The National Rural Health Association (NRHA) is hosting their annual Critical Access Hospital trade show and conference this week in Kansas City, Missouri. The NRHA is a national nonprofit membership organization which provides leadership on rural health concerns through advocacy, communications, education and research. The 13th Annual Critical Access Hospital Conference, in which HydroWorx will be participating, will take place Wednesday October 1st and 2nd in Kansas City, MO. The goal of this conference is to share effective policies insights when addressing many of the access, quality and patient safety issues confronted by Critical Access Hospitals and Rural Health Clinics.
The obstacles faced by health care providers and patients in rural areas are vastly different than those in urban areas. Rural Americans face a unique combination of factors that create disparities in health care not found in urban areas. Economic factors, cultural and social differences, educational shortcomings, lack of recognition by legislators and the sheer isolation of living in remote rural areas all conspire to impede rural Americans in their struggle to lead a normal, healthy life.
Freeman Health Systems which is located in Joplin, MO, surrounded by many rural towns, boasts a HydroWorx 2000 Series aquatic therapy pool. Their pool, which is unique to that region, features an underwater treadmill and underwater cameras that allow physical therapists to monitor patients’ gait patterns and form during a therapy session. With a fully adjustable floor that raises to ground level for easy and safe access into the pool, Freeman Hospital clinicians are able to treat a variety of patients.
“This pool is allowing our patients to get into a more therapeutic environment, begin their therapy early, more comfortably, and progress toward land-based activities in a much more rapid manner. So we really believe it’s been an excellent tool to help us continue to achieve nationally ranked outcomes.” – Mick Ward, Director of Rehabilitation and Sports Medicine Services at Freeman Health System in Joplin, MO
One patient in particular utilized the HydroWorx therapy pool at Freeman Health System to recover from a severe spinal cord injury. For this young patient, the diagnosis was originally paraplegia, but he made such great progress with his rehab that now it is considered an incomplete spinal cord injury to the L1 and L4. Ronnie was previously wheelchair bound, but with the combination of water and land therapy, Ronnie has been walking around his school on crutches carrying his backpack! At Freeman Health, the therapists are focusing on increasing his right hamstring contraction and control as well as increasing his overall strength in his lower extremities. He is able to ambulate with bilateral upper extremity support using a floating long dumbbell with assistance in order to achieve full knee extension on his right side.
Watch the videos of Ronnie’s rehabilitation in the pool at Freeman Health System:
HydroWorx is looking forward to the NRHA’s Critical Access Hospital Conference this week in Kansas City, MO. Stop by to learn more about the impact aquatic therapy can have in your rural clinic.
Keeping with our ICAA Active Aging Week theme for this week, Friday is Walking/Group Classes Day. When we think of walking for wellness, most of us automatically envision going for a walk in the neighborhood, on a track or at a mall. These are all great ways to go for a walk, but sometimes we need a change of pace or are limited in how much we can do on land because of pain.
An alternative way to “go for a walk” or even to engage in group classes, is in a HydroWorx therapy pool. For those that are limited with what they can accomplish on land, the buoyancy of the water reduces an individual’s body weight between 20%-100%, making activities such as walking or even jogging more tolerable and enjoyable because of reduced pain.
Even for those that enjoy going for a walk outside, the viscosity of the water alone or combined with resistance jets can provide a method of increasing resistance which can lead to greater strength and cardiovascular endurance.
Using the HydroWorx 2000 Series pool at Pieters Family Life Center in Rochester, NY, Wellness Coordinator, Barb Cacia, provides multiple types of group classes which include walking on an underwater treadmill to encourage members to improve their health. Classes are created based on condition type, capabilities and interest and provide an enticing environment for participants to improve physically while also fostering personal relationships.
In the session shown below, Barb starts her class with a five-minute walking warm-up using the underwater treadmill and support bars within the pool. After that, she spends time focusing on strength exercises, balance, flexibility and cardiovascular endurance in order to help participants in all areas of their daily activities.
Watch one of Barb’s classes below:
To learn more about how aquatic therapy can impact wellness, rehabilitation and falls in your community, download our tip sheet “Why Water Worx for Senior Living Services.”
In 2010, the Center for Disease Control and Prevention (CDC) revealed that one third of persons ages 65+ can expect to fall annually. Thankfully, the majority of those who fall are able to return to their daily activities, but up to 30% percent will pass away from their falls, increase their likelihood of passing sooner and/or have to be hospitalized sooner as a result of the fall.
