Uploaded:  12/24/2008

L. Kelly
Aquatic Therapy:  Not Just a Day at the Pool
L. Kelly

We figured out early on that our daughter loved bath time.  She was content to sit in her bath chair and soak until the water got cold.  It was one of the few times she could get all of her tight muscles to relax.  We put her in the tub every night, but as she got bigger it has became increasingly difficult to get her fully submerged in the tub. 

Then one day her physical therapist brought up the idea of aquatic therapy.  We knew as soon as the PT mentioned it that aquatic therapy would be a hit.  From the very first session, it was obvious that our daughter, who is severely disabled and has spastic quadriplegic cerebral palsy, could participate more fully in the water than she could on land.  She just melted in the warm water.  Her head control improved, she started demonstrating improved range of motion in her shoulders, we saw increased strength in her trunk, and, of course, she loved every minute of it!

Aquatic therapy, also called pool therapy, can be a wonderful addition to your child's current therapy program.  Simply put, it is physical, occupational, and/or speech therapy held in a swimming pool.  Although it takes place in a pool, aquatic therapy is very different from swimming in a recreational pool.  Aquatic therapy uses the setting of a swimming pool to target therapy goals for children and adults with a wide range of disabilities and levels of function.  It may take place in outdoor or indoor pools, in cool or warm water.  The most popular setting is an indoor pool specially designed for aquatic therapy with water a bit warmer than a recreational pool, typically 95-98 degrees.  Many of these pools have built in lifts that allow for easy, safe transfers from wheelchair to water and adapted shower and changing facilities to allow caregivers to assist in showering after time in the pool and getting back into dry clothes.

Children of all ages and levels of function with an injury or chronic condition that requires therapy are good candidates.  Most therapy pools will allow children to wear swim diapers into the pool, permitting children who are incontinent of bowel and bladder to participate.  Children who are ill, running a fever, or who have medical conditions or equipment that prevent them from being submerged would obviously not be able to participate.

Therapists, therapy assistants, and certified life guards may also be in the pool while your child receives therapy.  Numerous pool toys and equipment may also be incorporated into the therapy program, including weights, noodles, flotation vests and head floats.  Some therapy pools have underwater treadmills for those working on gait and walking.  At times, your child's speech therapist may even team up with the PT or OT to address communication goals while in the pool.

There are a number of benefits to having therapy in a pool.  First, the setting itself, a swimming pool, and the act of going swimming are typically considered fun, making aquatic therapy especially motivating and rewarding for many children.  As with traditional "land" therapy, gains in balance, coordination, and strength can be made during aquatic therapy sessions.  Unique to aquatic therapy, however, is the physical properties of water that provide support and take the body's weight (about 90%) off of weak muscles, allowing them to work more efficiently and offer resistance for strength exercises.  Warmer water pools can reduce spasticity, improve circulation, and increase range of motion.  Cooler water pools carry the benefits of reducing inflammation and pain in the case of injuries.

Every week, we leave work a little early to go to aquatic therapy.  In addition to our daughter's enjoyment of her time in the pool, we've experienced many of the benefits mentioned above, including improved range of motion and improved head control.  The worst part, in my opinion, is the effort required to change a wet, unhappy (because the changing room is cold after the warm water) child out of a swimming suit and back into regular clothes!