Aquatic Exercise Program for Individuals With Osteoarthritis: Pain, Stiffness, Physical Function, Self-Efficacy.

PURPOSE: This research was conducted to determine the effects of an aquatic exercise program on pain, stiffness, physical function, and self-efficacy in individuals with osteoarthritis. DESIGN: A randomized controlled trial. METHODS: Participants in the experimental group participated in the aquatic exercise program three times a week for 8 weeks; participants in the control group did not. FINDINGS: The mean scores of the experimental group on the pain, stiffness, and difficulty in carrying out physical functions subscales of the Western Ontario and McMaster Universities Osteoarthritis Index decreased significantly, whereas those of the control group decreased very little. The mean scores of the experimental group on the Arthritis Self-Efficacy Scale and the isokinetic muscle strength measurements increased, but those of the control group did not change in the final measurements. The difference between the groups was statistically significant. CONCLUSIONS: Through the study, it was determined that the aquatic exercise program decreased pain, stiffness, and difficulty in carrying out physical functions and increased self-efficacy and muscle strength of individuals with osteoarthritis. CLINICAL RELEVANCE: The aquatic exercise program can be used by nurses as a reference in the management of osteoarthritic patients' health status.

An Assessment of the Effects of Hydrotherapy During the Active Phase of Labor on the Labor Process and Parenting Behavior.

This study was conducted to assess the effect on labor process and parenting behavior of hydrotherapy applied during the active phase of labor. This quasi-experimental study was conducted by using an equivalent comparison group (n = 40). The participants in the experimental group whose cervical dilation was 5 cm were taken to the hydrotherapy tub. This application continued until cervical dilation reached 10 cm. The Participants Questionnaire, The Birth Follow-up Questionnaire, The Postpartum ]collection tools. The duration of the active phase and second stage of labor was extremely short in the experimental group in comparison with the equivalent comparison group (p = .001). The Visual Analogue Scale (VAS) scores of the experimental group were lower than those of the equivalent comparison group when cervical dilation was 6 cm and 10 cm (p = .001). The experimental group also displayed more positive parenting behavior and positive labor feeling (p = .001).

Culture, bathing and hydrotherapy in labor: An exploratory descriptive pilot study.

OBJECTIVE: Though bathing (hydrotherapy) is widely used during labor to decrease anxiety and pain and to promote relaxation, the influence of cultural beliefs about bathing by parturients is virtually unknown. This pilot study explored pregnant women's experiences of bathing, bathing in labor, and cultural beliefs about bathing. DESIGN: An exploratory, descriptive design. SETTING: Low risk obstetrical clinics. PARTICIPANTS: Healthy Hispanic, Black, White, American-Indian and Asian women (N = 41) at >37 weeks gestation. METHODS: During a routine prenatal visit women responded to a brief openended questionnaire on the use of bathing. Data was captured using a modified ethnographic method involving observation and note taking with thematic analysis and quantification of percent response rates. FINDINGS: Forty-six percent (N = 41) of women used bathing for purposes other than hygiene but only 4.9% (N = 41) of these women bathed during a previous labor. The women described bathing as relaxing, easing, calming, and efficacious for relief of menstrual cramps and labor contractions. Ten percent of women reported cultural beliefs about bathing. CONCLUSIONS: Women who bathe, report relief of anxiety, menstrual and labor pain and promotion of mental and physical relaxation. The findings do not support the view that bathing is associated with identifiable cultural beliefs; rather, they suggest that bathing is a self-care measure used by women. This practice is likely transmitted from generation to generation by female elders through the oral tradition. Assumptions that race or ethnicity precludes the use of bathing may be faulty. Cautionary instructions should be given to pregnant women who are <37 completed weeks of gestation, to avoid bathing for relief of cramping or contractions and to seek immediate health care evaluation. Study of culturally intact groups may uncover additional themes related to bathing in labor and as a self-care measure for dysmenorrhea.

