Canis ISSN: 2398-2942

Hydrotherapy

Contributor(s): Vetstream Ltd, Gillian Calvo

Introduction

  • Hydrotherapy is the terminology used to describe water-based therapy. It is commonly used for managing musculoskeletal injuries and correction and rehabilitation of tonal or gait abnormalities.
  • Hydrotherapy is widely used in canine patients with evidence-based literature increasing year on year in its anatomical and physiological benefits. 
  • The practice of hydrotherapy has evolved from physiotherapist led aquatic therapy in the human medical profession for the treatment of:
    • Musculoskeletal conditions.
    • Orthopedic conditions.
    • Neurological conditions.
    • Sports injuries.
    • Medical conditions.
    • Obesity.
    • Cardiovascular fitness.
    • Body conditioning.
  • Hydrotherapy is an effective technique for improving muscular strength and endurance (including cardiovascular endurance), increasing joint mobility, improving postural control, proprioception training, coordination and reducing the incidence of secondary musculoskeletal injuries. It can be used as a stand-alone modality or in conjunction with physiotherapy.
  • Known properties of hydrotherapy also include:
    • Reduction in pain.
    • Reduced muscle spasm - promotes relaxation.
    • Increased muscle tone - muscle activation.
    • Reduced edema.  
  • A significant property of hydrotherapy is the ability to regulate weight-bearing load on limbs by increasing or decreasing buoyancy. By reducing limb-load this can improve joint motion and coordination with or without the need for manual assistance by therapist.
  • The canine athletic circle is becoming more and more directed towards the use of hydrotherapy (and physiotherapy) to enhance performance during trials and competitions through its positive effects on core stability, musculoskeletal strength and coordination, ultimately improving their body condition. This concept is also becoming a familiar scene for dogs competing in the show ring due to the overall appearance associated with muscle fine-tuning and posture.
  • Hydrotherapy is most commonly utilized for:
  • The physical properties of the water may be varied to individualize the therapeutic effects for each patient. These include altering buoyancy, hydrostatic pressure, and viscosity, and variations in temperature:
    • The increased buoyancy and resistance in hydrotherapy improves joint stability and reduces weight-bearing on muscles and joints.
    • Immersion in water leads to circumferential compression, in proportion to the depth of water, which increases extra-vascular pressure promoting circulation and reducing edema.
    • Varying the temperature of the water may lead to different effects. Warm water causes vasodilation, increased circulation, and decreased muscle spasm. Cold water reduces inflammation by decreasing blood flow and inflammatory mediators.
  • Underwater treadmills (UWTM) are capable of holding a varied volume of water and provide more adaptability in buoyancy when compared to hydrotherapy pools, therefore allowing more individualized rehabilitation protocols. Both UWTM and hydrotherapy pools come with ‘hydrojets’ which create additional turbulence and increased limb resistance.

Uses

  • Hydrotherapy training helps improve cardiovascular function, aids repair of, and reduces, musculoskeletal injury. It is particularly useful in providing a medium to high-intensity workout without subjecting the musculoskeletal system to high levels of concussive force. This enables patients to maintain a level of cardiovascular fitness during post-operative rehabilitation or whilst injuries heal.
  • Hydrotherapy may also be used as a maintenance fitness regime in patients with chronic conditions, eg osteoarthritis.
  • UWTM walking affects stride length, gait and joint range of motion depending on the depth of water and speed of the treadmill, factors which are challenging to alter in a hydrotherapy pool. Thoracolumbar lateral bending, pelvic flexion, and axial rotation are also influenced by the depth of water in the UWTM.

Advantages

  • Reduce stresses placed on limbs.
  • Improved range of motion of joints.
  • Improved muscle aerobic capacity and strength.
  • Increased cardiovascular and respiratory endurance.
  • Reduce limb swelling and edema.

Disadvantages

  • Hydrotherapy should not be used in patients with cardiovascular or respiratory disease because of the exertion on the CV system and increased hydrostatic pressure on the body.
  • Hydrotherapy contraindications:
    • Fear of water.
    • Pain that is not well managed or under control.
      • Hydrotherapy may be used as an adjunct therapy to conventional pain management protocols, eg in the management of osteoarthritis.
    • Unhealed surgical incisions.
    • Open  / infected / draining wounds.
    • Skin disease.
    • Neoplasia.
    • Joint inflammation:
      • The temperature of water will exacerbate.
    • Elevated temperature / hyperthermia.
    • Cardiovascular disease.

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Waining M, Young I S, Williams S B (2011) Evaluation of the status of canine hydrotherapy in the UK. Vet Rec 168 (15), 407 PubMed.
  • Korvick D L, Johnson A L, Schaeffer D J (1994) Surgeons' preferences in treating cranial cruciate ligament ruptures in dogs. J Am Vet Med Assoc 205 (9), 1318-1324 PubMed.

Other sources of information

  • Millis D, Levine D (2013) Canine Rehabilitation and Physical Therapy. 2nd edn. Elsevier.


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