Publication
Table of Contents
Feature Articles
Creating Optimal Healing Environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Sheralee Beebe, HBOR
Redwood City, CA
Feature Columns
Are You Prepared? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Sue Skaros, BA, BS, PA-C, Medical College of Wisconsin, Milwaukee
Others
From the Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Research Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Healing
In the context of this article, healing is
defined as the dynamic process of
recovery, repair, restoration, renewal
and transformation that increases
resilience, coherence and wholeness.
Healing is an emergent process of the
persons whole system: physical, mental, social, spiritual and environmental.
Healing is a unique, personal and communal process and an experience that
may, or may not, involve curing.2
Healing is facilitated through development of proper attitudes and intentions
within both the client and aquatic
provider. It includes the recipients use
of personal self-care practices, creating
healing relationships, applying the
knowledge of health promotion and
maintenance, as well as appropriate
integration of complementary and conventional medicine practices.2
An optimal healing environment (OHE)
is defined as one in which the social,
psychological, spiritual, physical, and
behavioral components of health care
are oriented toward support and stimulation of healing and achievement of
wholeness.3 According to the Samueli
institute, the major characteristics of an
optimal healing environment include
Developing awareness and healing
intention.
Experiencing personal wholeness.
Cultivating healing relationships.
Practicing healthy lifestyles
Applying integrative or collaborative
medicine.
Creating healing places and healing
spaces.
psychological adjustment with a multiplicity of measures, have better adherence to medication regimes, have better
academic performance and find greater
meaning in difficult life events.8 In a
study where hopefulness was used as an
intervention with depressed elderly
patients, it was found that participants
in the hope group showed significant
decreases in anxiety, hopelessness and
functional disability, as well as improvement in social interaction.9
Dr. Seligman and colleagues study the
use of cognitive methods to train people to dispute pessimistic thinking, and
teach positive methods simple enough
to work for both adults and children.
This goal is development of strength,
not remediation of weakness. Their
research shows that optimism training
is successful, and once learned,
becomes self-reinforcing. People use
the skills they have been taught to help
themselves in life situations. Seligman
and colleagues have documented that
learned optimism cuts in half the future
incidence of depression and anxiety in
both children and adults.10
Consider the emotional effects of these
opposing statements. Focus deeply on
the first statement in the pair. Then
clear your mind and do the same with
the second statement. Pay attention to
your body. Does anything change
your breath, a stirring or feeling, sensations in the body? Notice how thoughts
cause physical sensations and note
where you feel thoughts in the body, as
well as what you feel. The first statement; is spoken by a person victimized
by his or her situation, the second
statement represents proactive and positive choice.
My life is a mess and I am out of
control. Vs. I am willing to let go
of the behaviors that create stress
in my life.
Nobody loves me and I feel alone
in life. Vs. I am in the process of
positive changes and building
healing relationships.
I hate my job and it is making me
sick. Vs. I am going to focus on the
good aspects of my job, and develop positive relationships with my
workmates, while I search for fulfilling work and create opportunities for myself.
I am so unorganized my life is
chaotic. Vs. I will take action each
day to bring order and calm into
my life, I will ask for help when I
need it. I see a positive clutter free
life now.
Teach your clients to positively
affirm their own progress and goals
in advance, to help improve outcomes.
Encourage the practice of stating positive affirmations at the start and end of
each session. Encourage client initiated
positive affirmations throughout the
therapeutic process. Involve family
members is supporting positive
affirmations.
Developing Personal
Wholeness
What actions and practices might be
necessary for an aquatic health care
professional to create self-awareness,
personal wholeness, self-growth and
improved outward client awareness?