How can we help prevent that statistic from growing?
A recently published research study from Utah State University, “Effect of Aquatic Immersion on Static Balance,” was created with that question in mind. The study, authored by Talin J. Louder, compared the measures of static balance and limits of stability in both land and aquatic environments. During their research, Louder and his fellow study authors, including Utah State University’s Dr. Dennis G. Dolny, measured participants’ balancing abilities under three settings: on land, submerged in a HydroWorx therapy pool to the waist, and then submerged in the same pool to the chest. The results indicated that when they were in the aquatic environment, participants had to work harder to maintain their balance.
“When healthy adults stand quietly in chest deep water, they display greater postural instability compared to on land. Developing stability using exercises that are characteristically unstable, yet safe (e.g., aquatic environment) improves coordination and balance. Improvements in balance lead to reduced fall risk in the elderly. So the water provides a more challenging environment to work on stability, yet is obviously a much safer environment with essentially no down side if loss of balance occurs, as compare to land.” – Dr. Dennis Dolny
The results of this study indicate that aquatic therapy may provide a more promising and challenging environment to improve overall balance than land. At Stonehill Franciscan Services in Dubuque, Iowa, Director of Rehabilitation Rachel McDermott, PTA, regularly utilizes their HydroWorx 2000 Series therapy pool to improve patients’ overall stability and balance. As she notes, putting their patients in the pool and using the resistance of the water (as well as the resistance jets and variable-depth underwater treadmill floor) has been tremendously helpful.
“We’ve seen a better return in balance for our patients, and a little quicker return as well. People often have a fear of falling, so putting them on a ball or asking them to lift up a foot is impossible on land. In the pool, they feel like they can accomplish more. There’s less fear of falling, and they build more confidence. They are able to progress nicely. Any therapeutic exercises you can do on land, you can creatively adapt to the water.”
Often, the increased confidence of your residents and patients leads to fewer cancelled appointments which positively impacts their lives and your organization as well. Learn more about this research study today>>
Download our Research Studies Book for a comprehensive overview of studies that have been done on underwater treadmills.
The theme of this year’s ICAA Active Aging week is “Let the Adventure Begin!” According to their website, “Active Aging Week is an annual health promotion event held each year during the last week of September. The weeklong observance celebrates adults ages 50 and older as fully participating members of society and promotes the benefits of leading an active, healthier lifestyle. It also highlights the ability of older adults to live well, regardless of age or health conditions.”
Today is “Falls Prevention Awareness Day.” According to the US Centers for Disease Control and Prevention, one-third of Americans aged 65 and older fall each year with up to 30% experiencing fall related injuries that negatively impact function and independence. Muscle weakness and gait impairments are the most common causes of falls in all older adults.
But, falling does not have to be an inevitable result of aging. Through evidence-based interventions, comprehensive wellness programs combined with simple lifestyle adjustments can substantially reduce the number of falls among adults. Recent research published by Utah State University in the International Journal of Aquatic Research and Education shows how aquatic therapy can improve balance in aging adults. Based on their findings, they concluded that the inclusion of aquatic training is an important consideration as part of a comprehensive training/rehabilitation program. Developing stability through exercises that are characteristically unstable improves neuromuscular coordination and postural control strategies as well as reduces risk of falls.
Addtionally, research done at Texas A&M University shows greater lean muscle mass increases when resistance training is used in combination with aquatic treadmill training than with land treadmill training.
Creating balance and strength training programs with an aquatics component can yield valuable results. We recently posted about an article written by Jackie Halbin, who is a Living Well Manager at Lakeview Village in Kansas and Master FallProof and FallProof H2O instructor and is Aquatic Exercise Association-certified. She says:
“Thus far, there has been an overall 45 percent increase in center of gravity, 64 percent increase in lower body strength, and 35 percent increase in agility in participants, thanks to the program and the therapy pool.”
To learn more about Why Water Worx for Senior Living, download our tip sheet with more fall stats as well as the financial impacts of reducing falls>>
As Baby Boomers age, they will be looking for communities in which they can maintain their active lifestyles despite physical limitations that they may encounter. There are a multitude of ways to offer wellness programs in a senior living community and each are important in order to accommodate a broad range of physical abilities. Offering unique technologically-advanced fitness options such as an aquatic therapy pool with underwater treadmill and resistance jet can set a senior living community apart from others in the area.
