Aquatics Training Great for Imbalance
The following post was written by guest blogger Mike Studer, PT, MHS, NCS, CEEAA, President, Northwest Rehabilitation Associates Inc.
Balance, like most any other impairment, must be challenged to be improved.
Strength, flexibility, endurance all require a sufficient stimulus that helps to extend the limits of the current capacity. Additionally, all of these impairments offer very little transfer of training from one environment or task to another.
Strength gains are specific to the closed/open chain or concentric/eccentric nature; endurance improvements are largely modality specific. Changes in balance are largely specific to the practice characteristics as well (dynamic vs static, perturbed vs anticipatory postural adjustments, available sensory resources, etc).
However, balance is unique in that the learner or patient is often fearful of that very level of (rehabilitative loss of balance/perturbation) stimulus required for improvement. In other words, people that are weak may seek out a strengthening program and be invigorated by it.
No matter how motivated, people with imbalance are often fearful of the practice required to improve. Incorporating balance into a hydrotherapy setting can minimize the risk, and therefore the fear.
Consider these important reasons why your patient with impaired balance should be challenged using a Hydroworx therapeutic pool:
1) Cannot sustain an injurious fall
2) Limited visual reference (cannot see their feet while walking)
3) Easier to challenge endurance with the effects of buoyancy on workload
4) Directional changes available on the treadmill while it is in motion
5) Decreasing fear and carryover – progression depth
6) More tolerable losses of balance and corrections on joint impact with buoyancy
7) Dynamic nature of walking balance being challenged rather than static balance
I would recommend the following as rough parameters to use for a community-dwelling elderly client with imbalance as the primary problem:
– Begin with .8 to 1.3 mph treadmill without resistance jets
– Progress from hands on to hands off the parallel bars
– Progress from eyes open to moments or steps with eyes closed
– Advance to turning/changing directions on the treadmill (again progressing to no hand support)
For these and many more reasons, think outside the box and INSIDE the water the next time you have the opportunity to help someone regain the skill and confidence of balance again.
President, Northwest Rehabilitation Associates Inc.
Serving You With Specialist Care and a Personal Touch
Phone: (503) 371-0779
Fax: (503) 371-0886