Talk:Aquatic therapy

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Original Article - Comments, Text

This article has almost nothing to do with the topic of "aquatic therapy." Most of the text concerns physical therapists. That should belong in an article about "physical therapists" or "physical therapy." This article should explain the differences between regular land-based physical therapy and aquatic/water-based therapy. 123home123 (talk) 10:30, 25 November 2008 (UTC)

Redirect to hydrotherapy? This article is poorly written, highly disorganized, and Google seems to indicate it's mostly if not all just material copy-pasted from other sources. Furthermore, we already have a decent article about the topic at hydrotherapy. So how about just scrapping this and redirecting it to hydrotherapy? Is there anything worth salvaging? 24.58.237.196 (talk) 02:36, 22 October 2011 (UTC)

I suggest we start over with solid sources, clear scope, and a clean outline. I'm moving the existing text here so we can draw from it. Below is a start at solid sources, scope, and outline. TheProfessor (talk) 07:59, 18 March 2014 (UTC)

Original Text, 22:09, 19 December 2013

Definition of Aquatic Therapy: A therapeutic procedure which attempts to improve function through the application of aquatic therapeutic exercises. These procedures require constant attendance of a therapist educated in performing aquatic therapeutic exercises. [1, 2] Common synonyms: Aquatic Rehabilitation, Aqua Therapy, Pool Therapy, Water Therapy, Hydrotherapy (outside the USA). Note that aquatic therapy, as defined by the AMA, is not "tied" to a single profession. It can arguably be performed by several legally-regulated healthcare providers who have scopes of practice which permit them to perform such services and who are permitted to use the AMA's Current Procedural Codes (CPT).

http://www.aquaticnet.com/qualifications.htm ©1997-2007, Aquaticnet.com

Aquatic therapy or pool therapy is physical therapy that is performed in the water. Aquatic therapy use the resistance of water instead of weights. It aims to rehabilitate patients after injury or those with chronic illness, avoiding the amount of weight placed on the joints by exercise outside the water.

The Aquatic Therapy Association of Chartered Physiotherapists defines aquatic physical therapy as: "A therapy programme utilising the properties of water, designed by a suitably qualified physiotherapist specifically for an individual to improve function, carried out by appropriately trained personnel, ideally in a purpose built, and suitably heated hydrotherapy pool" (ATACP, 2008). Also the South African Aquatic Physiotherapy Group (2009) [2] uses a definition which is very much alike: “Aquatic physiotherapy is physiotherapy which uses more than one of the unique properties of water for therapeutic rehabilitation”.

A Dutch definition, used in courses of the Dutch Centre of Allied Health Care (NPI) is: "Aquatic (Physical) Therapy is a programme, using mechanical and thermal characteristics of water during partial or complete immersion, in combination with the effects of movement. It evokes short-term and long-term adaptational mechanisms of a person with a deranged biological system, using specific stimuli to create biological and thus therapeutic effects."

Jenny Geytenbeek, author of the Aquatic Physiotherapy Evidence-Based Practice Guide (2008) [3], published by the National Aquatic Physiotherapy Group of the Australian Physiotherapy Association, gives the following definition and explanation:

Aquatic Physiotherapy” refers to the special practice of physiotherapy, with therapeutic intent toward the rehabilitation or attainment of specific physical and functional goals of individuals using the medium of water. It differs from the more generic term “hydrotherapy” which connotes any water-based therapy conducted by an array of professional specialties, including immersion in warm water, immersion in mineralized water (balneotherapy and spa therapy), immersion in mechanically turbulent warm water (spa therapy), application of pressurized water to the external body (whirlpool), application of warm water into the colon (colonic irrigation), the application of water of various temperatures and pressures via showers and towels (Kneipp therapy), and movement-based therapy in water (hydrokinesiotherapy). “Aquatic therapy” similarly refers to water-based activity of therapeutic intent, is common among American literature, and includes the practice of e.g. physical therapists, exercise therapists, nurses and exercise instructors. “Aquatic exercise” has the intention of fitness training in both healthy and symptomatic individuals, and “water exercise” is its synonym."