To create a healing environment, practitioners should focus on practicing techniques that foster a palpable healing
presence. That presence should be
based in compassion, love, and awareness of interconnectivity.11
Practitioners interested in creating a
healing aquatic environment are
encouraged to practice transformative
self-care behaviors that facilitate personal integration and the experience of
wholeness and wellbeing. The Healer
Within, authored by Roger Jahnke,
Doctor of Oriental Medicine, prescribes
traditional Chinese techniques to
release your bodys own medicine,
through movement, massage, meditation and breathing exercises.12 A core
thesis is that every healing effort and
intention starts within the health care
professional. Thus, an accepting, mindful and warm-hearted relationship
with the self is primary to any healing
intention.13
To the Western mind a therapist must
do some procedure or intervention to
heal a client. The healer principle is
about being, aside from doing. Being
Cultivating Personal
Relationships
A good personal relationship between
practitioner and client is based on
development of listening and communication skills that foster trust and establish a bond. Further the practitioner has
compassion, empathy, and a desire to
serve, exhibiting altruistic behaviors
that cultivate social support and trust.15
The aquatic health care professional
must stimulate an interest within the
client to become more self-aware. The
two develop a relationship in-order to
foster wholeness and personal growth
for the purpose of healing in general.
Empirically, health psychology
research literature indicates good
provider-patient communication leads
Applying Integrative or
Collaborative Medicine
Creating a healing environment
includes responsible application of integrative medicine via the collaborative
application of conventional and complementary practices in a manner supportive of healing processes. The
United States has the most expensive
health care system in the world, but
people of America are not as healthy as
people in other countries who spend far
less on medical care, in-fact Americans
hold 26th place in world health.29 The
key to improved medical outcomes is
focus on healing care, in contrast to
focus on curing disease. The aquatic
environment has long welcomed inclusiveness of disciplines, as the water
attracts every discipline, from doctors
to fitness professionals. Many different
techniques from many professions have
been integrated into our water practices, examples might include, but are
not limited to Watsu and other aquatic
massage techniques, meditation, and
guided meditations, Osteopathy, Yoga,
Reiki, Lyu Ki Dou, Ai Chi, Qi gong,
Cranial Sacral, Feldenkrais, Palates,
healing sounds and music therapy.
MBSR, acupuncture.
A physical environment that supports
healing, including, but not limited to,
providing a physical sense of safety
while present in the facility, clean,
quiet/low decibel sound level, pleasing dcor, cheerfulness, sense of nurturing while in the facility, and fresh
air free of strong odors.
Patient-centered relationships.
A respectful manner of treating
patients.
Access for privacy in patient-health
care provider interactions.
Continuity of care between the
provider and patient.
Methods for following patients
sequentially over an extended period
of time
Adequate interpreter services, if
needed.
Flexibility in accommodating treatment assessments and requirements
for patients with varied needs
Minimal waiting time to see practitioner.
Behavioral interventions or referrals
to community organizations with
resources for diet, smoking cessation,
exercise, and environmental
alterations.
Educational materials with menu of
options such as motivational, educational, maintenance interventions
Personal counseling for high-risk
groups.
Availability of a wellness counselor/
educator.
Individual goal setting and acknowledgement for goal achievement.
Support groups available.
Cognitive behavioral therapy/dialectical behavioral therapy available.
Availability of a nutritionist available
for referrals.
(This entire list is an excerpt.33)
Conclusion
Many qualities of the optimal healing
environment occur naturally within the
aquatic therapy environment. Water
has many therapeutic qualities; water is
beautiful in how it interacts with light,
creating dancing patterns of shadow
and light about the room. The sound of
gently running water is calming and
slows the heart rate. Water provides a
warm and tactile input, while taking
away weight and pain, encouraging
Author
Sheralee Beebe, Honors
Bachelor in Recreation,
is a Post-Rehab Aquatic
Specialist who has been
practicing since 1991. She has developed three full service aquatic rehab
programs in Canada and now in Palo
Alto, CA. Beebe is the co-author of the
ATRI Rheumatology Certification and
an aquatics veteran of many current
and non-current certifications. She has
been a presenter for ATRI for 10 years
and is owner of For Your Health In
Home and Aquatic Therapies. Contact
Beebe at sheraleebeebe@comcast.net.
