Stroke Rehabilitation with Hydrotherapy

Hydrotherapy in Stroke Rehabilitation

Hydrotherapy is an effective method to help stroke patients regain strength, mobility and independence. Hydrotherapy can play a transformative role in the rehabilitation process, especially for patients who have had a stroke due to spinal cord injuries, stroke or neurological conditions.

What is Hydrotherapy?

Hydrotherapy is a safe form of therapy that supports mobility, strength and overall health by utilizing the therapeutic properties of water. In specially designed pools, the temperature, buoyancy and resistance of the water are adjusted in a controlled manner to support the patient’s recovery and rehabilitation process. The warm water used in hydrotherapy (usually between 33°C and 36°C) relaxes the muscles, increases circulation and reduces pain.

What are the benefits of hydrotherapy for stroke patients?

Hydrotherapy is especially beneficial for treating stroke patients. Water provides a safe place to relearn skills and retrain the body, regardless of the patient’s mobility. Some of the benefits of hydrotherapy for stroke patients include:

Improved Mobility: Immersion in water reduces an individual’s body weight by up to 90%, making it easier for paralyzed patients to move without putting pressure on their joints. At the same time, the resistance of water means that a person moves through it more slowly. In this way, the water provides extra support to the body and allows a paralyzed patient to work more freely on their balance and coordination. When these two aspects of water come together, it provides a great therapeutic environment for stroke patients. Patients can work on range of motion exercises and simulated walking in the water, even if they are not strong enough to complete these exercises outside of the water.

More Strength:Due to the natural resistance of water, it is possible to gain more strength in a shorter amount of time when exercising in water. The natural resistance provided by moving in water means that every session is a strength workout. Additionally, working out in water makes it easier to target areas of the body that a patient cannot do on land. For example, a patient whose legs are too weak to support them may not be able to do squats and lunges on land, but they can in water. This way, patients can better work towards regaining lost abilities, such as walking.

Pain Relief:Water is not only a good exercise medium, it is also a good pain reliever. The pressure provided by the water effectively massages the muscles, reducing pain during and after the session. These effects are usually enhanced when the water is kept warm, at body temperature. Warm water helps to reduce tension in the body while also stimulating the release of endorphins, the body’s natural painkillers.

Protects Cardiovascular Health:Immersion in water is a great way to increase cardiovascular fitness in a low-impact way. By simply standing in water, the increased pressure on the body forces the heart to work harder to move blood, which improves the condition of the heart over time. Cardiovascular fitness not only helps improve a stroke patient’s endurance, but it can also help reduce the patient’s risk of having another stroke.

Facilitates Balance Training:Since strokes tend to affect one side of the body more than the other, stroke patients tend to have balance issues, making it difficult to walk or perform daily activities. Hydrotherapy provides a safe environment for balance training. In fact, hydrotherapy is often more effective in this area than land-based training, because the water keeps the patient from falling while performing the exercises. A resistance jet can be added to the exercises to increase the difficulty.

Muscle Relaxation:Muscle spasticity is a common problem in stroke survivors, and stiff muscles can become painful over time. Hydrotherapy, especially in a warm pool, can help relax these muscles, reduce spastic attacks, and allow the patient and therapist to work on lengthening the muscle.

What are the hydrotherapy techniques used in stroke rehabilitation?

Hydrotherapy includes many techniques customized to the needs of the patients:

Water Exercises: These exercises, which increase range of motion, develop muscle strength and provide balance, allow patients to move more comfortably in the water.

Walking Training: The buoyancy of the water makes walking practice easier. This is especially effective in regaining walking ability for patients with partial stroke.

Water Treadmill: It allows walking or running exercises to be performed by reducing the pressure on the joints. This ease strengthens the muscles of the patients and protects their joints.

Passive Stretching: Water increases the flexibility of the muscles and joints. This is especially beneficial for patients with spasticity.

Functional Training: It helps to regain daily activities, thus allowing patients to regain their independence.

What is the scientific evidence for hydrotherapy?

The effectiveness of hydrotherapy is supported by many scientific studies. A 2018 study showed that hydrotherapy increased muscle strength and quality of life in patients with spinal cord injuries, and improved motor functions and reduced spasticity in patients with hemiplegia after a stroke.

Another study in 2020 revealed that hydrotherapy increased mobility and reduced pain in neurological diseases.

Who can benefit from hydrotherapy?

Hydrotherapy is suitable for patients with spinal cord injuries, stroke, multiple sclerosis, cerebral palsy, traumatic brain injury, and peripheral neuropathy. However, its use may be limited in cases such as open wounds or serious cardiovascular problems.

What are the stages of hydrotherapy?

Hydrotherapy sessions generally consist of the following stages.

  • Evaluation: The therapist evaluates the patient’s condition and determines the goals.
  • Warm-up: Light exercises are performed to get used to the water.
  • Therapeutic Exercises: Personalized exercises are performed.
  • Cool-down: Relaxation techniques are applied at the end of the session.

Sources:

  • American Physical Therapy Association (APTA)
  • Journal of Spinal Cord Medicine
  • Journal of Stroke and Cerebrovascular Diseases
  • Frontiers in Neurology
  • Mayo Clinic
  • National Center for Biotechnology Information (NCBI)
  • British Journal of Sports Medicine
  • World Confederation for Physical Therapy (WCPT)