Impacto da fisioterapia aquática em UTIN sobre a mobilidade diafragmática avaliada por ultrassonografia cinesiológica: ensaio clínico / Impact of Aquatic Therapy in the NICU on diaphragmatic mobility assessed by ultrasound: clinical trial

INTRODUÇÃO: A fisioterapia aquática é uma modalidade de hidroterapia realizada em recém-nascidos (RN) nas Unidades de Terapia Intensiva Neonatal (UTIN). Os efeitos sobre nível de dor, estado comportamental e função respiratória já são conhecidos, porém pouco se refere aos efeitos sobre a função diafragmática na população recém-nascida a termo prematura. OBJETIVO: Avaliar o efeito da fisioterapia aquática sobre a amplitude diafragmática por meio da ultrassonografia cinesiológica diafragmática (USCD) em RNs internados em UTIN, bem como a segurança de sua realização quanto a estabilidade clínica dos RNs, estado comportamental, dor e desconforto respiratório. MÉTODOS: Ensaio clínico tipo antes e depois, de caráter transversal. Os RNs participantes do estudo receberam uma única intervenção com fisioterapia aquática durante 10 minutos. Foi realizada a avaliação utilizando a USCD antes e depois da sessão, e anotado as frequências cardíaca e respiratória, estado comportamental, dor e desconforto respiratório. RESULTADOS: Participaram 26 RNs. Observou-se aumento significativo da amplitude diafragmática (p= 0,02) e da saturação periférica de oxigênio (p= 0,05); os parâmetros fisiológicos permaneceram nos limites da normalidade e a intervenção não provocou desorganização comportamental, dor ou desconforto respiratório aos RNs. CONCLUSÃO: A fisioterapia aquática promoveu aumento da amplitude diafragmática, sugerindo que esta técnica pode ser utilizada como forma de estimular a contração da musculatura respiratória em RN, além de se mostrar uma técnica segura, pois não gerou instabilidade clínica, desorganização comportamental, dor ou desconforto respiratório aos participantes.

INTRODUCTION: Aquatic physiotherapy is a modality of hydrotherapy performed on newborn babies (NB) in the Neonatal Intensive Care Unit (NICU). The effects on pain levels, behavior, and respiratory function are already known; however, little has been said about the effects on diaphragmatic function in the preterm newborn population. OBJECTIVE: To evaluate the effect of aquatic physiotherapy on diaphragmatic amplitude using diaphragmatic kinesiologic ultrasound (DKUS) in NBs admitted to a NICU, as well as the safety regarding the clinical stability of the NBs, behavioral state, pain, and respiratory distress. METHODS: Crosssectional before-and-after clinical trial. The NBs participating in the study received a single intervention with aquatic physiotherapy for 10 minutes. An assessment was performed using the USCD before and after the session, and heart and respiratory rates, behavioral state, pain, and respiratory discomfort were recorded. RESULTS: Twenty-six NBs participated. There was a significant increase in diaphragmatic amplitude (p= 0.02) and peripheral oxygen saturation (p= 0.05); physiological parameters remained within normal limits, and the intervention did not cause behavioral disorganization, pain, or respiratory discomfort in NBs. CONCLUSION: Aquatic physiotherapy promoted an increase in diaphragmatic amplitude, suggesting that this technique can be used as a way to stimulate the contraction of the respiratory muscles in NB, in addition to being a safe technique, as it did not generate clinical instability, behavioral disorganization, pain, or respiratory discomfort to the participants.