Your reading and study of Creating Optimal Healing Environments by Sheralee Beebe can result
in 2 ICATRIC/AEA approved CECs. First, study the article. Then complete the study guide assignments as
described below. Send your completed assignment and the course fee to Aquatic Consulting & Education
Resource Services, 7252 W. Wabash Avenue, Milwaukee, WI 53223. Study of this article must be completed
no later than March, 2009. Please allow 4-6 weeks for processing, and your receipt of completion verification.
Course fees depend on CEC verification requested. Fees are non-refundable.
ICATRIC = $30
AEA = $20
ICATRIC and AEA = $45
AEA Member discount 20%
ICATRIC = $24
AEA = $16
ICATRIC and AEA = $36
Assignment Preparation All assignments must be typed. Handwritten material will not be accepted. Start with a cover
sheet including your name, mailing address, phone, e-mail address, and CEC article title. Then, begin another sheet of paper
and answer the following questions/complete the following applications. If answering a question, state the question prior to
supplying the answer. If documenting an application, state the application requirement and then provide your response.
Comprehension
1. Within the context of this article, how is healing defined?
2. According to the Samueli institute, what are the 6 major characteristics of an optimal healing environment?
3. How does thought affect the immune system?
4. List 4 lifestyle health behaviors that support self-healing.
5. A good personal relationship between practitioner and client is based on what?
Application
1. How can you implement optimism training in your therapy sessions?
2. Describe the aspects of your work setting that make it a healing environment for your clients.
3. Describe areas of improvement needed at your work setting to improve environmental aspects of healing.
Possibilities
a. You call out Hey Fred locker
room is that way and point in the
correct direction. Fred gives you a
half-hearted wave, turns and heads
on his way. You recognize something
isnt right, and watch Fred take a
few more steps. Yes, his gait isnt
what it usually is. He seems to be
dragging one foot. You climb out of
the water and activate your
Emergency Action Plan, asking your
in-water people to move to the side
of the pool. You approach Fred, saying Fred, wait up a minute. I need
to check a few things for you. You
then perform a F.A.S.T. assessment.
b. You call out Hey Fred locker
room is that way and point in the
correct direction. Fred gives you a
half-hearted wave, turns and heads
on his way while you resume your
activities.
c. You call out Hey Fred locker
room is that way and point in the
correct direction. Fred gives you a
half-hearted wave, turns and heads
of this project
How can I effectively connect with
the children throughout the WATSU?
What WATSU movements, transitions, and positions are more
comfortable and acceptable for the
children?
Following a WATSU session, what
changes in the children could be
identified?
In order to investigate these questions,
I decided to organize the project around
three WATSU principles
Being with the person.
Not doing TO the person.
Safety.
WATSU Principles
Working in warm water is effective
because pain generally decreases in
warm water enabling a person to experience a greater range of movement
(Giesecke 1997; Vargas 2004).
Resistance to movement or to stretching decreases when the person is supported, moved and rocked while being
stretched (Morris 1997). With a continuous flow of movement through a
sequence of positions, the person loses
the ability to anticipate the next movement, which, in turn, decreases both
the fear of movement pain and the
resistance to movement (Dull 1997a).
From experience, I found WATSU ideal
for working with adults with disabilities. The warm water and continuous
movement encouraged relaxation and
increased flexibility. I expected
WATSU would be equally beneficial for
children with disabilities, yet when I
first tried to use WATSU with the students, they were very uncomfortable
and became even more anxious. As a
result, three questions became the focus
Student Population
Gateway Education Center is a public
separate school in Greensboro, NC.
Gateway serves students ranging in age
from birth to twenty-one years of age
who have severe and profound disabilities. Children with severe and profound disabilities require pervasive,
ongoing supports in one or more major
life activities. These supports provide
the greatest degree of independence for
the functioning of the individual in specific contexts and consider intellectual
abilities, adaptive behaviors, and health,
as well as interaction, participation, and
social roles. Specifically, supports at
Gateway focus on improving opportunities for student communication, mobility, self-care, and academic skills.
Many of the students at Gateway are categorized as MU/SPH; multiple severe
and profound handicapped. Primary
disabilities of children who are served by
Gateway include cerebral palsy, autistic
spectrum, and medical and health
impairments. Many children also have
developmental delays, vision and hearing impairments, or seizure disorders.