Aquatic physical therapy can be applied at all three dimensions of the International Classification of Functioning, Disability and Health (World Health Organisation, 2001). A fourth dimension is Quality of Life, also an important goal in Aquatic Physical Therapy.

Aquatic physical therapy might also be supportive in treating some of the modern life-style conditions as well. A special issue of Physiotherapy Theory and Practice titled ‘Physiotherapy practice in the 21st century: a new evidence-informed paradigm and implications’, identified topics like nutrition and weight control, sustainability of physical activity and exercise, management of sleep disturbance and undue life stress. Evidence is still scarce, but issues like obesitas (Nagle 2007), adherence (Kang 2007), management of sleeping patterns (Vitorino 2006) and stress reduction (Bood 2009) have been addressed in aquatic literature, see also the chapter of the physiology of immersion and the autonomic nervous system.

Therapists who work in water typically seek aquatic therapy training as most physical therapy programs do not provide education in aquatic therapy techniques. Aquatic Therapy University [4] and the European Union Aquaevidence Network [5] provide therapists with post-graduate studies in aquatic therapy. In July 2010 the Board of the World Confederation of Physical Therapy (WCPT) approved the start of a formal network: Aquatic Physical Therapy International [6]. This network provides opportunity to (physical) therapists to connect and share information. Objectives and activities are listed on the website.

Examples of aquatic therapy techniques include: Ai Chi, Aquatic PNF, the Bad Ragaz Ring Method [7], Fluid Moves, the Halliwick Concept [8], Swim Stroke Training and Modification, Task Type Training Approach and Watsu. The originators of each of these unique technique worked together with the Aquatic Resources Network [9] to craft operational definitions to aid in communication within the industry.

When available, an interview was done with the creator of the technique (Ai Chi, Fluid Moves, Watsu). When the creator was deceased, an agent of the organization charged with managing the technique was interviewed (Halliwick). When the technique was developed over time by the contributions of many individuals, the interview was done with an aquatic physical or occupational therapist who has published work on the technique in either a professional journal or textbook (Bad Ragaz Ring Method, Swim Stroke Modification and Training, Task-Type Training Approach).

This Operational Definitions of Aquatic Specialty Techniques [10] is available online to help understand each technique's nuances. NOTE: Aquatic Resources Network is currently remodeling their website to become a more news/research oriented resource for the industry."Aquatic Resources Network (Beta)". Retrieved 26 July 2012.

TheProfessor (talk) 07:59, 18 March 2014 (UTC)

References

Rewrite: Sources, Scope, and Outline

Key Sources:

Audette JF and Bailey A. 2008. Integrative pain medicine: the science and practice of complementary and alternative medicine in pain management. Humana Press. ISBN-13: 978-1588297860.

Becker BE. 2009. Aquatic therapy: scientific foundations and clinical rehabilitation applications. Physical Medicine and Rehabilitation 1:859-872.

Becker BE. 2009. Research needs in aquatics. International Journal of Aquatic Research and Education 3:4-9.

Becker BE and Cole AJ (eds). 2011. Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Brody LT and Geigle PR (eds). 2009. Aquatic exercise for rehabilitation and training. Human Kinetics. ISBN 978-0736071307.

Gamper, U and Lambeck J. 2011. The Bad Ragaz Ring Method. In: Becker, BE and Cole, AJ (eds). 2011. Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Geytenbeek J. 2008. Aquatic physiotherapy evidence-based guide. National Aquatic Physiotherapy Group. Australian Physiotherapy Society.

Kinnaird DW and Becker BE. 2008. Contemporary aquatic therapy and pain management. pp 285-306 In: Audette JF and Bailey A. (eds). Integrative Pain Medicine: The Science and Practice of Complementary and Alternative Medicine in Pain Management. Humana Press. ISBN 978-1588297860.