Efectividad de la Terapia Acuática en la Función Motora Gruesa en Población Infantojuvenil con Parálisis Cerebral. Una Revisión Narrativa / Effectiveness of Aquatic Therapy on Gross Motor Function in Children and Young People with Cerebral Palsy. A Narrative Review

Introducción. La parálisis cerebral (PC) es una de las principales causas de discapacidad en la población infantil, afectando diversas áreas del desarrollo como la función motora gruesa; equilibrio y marcha. Hay evidencia de los beneficios de la terapia acuática y de cómo puede complementar la rehabilitación. Objetivo. Describir la efectividad de las intervenciones acuáticas en personas con PC, determinar mejoras en la función motora gruesa uso de métodos, protocolos y dosificación. Métodos. Se analizaron 9 estudios aleatorizados controlados desde el 2012 a la fecha, seleccionados por un experto y cuyos sujetos tenían PC espástica, Gross Motor Function Classification System (GMFCS) I a IV, entre los 2 y 20 años. Post intervención acuática se reportan mejoras significativas en el promedio de los ítems medidos por Gross motor function measure (GMFM). De los métodos que contribuyeron a mejoras se encuentra Halliwick y ejercicios acuáticos sin un programa específico. Resultados. Se obtuvieron mejoras de 35 a 100 minutos, y de 12 a 30 sesiones en total. No se logra concluir el tipo de terapia más efectiva, ya que las medidas de resultado y las características de los sujetos eran diversas. Conclusión. Una dosificación mínima de 2 veces por semana, 35 minutos de intervención en un total de 16 sesiones (9,3 horas en total) pareciera mejorar la función motora gruesa, cuyos resultados son transferibles a las actividades en tierra inmediatamente, sin embargo, no se obtiene información si se mantienen a mediano o largo plazo.

Background. Cerebral palsy (CP) is one of the main causes of disability in the child population, affecting various areas of development such as gross motor function; balance and gait. There is evidence of the benefits of aquatic therapy and how it can complement rehabilitation. Objective. to describe the effectiveness of aquatic interventions in people with CP, to determine improvements in gross motor function using methods, protocols, and dosage. Methods. Nine randomized controlled studies were analyzed from 2012 to date, selected by an expert and whose subjects had spastic CP, Gross Motor Function Classification System (GMFCS) I to IV, between 2 and 20 years of age. Results. After the aquatic intervention, significant improvements were reported in the average of the Gross motor function measure (GMFM) items measured. Of the methods that contributed to improvements, there is Halliwick and aquatic exercises without a specific program. Results. Improvements were obtained from 35 to 100 minutes, and from 12 to 30 sessions in total. It is not possible to conclude the most effective type of therapy, since the outcome measures and the characteristics of the subjects were diverse. Conclusion. A minimum dosage of 2 times per week, 35 minutes of intervention in a total of 16 sessions (9.3 hours in total) seems to improve gross motor function, the results of which are immediately transferable to activities on land, however, it is not obtains information if they are maintained in the medium or long term.

Aquatic exercises in the knee injury rehabilitation of athletes / Exercícios aquáticos na reabilitação das lesões nos joelhos de atletas / Ejercicios acuáticos en la rehabilitación de lesiones de rodilla en deportistas

