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HYDROTHERAPY POOL DESIGN ,TECHNIQUES IN CURRENT USE & SPECIALIZED EQUIPMENTS. Sekar.L. GENERAL INFORMATION & OUTLINE OF MAJOR POINTS ABOUT HYDROTHERAPY POOL DESIGN. The main factors for consideration are;
HYDROTHERAPY POOL DESIGN ,TECHNIQUES IN CURRENT USE & SPECIALIZED EQUIPMENTS Sekar.L
GENERAL INFORMATION & OUTLINE OF MAJOR POINTS ABOUT HYDROTHERAPY POOL DESIGN • The main factors for consideration are; • 1. POOL DESIGN & DIMENSION – BELOW GROUND ideally. It should be large enough for the users to carry out a full rehabilitation program. In practice pools no smaller than 9.25m (30 feet) by 4.57m (15 feet). Approximately for 8 people to carry out their activities.
2. TYPE, SHAPE, SIZE, DEPTH, FLOOR & ENTRY – The shape of pool should be simple – most common shape is RECTANGLE. • It is suggested that a depth that varies between 0.84 m & 1.42 m is ideal. (Person’s lower end of sternum to shoulder height.) • The pool floors may be stepped or sloping & it is most satisfactory. • The entry to pool can be by several methods. They are; • a) Steps – at the shallow end • b) Ramps – mainly for wheelchair users • c) Hoists – Mechanical, Hydraulic & electrical (can be fitted with a stretcher, a seat or both) • d) Over the side
3. TEMPERATURE & VENTILATION – When considering water temperature, the things to bear in mind are the type & severity of the exercise in addition to the duration of activity. • In tropical & sub-tropical climates the pool temperature might range between 34-35˚C (92.6-98.6˚F) in winter & 31-33˚C (87.4-92˚F) in summer. • In general to cover for all condition & to avoid any adverse effect, the following temperature guidelines is used; 32-34 or 35˚C (89.6-93.2 or 95˚F). • The air temperature of the pool area is usually kept at 25˚C & the changing rooms 4˚C lower. • Ventilation should ensure that excessive condensation does not build up & that humidity is maintained at 50%.
4. EQUIPMENT – It involves both in pool – fixed & movable - & external equipment items. (Handrails are fixed in-pool) • Underwater jetsare installed in some pools to provide a massaging effect & for resistance to movement, thus improving strength & endurance. • The inlet for the water to the pool needs to be sited at the deep end & the flow should be slow & gentle. • Other equipment items, such as parallel bars, stools, seats & plinths should be movable, not permanently fixed. • Floats of all types(Rings, Toys, Kickboards, Balls, Bats & Flippers) can be moved from the bath side at the end of the day & horsed down & stored on hooks wooden slatted shelves.
5. LIGHTING – The pool area needs to be well lit. (Refraction & Reflection must be taken into account) • 6. FACILITIES – It comprise; • a) Changing areas • b) Showers • c) Resting space • d) Toilets • Additional facilities include; • a) Office area for staff • b) Rooms for drying linen & clothing • c) Plant room & storage space for equipment & chemicals
7. SURFACES – Both those in the pool, those around the pool & in facilities need to be NON-SLIP, NON-ABRASIVE & EASILY CLEANED. • In the pool specially manufactured tiles with non-slip surfaces should be used on the floor. • 8. NOISE FACTORS – It tend to be NOISY where much activity, laughter, shouting & splashing inevitably occur. When designing & constructing a pool ACOUSTIC MATERIALS should be used for the walls & the ceiling of the pool area.
9. STAFFING / CARE & MAINTENANCE – PT, Assistants, cleaning & maintenance staff. (Generally PT’s are given an over all management role) • 11. SAFETY & EMERGENCY EQUIPMENT – All staff must be fully aware of use of CPR skills. • Test the water for residual chlorine content & PH value. • A full bacteriological analysis of the water should be carried out every 2 – 4 weeks. • 12.COSTS & COSTING – The costs of constructing, equipping, maintaining & running a hydrotherapy pool are high.
TECHNIQUES IN CURRENT USE • Treatment schools of Thought, These include; • 1. BAD RAGAZ RING METHOD (BRRM) • 2. HALLIWICK METHOD • 3. WATSU
1. BAD RAGAZ RING METHOD (BRRM) • It is a collection of therapeutic techniques performed in the water. • It use specific movement (Unilateral / Bilateral) patterns of arm, leg & trunk for MUSCLE RE-EDUCATION, STRENGTHENING, SPINAL TRACTION/ELONGATION, RELAXATION, RANGE OF MOTION & TONE INHIBITION in the water. • These patterns may encourage ISOTONIC or ISOMETRIC muscle contractions. • This was principally designed to treat a variety of MUSCULOSKELETAL MOVEMENT DIORDERS.
2. HALLIWICK METHOD • This method is based on principles of HYDRODYNAMICS & BODY MECHANICS, safe for people for all ages, with any disability & of any severity. (It is a NEUROTHERAPEUTIC FACILITATION REHABILITATION TECHNIQUE) • PT’s use activities to FACILITATE (ASSIST) MOVEMENT PATTERNS by varying the activities level of difficulty & the amount of manual guidance provided.
3. WATSU • WATSU was created as a massage or wellness technique that was not necessarily designed for patients as they are classically defined. • The aquatic rehabilitation therapists have applied the approach to clients with a variety of neuromuscular & musculoskeletal disorders. • One of the most beneficial results of WATSU is effective stretching. • WATSU can be best described as a muscle reeducation approach
SPECIALIZED EQUIPMENTS • 1. FLOTATION DEVICES:- • For central trunk flotation – NEO-PRENE VESTS & FOAM WAIST-BELTS are most commonly used. • Bad Ragaz techniques use FOAM RINGS that are placed around arms & legs or under head. • Other devices are; • a) Kick boards • b) Leg floats • c) Vinyl foam flexible buoys
2. RESISTIVE DEVICES:- • a) Finned dumbbells • b) Finned boots • c) Kick boards • d) Flotation devices