Koury JM. 1996. Aquatic therapy programming: guidelines for orthopedic rehabilitation. Human Kinetics. ISBN 0-87322-971-1.

Lambeck, J and Bommer A. 2011. Ai Chi: applications in clinical practice. In: Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Lambeck J and Gamper U. 2011. The Halliwick Concept. In: Becker, BE and Cole, AJ and (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Schoedinger P. 2011. Watsu in aquatic rehabilitation. In: Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Wilder RP and Brennan DK. 2011. Aqua running. In: Becker, BE and Cole, AJ and (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

TheProfessor (talk) 08:38, 4 April 2014 (UTC)

What is Aquatic Therapy?

How does aquatic therapy differ from Hydrotherapy, Aquatic Exercise, ?

What are major principles (theory)?

Who performs aquatic therapy?

What are main techniques of aquatic therapy?

How is aquatic therapy used?

Has research demonstrated effectiveness and safety?

How are aquatic therapy pools designed?

What training is required to become an aquatic therapist?

TheProfessor (talk) 18:57, 25 March 2014 (UTC)

Outline - Draft, 25-Mar-2014

1. Overview

2. Principles

3. Aquatic healthcare

4. Techniques

5. Applications

6. Training and Certification

7. Facility design and management

TheProfessor (talk) 18:23, 10 November 2014 (UTC)

Notability and Source Reliability

The sub-types aren't notable enough to have standalone articles and if covered at all should be merged in here, I think. Alexbrn ^{talk|contribs|COI} 06:51, 22 March 2014 (UTC)

Hi Alexbrn. Thank you for your interest in the quality of this article. Yes, the question of notability is important, so I have been going through sources. The following are clearly notable: Halliwick, Bad Ragaz Ring Method, Watsu, Aqua running/Deep Water Running/Aquajogging, and Ai Chi. TheProfessor (talk) 11:18, 24 March 2014 (UTC)

Not for standalone articles I think. Rather than have a handful of stubby small articles, it would be preferable to merge them here so this can be more a substantial piece. Alexbrn ^{talk|contribs|COI} 11:32, 24 March 2014 (UTC)

I agree, we don't need more stubby articles. How about if we give them reasonable time to develop? As far as notability goes, I don't think that is an issue for the list above. The main issue is if anybody takes on developing these articles. Are you interested in developing any of them? TheProfessor (talk) 11:51, 24 March 2014 (UTC)

MEDRS reliability of Dutton 2011 (below) has been brought into question, so I removed it for now. Why was it tagged? As far as I can determine, it is a reliable source, the main value of which is providing concise encyclopedic summaries (see below). Please let me know your thoughts. Thanks. TheProfessor (talk) 11:44, 24 March 2014 (UTC)

Dutton, M. 2011. Orthopaedics for the physical therapist assistant. p 187, Halliwick Concept. Jones & Bartlett Learning. ISBN 978-0763797553. MEDRS:

"The Hallick method aims to teach people how to maintain balance control in the water and to teach them to swim by combining the unique qualities of water and rotational control patterns. The Hallick method uses a 10–point program that is divided into four phases: 1) attempts to address the psychological aspects of being in the water; 2) improves the patient's ability to restore balance for all positions in the water; 3) concentrates on teaching the patient to inhibit undesirable movements while maintaining stability in the water; and 4) teaches the patient to move (swim) from a position of stability." (Dutton 2011, p 187, Halliwick method)

"Bad Ragaz ring method: BRRM is an aquatic version of Proprioceptive Neuromuscular Facilitation designed by a German physician that seeks to improve muscle function via patterns of movement and clinician resistance. Exercises are performed while lying horizontal in the water with support provided by rings or floats around the neck, arms, pelvis, and knees. By using the extremities as levers, the trunk muscles are activated."(Dutton 2011, p 187, Bad Ragaz ring method, BRRM)

TheProfessor (talk) 11:52, 24 March 2014 (UTC)

Hadn't come across Jones & Bartlett Learning before, but on further investigation seems they're part of the Ascend megacorp. so probably okay! Alexbrn ^{talk|contribs|COI} 12:39, 24 March 2014 (UTC)