ABSTRACT Introduction: Volleyball requires jumping and strenuous movements and certain sports injuries inevitably occur during the sport. The surface of the knee joint is considerably large and shallow, making the lever effect strong and negative, easily targeted for injury in the unstable movements caused by this sport. Objective: Investigate the main causes of knee joint injuries in volleyball players and evaluate the effect of treatment with intervention through aquatic therapy. Methods: Eight volleyball players from a university with different degrees of knee joint injury were randomly divided into an experimental group and a control group. The experimental group used intervention training with aquatic exercise therapy, while the control group did not include additional rehabilitation measures. The knee condition of the subjects before and after the experiment was analyzed and compared. Results: The knee joint injury in the subjects in the experimental group was significantly improved, and the recovery from the knee joint injury of the subjects in the experimental group was better than that of the subjects in the control group. Conclusion: Water sports therapy can significantly improve the knee joint injury of volleyball players, leading to the belief that water sports therapy can effectively improve the agility, strength, and endurance of muscles adjacent to knee joints in patients, reducing their pain, and increasing the range of motion of these joints. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O voleibol exige saltos e movimentos extenuantes sendo inevitável que certas lesões esportivas ocorram no decurso do esporte. A superfície da articulação do joelho é consideravelmente grande e pouco profunda, tornando o efeito de alavanca forte e negativo, facilmente alvo de lesões nos movimentos instáveis ocasionados por esse esporte. Objetivo: Investigar as principais causas das lesões da articulação do joelho nos jogadores de voleibol e avaliar o efeito do tratamento com intervenção através de terapia aquática. Métodos: Oito jogadores de voleibol de uma universidade, com diferentes graus de lesão articular do joelho, foram divididos aleatoriamente em um grupo experimental e um grupo controle. O grupo experimental utilizou treino de intervenção com terapia de exercício aquático, enquanto o grupo de controle não contemplou medidas de reabilitação adicionais. A condição do joelho dos indivíduos antes e depois da experiência foi analisada e comparada. Resultados: A lesão articular do joelho nos sujeitos do grupo experimental foi significativamente melhorada, e a recuperação da lesão articular do joelho dos sujeitos do grupo experimental foi melhor do que a dos sujeitos do grupo de controle. Conclusão: A terapia com esportes aquáticos pode melhorar significativamente a lesão da articulação do joelho dos jogadores de voleibol, levando a acreditar que a terapia com esportes aquáticos pode efetivamente melhorar a agilidade, força e resistência dos músculos adjacentes às articulações do joelho nos pacientes, reduzindo a sua dor, e aumentando a amplitude de movimento dessas articulações. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El voleibol requiere saltos y movimientos extenuantes y es inevitable que se produzcan ciertas lesiones deportivas en el transcurso del deporte. La superficie de la articulación de la rodilla es considerablemente grande y poco profunda, lo que hace que el efecto de palanca sea fuerte y negativo, siendo fácilmente objeto de lesiones en los movimientos inestables que provoca este deporte. Objetivo: Investigar las principales causas de las lesiones de la articulación de la rodilla en jugadores de voleibol y evaluar el efecto del tratamiento con intervención mediante terapia acuática. Métodos: Ocho jugadores de voleibol de una universidad, con diferentes grados de lesión en la articulación de la rodilla, fueron divididos aleatoriamente en un grupo experimental y un grupo de control. El grupo experimental utilizó un entrenamiento de intervención con terapia de ejercicios acuáticos, mientras que el grupo de control no contempló medidas adicionales de rehabilitación. Se analizó y comparó el estado de las rodillas de los sujetos antes y después del experimento. Resultados: La lesión de la articulación de la rodilla en los sujetos del grupo experimental mejoró significativamente, y la recuperación de la lesión de la articulación de la rodilla de los sujetos del grupo experimental fue mejor que la de los sujetos del grupo de control. Conclusión: La terapia de deportes acuáticos puede mejorar significativamente la lesión de la articulación de la rodilla de los jugadores de voleibol, lo que lleva a pensar que la terapia de deportes acuáticos puede mejorar eficazmente la agilidad, la fuerza y la resistencia de los músculos adyacentes a las articulaciones de la rodilla de los pacientes, reduciendo su dolor y aumentando la amplitud de movimiento de estas articulaciones. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effect Of Structured Exercise Regimen On Quality Of Life, Balance And Strength On A Patient With Miyoshi Myopathy – A Case Report

Background: Dysferlinopathy is an autosomal recessive disease seen in adolescence or young adulthood. Miyoshi Myopathy is characterized by weakness and wasting of posterior compartment leg muscles rather than the anterior compartment and distal upper limb muscles. Still, the intrinsic muscles of the foot and hands are spared. There are several undiagnosed cases in India and also around the world with dysferlinopathy. Diagnosis for the same requires advanced biological laboratories along with high economic funding for diagnostic purposes. Case Summary: This case report presents a 22-year-old male diagnosed with Miyoshi myopathy/LGMD2b (dysferlinopathy). The subject complained about a loss of balance, strength, and difficulty in performing activities of daily living. The patient was given Aquatic Therapy along with conventional physical therapy for a duration of 6weeks, which included three days of supervised therapy along with 3days home protocol and a rest day kept at the end of every week. Outcome Measures: Standardized scales like the Barthel Index and the Berg Balance Scale were used for the assessment of pre and post the progress of the subject for Quality of Life and Balance, respectively. Manual Muscle testing was used for assessments for pre and post muscle strength of the subject. Conclusion: The timely diagnosis of a rare condition before the advancement of the disorder and thus the use of appropriate intervention of physiotherapy, which consisted of progressive muscle-strengthening exercises along with balance training proved to be promising in preventing falls, muscle atrophy and thus making the patient independent for doing daily activities.

