Here is the essential information for designing, implementing, and managing an aquatic therapy program. This complete guide to the aquatic treatment of orthopedic injuries addresses topics ranging from program format to risk management and pool design. The book also presents 28 plans of care for the treatment of injuries to the lower extremities, upper extremities, and spine.

First, Aquatic Therapy Programming gives you the tools you'll need to develop a plan of care for aquatic therapy. You'll learn the basic properties and principles of movement in water and how to apply them to aquatic therapy, how to use water depth during the different stages of treatment, and how to use equipment to facilitate exercise.

Author Joanne Koury then describes her unique six-phase approach to designing aquatic treatment plans. The steps include

• assessment and early treatment;
• strengthening and local muscular endurance;
• balance, coordination, and cardiovascular conditioning;
• task-related and sport-simulated skills development;
• transitional aquatic therapy; and
• maintenance and fitness.

Next, the book explains how to implement the six-phase plan of care in the treatment of selected orthopedic injuries. You'll find 28 specific plans of care for acute injuries to the

• pelvis, hip, and thigh;
• knee;
• lower leg, ankle, and foot;
• shoulder region;
• elbow, wrist, and hand;
• lumbar, thoracic, and cervical spine; and
• trunk and neck.

Descriptions of exercises used within the treatment plans are enhanced by photographs. You can use these plans of care as a starting point for treatment in the pool, modifying them to meet the needs of individual clients.

Finally, Aquatic Therapy Programming discusses the administrative concerns of aquatic therapy facility managers. The book addresses many aspects of risk management and safety planning, including legal responsibility, safety and rescue equipment, pool maintenance, client screening, and staff hiring and training. It also describes how to design a safe and functional aquatic-therapy facility, offering suggestions for new pool design, adapting an existing pool for therapeutic use, and using small swim tanks.

Contents

Introduction: Benefits of an Aquatic Therapy Program

• Physiological Benefits
• Psychological Benefits
• Summary

Part I: Designing an Aquatic Therapy Program
Chapter 1. Applying Hydrodynamics to Aquatic Therapy

• The Physical Properties of Water
• Using Buoyancy to Achieve Various Positions
• Using Buoyancy to Grade Exercises
• Using Water's Density and Viscosity to Alter Resistance
• Using Curvilinear and Angular Movements to Grade Exercises
• Using Curvilinear Motions to Improve Movement Efficiency
• Using the Physical Laws of Motion
• Summary

Chapter 2. Using Water Depth to Enhance Movement

• Early Treatment
• Intermediate Treatment
• Late Treatment
• Summary

Chapter 3. Incorporating Pool Equipment to Facilitate Exercise

• Buoyancy Assistance Devices
• Buoyancy Support Devices
• Stabilization Devices and Methods
• Resistance Training Equipment and Methods
• Endurance Conditioning Equipment
• Summary

Chapter 4. The Six-Phase Plan of Care

• Format for Sessions
• Phase I: Assessment and Early Treatment
• Phase II: Strengthening and Local Muscular Endurance
• Phase III: Balance, Coordination, and Cardiovascular Conditioning
• Phase IV: Task-Related and Sport-Simulated Skills Development
• Phase V: Transitional Aquatic Therapy
• Phase VI: Maintenance and Fitness
• Markers: When to Progress the Client
• Summary

Part II: Implementing the Six-Phase Plan of Care for the Lower Extremities
Chapter 5. The Pelvis, Hip, and Thigh

• Contusions to the Iliac Crest
• Gluteal Strain
• Quadriceps Strain
• Hamstrings Strain
• Adductors Strain
• Degenerative Joint Disease of the Hip

Chapter 6. The Knee

• Anterior Cruciate Ligament Sprain
• Medial Collateral Ligament Sprain
• Meniscal Injuries
• Chronic Anterior Knee Pain
• Degenerative Joint Disease of the Knee

Chapter 7. The Lower Leg, Ankle, and Foot

• Achilles Tendon Strain
• Gastrocnemius Strain
• Acute Ankle Sprains
• Avulsion Fracture of the Upper Tibia With Lateral Malleolus Fracture
• Tibia-Fibula Fracture
• Achilles Tendinitis
• Chronic Anterior Leg Pain, Stress Fractures, and Plantar Fasciitis

Chapter 8. Exercises for the Lower Extremities

• Walking Patterns (Shallow Water)
• Stride Walking (Deep Water)
• Cycling (Deep Water)
• Squats (Shallow Water)
• Lunges (Shallow Water)
• Unilateral Hip Flexion and Extension (Shallow Water)
• Hip Abduction and Adduction (Shallow Water)
• Bilateral Abduction and Adduction (Deep Water)
• Internal and External Hip Rotation (Shallow Water)
• Hip Circles (Deep Water)
• Lower Extremity PNF Diagonals
• Knee Flexion and Extension (Shallow Water)
• Knee Flexion and Extension (Deep Water)
• Ankle and Foot Exercises (Shallow or Deep Water)
• Toe Raises (Shallow Water)
• Heel Rock (Shallow Water)
• Bench Stepping (Shallow Water)
• Water Running
• Swim Kicking
• Treading Kicks (Deep Water)
• Balance, Coordination, and Impact Moves (Shallow Water)
• Plyometrics (Shallow Water)
• Plyometrics (Deep Water)
• Lower Extremity Stretching Exercises (Shallow Water)
• Lower Extremity Stretching Exercises (Deep Water)

