neck and shoulder ( p<0.027), flexibility ( p<0.027), postural control and coordination ( p<0.028), and general well being ( p<0.028). On the SF-36 Health Survey, the patients were improved in the items "Physical functioning" ( p<0.027), "Vitality" ( p<0.027) "Role-physical" ( p<0.026), and "Social functioning" ( p<0.043). CONCLUSIONS: A hydrotherapy group for laryngectomized patients proved to be safe, feasible, and effective in this pilot study.

Activities of Daily Living↗
PubMed1995

Bilateral amputations following hydrotherapy tank burns in a paraplegic patient.

Hydrotherapy is an important part of wound care and physical therapy. The benefits of hydrotherapy are derived from water's cleansing ability, buoyancy, drag, inertia and temperature. If the temperature of the water is not adequately controlled, an immersion scald burn can occur. A paraplegic patient who was receiving hydrotherapy for treatment of his malleolar ulcers sustained immersion scald burns that ultimately necessitated below-the-knee amputations.

Adult↗
PubMed2001

Prolonged intermittent hydrotherapy and early tangential excision in the treatment of an extensive strong alkali burn.

It is well known that the first step in the treatment of cutaneous strong alkali burn is very early and persistent washing of the site of injury with large volumes of water. However, ideal duration and the technique of hydrotherapy has not yet been established. Besides hydrotherapy, tangential excision of the injured skin might prevent further tissue damage if it is performed early enough. We report the treatment of a 36-year-old male who sustained 53% body surface area (BSA) cutaneous burn due to caustic soda (NaOH). Prolonged intermittent hydrotherapy, early tangential excision and autografting of the injured skin are the keys for the proper management of extensive strong alkali burn.

Accidents, Occupational↗