What is hydrotherapy?

Indications and Procedures

Hydrotherapy, or water treatment, is one of the oldest therapies still in use. A procedure with origins in ancient Greece has today found a place in alternative medicine.

One use of hydrotherapy is as an alternative method of exercising for patients with chronic heart failure, since the buoyancy effect reduces loading. Exercises to improve mobility, strength, and cardiovascular fitness can be provided easily in water. Immersion in warm water has been used in bathing resorts in Europe since the beginning of the twentieth century to reduce heart failure symptoms as well as to enhance heart function.

Systemic diseases such as diabetes mellitus, peripheral heart disease, neuropathy, steroid dependence, and venous stasis are major contributing factors to forming chronic wounds. The consequence is a nonhealing wound with hypoxia, infection, edema, and metabolic abnormalities. Patients with such wounds, in need of extensive debridement, have traditionally been advised to be immersed in a full-body whirlpool. The reason behind whirlpool therapy is that whirling and agitation of the water, with injected air, removes contaminants and toxic debris and dilutes bacterial contents. The common therapeutic protocol is a five- to twenty-minute session, once daily. Typically, this regimen is continued for a brief period. Other debridement techniques have been gaining in popularity in recent years due to concerns about whirlpool therapy including high water pressure, oversaturation of the skin, and cross-contamination.

Physical therapists have always recommended hydrotherapy to relieve extreme pain. Therefore, it is not surprising that it has found a place in providing relief for patients with fibromyalgia.

Another area where hydrotherapy has found popularity is in labor
and childbirth. Studies indicate using hydrotherapy for relief of rapid pain and anxiety in labor. Subjective maternal responses to bathing in labor have been favorable. No maternal or infant infections have been attributed to bathing with intact or ruptured membranes. Maternal bathing in labor does not appear to affect Apgar scores at five minutes or stress hormones at birth.

A 2003 case study indicated that hydrotherapy may be beneficial in treating Rett syndrome. An eleven-year-old girl with stage III Rett syndrome was treated with hydrotherapy in a swimming pool twice a week for eight weeks. After the application of hydrotherapy, stereotypical hand movements had decreased and purposeful hand functions and feeding skills had increased. Research into the effectiveness of hydrotherapy in treating this and other neuromuscular conditions is ongoing.

Perspective and Prospects

Ancient Greek literature contains a considerably large volume of published articles concerning different types of baths and hydrotherapy. These topics were addressed for preventive, hygienic, or therapeutic purposes. These Greek baths were classified in two categories: cold water baths and hot water baths. Cold water baths were said to slow blood circulation; decrease the amount of sweat produced; increase muscular strength, the ability to work, and a sense of well-being; and improve physical, mental, and moral balance. The hot water baths were reported to be relaxing, antispasmodic, and beneficial for treating nervous disturbances.

Bibliography

Buchman, Dian Dincin. The Complete Book of Water Healing. 2d ed. Chicago: Contemporary Books, 2002.

Cole, Andrew J., and Bruce E. Becker, eds. Comprehensive Aquatic Therapy. 3d ed. Pullman, Wa.: Washington State University Publishing, 2011.

"Hydrotherapy." American Cancer Society, March 7, 2011.

Johnson, Filip. "Hydrotherapy." North American Spine Society, March 21, 2011.

Kloth, Luther, and Joseph M. McCulloch. "Wound Bed Preparation/Debridement: Hydrotherapy." In Wound Healing: Evidence-Based Management. Philadelphia: F.A. Davis, 2010.

Ruoti, Richard G., David M. Morris, and Andrew J. Cole, eds. Aquatic Rehabilitation. Philadelphia: Lippincott, 1997.

Ryrie, Charlie. The Healing Energies of Water. North Clarendon, Vt.: Charles Tuttle, 1999.

Tharpe, Nell, Robin G. Jordan, and Cindy L. Farley. "Care of the Woman Using Hydrotherapy in Labor." In Clinical Practice Guidelines for Midwifery and Women's Health. 4th ed. Burlington, Mass: Jones & Bartlett Learning, 2013.