Warm Water Pool Exercise
"Pool exercise is one of
the best types fo exercise that a person with Pos-Polio can participate
in since it is less stressful to the body," according to Robbie
Leonard, M.S., P.T., former Director of Physical Therapy at Roosevelt
Warm Springs Institute for Rehabilitation, Warm Springs, Georgia. But it
depends on an individuals’ strengths and weaknesses as to whether pool
exercise is appropriate. Each person should be evaluated by a physical
therapist and given an individualized exercise program, since each
person’s strengths and weaknesses are unique.
POTENTIAL BENEFITS
Benefits depend on the
temperature of the water as well as the amount of time spent in the
pool.
- Increased strength and
coordination
- Increased ability to
ambulate
- Increased range of motion
and flexibility
WHY WARM WATER?
The recommended water
temperature in 90 - 92 degrees Fahrenheit (It feels quite warm as you
get in.) The pool water temperature definitely should be no less than 85
degrees Fahrenheit.
- Most individuals
experiencing post-polio have an intolerance to cold; therefore
the warm water is a must.
- Warm water has a pain
relieving effect.
PHYSIOLOGIC BENEFITS
Immersion in warm water
causes:
- Increased metabolic rates
- Increased heart rates
- Increased circulation to
surface and muscles
- Increased respiratory rates
- Muscle relaxation
Note: Heart rates are generally
lower in water exercise than in land exercise due to compression,
temperature, and pressure. Heart rates based on land exercise are not
applicable in the water.
PERSONS WITH RESPIRATORY
PROBLEMS
People who are
experiencing respiratory difficulties may find water helps respiratory
function because hydrostatic pressure of the water on the chest wall
stimulates chest expansion.
- This must be closely
monitored.
- Water exercise for someone
with a tracheostomy is generally not recommended.
WHO SHOULD NOT PERFORM POOL
EXERCISE?
Person with:
- Severe cardiac problems
- Urinary tract infections
- Open wounds/sores
- Contagious diseases or skin
conditions.
INDIVIDUALIZING A POOL EXERCISE
PROGRAM
A doctor and a physical or
occupational therapist (preferably one familiar with PPS) should
evaluate the individual and then if indicated, develop an exercise
program based on the testing. Not everyone is an appropriate candidate
for pool exercise.
The therapist should note:
- Range of motion
- Flexibility
- Muscle strength
- Endurance
- Ambulatory skills
- Transfers (especially pool
transfers)
The exercises should be
appropriate for the water. An exercise program designed for land will
not be appropriate for the water since buoyancy rather than gravity is
the predominating force.
HOW THE WATER AFFECTS YOU
Buoyancy is the
predominant force at work.
- Movement up towards the
surface is Buoyancy Assisted.
- Movement down towards the
pool bottom is Buoyancy Resisted.
- Movement in a horizontal
plane is Buoyancy Supported.
For hip flexor muscles: stand at
side of pool or sit in a pool chair; bring the knee up towards the
chest, letting the buoyancy of the water assist the movement. For hip
flexor muscles: lie on stomach holding pool ledge, bring knee towards
the chest. The faster the movement, the greater the resistance. For hip
flexor muscles: lie on your side while holding pool ledge, bring knee
towards the chest, then back to straight position.
- Individual exercise program
will depend on muscle strengths.
- Water is also an excellent
medium for stretching - but not to the point of over-stretching.
Stretches should be for tight muscles and be recommended
individually.
MUSCLE GRADES AND BUOYANCY
Muscles below a fair (3)
grade should do Buoyancy Assisted or Buoyancy Supported Exercises. A
fair grade muscle can perform a movement against gravity. (For example,
if you can bring your knee up towards your chest in the sitting
position, you have at least a fair grade hip flexor muscle. If you
cannot perform that movement, you have below a fair grade.
Muscles that are graded fair or greater (3-5) can perform Buoyancy
Resisted exercises. The degree of resistance will depend on muscle
strengths and endurance.
GOOD EXERCISE PRINCIPLES
AND GOOD BODY MECHANICS
Do not exercise to the
point of fatigue. (The combination of heat and exercising can be
fatiguing.) Exercise may need to be short (10 minutes) and then
lengthened as endurance improves. A person should spend no more than
30-45 minutes in water above 90 degrees.
Do the exercise during the "good" part of your day (when you
have the most energy).
The best benefits will be achieved in an exercise program 2 or 3 days a
week.
Be careful not to overstress the joints.
Use good body mechanics - do not lock or hyper-extend the joints during
exercise.
Movements in the water should be smooth, slow, and controlled (not
jerky, fast movements).
Know your limitations. If you become fatigued, short of breath, dizzy,
or stressed, stop the exercise. (You may need to check with your doctor
before resuming the program if you become dizzy or short of breath.)
If any exercise causes pain, do not do it. Listen to your body. "No
Pain, No Gain" is not a good philosophy for persons with PPS.
Have fun in the water. If this exercise program is a negative experience
for you, it is not an appropriate program.
Remember this principle: Each individual should have a doctor’s
recommendation for pool exercise, and each individual program should be
recommended by a therapist who knows your strengths and weaknesses.
ENHANCE YOUR ABILITIES
Robbie Leonard, M.S., P.T.
says, "If your program is recommended by your doctor and
individualized for you by your therapist, and you follow these basic
principles, you should have a successful pool exercise program that will
enhance your abilities."
CHOOSING A POOL
The pool should have
close, accessible parking. (If it takes all your energy to get to the
pool, the exercise program will not be beneficial.)
The pool should have a lift, ramp, or steps for ease fo transfer into
the pool. (Again, if it takes all of your energy to get into the pool,
the effects of the exercise will be negated.)
The pool should be monitored at all times for safety. Individuals should
never be left unattended.
The depth of the water where the exercises are performed should be
between waist and chest high. (Deeper water could cause heat-related
problems and will make exercising difficult.
- The deck of the pool should
not be slippery.
- If you have an unsteady
gait or difficulty with transfers, then tennis or aquatic shoes
are recommended. (Lower priced aquatic shoes may be available at
K-Mart, WalMart or other discount stores in the summer months).
- The pool water temperature
should be no less than 85 degrees. Recommended temperature is
between 90 and 92 degrees.
- The air temperature around
the pool should also be warm.
| From
"Pool Exercise - Principles and Guidelines for Polio
Survivors" by Robbie B. Leonard, M.S., P.T. |
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