2. HYDROTHERAPY POOL DESIGN,TECHNIQUES IN CURRENT USE & SPECIALIZED EQUIPMENTS Sekar.L

3. GENERAL INFORMATION & OUTLINE OF MAJOR POINTS ABOUT HYDROTHERAPY POOL DESIGN  The main factors for consideration are; POOL DESIGN & DIMENSION  1. POOL DESIGN & DIMENSION – BELOW GROUND ideally. It should be large enough for the users to carry out a full rehabilitation program. In practice pools no smaller than 9.25m (30 feet) by 4.57m (15 feet). Approximately for 8 people to carry out their activities.

4. TYPE, SHAPE, SIZE, DEPTH, FLOOR & ENTRY  2. TYPE, SHAPE, SIZE, DEPTH, FLOOR & ENTRY – The shape of pool should be simple – most common shape is RECTANGLE.  It is suggested that a depth that varies between 0.84 m & 1.42 m is ideal. (Person’s lower end of sternum to shoulder height.)  The pool floors may be stepped or sloping & it is most satisfactory.  The entry to pool can be by several methods. They are;  a) Steps – at the shallow end  b) Ramps – mainly for wheelchair users  c) Hoists – Mechanical, Hydraulic & electrical (can be fitted with a stretcher, a seat or both)  d) Over the side

5. TEMPERATURE & VENTILATION  3. TEMPERATURE & VENTILATION – When considering water temperature, the things to bear in mind are the type & severity of the exercise in addition to the duration of activity.  In tropical & sub-tropical climates the pool temperature might range between 34-35˚C (92.6-98.6˚F) in winter & 31-33˚C (87.4-92˚F) in summer.  In general to cover for all condition & to avoid any adverse effect, the following temperature guidelines is used; 32-34 or 35˚C (89.6-93.2 or 95˚F).  The air temperature of the pool area is usually kept at 25˚C & the changing rooms 4˚C lower.  Ventilation should ensure that excessive condensation does not build up & that humidity is maintained at 50%.

6.  4. EQUIPMENT  4. EQUIPMENT – It involves both in pool – fixed & movable - & external equipment items. (Handrails are fixed in-pool)  Underwater jets are installed in some pools to provide a massaging effect & for resistance to movement, thus improving strength & endurance.  The inlet for the water to the pool needs to be sited at the deep end & the flow should be slow & gentle.  Other equipment items, such as parallel bars, stools, seats & plinths should be movable, not permanently fixed.  Floats of all types(Rings, Toys, Kickboards, Balls, Bats & Flippers) can be moved from the bath side at the end of the day & horsed down & stored on hooks wooden slatted shelves.

7.  5. LIGHTING  5. LIGHTING – The pool area needs to be well lit. (Refraction & Reflection must be taken into account)  6. FACILITIES  6. FACILITIES – It comprise;  a) Changing areas  b) Showers  c) Resting space  d) Toilets  Additional facilities include  Additional facilities include;  a) Office area for staff  b) Rooms for drying linen & clothing  c) Plant room & storage space for equipment & chemicals

8.  7. SURFACES NON- SLIP, NON-ABRASIVE & EASILY CLEANED  7. SURFACES – Both those in the pool, those around the pool & in facilities need to be NON- SLIP, NON-ABRASIVE & EASILY CLEANED.  In the pool specially manufactured tiles with non- slip surfaces should be used on the floor.  8. NOISE FACTORS a pool ACOUSTIC MATERIALS  8. NOISE FACTORS – It tend to be NOISY where much activity, laughter, shouting & splashing inevitably occur. When designing & constructing a pool ACOUSTIC MATERIALS should be used for the walls & the ceiling of the pool area.

9.  9. STAFFING / CARE & MAINTENANCE  9. STAFFING / CARE & MAINTENANCE – PT, Assistants, cleaning & maintenance staff. (Generally PT’s are given an over all management role)  11. SAFETY & EMERGENCY EQUIPMENT  11. SAFETY & EMERGENCY EQUIPMENT – All staff must be fully aware of use of CPR skills.  Test the water for residual chlorine content & PH value.  A full bacteriological analysis of the water should be carried out every 2 – 4 weeks.  12.COSTS & COSTING  12.COSTS & COSTING – The costs of constructing, equipping, maintaining & running a hydrotherapy pool are high.

10. TECHNIQUES IN CURRENT USE  Treatment schools of Thought, These include;  1. BAD RAGAZ RING METHOD (BRRM)  2. HALLIWICK METHOD  3. WATSU

11. 1. BAD RAGAZ RING METHOD (BRRM)  It is a collection of therapeutic techniques performed in the water.  It use specific movement (Unilateral / Bilateral) patterns of arm, leg & trunk for MUSCLE RE- EDUCATION, STRENGTHENING, SPINAL TRACTION/ELONGATION, RELAXATION, RANGE OF MOTION & TONE INHIBITION in the water.  These patterns may encourage ISOTONIC or ISOMETRIC muscle contractions.  This was principally designed to treat a variety of MUSCULOSKELETAL MOVEMENT DIORDERS.

12. 2. HALLIWICK METHOD  This method is based on principles of HYDRODYNAMICS & BODY MECHANICS, safe for people for all ages, with any disability & of any severity. (It is a NEUROTHERAPEUTIC FACILITATION REHABILITATION TECHNIQUE)  PT’s use activities to FACILITATE (ASSIST) MOVEMENT PATTERNS by varying the activities level of difficulty & the amount of manual guidance provided.

13. 3. WATSU  WATSU was created as a massage or wellness technique that was not necessarily designed for patients as they are classically defined.  The aquatic rehabilitation therapists have applied the approach to clients with a variety of neuromuscular & musculoskeletal disorders.  One of the most beneficial results of WATSU is effective stretching.  WATSU can be best described as a muscle reeducation approach

14. SPECIALIZED EQUIPMENTS  1. FLOTATION DEVICES  1. FLOTATION DEVICES:-  For central trunk flotation – NEO-PRENE VESTS & FOAM WAIST-BELTS are most commonly used.  Bad Ragaz techniques use FOAM RINGS that are placed around arms & legs or under head.  Other devices are;  a) Kick boards  b) Leg floats  c) Vinyl foam flexible buoys

15.  2. RESISTIVE DEVICES:-  a) Finned dumbbells  b) Finned boots  c) Kick boards  d) Flotation devices