WHAT is APT?
Aquatic Physical Therapy (APT) is the practice of therapeutic treatment interventions in the water environment. It is a tool to achieve optimal movement and function potential in clients using the mechanical and thermal properties of water. APT can produce short and long-term therapeutic effects, using specific stimuli to generate a positive physiological response. It is also called hydrotherapy.
The Healing Properties of Water
Water is not gravity eliminated but offsets the downward force of gravity. Buoyancy assists movement and decreases joint compression.
Gradual pressure on the body in a standing position and is proportional to depth of immersion. Hydrostatic pressure moves fluid through the lymphatic and vascular network from the limbs to the thoracic and pelvic cavities. It reduces limb swelling and improves heart efficiency (Vilalta, 2013, Becker, 2011).
Uses wave action to create positive and negative pressures (undulating) produced by client or therapist. Any movement in the water creates waves that can gently or radically challenge balance in any direction. Creates multidirectional proprioceptive response to limb moving in water, not a linear plane of movement. Gentle wave action can mimic lymphatic massage (Tidhar, 2008).
Viscosity and Pressure Drag
Movement of the body through the water creates patterns of resistance. Challenging balance in a ‘safe-falls’ environment and providing a total body workout to maintain stance. It slows reaction time and increases the ability to maintain and practice balance.
Warmer water can increase circulation and joint lubrication which results in a reduction in muscle spasm and increased range of motion. The thermal sensation on skin overrides pain pathways and decreases pain perception.
Motor Learning – Why Water?
The general principles of motor relearning support the use of ‘other stimuli’ and environments to affect the process of change in the neural programming:
Achieving a "relatively permanent” change towards skilled motor behavior, resulting from practice, also capable of error-detecting and responding to the constraints of the environment (Schmidt & Lee 1999).
Achievement depends on structure (quality and quantity) of practice and feedback as well on the interaction between the person, the task and the environment; Dynamic Systems Model / DSM (Newell 1986)
An effective way of learning is by offering variability of skill performance by changing context and (bio)mechanical constraints (Schmidt and Lee, 1998).