Paediatric Hydrotherapy

Buoyancy

Hydrotherapy (therapy in water) has always been one of the preferred therapy options, for adults, children and even animals. However, limited appropriate facilities mean that it is not used enough in South Africa. This article sets out to provide parents with some more information about this therapy option, what it can be used for with children and what to look for when choosing an appropriate facility to take your child to.

What can hydrotherapy be used for in children?

  • Increasing range of movement of joints, soft tissue and muscles
  • Facilitating active movements, and improving strength and endurance of weak muscles (including core)
  • Improving balance and stability
  • Improving co-ordination
  • Reducing pain
  • Reducing muscle spasm
  • Stimulating healing and recovery of injured body parts
  • Early rehabilitation after surgery
  • Developing gross motor milestones
  • Regulating and integrating the sensory system
  • Normalising abnormal tone
  • Improving function
  • Enhancing psychological mood
  • Relaxation and decreasing anxiety
  • Cardiovascular exercising (for fitness and weight loss)
  • Assisting rate and depth of respiration
  • Assisting with digestion
  • Enhancing the immune system response
  • Improving sleep patterns

Group fun

Pool as playgroundHydrotherapy vs land based therapy for children

  • Hydrotherapy is FUN for children. Often the kids needing therapy have most of their days consumed with conventional therapy, which alone can make them anxious and depressed. They don’t see their water sessions as ‘therapy’ but rather as having some fun in the pool.
  • Certain activities are allowed in water when not yet allowed on land. An example of this is gait and walking exercises can be done in water, before a child is allowed to take full weight on an injured leg, on land.
  • Certain activities can be achieved in water and then progressed to land. An example of this is children with poor balance may fall on land, but can practice in a safer water environment as the buoyancy gives them more time to react and adjust to movement.
  • Certain activities are too painful on land, but can be done in water. This is due to buoyancy, warm water temperature, and specialized aquatic techniques that decrease pain.

What to look for when choosing a hydrotherapy facility?

  1. The standard of the water is essential – especially when dealing with children who are most likely immune-compromised. Public facilities, like gyms, are a concern in South Africa, as there is no regulatory body checking water standards and water hygiene. Pools need to be monitored closely, with the correct chlorine and pH levels maintained at all times.
  2. Water temperature has to be at least 32 degrees, especially for babies. For certain conditions, like relaxing tone and decreasing anxiety, warmer temperatures of 35 degrees may be preferable.
  3. The therapist working with your child in the pool needs to be appropriately trained:
  • They should be trained in and use a wide range of different hydrotherapy treatments
  • These treatments should include active and passive techniques
  • It would be preferable that the therapist has a medical background which enables them to choose the best combination of treatment methods for your child
  • Knowledge of and experience with childhood development is essential to ensure that treatments are appropriate and functional
  • The therapist should look at the child from a holistic perspective. For example, when working with a child’s gross motor skills it is important to remember that you are dealing with that child’s emotional and social development too
  • Children learn better in a group and should be given positive feedback and praise
  • The environment should allow the child to explore and play in order to develop and grow
  • Knowledge of the latest thinking in teaching water safety and swimming

Vestibular system

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