O potencial terapêutico de uma oficina no território: autonomia e noção de pertença / El potencial terapéutico de un taller en el territorio: la autonomía y el sentido de pertinência / The therapeutic potential of a workshop in the territory: autonomy and sense of belonging

Objective: This study describes the therapeutic potential of a workshop in the territory for users of the Psychosocial Care Center and discuss the proposed therapy workshop and user interaction with the territory. Methods: Descriptive and exploratory research. The data resulted from participant observation and interviews as two coordinators. Thematic kind of content analysis was used for data processing. Results: As a result we obtained two thematic categories: Pool and the territory, and Benefits of a Pool Workshop. Conclusion: The workshop held in the territory allows the user to see himself/herself as part of it and also reframe the ways of living in that territory. The notion of belonging, social acceptance and citizenship are keys in building the social subject.

Objetivo: Descrever o potencial terapêutico de uma oficina no território para os usuários de saúde mental e discutir a proposta terapêutica da oficina e a interação dos usuários com o território. Método: Trata-se de estudo descritivo-exploratório. Os dados resultaram da observação participante e das entrevistas com os coordenadores, sendo utilizada a Análise de Conteúdo do tipo Temática para o tratamento dos dados. Resultados: Apresentaram-se duas categorias temáticas: Piscina e o território; e Os benefícios da Oficina de Piscina. Conclusão: A oficina realizada no território permite que o usuário se perceba parte dele e, ainda, ressignificar as formas de viver naquele território, bem como a noção de pertença, de aceitação social e cidadania que são fundamentais na construção do sujeito social.

Objetivo: El presente estudio describe el potencial terapéutico de un taller en el territorio, para los usuarios del Centro de Atención Psicosocial y discutir el taller de terapia propuesta y la interacción del usuario con el territorio. Método: La investigación descriptiva y exploratoria. Los datos de resultado de la observación participante y entrevistas como dos coordinadores. Tipo temático de análisis de contenido fue utilizado para el procesamiento de datos. Resultados: Como resultado se obtuvieron dos categorías temáticas: Piscina y el territorio; y Privilegios taller. El taller realizado en el territorio permite que el usuario se da cuenta parte de ella y también replantear las formas de vivir en ese territorio. Conclusión: La noción de pertenencia, aceptación social y la ciudadanía son clave en la construcción del sujeto social.

Computer tablet distraction reduces pain and anxiety in pediatric burn patients undergoing hydrotherapy: A randomized trial.

BACKGROUND: Distraction is often used in conjunction with analgesics to minimize pain in pediatric burn patients during treatment procedures. Computer tablets provide many options for distraction items in one tool and are often used during medical procedures. Few studies have examined the effectiveness of tablet distraction in improving the care of pediatric burn patients. AIM: This study examines the effectiveness of tablet distraction provided by a child life specialist to minimize pain and anxiety in pediatric burn patients undergoing hydrotherapy. METHODS: Thirty pediatric patients (4-12) undergoing hydrotherapy for the treatment of burns participated in this randomized clinical trial. The tablet distraction group received tablet distraction provided by a child life specialist while those in the control group received standard care. Pain was assessed through self-reports and observation reports. Anxiety was assessed through behavioral observations. Length of procedure was also recorded. RESULTS: Nurses reported significantly less pain for the tablet distraction group compared to the control group. There was no significant difference between groups on self-reported pain. The tablet distraction group displayed significantly less anxiety during the procedure compared to the control group. Also, the tablet distraction group returned to baseline after the procedure while those in the control group displayed higher anxiety post-procedure. There was no difference in the length of the procedure between groups. CONCLUSIONS: These findings suggest tablet distraction provided by a child life specialist may be an effective method for improving pain and anxiety in children undergoing hydrotherapy treatment for burns.

Effects of yoga versus hydrotherapy training on health-related quality of life and exercise capacity in patients with heart failure: A randomized controlled study.