A Survey on the Current Working Conditions and Job Satisfaction on Aquatic Therapy Performed by Physical Therapists

PURPOSE: This study assessed the current working conditions and job satisfaction on aquatic therapy performed by physical therapists in South Korea. METHODS: A total of 139 (managers: 53, staff: 86) physical therapists participated in this survey (90 questionnaires) and the data were analyzed using the SPSS 21.0 Windows. RESULTS: The retention conditions of aquatic therapy facilitation was high in the rehabilitation centers (or disabled living facilities) and rehabilitation hospitals. On the other hand, there were regional variations. The physical therapists in this field were likely to have limitations or restrictions of professional aquatic therapy education. The subjects showed a tendency for a career interruption during their fifth working year. The overall job satisfaction on aquatic therapy of physical therapists was high (managers: 94.3%, staff: 95.3%, p=0.276), but the work intensity was higher than the other parts of physical therapy and the relative reward was comparatively low (managers: 60.3%, staff: 66.3%, p=0.865). CONCLUSION: Based on this study, the current working conditions regarding aquatic therapy by physical therapists were assessed. These results will help enhance aquatic therapy and/or in aquatic therapy facilitation.

Treinamento de classe em circuito em água versus terra em pacientes pós-acidente vascular cerebral: um protocolo para um estudo controlado randomizado / Circuit Class Training in water versus land in Post-Stroke patients: a protocol for a randomized controlled trial

INTRODUÇÃO: Uma alta porcentagem de pacientes pós-AVC tem consequências permanentes, apesar da reabilitação convencional. O treinamento em circuito oferece uma maneira eficiente de realizar a prática estruturada de atividades relacionadas à tarefa durante a reabilitação do AVC. A terapia aquática é outra abordagem terapêutica que oferece uma grande variedade de opções para ser um ambiente altamente dinâmico, o que ajuda a melhorar a funcionalidade e recuperar a qualidade de vida e a independência das pessoas com deficiência. OBJETIVO: Desenvolver um protocolo para um estudo controlado randomizado. MÉTODOS: Quarenta participantes serão randomizados em dois grupos: treinamento em classe de circuito aquático (ACCT) e treinamento em circuito de terra (LCCT). Em ambos os grupos, a intervenção será uma terapia de classe de 7 semanas, 3 vezes por semana, dando um total de 20 sessões, 60 minutos cada. Os avaliadores cegos conduzirão avaliações, utilizando ferramentas padronizadas: linha de base, pós-intervenção e 20 dias de acompanhamento para a eficácia da terapia em termos de marcha, equilíbrio e função motora do membro superior. RESULTADOS / CONCLUSÃO: Este estudo examinará o efeito imediato e de médio prazo de um programa ACCT em comparação com um programa LCCT em pessoas com AVC. Tem o potencial de identificar intervenções que possam melhorar a reabilitação desses pacientes. Ambos os programas do CCT são baseados no modelo da Classificação Internacional de Função, Incapacidade e Saúde, com atividades voltadas para os níveis de deficiência, atividade e participação. [AU]

