By Maureen Grossi, PT
One of the favorite activities enjoyed by many of the students and therapists at HollyDELL is our Aquatic Therapy Program. Each week on a rotating basis, we take a group of students for one-to-one therapy to the therapeutic pool at Virtua Health and Wellness Center at Washington Township.
Aquatic therapy is often confused with adaptive aquatics (teaching swimming to disabled individuals) and aquatic fitness (group classes supervised by an individual with some training in aquatics). While there are certifications at various levels that provide training for these positions, aquatic therapy is specifically administered by a state-licensed physical, occupational or speech therapist. In addition to licensure, advanced training through sanctioned continuing education courses provides best practice for aquatic therapy.
HollyDELL’s Aquatic Therapy Program has been extremely beneficial for our students in so many ways. The act of being able to freely move–sometimes for many, their very first time–has been a sheer joy to experience. The temperature of the water is in a therapeutic range of 90-94 degrees. The warmth of the pool helps to relax muscles and increase blood flow to affected areas. The properties of the water help us as therapists use the pool as a medium to facilitate therapeutic goals, enhancing our students functional abilities, whether it is working on reaching, grasping and releasing or walking and taking steps.
As pediatric therapists, we use play as a means to gain functional skills. In the water, we use various toys and flotation devices. The pool noodles help with vertical suspension and can act as a “play horse” by straddling the noodle and working on trunk control and sitting balance. When climbing onto the large flotation mat, the students can work on weight shifting, strengthening and movement transitions, as well as balance activities. Using the dive toys helps students overcome the fear of putting their head in the water and working on breath control. The sprinkling cans, buckets and squeezable fish engage the students to work on reaching, range of motion and strengthening.
The dynamic of the group setting is amazing for peer interaction and encouragement. Some of our more timid students are willing to accept the challenge from another student to beat their time, or race to collect more fish or to stay on the mat the longest.
Our students frequently have various orthopedic surgeries and are so delighted when finally given the clearance to return to aquatic therapy.
Buoyancy can be used to progress through exercise by being assistive (move toward the water surface), supportive (move parallel to the water surface) or resistive (move opposite to the water surface). This helps to increase range of motion as well as strengthen the trunk, arm and leg muscles.
Viscosity is another physical property of water that is helpful in therapy. This provides resistance to movement through the water which allows the students to work on strengthening in a fun and supportive environment. By changing the speed of movement through the water, we can increase or decrease the resistance. When we walk in front of the student and create drag, this lessens the amount of resistance they experience.
A third property of water useful in therapy is hydrostatic pressure. This is the pressure water exerts equally at rest in all directions. It is helpful for sensory-motor development as it enhances body awareness and proprioception (the ability to sense the position of our joints). It helps with reducing edema, which many of our post-operative students experience. It also helps strengthen their respiratory and cardiac function by providing some resistance to chest expansion. Depending on which depth of water we work with the students, this can be modified to make it easier or harder.
HollyDELL’s Aquatic Therapy Program is provided by the occupational and physical therapy staff and organized by Kate Marrocco, our community outings teacher and Jen Bennett, our physical therapy aide. It takes a team effort to make this program work. Our school nurses and all the classroom staff are invaluable in helping the students participate and make this program successful!