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At least 19 recordsLinked to original sources
PubMed2005

Is hydrotherapy cost-effective? A randomised controlled trial of combined hydrotherapy programmes compared with physiotherapy land techniques in children with juvenile idiopathic arthritis.

OBJECTIVES: To compare the effects of combined hydrotherapy and land-based physiotherapy (combined) with land-based physiotherapy only (land) on cost, health-related quality of life (HRQoL) and outcome of disease in children with juvenile idiopathic arthritis (JIA). Also to determine the cost-effectiveness of combined hydrotherapy and land-based physiotherapy in JIA. DESIGN: A multicentre randomised controlled, partially blinded trial was designed with 100 patients in a control arm receiving land-based physiotherapy only (land group) and 100 patients in an intervention arm receiving a combination of hydrotherapy and land-based physiotherapy (combined group). SETTING: Three tertiary centres in the UK. PARTICIPANTS: Patients aged 4-19 years diagnosed more than 3 months with idiopathic arthritides, onset before their 16th birthday, stable on medication with at least one active joint. INTERVENTIONS: Patients in the combined and land groups received 16 1-hour treatment sessions over 2 weeks followed by local physiotherapy attendances for 2 months. MAIN OUTCOME MEASURES: Disease improvement defined as a decrease of > or =30% in any three of six core set variables without there being a 30% increase in more than one of the remaining three variables was used as the primary outcome measure and assessed at 2 months following completion of intervention. Health services resource use (in- and outpatient care, GP visits, drugs, interventions, and investigations) and productivity costs (parents' time away from paid work) were collected at 6 months follow-up. HRQoL was measured at baseline and 2 and 6 months following intervention using the EQ-5D, and quality-adjusted life-years (QALYs) were calculated. Secondary outcome measures at 2 and 6 months included cardiovascular fitness, pain, isometric muscle strength and patient satisfaction. RESULTS: Seventy-eight patients were recruited into the trial and received treatment. Two months after intervention 47% patients in the combined group and 61% patients in the land group had improved disease with 11 and 5% with worsened disease, respectively. The analysis showed no significant differences in mean costs and QALYs between the two groups. The combined group had slightly lower mean costs (-6.91 pounds Sterling) and lower mean QALYs (-0.0478, 95% confidence interval -0.11294 to 0.0163 based on 1000 bootstrap replications). All secondary measures demonstrated a mean improvement in both groups, with the combined group showing greater improvements in physical aspects of HRQoL and cardiovascular fitness. CONCLUSIONS: JIA is a disease in which a cure is not available. This research demonstrates a beneficial effect from both combined hydrotherapy and land-based physiotherapy treatment and land-based physiotherapy treatment alone in JIA without any exacerbation of disease, indicating that treatments are safe. The caveat to the results of the cost-effectiveness and clinical efficacy analysis is that the restricted sample size could have prevented a true difference being detected between the groups. Nevertheless, there appears to be no evidence to justify the costs of building pools or initiating new services specifically for use in this disease. However, this conclusion may not apply to patients with unremitting active disease who could not be entered into the trial because of specified exclusion criteria. For this group, hydrotherapy or combined treatment may still be the only physiotherapy option. Further research is suggested into: the investigation and development of appropriate and sensitive outcome measures for use in future hydrotherapy and physiotherapy trials of JIA; preliminary studies of methodologies in complex interventions such as physiotherapy and hydrotherapy to improve recruitment and ensure protocol is acceptable to patients and carers; hydrotherapy in the most common paediatric user group, children with neurological dysfunction, ensuring appropriate outcome measures are available and methodologies previously tried; patient satisfaction and compliance in land-based physiotherapy and hydrotherapy and European studies of hydrotherapy in rare disorders such as JIA.

Adolescent↗
PubMed2003

Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme.