INTRODUCTION: A high percentage of post-stroke patients have permanent aftermathsdespite conventional rehabilitation. Circuit class training offers an efficient way to achieve structured practice of task-related activities during stroke rehabilitation. Aquatic therapy is another therapeutic approach that offers a great variety of options to be a highly dynamic environment, which helps to improving functionality and recover quality of life and independence in people with disabilities. OBJECTIVE: To develop a protocol for a randomized controlled trial. METHODS: Forty participants will be randomized in two groups: aquatic circuit class training (ACCT) and land circuit class training (LCCT). In both groups, the intervention will be a 7-week class therapy, 3-times weekly, giving a total of 20 sessions, 60 minutes each. Blinded assessors will conduct assessments, using standardized tools: baseline, post-intervention, and 20 days follow-up for the effectiveness of the therapy in terms of gait, balance and upper limb motor function. RESULTS/CONCLUSION: This trial will examine the immediate and medium term effect of an ACCT program as compared to a LCCT program in people with stroke. It has the potential to identify interventions that may improve rehabilitation of these patients. Both CCT programs are based in International Classification of Function, Disability and Health model with activities aimed at impairment, activity and participation levels. [AU]

Efeitos da terapia aquática na força muscular respiratória em indivíduos com fibromialgia e suas repercussões na velhice / Effects of aquatic therapy on respiratory muscle strength in individuals with fibromyalgia and its repercussions on old age / Efectos de la terapia acuática en la fuerza muscular respiratoria en individuos con fibromialgia y sus repercusiones en la vejez

A pesquisa avaliou os efeitos da terapia aquática na força muscular respiratória em indivíduos com fibromialgia. Recebeu abordagem quanti-qualitativa do tipo quase experimental e a amostra foi composta por mulheres, algumas em meia-idade, com diagnóstico clínico de fibromialgia. Aplicou-se um protocolo de terapia aquática durante 10 semanas. Avaliaram-se o FIQ, manovacuometria e espirometria, que demonstraram resultados significativos e de extrema relevância para as mulheres, especialmente preparando-as para evitarem o agravamento dessa problemática após os 60 anos de idade.

The study evaluated the effects of aquatic therapy on respiratory muscle strength in individuals with fibromyalgia. It received a quasi-experimental quanti- qualitative approach and the sample was composed of women, some in middle age, with clinical diagnosis of fibromyalgia. A protocol of aquatic therapy was applied for 10 weeks. The FIQ, manovacuometry and spirometry were evaluated, which demonstrated significant and extremely relevant results for women, specially preparing them to avoid the aggravation of this problem after 60 years of age.

La investigación evaluó los efectos de la terapia acuática en la fuerza muscular respiratoria en individuos con fibromialgia. Recibió un abordaje cuan- titativo cualitativo del tipo casi experimental y la muestra fue compuesta por mujeres, algunas en mediana edad, con diagnóstico clínico de fibromialgia. Se aplicó un proto- colo de terapia acuática durante 10 semanas. Se evaluaron el FIQ, la manovacuometría y la espirometría, que demostraron resultados significativos y de extrema relevancia para las mujeres, especialmente preparándolas para evitar el agravamiento de esta problemática después de los 60 años de edad.

Advance of Aquatic Therapy for Autistic Children (review) / 中国康复理论与实践

The aquatic therapy is a part of comprehensive rehabilitation. Aquatic therapy may benefit the social interaction, stereotyp-ing and motor learning of children with autism, which may associate with the physical and mental mechanism. The programs applied for the autism include game in water, swimming, physical fitness training in water, etc. The assessment tools include scales and video, and so on.

Effect of water temperature on the recovery of spinal cord injury in zebrafish / 中国实验动物学报

Objective Using zebrafish to analyze the effect of water temperature on the recovery of spinal cord in-jury. To detect the cell proliferation and changes of gene expression at the injury site during the process of recovery. Meth-ods Surgical operation was performed to induce spinal cord injury ( SCI) on adult fish. Water at a series of temperature was applied to culture the fish. Swimming ability was adopted to observe the recovery of spinal cord injury following surger?y. Vibration sections and immunohistochemistry were performed to observe the cell number post SCI at different stages. The changes of gdnf and nos gene expression were determined by real?time PCR. Results The water temperature changes from 28℃ to 32℃ did not affect the swimming ability of non?injured and sham?injured fish ( P>0. 05 ) . The swimming ability recovered mostly in 8 weeks post spinal cord injury. At 32℃, the swimming ability recovered faster than at 28℃ or at 30℃(P<0. 05). The cell proliferation increased obviously following spinal cord injury (P<0. 05). The proliferation of cells surrounding the spinal cord in jury was more extensive in SCI fishes incubated in 32℃ water than in 28℃ or 30℃ water ( P<0. 05). Real?time PCR assay showed that gdnf was up?regulated in all groups post SCI at 24 h, and 7 and 14 days (P<0. 05). The nos expression was up?regulated in all groups following SCI in 24 h (P<0. 05) and 7 days. There was no sig?nificant difference between the SCI group and sham?injury group (P<0. 05), while after 14 days, the expression of nos was reduced in the SCI group compared with the sham?injury group (P<0. 05). Conclusions A slight increase of incu?bating water temperature can accelerate the recovery of spinal cord injury in zebrafish.