Great. Thanks for checking. Please let me know if you have further insights. I'm going by the content, which is solid based on my reading of this and other sources. TheProfessor (talk) 12:51, 24 March 2014 (UTC)

Working Definition and Scope

Let's clarify the scope of the Aquatic therapy article, especially with respect to how it is distinct from the Hydrotherapy article. The two already are cleanly distinguished based on definitions used in America. I've removed the synonymy (below) because the list is not referenced and the NHS definition confuses the issue unless it is included in context of a clear statement of the scope of the article.

Text removed from Aquatic therapy article pending discussion of scope and determination of reliable sources:

Common synonyms of aquatic therapy include aquatic rehabilitation, aqua therapy, pool therapy, water therapy, aquatics, and (outside the United States) hydrotherapy.

According to the UK National Health Service, aquatic therapy is synonymous with hydrotherapy as "a form of physiotherapy carried out in water".

Aquatic Therapy Association of Chartered Physiotherapists (ATACP, United Kingdom) defines aquatic physical therapy as: "A therapy programme utilising the properties of water, designed by a suitably qualified physiotherapist specifically for an individual to improve function, carried out by appropriately trained personnel, ideally in a purpose built, and suitably heated hydrotherapy pool" (ATACP, 2008). "prior to 2008 aquatic physiotherapy was called ‘hydrotherapy’ in the UK. The reason for the change to aquatic physiotherapy was two-fold: 1) to be in line with the international term aquatic physical therapy, and 2) to make use of the protected term physiotherapy." (ATACP, 2008)

Definition: "Aquatic Physical Therapy is the evidence-based and skilled practice of physical therapy in an aquatic environment by a physical therapist, or a physical therapist assistant under the supervision of a physical therapist. Aquatic Physical Therapy includes but is not limited to treatment, rehabilitation, prevention, health, wellness and fitness of patient/client populations in an aquatic environment with or without the use of assistive, adaptive, orthotic, protective, or supportive devices and equipment.

The unique properties of the aquatic environment enhance interventions for patients/clients across the age span with musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary diseases, disorders, or conditions. Aquatic Physical Therapy interventions are designed to improve or maintain:

• function
• aerobic capacity/endurance conditioning
• balance, coordination and agility
• body mechanics and postural stabilization
• flexibility
• gait and locomotion
• relaxation
• muscle strength, power, and endurance

Interventions used in Aquatic Physical Therapy include, but are not limited to, therapeutic exercise, functional training, manual therapy, breathing strategies, electrotherapeutic modalities, physical agents and mechanical modalities using the properties of water and techniques unique to the aquatic environment." (American Physical Therapy Association, http://www.aquaticpt.org/about-aquatic-physical-therapy.cfm).

Abbreviated Definition: Aquatic Physical Therapy is the scientific practice of physical therapy in an aquatic environment by physical therapists and physical therapists assistants. Aquatic Physical Therapy includes but is not limited to treatment, rehabilitation, prevention, health, wellness and fitness of patient/client populations in an aquatic environment. The unique properties of the aquatic environment enhance treatments for patients/clients across the age span with musculoskeletal, neuromuscular, cardiovascular/pulmonary, and integumentary (skin) diseases, disorders, or conditions. (American Physical Therapy Association, http://www.aquaticpt.org/about-aquatic-physical-therapy.cfm).

Working Definition:

The broadest, simplest definition of aquatic therapy refers to "water-based activity of therapeutic intent", "is common among American literature", and includes diverse professionals. (Geytenbeek, J. 2008. Aquatic Physiotherapy Evidence-Based Practice Guide. National Aquatic Physiotherapy Group of the Australian Physiotherapy Association.) Other definitions tend to add terms like "physiotherapy" or "physical therapy" to be more specific or restrictive.

