Therapeutic Aquatics

Water has been a useful and enticing medium for relaxation and healing for centuries. There is documentation that the Hindus used water to combat fever as early as 1500 BC. Throughout history, the use of water has vacillated between passive use, such as drinking and sitting in it, to therapeutic use in treatment modalities, such as whirlpool baths and underwater exercises by the early 1900s.

Simon Baruch, MD, was one of the first Americans to devote his life to the research of hydrotherapy and was later the first professor and chair of hydrotherapy at Columbia University in New York, N.Y. His classic books, An Epitome of Hydrotherapy, The Uses of Water in Modern Medicine and The Principles and Practice of Hydrotherapy, all published in the late 1800s, represent some of the first discussions of the use of water in medicine.

Water is used routinely for healing, fitness, and well-being in health care today. When a problem-based approach is used, what I like to call, the Neuro-Developmental Treatment (NDT) approach, the options in therapeutic aquatics are endless! To do this, one must understand the physical properties of water and how they affect the human body when it is in water. There must be a clear examination and evaluation of the client, both from a land-based as well as a water-based perspective. Functional goals of the client and/or family must be identified for a structured treatment sequence; keeping in mind that water can lessen or increase the amount of muscular and cardiac work of the client. This is where the therapist must have a clear understanding of how to use water effectively. The functional goals can be based on function in gravity, on land; or function in the environment of the pool, where gravity is lessened and the force of buoyancy can be used to advantage.