Can Aquatic Therapy Help Older Adults?
Treating water as a therapeutic tool for better mobility and overall health
In 1948, Italian immigrant Candido Jacuzzi's young son had severe rheumatoid arthritis, and doctors told the boy's father that water therapy could help. Jacuzzi's family were inventors in agriculture and aviation, and Jacuzzi began to look at creating a pump that could be submerged in water and help ease his child's pain.
People have used water therapy to lower stress and relieve pain for centuries.
It was a success, and the company started to sell the product to medical supply stores and pharmacies. By 1956, the company's engineers had developed a home version that consumers could use.
Seventy-five years after Jacuzzi sought relief for his son, the brand is still strong. Although the Jacuzzi tub is a well-known brand name and a pioneer for hydro massage and whirlpool baths, people have used water therapy to lower stress and relieve pain for centuries.
Hot springs were popular gathering spots for many ancient cultures, and Romans piped in hot water to pools in city centers.
Water Is Good Medicine
Aquatic therapy, or water use for therapy or rehabilitation purposes, is considered reliable for helping people with many issues. This can include swimming pools, hydromassage tubs, or other bodies of water.
And exercises can easily be adapted, if certainly not limited, to the confines of a private hydromassage tub.
There are two types of aquatic therapy. Hydrostatic pressure uses water force to support the body, help with balance, and even reduce inflammation and swelling. On the other hand, water turbulence, or water movement, can increase resistance.
Both types of therapy have been used for centuries to treat various conditions, from injuries and illnesses to chronic pain and mobility problems.
Aquatic therapy might combine exercise, movement, or stretching underwater, as the water's buoyancy helps reduce resistance, increase strength and relieve joint strain or pain. This can significantly help older adults with mobility limitations or other conditions inhibiting pain-free movement.
"[Aquatic therapy] can be especially beneficial for older adults with arthritis or who are overweight since the buoyancy of the water helps support the weight of the person on the injured body part," says Elizabeth Matzkin, chief of women's sports medicine at Mass General Brigham in Boston, Massachusetts.
Aquatic exercise can improve depression, self-esteem, and provide similar health benefits as other forms of exercise.
She adds, "The water also decreases the stress across joints which will make the exercises and therapy less painful. Exercising in waist deep water can reduce body weight by 50% and exercising in shoulder deep water can reduce body weight by 90%."
"I am not certain that the basic principles of aquatic therapy have changed over the years but the benefits from both a physical and psychological standpoint are better recognized," says Matzkin.
"The benefits of aquatic therapy for patients with more chronic conditions such as arthritis, multiple sclerosis, cerebral palsy, muscle spasticity, and long term recovery from orthopedic procedures can be multi-factorial – especially if unable to exercise on land."
"Aquatic exercise can improve depression/mood, self-esteem/body image and provide similar health benefits as other forms of exercise," Matzkin says.
Aquatic Therapy and Multiple Sclerosis
A recent (but limited) systematic review and meta-analysis pointed to aquatic therapy as a valuable part of occupational therapy for patients with multiple sclerosis (MS).
Water helps support body weight, reducing stress on joints and allowing better flexibility while strengthening muscles. It also indicated an improvement in balance, one of the most challenging and potentially dangerous symptoms of MS.
Heat intolerance is common in people with MS. Dr. Brandon Shaw and his colleagues noted in the study that aquatic therapy helped MS patients manage core body temperature and lower heat from exercise.
Water therapy in temperature-controlled pools could improve the clinical outcomes of MS patients. It might also offer an enjoyable outlet encouraging patients to stick to treatment schedules.
Other Therapeutic Uses
Some other physical conditions that can be treated with aquatic therapy are:
- Sports-related injuries
- Mobility issues resulting from stroke
- Obesity
- Arthritis
- Lymphedema
- Traumatic brain injury
- Spinal cord issues
- Fibromyalgia
- Post-surgery healing
- Muscle injury or pain
"Patients that are unable to support their full body weight due to an injury will benefit most from aquatic therapy," says Matzkin. "Patients are still able to perform exercises for range of motion and strengthening while limiting the weight and stress on the healing muscles or bones."
Aquatic therapy is increasingly recognized as a valuable part of therapy for veterans and others living with Post Traumatic Stress Disorder (PTSD). PTSD can occur from the experience of traumatic events.
Recently a San Diego-based non-profit, Healing Wave Aquatics, opened the first-of-its-kind facility that offers aquatic therapy to treat PTSD for military members and veterans at no cost.
Patients that are unable to support their full body weight due to an injury will benefit most from aquatic therapy.
Some aquatic therapy equipment that might be included in a treatment program include:
- Pool balls: Often used to improve core stability and help with balance.
- Water bikes and gyms: Underwater bicycles strengthen muscles and provide resistance to the pedaling movement. Other aquatic gym equipment helps the patient exercise by rowing, stair climbing, or underwater leg pressing.
- Floats: Floating equipment like pool noodles or float boards helps patients safely move around in the water while stretching, and doing range-of-motion exercises or other treatments.
- Furniture. Pool lifts, access chairs, walkers, and other specially designed furniture aid in the transfer and comfort of a patient while moving in and out of, or performing, aquatic therapy.
Necessary Precautions
Matzkin cautions that individuals being treated for medical conditions should be under the guidance of a health care professional. "They can learn the program and then perform many of the exercises on their own," Matzkin says.
"Certain exercises may need to be avoided depending on the injury or post-operative condition being treated," she explains. Patients should continuously be monitored during aquatic therapy to avoid drowning, passing out from the warm water and exercise, infection, or slipping or falling getting in and out of the pool area.
"Please let health care providers know if you are not a comfortable swimmer, have an active infection, or bowel or bladder incontinence. Some patients with cardiac disease may be better off avoiding aquatic therapy," says Matzkin. "Speak to your physicians before beginning a program."