AIMS: The aims of this study were to determine whether yoga and hydrotherapy training had an equal effect on the health-related quality of life in patients with heart failure and to compare the effects on exercise capacity, clinical outcomes, and symptoms of anxiety and depression between and within the two groups. METHODS: The design was a randomized controlled non-inferiority study. A total of 40 patients, 30% women (mean±SD age 64.9±8.9 years) with heart failure were randomized to an intervention of 12 weeks, either performing yoga or training with hydrotherapy for 45-60 minutes twice a week. Evaluation at baseline and after 12 weeks included self-reported health-related quality of life, a six-minute walk test, a sit-to-stand test, clinical variables, and symptoms of anxiety and depression. RESULTS: Yoga and hydrotherapy had an equal impact on quality of life, exercise capacity, clinical outcomes, and symptoms of anxiety and depression. Within both groups, exercise capacity significantly improved (hydrotherapy p=0.02; yoga p=0.008) and symptoms of anxiety decreased (hydrotherapy p=0.03; yoga p=0.01). Patients in the yoga group significantly improved their health as rated by EQ-VAS ( p=0.004) and disease-specific quality of life in the domains symptom frequency ( p=0.03), self-efficacy ( p=0.01), clinical summary as a combined measure of symptoms and social factors ( p=0.05), and overall summary score ( p=0.04). Symptoms of depression were decreased in this group ( p=0.005). In the hydrotherapy group, lower limb muscle strength improved significantly ( p=0.01). CONCLUSIONS: Yoga may be an alternative or complementary option to established forms of exercise training such as hydrotherapy for improvement in health-related quality of life and may decrease depressive symptoms in patients with heart failure.

[Support in addictology: hydrotherapy]. / Accompagnement en addictologie: une pratique de l'hydrothérapie.

Hydrotherapy is a corporal mediation treatment used with patients with addictions by the Mayenne centre for addiction support therapy and prevention. A demonstration of the benefit of hydrotherapy for these patients through a patient's case.

Summative evaluation of a pilot aquatic exercise program for children with disabilities.

BACKGROUND: Children with disabilities have lower physical activity levels and participate less in community-based sport and exercise programs than do children without disabilities. This in part is due to environmental barriers and lack of appropriate resources in these programs. Adaptive programs encouraging increased physical activity for children with disabilities are needed, and as these programs are developed, they should be critically evaluated. PURPOSE: The purposes of this article are to describe a pilot aquatic exercise program for children with disabilities, to evaluate the program, and to determine areas of strength and areas needing modifications. METHODS: A summative program evaluation design was used to assess this twice per week aquatic exercise program lasting 14 weeks. Sixteen children, ages 6-12 years, with developmental disabilities participated in the program. Children swam laps, participated in relay races and water basketball games, and performed arm and leg strengthening exercises using aquatic noodles, foam barbells, and water for resistance. Swimming skills, program evaluation questionnaires, physical activity questionnaires, and interviews of pool site directors were used to determine program outcomes. RESULTS: Findings suggest that children made improvements in their swimming skills, parents were satisfied with the program, and children increased their physical activity levels during the program and maintained the increased physical activity levels six months after the program ended. The program continued in some form after the 14-week intervention ended. CONCLUSIONS: The program was successful in achieving its objectives and recommendations for application of this program are provided.

Observing position and movements in hydrotherapy: a pilot study.

OBJECTIVE: To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. DESIGN: Descriptive, observational pilot study. SETTING: A rural community hospital that provided hydrotherapy in labor. PARTICIPANTS: Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. MEASURES: For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. RESULTS: Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. CONCLUSIONS: Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

Effects of footbathing on autonomic nerve and immune function.