The equipment itself can attract residents, but it is also important to successfully incorporate the technology into your wellness programs. This will ensure a positive return on investment as well as word of mouth referrals and buzz.
From a piece, “Underwater Treadmills Woo Boomers to Retirement Communities, Encourage Innovative Fitness Programs,” Kim Eichinger, Executive Director of Fitness at Country Meadows Retirement Communities, offers some elements of her favorite successful exercise programs that she uses with her residents:
Step One: The Warm-Up
As any fitness instructor knows, the warm-up stage is integral to the overall success of any training session. Even in tepid water (we keep our pool at around 92 degrees Fahrenheit), the warm-up is equally as important as in land-based fitness routines.
I typically like to start the warm-up from the bottom of the body and work upward. Thus, the short warm-up typically includes:
Heel-Toe Raises – The rocking motion encourages plantar flexion and dorsa flexion, which is essential for walking heel to toe. This movement is important for forward propulsion when walking and helps prevent shuffling.
Side-to-Side Rocking – Helps to prepare for weight shifting and side stepping patterns. In addition to the heel-toe raises, this is a great exercise for working the sides of the feet. Often, this is one area that’s ignored during warm-ups, but it’s essential for a positive outcome on an underwater treadmill. It also helps engage the hips and legs.
Trunk Rotation and Posture Press Ups – The handrails of a HydroWorx pool work as a great feature to assist with exercises that encourage upright posture and trunk movement. By lightly pressing down on the rails to extend the spine and by reaching across the body to grasp the rails, participants can perform exercises to engage the core muscles.
Step Two: Walking Workout
Because of its intrinsic nature, the underwater treadmill lends itself to walking. However, I try not to allow our community’s residents to simply walk as they would normally do on land. By forcing them to think about their posture, gait and speed, I can give them an extremely comprehensive workout that leaves them feeling refreshed but not uncomfortable.
During the walking workout, I employ the following methods to get a significant calorie burn:
Arm-Swing Progressions – Reconnecting arm swing with walking is important for mobility. Participants who ambulate with a walker typically do not swing their arm when walking. We can gradually connect arm swing with walking and still have the safety of the bars to assist the participant while they progress from swinging one arm to both arms.
Level 2 Arm Swing – As arm swing coordination improves strength and endurance can continue to be challenged by extending the arms through a greater range of motion or with more force against the natural resistance of the water. Interval training can also be performed by alternating periods of walking while grasping the bars, then swinging arms while standing in place and then walking while swinging arms.
Cross-Shoulder Swing – The motion of the cross-shoulder swing also provides a boost to the caloric “burn” of the underwater treadmill walking routine. When the arms are forced to move across the body against the natural resistance of the water, their flexibility and strength are engaged.
Step Three: Range of Motion, Strength and Balance
I feel it would be remiss to simply offer walking in a HydroWorx pool; after all, there’s so much more to do! For instance, range of motion, strength and balance (all of which are daily concerns of aging residents) can all be improved during the underwater treadmill workout.
Below are three of my favorite exercises to introduce:
Sit-Back Hip Stretch – Holding onto the bars for balance (or doing so without them, if possible), an individual can “sit back” in the water, bending downward to stretch the upper legs and hip area. To emphasize balance and give the abdominals a workout, I ensure that the core is engaged during this process.
Hip Abduction – Important for balance and walking. The handrails and resistance jet allow for a number of options for varying positions and resistance level in performing these exercises. This is also a great exercise to prepare participants for the strength, range of motion and coordination for side stepping on the underwater treadmill.
Balance Exercises Using Jets – Because the pools come with resistance jets, I use them to build balance. During the training, I have participants stand on both legs, then on one at a time, while the jets are on. Again, the handrails are available for protection and comfort if necessary.
Step Four: Massage
By attaching the massage hose to the resistance jets, my residents can get a deep tissue massage along their legs, arms and back. It’s a great way to cool down, as it facilitates blood flow and reduces edema. So many of the Boomers I work with rave about how good it feels… and how it keeps them from getting sore the next day. Massage also enhances the social component of the cool down phase of the class. Participants love to relax and chat and this makes a nice closure to the workout.
“They can’t believe it– they can’t believe the way their body feels! They just love it!”
Get more great ideas for aquatic programs from Kim Eichinger during her webcast on September 23, 2014 at 4:00pm EDT. Register here>>