OBJECTIVE: To compare the effects of a hydrotherapy resistance exercise programme with a gym based resistance exercise programme on strength and function in the treatment of osteoarthritis (OA). DESIGN: Single blind, three arm, randomised controlled trial. SUBJECTS: 105 community living participants aged 50 years and over with clinical OA of the hip or knee. METHODS: Participants were randomised into one of three groups: hydrotherapy (n = 35), gym (n = 35), or control (n = 35). The two exercising groups had three exercise sessions a week for six weeks. At six weeks an independent physiotherapist unaware of the treatment allocation performed all outcome assessments (muscle strength dynamometry, six minute walk test, WOMAC OA Index, total drugs, SF-12 quality of life, Adelaide Activities Profile, and the Arthritis Self-Efficacy Scale). RESULTS: In the gym group both left and right quadriceps significantly increased in strength compared with the control group, and right quadriceps strength was also significantly better than in the hydrotherapy group. The hydrotherapy group increased left quadriceps strength only at follow up, and this was significantly different from the control group. The hydrotherapy group was significantly different from the control group for distance walked and the physical component of the SF-12. The gym group was significantly different from the control group for walk speed and self efficacy satisfaction. Compliance rates were similar for both exercise groups, with 84% of hydrotherapy and 75% of gym sessions attended. There were no differences in drug use between groups over the study period. CONCLUSION: Functional gains were achieved with both exercise programmes compared with the control group.

Aged↗
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↗
PubMedDate not supplied

Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip.

OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of electro-acupuncture (EA) and hydrotherapy, both in combination with patient education or with patient education alone, in the treatment of osteoarthritis in the hip. METHODS: Forty-five patients, aged 42-86 years, with radiographic changes consistent with osteoarthritis in the hip, pain related to motion, pain on load, and ache were chosen. They were randomly allocated to EA, hydrotherapy, both in combination with patient education, or patient education alone. Outcome measures were the disability rating index (DRI), global self-rating index (GSI), and visual analogue scale (VAS). Assessments were done before the intervention and immediately after the last treatment and 1, 3, and 6 months after the last treatment. RESULTS: Pain related to motion and pain on load was reduced up to 3 months after last the treatment in the hydrotherapy group and up to 6 months in the EA group. Ache during the day was significantly improved in both the EA and hydrotherapy group up to 3 months after the last treatment. Ache during the night was reduced in the hydrotherapy group up to 3 months after the last treatment and in the EA group up to 6 months after. Disability in functional activities was improved in EA and hydrotherapy groups up to 6 months after the last treatment. Quality of life was also improved in EA and hydrotherapy groups up to 3 months after the last treatment. There were no changes in the education group alone. DISCUSSION: In conclusion, EA and hydrotherapy, both in combination with patient education, induce long-lasting effects, shown by reduced pain and ache and by increased functional activity and quality of life, as demonstrated by differences in the pre- and post-treatment assessments.

Adult↗
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↗
PubMed2004

Retrograde commercial colonic hydrotherapy.

OBJECTIVE: To ascertain the current practice of commercial colonic hydrotherapy in the UK and to collect data on the profiles of both the practitioners and their clients. In addition to understand how colonic hydrotherapy is perceived by those who use it and how much economic benefit it generates for the practitioners. Information as to training and complications was sought. PATIENTS AND METHODS: A questionnaire was sent to all 80 practitioners registered with the Association of Colonic Hydrotherapists (ACH) of the UK. The practitioners who responded were sent 10 questionnaires to be given to a group of consecutive clients. This client questionnaire included an SF-36 self-administered scoring system and a satisfaction survey. To understand the methodology and ritual of the hydrotherapy procedure a field trip was arranged and two of the authors (NJT and PJM) underwent one colonic hydrotherapy session with an experience practitioner. RESULTS: Thirty-eight (48%) of practitioners responded to our practitioner survey and 242 client questionnaires were returned. One third of practitioners reported a previous clinical background and 32 (83%) were single-handed practitioners. The average time in practice was six years and with an average age of the hydrotherapists being 50 years (22-78 years). Estimated number of sessions conducted were 3200 (range 140-10 000). Average annual income before expenses per practitioner was estimated at pound 45 675. The clients' ages ranged was 18 and 82 years of age (mean 44 years) and had undergone an average of 35 hydrotherapy treatments (range 1-2500). Clients had lower SF-36 scores than the UK norm. CONCLUSION: Colonic hydrotherapy is practised widely in the UK with an estimated 5600 procedures carried out by ACH practitioners monthly. It is not known how much activity is carried out by non-ACH members. ACH practitioners appear to be well trained and a proportion have medical backgrounds. Clients, who are often unhappy with orthodox medicine seem satisfied enough with the experience of colonic hydrotherapy to undergo regular purgings. No serious side-effects have been reported to us. Economic factors could be a driving force for the continuation of the practice as the monies earnt are not inconsiderable.

