Pediatric Aquatic Therapy

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Working with younger patients in need of physical therapy can sometimes be a challenge for clinicians. Children’s needs and desires when it comes to exercises and limitations differ from adults. Pediatric patients are typically:

  • Smaller in stature than their adult counterparts.
  • Less likely to respond to requests by physical therapists to continue exercises that could be uncomfortable or cause even just a little discomfort.
  • Short in attention spans compared to teens or adults.
  • Fearful of any kind of medical experience due to past negative associations with medical professionals.

For these reasons and many others, many clinicians prefer to use aquatic therapy for kids instead of, or in addition to, traditional land-based physical therapy sessions.

Advantages of Aquatic Therapy for Kids

The advantages of pediatric aquatic therapy help combat some of the challenges faced by physical therapists working with a younger client base. Aquatic therapy for kids is advantageous because it:

child-icon Is geared for persons of any size, including children.
brain-icon-pain Reduces pain and discomfort in physical therapy patients of all ages — this means children are less reluctant to fully engage in pediatric water therapy than they might be for land sessions.
fun-icon Is seen as fun for kids. As long as they have no fears of the water, they enjoy the sessions and see it as a pleasure, not a task.
recreation-icon Has a recreational feeling to it, not a clinical feeling. If a child has associated his or her trauma, condition or illness with clinical experiences, land sessions may be psychologically challenging. Water therapy sessions will seem less intimidating.

By acknowledging these advantages, physical therapists can make the most of all aquatic sessions with their younger clients and come up with creative pediatric aquatic therapy ideas. There are plenty of ways to make therapeutic exercise feel more like play rather than therapy in the water.

Types of Pediatric Patient Conditions Assisted by Aquatic Therapy

Pediatric patients who are prescribed aquatic therapy may come from a variety of backgrounds and medical experiences. However, there are some conditions that have been studied to determine short- and long-term responses to aquatic therapy.

One of these conditions is limited mobility because of childhood growth and developmental delays. In a research paper that was released in a 2007 issue of Pediatric Physical Therapy, the authors studied the responses of 37 children who were of infant or toddler ages and who were delayed in terms of their functions and mobility. Some of the children were prescribed aquatic therapy; others were prescribed traditional land physical therapy. The study’s authors concluded that the group that received water therapy gained more mobility than the other group.

Another condition that has responded well to water therapy is autism. A 2006 academic article examined whether aquatic therapy might be a viable intervention strategy to help children who were diagnosed as being on the autism spectrum. The result of the study was that the children who engaged in aquatic therapy and aquatic exercises improved some of their limitations. As the study’s authors noted, water therapy could play a part in combatting some of the problems associated with autism.

Cerebral palsy patients who are juveniles have also shown improvement when they are exposed to aquatic therapy as part of physical therapy. In one clinical study from the University of Las Vegas, researchers tested the effects of water therapy on ambulatory children with cerebral palsy. The conclusion of the author of this study was that kids with cerebral palsy could improve weakness, balance and mobility by performing water exercises in a therapy pool.

These are just a few of the conditions that physical therapists are treating using aquatic therapy methods. There are many others, as every child’s physical condition and background is unique. For clinical case study videos treating pediatric patients, visit our video library.

In the following video, Lynn Grabe, a physical therapist from St. Paul’s Children Hospital, uses a HydroWorx pool to help a six-year old girl named Anna who suffers from arthrogryposis multiplex congenita. Since Anna’s joints are structured different, aquatic therapy was the best choice to help her increase muscle strength and mobility.

Pediatric Aquatic Exercises to Try in the Pool

Physical therapists working with children in an aquatic therapy pool should use some specific pediatric aquatic therapy techniques. A few popular pediatric aquatic therapy ideas are listed below. Be aware that these do not represent all the aquatic therapy exercises available — there is no limit to what a clinician can try. Many land therapy exercises can be modified for water therapy sessions with or without the help of pool assisted devices like “noodles”, floating dumbbells, and ankle or waist weights or belts.
pediatric-exercises

  1. Walking Using Underwater Treadmill: For children who have difficulty walking by themselves on land due to conditions such as cerebral palsy, multiple sclerosis, spine injuries or other problems, it may be possible for them to walk in the water using assistive devices, such as hand rails, dumbbells or noodles. The physical therapist may also need to assist the patient as he slowly walks around the floor of the pool or on the underwater treadmill. Having a therapy pool with an adjustable depth floor to change the depth of the water for each patient is necessary for this kind of activity.
  2. Leg Presses: When two physical therapists are available for a water therapy session, one may hold the patient at the back while the other pushes at his legs from the front. Using his lower body strength, he is expected to “push away” the second physical therapist. This kind of repetitive motor activity builds the muscles in the legs.
  3. Step-Ups: A submersible “block” can be placed on the floor of the therapy pool, and the pediatric patient can be instructed to “step up” and “step down.” Depending upon his ability to balance, it may be necessary for a physical therapist to assist him by holding his body upright during this challenging exercise.

Opportunities for Physical Therapists Open to Pediatric Aquatic Therapy

Physical therapists who wish to expand their practices to include aquatic therapy will be pleased to know that the pediatric market needs this kind of productive form of therapeutic exercise. While it’s necessary for an upfront investment in a specialized therapy pool, many organizations have been surprised at how quickly they are able to recover their investment dollars through the marketing and successful operation of their pediatric water therapy practices.

Moving forward, pediatric aquatic therapy will continue to advance and become more commonplace. This can only benefit both children and the physical therapist practices.