The purpose of this study was to investigate the effects of footbathing on autonomic nerve and immune function. Eleven healthy female volunteers (aged 22-24 years) undertook footbaths at 42 degrees C for 10 min, with or without additional mechanical stimulation (air bubbles and vibration). Autonomic responses were evaluated by electrocardiography and spectral analysis of heart rate variability, and by measurement of blood flow in the sural region. White blood cell (WBC) counts, ratios of lymphocyte subsets, and natural killer (NK) cell cytotoxicity were used as indicators of immune function. Footbathing with mechanical stimulation produced (1) significant changes in the measured autonomic responses, indicating a shift to increased parasympathetic and decreased sympathetic activity and (2) significant increases in WBC count and NK cell cytotoxicity, suggesting an improved immune status. Because these physiological changes are likely to be of benefit to health, our findings support the use of footbathing in nursing practice.

Aquatics, health-promoting self-care behaviours and adults with brain injuries.

PRIMARY OBJECTIVE: To determine the effect of an aquatic programme on the health promoting behaviours of adults with brain injuries. MAIN OUTCOMES AND RESULTS: Eighteen individuals participated in the programme and were randomly assigned to an experimental (n = 9) or control group (n = 9). Health promoting behaviours, physical self-concept and self-esteem were measured pre- and post-intervention. Significant differences and large effect sizes were found between scores for the experimental group only, indicating an increase in health promoting behaviours, physical self-concept and self-esteem. CONCLUSIONS: Results have useful implications for health professionals as exercise prescription may enhance health promoting behaviours and decrease health care costs after a brain injury.

Water-friendly virtual reality pain control during wound care.

Recent research suggests that entering an immersive virtual environment can serve as a powerful nonpharmacologic analgesic for severe burn pain. The present case study describes an attempt to use water-friendly virtual reality (VR) technology with a burn patient undergoing wound care in a hydrotherapy tub. The patient was a 40-year-old male with 19% total body surface area deep flame/flash burns to his legs, neck, back, and buttocks. The virtual reality treatment decreased the patient's sensory and affective pain ratings and decreased the amount of time spent thinking about his pain during wound care. We believe that VR analgesia works by drawing attention away from the wound care, leaving less attention available to process incoming pain signals. The water-friendly VR helmet dramatically increases the number of patients with severe burns that could potentially be treated with VR (see http://www.vrpain.com).

Implementation of the Vienna Hydrotherapy Group for Laryngectomees--a pilot study.

GOALS: Laryngectomy involves several problems for the individual, such as the need to cope with a stoma, adjustment to tracheostomal breathing, and the formation of a voice. Contact with water, resulting in aspiration, may prove fatal for laryngectomized patients in the absence of appropriate aids. The aim of this pilot study was to conduct a hydrotherapy group for laryngectomized patients and to evaluate its feasibility and outcome in relation to the goals of therapy. PATIENTS AND METHODS: Six male patients who had undergone laryngectomy were included in a pilot study. The patients underwent a structured hydrotherapy rehabilitation program (three times a week for 8 weeks), using a special underwater therapy device. The patients' posture was controlled by posturography and their endurance capacity by standard ergometry and the 6-min walk. The parameters of fatigue, expectoration, mobility, elasticity/flexibility, postural control/coordination, and general well being were registered on a visual analog scale (VAS). Quality of life was assessed by having the patients fill out the German version of the SF-36 Health Survey. MAIN RESULTS: Posturograpy findings showed an improvement of two subtests ( p<0.028). Exercise testing showed an improved endurance capacity ( p<0.028). The patients were able to walk a greater distance in the 6-min walking test ( p<0.028). The VAS also showed an improvement of endurance capacity ( p<0.028), fatigue ( p<0.028), expectoration ( p<0.043), mobility of the neck and shoulder ( p<0.027), flexibility ( p<0.027), postural control and coordination ( p<0.028), and general well being ( p<0.028). On the SF-36 Health Survey, the patients were improved in the items "Physical functioning" ( p<0.027), "Vitality" ( p<0.027) "Role-physical" ( p<0.026), and "Social functioning" ( p<0.043). CONCLUSIONS: A hydrotherapy group for laryngectomized patients proved to be safe, feasible, and effective in this pilot study.