Adolescent↗
PubMed2003

Thermal hydrotherapy improves quality of life and hemodynamic function in patients with chronic heart failure.

BACKGROUND: Chronic heart failure is characterized by increased peripheral vascular resistance and reduced peripheral perfusion due to adrenergic and renin angiotensin activation and impaired endothelial function. Recent studies have shown that nonpharmacological peripheral vasodilation with thermal therapy by means of warm-water baths and sauna has beneficial effects in chronic heart failure. European hydrotherapy (according to Kneipp) additionally uses short cold water stimuli, which lead to prolonged vasodilation and adaptive responses. Studies on the efficacy of hydrotherapy in chronic heart failure are lacking. METHODS: We studied 15 patients (5 men, 10 women, mean (+/- SD) age 64.3 +/- 1.8 years) with mild chronic heart failure (NYHA functional class II to III, ejection fraction 30%-40%). Patients were randomly assigned to 6 weeks of intensive home-based hydrotherapy or 6 weeks restriction in a crossover intervention trial. Quality of life and heart-failure--related symptoms were assessed by means of a validated questionnaire (PLC). Graded bicycle exercise test with incremental workloads (0, 50, 75, 100 watts) was performed at the end of each treatment period. The hydrotherapeutic program consisted of a structured combination of daily home-based external warm- and cold-water applications. RESULTS: Baseline characteristics were balanced between the groups. With hydrotherapy, a significant (P < or =.05) improvement in 3 of 6 dimensions of quality of life (mood, physical capacity, enjoyment) and a significant reduction in heart-failure-related symptoms was found. Heart rates at rest and at 50-Watt workload were significantly reduced by hydrotherapy; blood pressure decreased nonsignificantly at rest and during exercise. The hydrotherapeutic treatment was well accepted and no relevant adverse effects were observed. CONCLUSIONS: A home-based hydrotherapeutic thermal treatment program improves quality of life, heart-failure-related symptoms and heart rate response to exercise in patients with mild chronic heart failure. The results of this investigation suggest a beneficial adaptive response to repeated brief cold stimuli in addition to enhanced peripheral perfusion due to thermal hydrotherapy in patients with chronic heart failure.

Aged↗
PubMed2004

The use of hydrotherapy for the management of spasticity.

INTRODUCTION: Spasticity is a major problem for the rehabilitation team. Physiotherapy is a vital component of therapy. Oral medication and other modalities such as heat, cold, ultrasound, electrical stimulation, and surgery (neuro-surgical or orthopedic) can also be used. The aim of this study was to compare the effects of hydrotherapy on spasticity and Functional Independence Measure (FIM) scores of patients with spinal cord injury (SCI). MATERIALS AND METHODS: This is a control case matched study. Twenty SCI patients were divided into 2 groups and matched for age, gender, injury time, Ashworth scores, oral baclofen intake, American Spinal Injury Association, and FIM scores. The control group received passive range of motion exercise twice a day and oral baclofen for 10 weeks. The study group also received passive range of motion and oral baclofen, as well as 20 min of water exercises (at 71 degrees F, full immersion) 3 times per week. The authors evaluated spasm severity, FIM scores, oral baclofen intake, and Ashworth scales, between groups at the beginning and at the end of the treatment period. RESULTS: Both groups demonstrated a significant increase in FIM scores. However, the hydrotherapy group demonstrated a larger increase (P < 0.0001) than the control group. There was a statistically significant decrease in oral baclofen intake in the hydrotherapy group (P < 0.01). There was no statistical change in the control group. Spasticity was evaluated by the Ashworth scale. There was a statistical improvement in each group (P < 0.01, P < 0.02). However, when compared to the control group, the use of hydrotherapy produced a significant decrease in spasm severity (P < 0.02). CONCLUSION: Side effects are often seen when using oral drug treatment for spasticity. Adding hydrotherapy to the rehabilitation program can be helpful in decreasing the amount of medication required. Future studies must evaluate benefits of hydrotherapy for rehabilitation.

Activities of Daily Living↗
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↗