Effects of Ai Chi and Yamamoto new scalp acupuncture on chronic low back pain / Efeitos do Ai Chi e da cranioacupuntura de Yamamoto na dor lombar crônica

Abstract Introduction : Low Back pain affects a large part of the population and represents a major socioeconomic problem. There are many resources for treatment of this symptom, among them: acupuncture and aquatic therapy. Objective : To compare the effects of an aquatic physical therapy program (AI CHI) and Yamamoto New Scalp Acupuncture (YNSA) in pain intensity and functionality in patients with chronic low back pain. Material and methods : a clinical trial with a randomized sample. Sixty six individuals with chronic low back pain, of both genders were selected, however 44 individuals completed the study. The individuals were divided into three groups AI CHI (n = 15), YNSA (n = 15) and Control (n = 14). Ten 10 interventions with a program of aquatic therapy method (Ai Chi) and Yamamoto New Scalp Acupuncture (YNSA), were made, twice a week. The control group received the intervention only after the end of the study. Pain intensity was assessed by a visual analogue scale (VAS) and the functional capacity by Owestry functionality Index. Results : There was significant reduction in pain and improvement in functional capacity (p < 0.05) in YNSA and AI CHI and when compared to the control group. Conclusion : It was concluded that the YNSA and AI CHI were effective in reducing pain and improving the functionality of the lumbar spine in patients with chronic low back pain.

Resumo Introdução Lombalgias acometem grande parte da população e promovem grande impacto na sociedade. Existem diversos recursos para o tratamento deste sintoma dentre eles, a acupuntura e a fisioterapia aquática. Objetivo : comparar os efeitos de um programa atividade física aquática (AI CHI) e cranioacupuntura de Yamamoto (YNSA) na intensidade da dor e funcionalidade em indivíduos com dor lombar crônica. Material e métodos : estudo clínico experimental com amostra randomizada. Foram selecionados 66 indivíduos com dor lombar crônica, de ambos os gêneros, entretanto completaram o estudo 44 indivíduos. Os indivíduos foram divididos em três grupos AI CHI (n = 15), YNSA (n = 15) e Controle (n = 14). Foram realizados 10 atendimentos de um programa de fisioterapia aquática, com o método Ai Chi e de cranioacupuntura de Yamamoto, com frequência de 2 vezes por semana. O grupo controle recebeu intervenção somente após o término do estudo. A intensidade da dor foi avaliada por uma escala visual analógica (EVA) e a capacidade funcional pelo Índice de funcionalidade de Owestry. Resultados : Observou-se redução significativa na dor e incremento na funcionalidade (p < 0,05) nos grupos Ai Chi e YNSA e em relação ao grupo controle. Conclusão : Pode-se concluir que o Ai Chi e a YNSA foram efetivos na redução da dor e melhora na funcionalidade da coluna lombar em indivíduos com dor lombar crônica.

