1. Multiple Sclerosis (MS) and Aquatic Therapy
Tiffany Dean
Temple University
Therapeutic Recreation Major

2. Learning Outcomes
Define Multiple Sclerosis (MS) and describe the effects it causes.
Explain ways in which Aquatic Therapy is beneficial for individuals with Multiple Sclerosis
Identify Precautions that should be considered before an individual with MS participates in Aquatic Therapy.

3. Overview of Multiple Sclerosis
Multiple sclerosis (MS) is a chronic autoimmune disorder affecting movement, sensation, and bodily functions. It is caused by destruction of the myelin insulation covering nerve fibers (neurons) in the central nervous system (brain and spinal cord).
“Most common cause of neurological disability in young & middle aged adults affecting an estimated 400,000 people in the U.S.” (Salem, et al, 2011).

4. Types & Symptoms of MS Symptoms Types Relapsing- Remitting Pattern
visual disturbances
sensation in extremities
weakness or clumsiness in leg or hand
Spasticity
Difficulty with bladder control
Vertigo
Gait disturbances
Stiffness
Fatigue of limbs
Types
Relapsing- Remitting Pattern
Primary Progressive Pattern
Secondary Progressive Pattern
Progressive- Relapsing Pattern

5. Overview of Aquatic Therapy
Aquatic therapy is a form of physical therapy that is performed in a pool.
The goal of this particular form of therapy is to assist in restoring the person's strength and movement through the use of buoyancy, resistance, and heat.
 It aims to rehabilitate patients after injury or those with chronic illness.

6. Types of Aquatic Activity
Balance exercises
Ai Chi (Water Tai Chi)
Halliwick techniques
Relaxation and stretching
Stretching
Ai chi
Aquatic body work: Watsu,
Jahara, or Healing Dance
Strengthening exercises
Deep or shallow water techniques
Bad Ragaz Ring Method
Use of drag or resistance equipment

7. Sample Aquatic Exercises
Marching—stand with your side to the pool wall. Hold onto the wall if needed for balance. Lift one leg up and down, then the other. Repeat 5 to 8 times.
Side leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if needed for balance. Lift leg out to the side 5 to 8 times. Do the other leg.
Back leg lifts—stand facing the side of the pool. Hold onto the edge of the pool if needed for balance. Lift leg straight back 5 to 8 times. DO NOT arch the back. Do the other leg.
Runner's stretch—stand facing the side of the pool. Hold the edge of pool for balance. Step one leg back. Both feet flat on floor. Keep the heel of the back leg on the floor. Bend the knee of the forward leg. Lean forward from the ankles. You should feel a stretch in the lower leg or calf muscles. Hold for seconds. Do 1 to 2 times. Switch legs.

8. Equipment for Aquatic Therapy
Flotation devices
Ankle weights
Water barbells
Kickboards
Water shoes
Therapy bars

9. Benefits for Individuals with MS
Water Quality
Benefit
Buoyancy: The feeling of being lighter in the water; of floating.
Provides support for weak limbs.
Movement takes less effort. A greater range of motion can be achieved.
Promotes muscle relaxation.
Viscosity: The sensation that there is resistance to your movements; that you move slower through the water.
The resistance of water can be used to improve muscle strength.
Slower movement in water provides an opportunity to work on skills such as balance and coordination which may be harder to do on land.
Hydrostatic pressure: The sensation of compression while the body is in the water. Pressure increases with depth.
Compression can provide support for standing activities, such as walking, with less effort than on land.
Temperature Control
Cooler water can help maintain lower core body temperature even during vigorous activity. This is especially helpful for people with heat sensitivity issues.

10. Other Benefits… Decreases stress Pain relief Improved flexibility
Ease depression
Boost self-esteem
Improved posture
Increased circulation
Increased cardiovascular functioning

11. Research Study
Conducted by Physical Therapy Departments of Long Island University & Hunter College in 2011
Purpose: to examine the effects of group aquatic exercise in individuals with MS.
Methods: 11 participants, 5-week program, 2/wk for 1hr
Results: Improved gait speed, grip strength, muscle strength, walking speed, balance, & mobility
Conclusion: Aquatic Therapy is beneficial in improvement in motor functioning of individuals with MS.

12. Precautions Bowel incontinence with firm stools
Communicable diseases (cold flu, Hepatitis)
Autonomic dysreflexia
Sensitivity to disinfection chemicals
Sensitivity to heat/ humidity
Rashes, skin conditions with flaking or open areas
Hydrophobia
Controlled seizures,
Open wounds
Compromised immune system

13. Interested in Aquatic Therapy Certification?
Aquatic Therapy & Rehab Institute (ATRI)
How to get started %20Started12.pdf
ATRI Certification
Membership $45

14. Resources
Butler, C. (2002). Walking in Water. Inside MS, 20(3), 66. Chamberlayne, N. (2006). Come on in, the water's fine!. Inside MS, 24(4), Merck Manual Staff (2013). Overview of Multiple Sclerosis. Accessed via iple_sclerosis_ms.html?qt=muliple%20sclerosis&alt=sh Salem, Y., Scott, A., Karpatkin, H., Concert, G., Haller, L., Kaminsky, E., & ... Spatz, E. (2011). Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study. Disability & Rehabilitation, 33(9), doi: / Weiss, Thomas C. (2010). Aquatic Therapy- Facts and Information. Accessed via

15. Using Aquatic Therapy to treat individuals with Multiple Sclerosis
Tiffany Dean
Temple University
“If I could live in the water, I would.” –Mary Ann Lee.
Overview of Aquatic Therapy
Aquatic therapy is a form of physical therapy that is performed in a pool.
The goal of this particular form of therapy is to assist in restoring the person's strength and movement through the use of buoyancy, resistance, and heat.
Types of Aquatic Therapy include: Ai Chi, Halliwick Method, Watsu, Bad Ragaz Ring Method, etc.
Benefits of Aquatic Therapy
Improved muscle strength
Improved walking speed
Enhanced balance & coordination
Decreases stress
Pain relief
Improved motion
Improved flexibility
Promotes muscle relaxation
Ease depression
Boost self esteem
Resources:
Americans w/ Disabilities Act
The National MS Society
Moss Rehab
ATI Physical Therapy
Oxford Rehab Center
ATRI Certification
ATRA's Aquatic Therapy Treatment Network
Aquatic Resources Network
Just so you know…
Aquatic Therapy Certification will look great on your resume!
Aquatic Therapy has the power to change someone’s life!