Working Scope:

Hydrotherapy article: immersion, hot/cold, pressure application of water

Aquatic therapy article: water-based exercise and physical rehabilitation, therapist attended treatment

Approaches: aquatic rehabilitation, aquatic physiotherapy, aquatic physical therapy, aqua therapy, pool therapy, water therapy, aquatics, aquatic bodywork, aquatic massage therapy, therapist attended hydrotherapy

Healthcare professionals: physical therapists, physiotherapists, exercise therapists, medical doctors, osteopaths, chiropractors, nurses, massage therapists, aquatic bodyworkers, aquatic therapists, exercise instructors

Techniques and Procedures: water-based exercises and other treatments of therapeutic intent

TheProfessor (talk) 02:16, 26 March 2014 (UTC)

Professional training and certification

Content was recently deleted with a comment that "Wikipedia is not a directory", and leaving only mention of AMA, but not specific areas of therapeutic specialization. I agree that we need to rework this. Let's distill appropriate content for Wikipedia.

Deleted Text:

University offerings in aquatic therapy are limited, and include the following examples:

• East Carolina University (ECU) Department of Recreation and Leisure Studies, 12 hr certificate program in Aquatic therapy;
• University of North Carolina Greensboro (UCNG) Department of Kinesiology, 122 hr Aquatics Leadership concentration;
• West Virginia University (WVU) Division of Exercise Physiology, 15 hr Aquatic Therapy special emphasis area.

Non-university training and certification programs in aquatic therapy include the following:

• Aquatic Therapy and Rehab Institute (ATRI), aquatic therapy training with four types of certification: ATRI Aquatic Therapeutics, ATRI Reheumatology, Ai Chi, Risk assessment and Safety Training;
• American Association for Physical Activity and Recreation (AAPAR), credentials in Adaptive Aquatics;
• Aquatic Exercise Association (AEA), Aquatic Fitness Professional certification;
• WaterART Fitness International, 12 aquatic-based certifications (Instructor, Seniors and Specialized Populations Instructor, Personal Training Specialist, Weight Management Consultant, Managing a Healthy Weight Instructor, Shape UP and Water Train Instructor, Aquatic Rehabilitation Specialist, Arthritis Instructor, Kidz Instructor, Common Movement Disorders Instructor, Pre-Post Natal Instructor, Mind Body Instructor);
• Worldwide Aquatic Bodywork Association (WABA), Watsu, WaterDance, and Healing Dance practitioner and instructor training, Practitioner certification as adjunct to Certified Massage Therapist license, Therapist and Instructor advanced certifications.

I propose the following text:

University offerings concerning aquatic therapy are limited, and only a limited number of universities offer certification in Aquatic Therapy and Leadership. Most aquatic training and certification programs are through professional associations and training institutes, and are notable with respect to specific therapeutic specialities:

• Aquatic Therapeutics, Rheumatology, Ai Chi, Risk assessment and Safety Training through the Aquatic Therapy and Rehab Institute (ATRI);
• Adaptive Aquatics for physical disability through the American Association for Physical Activity and Recreation (AAPAR);
• Aquatic Fitness Professional certification through the Aquatic Exercise Association (AEA);
• Watsu, WaterDance, and Healing Dance stand-alone certifications, and adjunct certifications as part of Certified Massage Therapist licenses through Worldwide Aquatic Bodywork Association (WABA);
• Various specialized aquatic-based certifications through WaterART Fitness International.

TheProfessor (talk) 07:56, 16 June 2014 (UTC)

Is this discussed in any secondary sources? It seems rather undue. Alexbrn ^{talk|contribs|COI} 08:00, 16 June 2014 (UTC)

Hi Alexbrn. Yes, this is from a reliable secondary source:

Meyer R. 2011. Staff training and development in aquatic therapy. pp 423-442, Chapter 16 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

TheProfessor (talk) 08:08, 16 June 2014 (UTC)