19-1 A pioneer in development of aquatic therapy in Taiwan - Cheng Hsin General Hospital / 日本温泉気候物理医学会雑誌

Original missions: Aquatic therapy in Cheng Hsin General Hospital was founded specifically for patients with poliomyelitis in 1960s. At that time, Taiwan was shrouded in darkness due to the outbreak of polio. Many children were paralyzed overnight and thousands of families broke down. Desperate as they were, they had caught a glimmer of hope when the First Lady, Madam Chiang, decided to run a national shelter for children with polio. Cheng Hsin Children’s Home was built and involved in educational and medical systems to provide full time care for free. Aquatic therapy was also included at that time. Following Missions: After poliomyelitis being eradicated in Taiwan in 1983, our team was dedicated in aquatic rehabilitation for people with all kinds of disabilities. Since Taiwan National Health Insurance System being established in 1995, the population receiving rehabilitation kept on rising. As a pioneer in the field of aquatic therapy, we delivered our experience to assist in construction of aquatic rehabilitation nationwide. Learning from the numerous cases, we have accumulated much experience, especially neurological deficits. Thus, physical therapists in Cheng Hsin General Hospital have designed some treatment guidelines for neurological patients. These guidelines, though not standardized, provide therapists various aspects to evaluate clinical problems and to design programs (See Table). Further missions: From the polio to all kinds of special needs, aquatic therapy in Cheng Hsin General Hospital has prosperously developed. In order to broaden our horizon, our team is eager to joining international society of medical hydrology and adopting professional advices and collaboration.

Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care, with focus on rheumatologic, orthopaedic and neurological disorders / 日本温泉気候物理医学会雑誌

Introduction: The World Health Organization (WHO) is in the process of updating the "Guidelines for safe recreational water environments, volume 2: swimming pools and similar environments (2006). The update plans to contain a chapter on the health benefits of immersion and therapeutic aquatic exercise in pools and spas. Methods: In order to write a narrative review, searches in PubMed, Embase, Cinahl, Sportdiscus, PEDro and Cochrane central were conducted in May-October 2012.   The group of 8 experts focused on persons with a medical diagnosis as described in the ICD-10 and their resultants effects (as described in the ICF)., but has been restricted to diseases, which have been presented in aquatic research literature sufficiently.   Keywords about the interventions included “Hydrotherapy Or Water exercise Or Aquatic exercise Or Aquatic therapy Or Water rehabilitation Or Aquatic physical therapy Or Aquatic rehabilitation Or Aquatics”, as well as the appropriate keywords for the pathologies.   References were restricted to Level 1-3 evidence papers as defined by the Oxford Centre of Evidence Based Medicine. Results: In summary, across musculoskeletal disorders (low back and neck pain, osteoarthritis, joint replacement, fibromyalgia, rheumatoid arthritis and ankylosing spondylitis), both active and passive interventions have low to high clinical effects on outcome parameters at the various ICF levels and on quality of life. Adverse effects have not been reported.   The evidence across neurological diseases (stroke, Parkinson disease, multiple sclerosis) is limited in comparison to musculoskeletal ones and mainly focuses on balance, gait, functional independence and quality of life. Moderate to high clinical effects have been found for these parameters. Effects on fatigue are conflicting. No adverse effects have been reported. Discussion: This narrative review didn’t allow a comparison with other interventions and only focuses on the health benefits of aquatic interventions themselves. Description of intervention and the applied doses were often insufficient, therefore the exact parameters of the intervention tactics still have to be established. Many studies were underpowered and would need follow-up studies that are more rigorous in order to establish the health benefits with higher effects sizes and statistical significance. Conclusion: The average - level 2 - evidence of therapeutic aquatic exercise and balneotherapy in neuro-musculoskeletal diseases have moderate to high beneficial effects on variables at the levels if function (primarily pain) and activity of the ICF, as well as on quality of life. These benefits seem to comparable across the diseases.

Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care, with focus on rheumatologic, orthopaedic and neurological disorders / 日本温泉気候物理医学会雑誌

<b>Int</b><b>roduction:</b> The World Health Organization (WHO) is in the process of updating the "Guidelines for safe recreational water environments, volume 2: swimming pools and similar environments (2006). The update plans to contain a chapter on the health benefits of immersion and therapeutic aquatic exercise in pools and spas. <BR><b>Methods:</b> In order to write a narrative review, searches in PubMed, Embase, Cinahl, Sportdiscus, PEDro and Cochrane central were conducted in May-October 2012.<BR>  The group of 8 experts focused on persons with a medical diagnosis as described in the ICD-10 and their resultants effects (as described in the ICF)., but has been restricted to diseases, which have been presented in aquatic research literature sufficiently.<BR>  Keywords about the interventions included “Hydrotherapy Or Water exercise Or Aquatic exercise Or Aquatic therapy Or Water rehabilitation Or Aquatic physical therapy Or Aquatic rehabilitation Or Aquatics”, as well as the appropriate keywords for the pathologies.<BR>  References were restricted to Level 1-3 evidence papers as defined by the Oxford Centre of Evidence Based Medicine.<BR><b>Results:</b> In summary, across musculoskeletal disorders (low back and neck pain, osteoarthritis, joint replacement, fibromyalgia, rheumatoid arthritis and ankylosing spondylitis), both active and passive interventions have low to high clinical effects on outcome parameters at the various ICF levels and on quality of life. Adverse effects have not been reported.<BR>  The evidence across neurological diseases (stroke, Parkinson disease, multiple sclerosis) is limited in comparison to musculoskeletal ones and mainly focuses on balance, gait, functional independence and quality of life. Moderate to high clinical effects have been found for these parameters. Effects on fatigue are conflicting. No adverse effects have been reported.<BR><b>Discussion:</b> This narrative review didn’t allow a comparison with other interventions and only focuses on the health benefits of aquatic interventions themselves. Description of intervention and the applied doses were often insufficient, therefore the exact parameters of the intervention tactics still have to be established. Many studies were underpowered and would need follow-up studies that are more rigorous in order to establish the health benefits with higher effects sizes and statistical significance.<BR><b>Conclusion: </b>The average - level 2 - evidence of therapeutic aquatic exercise and balneotherapy in neuro-musculoskeletal diseases have moderate to high beneficial effects on variables at the levels if function (primarily pain) and activity of the ICF, as well as on quality of life. These benefits seem to comparable across the diseases.

A influência da terapia aquática na reabilitação de um portador de sindrome pós-poliomielite: relato de caso / The influence of aquatic therapy rehabilitative in patients with syndrome after-pólio: case of study

A síndrome pós-pólio é uma desordem do sistema nervoso que pode se manifestar em indivíduos que tiveram poliomielite, anos depois. É caracterizada por um novo quadro sintomatológico, sendo sua incidência e prevalência desconhecidas. A Organização Mundial da Saúde estima a existência de aproximadamente 12 milhões de pessoas em todo o mundo portadores de algum grau de limitação física causada pela poliomielite. Este trabalho teve como objetivo avaliar a influência da terapia aquática no tratamento de um paciente do gênero feminino, portador da Síndrome Pós-Poliomielite. O mesmo foi submetido a um tratamento através de recursos hidroterapêuticos, avaliaçãoda eficácia das técnicas utilizadas e aplicação de um questionário semi-estruturado, com perguntas especificas em relação à sua reabilitação, bem estar físico e mental. Pôde-se concluir que a terapia aquática é muito eficaz para a melhora do quadro clínico desta síndrome, obtendo ganhos em sua capacidade funcional, garantindo um bem estar físico e mental e proporcionando relaxamento muscular.

The post-polio syndrome is a nervous system clutter than can be disclosed in individuals who had polio by years later. It is characterized by a new symptomatology status, which has unknown incidence and prevalence. The Health Worldwide Organization esteems approximately the existence of 12 milion people in the whole world that have some degree of physical limitation caused by the poliomyelitis. This work aimed to evaluate the aquatic treatment infl uence in a female patient, who has the post-polio syndrome. She was submitted to treatment through hydrotherapeutics resources, evaluation of effectiveness of the techniques that were used and the application of a questionnaire semi-structuralized with specifi c questions about her mental and physical welfare rehabilitation. The conclusion was the aquatic therapy is very effi cient for the improvement of this syndrome clinical status, getting better functional capacity, guaranteeing a mental and physical welfare and beyond providing muscular relaxation.