Part III: Implementing the Six-Phase Plan of Care for the Upper Extremities
Chapter 9. The Shoulder

• Rotator Cuff Tendinitis and Impingement Syndrome
• Postsurgical Decompression or Rotator Cuff Repair
• Adhesive Capsulitis
• Acute and Recurrent Glenohumeral Dislocation
• Acromioclavicular Joint Sprain
• Sternoclavicular Sprain and Fracture of the Clavicle, Scapula, or Humerus

Chapter 10. The Elbow, Wrist, and Hand

• Injuries to the Elbow
• Fractures and Sprains of the Wrist and Hand

Chapter 11. Exercises for the Upper Extremities

• Shoulder Circumduction (Shallow Water)
• Shoulder Flexion and Extension (Shallow Water)
• Shoulder Lateral Abduction and Adduction (Shallow Water)
• Shoulder Horizontal Abduction and Adduction (Shallow Water)
• Shoulder Internal (IR) and External Rotation (ER) (Shallow Water)
• Blackburn Shoulder Exercises (Shallow or Deep Water)
• Wand Exercises (Shallow or Deep Water)
• Scapular Motions (Shallow Water)
• Upper Extremity PNF Diagonals
• Elbow, Forearm, Wrist, and Hand Exercises (Shallow Water)
• Vertical Sculling Patterns (Shallow Water)
• Horizontal Sculling Patterns (Shallow or Deep Water)
• Swimming Strokes (Shallow or Deep Water)
• Sport-Simulated and Task-Oriented Skills
• Upper Extremity Stretching Exercises (Shallow Water)
• Stretching for the Elbow Flexors and Extensors

Part IV: Implementing the Six-Phase Plan of Care for the Spine
Chapter 12. The Lumbar Spine

• Diagnostic Classification of Activity-Related Low Back Pain
• Patient Classification
• Treatment
• Spondylolysis or Spondylolisthesis
• Degenerative Joint Disease

Chapter 13. The Thoracic and Cervical Spine

• Thoracic Spine Pain
• Cervical Spine Pain

Chapter 14. Exercises for the Trunk and Neck

• Early Trunk and Neck Motions
• Cervical and Lumbar Traction (Deep Water)
• Pelvic Stability and Trunk Exercises (Shallow and Deep Water)
• Proprioceptive and Endurance Activities
• Stretching Exercises for the Trunk and Neck

Part V: Managing Aquatic Therapy Programs
Chapter 15. Risk Management and Safety Planning

• Understanding Legal Responsibility and Terminology
• Safety in Pool Design
• Signage and Safety Markings
• Safety and Rescue Equipment
• Pool Maintenance
• Other Facility Concerns
• Staff Training
• Participant Evaluation and Screening
• Handling Emergencies
• Summary

Chapter 16. Designing an Aquatic Therapy Facility

• Building a New Pool
• Design Elements of an Aquatic Therapy Pool
• Special Pool Features
• Pools for Small Spaces
• Adapting a Traditional Pool for Therapeutic Use
• Summary

Appendix A. Health/Fitness Form for Aquatic Therapy

Appendix B. Aquatic Skills Checklist

Appendix C. Guidelines for Progressive Resistance Exercise (PRE) Training

Appendix D. Guidelines for Cardiovascular Conditioning

Appendix E. Guidelines for a Self-Stretching Program

References

Suggested Readings

Index

About the Author

Audiences

Reference for aquatic rehabilitation specialists, athletic trainers, sports physical therapists, sport physicians, other rehabilitation professionals who work with orthopedic patients, and aquatic administrators.

Joanne M. Koury is a health and fitness professional with 25 years of experience in the industry specializing in aquatics and strength training. Joanne is currently the Fitness Manager for a Hospital-based medically-integrated center and continues to coach USA Swimming and teach group fitness classes. Her versatile professional history includes: aquatic director, fitness director, orthopedic technologist, head swim coach, and pool manager. She designed and operated an aquatic therapy facility and established treatment plans of care for orthopedic injuries and post-surgical rehabilitation.

Joanne was awarded a Master's Degree in Health and Physical Education with special emphasis in injury prevention and treatment from East Stroudsburg University of Pennsylvania in 1990 and was a national speaker during the early years of aquatic therapy growth in the United States. She is certified with the American College of Sports Medicine, the American Council on Exercise, the Aquatic Exercise Association, the American Swim Coaches Association (USA Swimming), and the American Red Cross. She currently resides in the Lehigh Valley in Pennsylvania.

"I found this book to be reader friendly and easily understood. Aquatic Therapy Programming should be of immense help to aquatic fitness specialists working with the medical profession."

Richard G. Routi, PhD, PT

Director and Cofounder

Bux-Mont Physical Therapy, Warminster, PA

"Excellent review of literature and equipment. This practical and applicable text can be used by new and experienced aquatic therapists."

Ruth Irene Meyer, MEd

Owner

Kinesiotherapy of New Hampshire