I don't think a book, "written by the leading aquatic practitioners" qualifies as a secondary source per WP:RS. See also WP:UNDUE and WP:NOTPROMOTION. Is this training or these certification discussed and recognized in third party, independent sources? What regulatory bodies recognize these certifications? If this content carries due weight for inclusion there should be significant coverage in uninvolved sources. - - MrBill3 (talk) 08:20, 16 June 2014 (UTC)

Hi MrBill3. You bring up good points. My understanding is this reference is clearly a secondary source that involves "generalization, analysis, synthesis, interpretation, or evaluation of the original information", and I do not see issues of WP:UNDUE and WP:NOTPROMOTION. And yes this is also third party, but not necessarily independent in that these are professionals in the field, as you point out (with the same relation to the professional organization that a typical MD might have to the AMA). In terms of regulatory bodies, these certifications are typically recognized as specialization within the scope of practice of various licensed professions (in particular Physical Therapists, Certified Massage Therapists, and Exercise Therapists), and for some settings as stand-alone certifications. Your help with this would certainly be appreciated. TheProfessor (talk) 09:19, 16 June 2014 (UTC)

If the source has "analysis" and "interpretation" of the offerings of these establishments, then it might be interesting to have that (though with a non-independent source care is needed) - but we shouldn't have a directory-like listing: that indeed is undue. Alexbrn ^{talk|contribs|COI} 09:40, 16 June 2014 (UTC)

Content to consider:

The Worldwide Aquatic Bodywork Association (WABA) oversees training and certification for Watsu, as well as for the related aquatic bodywork forms WaterDance and Healing Dance. Training consists of basic and advanced coursework, as well as logged practice and demonstration of mastery. Certification levels include "aquatic providers" as licensed professionals associated with a a spa, clinic or sports club; "aquatic practitioner" as a specialized adjunct to licensed professionals; and as "aquatic therapist" requiring more advanced training.

Licensed Professionals eligible for certification as professional providers or practitioners include Nationally Certified Massage Therapist (NCBTMB), Licensed Physical Therapist or Physical Therapy Assistant, Licensed Occupational Therapist or Occupational Therapist Assistant, Registered Nurse (BSN/MSN), License to practice Medicine or Dentistry (MD/DO/DC/DDS/DMD), State Licensed/Certified Massage Therapist (500+ Hours), ATRI Certified Aquatic Therapist (2003 Standards) with over 500 hours of certified training.

Sources:

Dull, H. 2008. Watsu: freeing the body in water, 4th edition. Watsu Publishing. ISBN 978-1605853710.

Jamison, L. 2009. Watsu. pp 117-128, Chapter 8 In: Brody, LT and Geigle, PR (eds). Aquatic exercise for rehabilitation and training. Human Kinetics. ISBN 978-0736071307.

Meyer, R. 2011. Staff training and development in aquatic therapy. pp 423-442, Chapter 16 In: Becker BE and Cole AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

Norton, CO and Jamison, L. 2009. Aquatic service providers. pp 15-24, Chapter 2 In: Brody, LT and Geigle, PR (eds). Aquatic Exercise for Rehabilitation and Training. Human Kinetics. ISBN 978-0736071307.

Schoedinger, P. 2011. Watsu in aquatic rehabilitation. pp 137-153, Chapter 5 In: Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.

TheProfessor (talk) 09:56, 16 June 2014 (UTC)

References

Sophia's Article Review

Great beginning sections. The overview was very thorough, as was the section on techniques. I think that the article could use a little beefing-up on the sections regarding licensing and efficacy. Perhaps providing some more research on the theory behind aquatic therapy and evidence for its use would give the reader a clearer picture of its current and future applications. Good layout. — Preceding unsigned comment added by Sgbroberg (talk • contribs) 01:28, 21 February 2019 (UTC)

Wiki Education assignment: LLIB 1115 - Intro to Information Research

This article was the subject of a Wiki Education Foundation-supported course assignment, between 21 August 2023 and 8 December 2023. Further details are available on the course page. Student editor(s): 2grovey2 (article contribs).

— Assignment last updated by 2grovey2 (talk) 17:22, 9 October 2023 (UTC)