The following was first published in the July 1994 Rancho Los Amigos Post-Polio Support Group Newsletter and is reprinted here with kind permission of the author, Mary Clarke Atwood and the Rancho Los Amigos Post-Polio Support Group.

PPSC DISCLAIMER

WARM WATER POOL EXERCISE
Compiled by Mary Clarke Atwood
Editorial assistance by V. Duboucheron
From "Pool Exercise - Principles and Guidelines for Polio Survivors"
by Robbie B. Leonard, M.S., P.T.

Rancho Los Amigos Post-Polio Support Group Newsletter - July 1994

Since this report was first written Robbie B. Leonard, M.S., P.T. has moved to:
Medical University of South Carolina
P.T. Program, University Ctr.
P.O. Box 5616, Greenville, SC 39606-5616
864-250-8862 FAX: 864-250-8869
leonardr@musc.edu
When asked to comment on this report Robbie B. Leaonard responded:
Everything looks good. I still believe all those things and find the pool therapy to be one of the best types of therapy for polio survivors! The only challenge is finding a warm, therapeutic pool. One addition - there is a videotape that I did with Sprint Rothhammer Inc. (Aquatic company) that goes over these principles and shows some of the exercises (www.sprintaquatics.com). You can get it from sprint or from the Roosevelt Institute (http://www.rooseveltrehab.org/postpolio.htm).

Hope that folks find this helpful.
Robbie
          14 January 2000

"Pool exercise is one of the best types of exercise that a person with Post-Polio can participate in since it is less stressful to the body,", according to Robbie Leonard, M.S., P.T., Director of Physical Therapy at Roosevelt Warm Springs Institute for Rehabilitation, Warm Springs, Georgia. But it depends on an individual's strengths and weaknesses as to whether pool exercise is appropriate. Each person should be evaluated by a physical therapist and given an individualized exercise program, since each person's strengths and weaknesses are unique.

POTENTIAL BENEFITS

Benefits depend on the temperature of the water as well as the amount of time spent in the pool.

WHY WARM WATER?

The recommended water temperature is 90° - 92° Fahrenheit (It feels quite warm as you get in.) The pool water temperature definitely should be no less than 85° Fahrenheit.

PSYSIOLOGIC BENEFITS

Immersion in warm water causes:

Note: Heart rates are generally lower in water exercise than in land exercise due to compression, temperature, and pressure. Heart rates based on land exercise are not applicable in the water.

PERSONS WITH RESPIRATORY PROBLEMS

People who are experiencing respiratory difficulties may find water helps respiratory function because hydrostatic pressure of the water on the chest wall stimulates chest expansion.

WHO SHOULD NOT PERFORM POOL EXERCISE?

Persons with:

INDIVIDULAIZING A POOL EXERCISE PROGRAM

HOW THE WATER AFFECTS YOU

Figure 1: BUOYANCY ASSISTED EXERCISE
image aqua1.gif (4546 bytes)


For hip flexor muscles: stand at side of pool or sit in a pool chair; bring the knee up towards the chest, letting the buoyancy of the water assist the movement.

Figure 2: BUOYANCY RESISTED EXERCISE

image aqua2.gif (3870 bytes)



For hip flexor muscles: lie on stomach holding pool ledge, bring knee towards the chest. The faster the movement, the greater the resistance.

Figure 3: BUOYANCY SUPPORTED EXERCISE
image aqua3.gif (4058 bytes)


For hip flexor muscles: lie on your side while holding pool ledge, bring knee towards the chest, then back to straight position.

MUSCLE GRADES AND BUOYANCY

Grading for Manual Muscle Testing attributed to Dr. J. Perry

GOOD EXERCISE PRINCIPLES AND GOOD BODY MECHANICS

  1. Do not exercise to the point of fatigue. (The combination of heat and exercising can be fatiguing.) Exercise may need to be short (10 minutes) and then lengthened as endurance improves. A person should spend no more than 30-45 minutes in water above 90° .

  2. Do the exercise during the "good" part of your day (when you have the most energy).

  3. The best benefits will be achieved in an exercise program 2 or 3 days a week.

  4. Be careful not to overstress the joints.

  5. Use good body mechanics - do not lock or hyperextend the joints during exercise.

  6. Movements in the water should be smooth, slow, and controlled (not jerky, fast movements).

  7. Know your limitations. If you become fatigued, short of breath, dizzy, or stressed, stop the exercise. (You may need to check with your doctor before resuming the program if you become dizzy or short of breath.)

  8. If any exercise causes pain, do not do it. Listen to your body. "No Pain, No Gain" is not a good philosophy for persons with PPS.

  9. Have fun in the water. If this exercise program is a negative experience for you, it is not an appropriate program.

  10. Remember this principle: Each individual should have a doctor's recommendation for pool exercise, and each individual program should be recommended by a therapist who knows your strengths and weaknesses.

ENHANCE YOUR ABILITIES

Robbie Leonard, M.S., P.T. says, "If your program is recommended by your doctor and individualized for you by your therapist, and you follow these basic principles, you should have a successful pool exercise program that will enhance your abilities."

CHOOSING A POOL

  1. The pool should have close, accessible parking. (If it takes all your energy to get to the pool, the exercise program will not be beneficial.)

  2. The pool should have a lift, ramp, or steps for ease of transfer into the pool. (Again, if it takes all of your energy to get into the pool, the effects of the exercise will be negated.)

  3. The pool should be monitored at all times for safety. Individuals should never be left unattended.

  4. The depth of the water where the exercises are performed should be between waist and chest high. (Deeper water could cause heat-related problems and will make exercising difficult.)

  5. The deck of the pool should not be slippery.

    • If you have an unsteady gait or difficulty with transfers, then tennis or aquatic shoes are recommended. (Lower priced aquatic shoes may be available at K-Mart, Wal-Mart or other discount stores in the summer months).

    • The pool water temperature should be no less than 85 degrees. Recommended temperature is between 90-92 degrees.

    • The air temperature around the pool should also be warm.



Reprinted from Rancho Los Amigos Post-Polio Support Group Newsletter July 1994.
© Rancho Los Amigos Post-Polio Support Group Newsletter and Mary Clarke Atwood

The Rancho Los Amigos Post-Polio Support Group meets the 4th Saturday,
from 2:00-4:00 in Downey, CA.
Contact: RanchoPPSG@hotmail.com for more information.

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