Aqua Therapy Following a Spinal Cord Injury

There’s no doubt that rehabilitation following a spinal cord injury (SCI) can be a long and challenging process for the individual concerned. There are several types of therapy which have shown to be beneficial for SCI patients during their recovery.

A lot does depends on the extent of the injury. Individuals will generally work with doctors and a professional physiotherapist to develop a regime that works for their condition. One important rehabilitation technique that is used quite widely with spinal cord injuries is aqua therapy, as known as aquatic therapy or hydrotherapy.

Here we take a closer look at this approach, how it can be beneficial and what to consider before undertaking aquatic exercise following a spinal cord injury.

What is Aqua Therapy?

Aquatic rehabilitation basically uses the supportive property of water to undertake gentle exercises which can help to improve coordination and mobility. Also called water therapy, it is always carried out at a specialist facility or shallow swimming pool under the supervision of a qualified therapist.

Aqua therapy can help with balance and coordination, improve flexibility, boost heart health and also increase overall strength. Different techniques are used depending on the condition of the patient and what they are capable of.

For example, aqua jogging involves wearing a floatation vest and improving a person’s gait by walking in the water. The water provides enough support so that the individual is able to stay upright and mobile without falling. It is often used before moving onto more intensive exercises out of the pool.

Benefits of Aqua Therapy Following a Spinal Cord Injury

There are huge benefits from using hydrotherapy following a spinal cord injury. The viscosity and buoyancy of the water provides an ideal environment and allows individuals to undertake physiotherapy that might not normally be possible outside of the pool.

• Someone with a brain injury, for example, can learn to walk again and training can be gradually increased with the support of the water.
• Individuals can learn to sit, stand and walk again and it can help with issues such as balance by strengthening particular muscle groups and giving participants more confidence than they have on dry land.
• Warm water that is gently circulated can help with issues such as pain management and can reduce stiffness. It also helps improve blood circulation and overall health.
• Underwater jets may be used for some patients so that they can benefit from resistance training, further strengthening muscles and perhaps preparing for more work to be done outside of the pool.

Examples of Aqua Therapy Exercises for SCI patients

A physiotherapist will work to find the right water therapy exercises for each patient with their condition and present capabilities taken into consideration.

Typical aqua therapy exercises include:

• Wearing floating rings around the arms, torso and legs and lying horizontally, completing gentle exercises such as moving the arms against the force of the water.
• The Halliwick programme is a much-used therapeutic approach that takes place over ten steps and focuses more on improving balance and coordination for the individual. This approach has been around since the 1950s and is still used today.
• Watsu, on the other hand, is a less active form of water therapy. The individual lies in the water and the physiotherapist manipulates their body, often using massage in the warm water to improve mobility and increase joint movement.
• Patients who are able to make some leg movements can benefit from jogging in the pool with the right additional support. The water gives them the confidence to move their legs without fear of losing balance. It can also help improve gait and muscle strength and prepare the individual for more intensive work out of the water.
• Ai Chi is another approach that brings the subtle gestures of T’ai Chi to the pool. This involves making small, slow and controlled movements whilst being supported by the water. 

Things to consider

Hydrotherapy can be extremely useful for spinal cord injury rehabilitation, but it may not be suitable in all cases. Even though a shallow pool is used, there are safety considerations, particularly with individuals who have an SCI.

There may be issues with incontinence for example, especially with more severe spinal cord injuries. Individuals who have challenges with spasticity may also be at more risk. It’s vital that any SCI aqua therapy session is controlled and supervised by a qualified physiotherapist who is aware of any potential risks and can keep the individual safe at all times.