Of the 59 potential students (with
parental permission to participate in the
therapeutic pool) in my student load, I
had 19 students with additional
parental permission to participate in
this project. Of those 19 participants, 9
students were classified as autistic; the
other 10 students were classified as
severe and profound multiple handicap.
Ages of the 19 project participants
ranged from 6 to 21 years of age.
The nine students classified as autistic
had excellent physical and motor abili-
Why WATSU?
WATSU is ideally suited for this population. The profound relaxation and
stretching helps improve flexibility,
range of motion, and muscular
strength in the children who have multiple handicaps (Styer-Acevedo 1997).
For our children with autism, relaxation, support and stretching in warm
water assists each child to make connections and interact with the person
giving the WATSU and the environment. In addition, many of our students have issues with anxiety, control
and trust which should be helped with
WATSU.
Considering my first project question
regarding the most effective ways to
make connections with the students, I
had already experienced that the
method of making a connection
taught in WATSU training (by centering in, connecting through the breath
and slow movement sequences) was
not effective with our children. In
fact, making connections using techniques from the WATSU training agitated many of our children rather
than calmed them. Many of our children struggle with developing control
over their bodies, emotions and communication. In the beginning of a
WATSU session, the trust required to
accept a close physical connection
appeared to be problematic for many
of the children. However, the same
physical closeness during the middle
or end of the session was usually
accepted.
10
worked with signed an informed consent and permission slip before this
project started. I used the form in
Appendix A to document each session
with each child. Teachers used the
form in Appendix B after each session
to document any changes he or she
noticed in the children.
Making Connections
Methodology
I work with the students in my student
load twice a week, once in the gym and
once in the pool, for 30 minutes. In
the gym I work with the whole class.
In the pool, I work with volunteers so
that a one on one relationship is maintained with the children. I also tried to
schedule a second 30 minute session
each week with the students who were
participating in this project in order to
generate as much information as possible. All parents of the students I
11
Since many of our students lack a swallow reflex and basic strength, as well as
head, neck and body control, I was able
to strengthen trust and ultimately the
connection with the child by making
sure the face, nose and ears were out
of water.
In a WATSU the connection between
the giver and the receiver is developed
through a supported, nurturing position
in the water, a quiet stillness, slow
movement, and breathing (Dull 1997b).
Before any connection can be made, it
is necessary for a person to feel safe and
secure in the water.
student felt comfortable, and then gradually slow the movement speed down.
By alternating quick movements with
slow movements, I was able to gradually
lengthen the time an individual would
tolerate the slower movements.
By watching the student and maintaining eye contact, I could later reestablish
physical contact and introduce a flowing movement sequence comfortable for
the student. Talking in a soft quiet
voice helped calm the student and
maintain a connection. WATSU positions students were most comfortable
were: Under Head: Seaweed; First
Position: Accordion, Near and Far Leg
Rotation; Head Cradle: Thigh and Leg
Press and Arm/Leg Rock.
Documentation
The last focus of the project was to document the effects of the WATSU on the
children. In addition to adapted physical education, many of the children also
receive speech therapy, physical therapy,
and occupational therapy. Our students
also have many opportunities for peer
interaction in their classrooms, media,
art, and music. Classroom teachers,
support staff and I would discuss each
childrens responses to the WATSU session. Classroom teachers and support
staff used the form in Appendix B to
document any changes in the children,
while I recorded my session observations on the form in Appendix A.
Flexibility showed improvement.
Children who had severe physical and
motor limitations became more flexible
after a session and were easier to dress.
12
Summary
References
WATSU was very beneficial for the children at Gateway Education Center.
Overall, the children became more flexible, and showed greater range of
motion. The children appeared calmer,
less aggressive, and demonstrated an
increased focus and willingness to try
new activities. Based on the responses
of the children, I made five basic modifications to the WATSU techniques over
the course of the project. I used floatation devices when necessary to maintain head above water for those students who lacked head control or who
made sudden unpredictable head movements. I used quiet, soothing talk and
eye contact to make a connection with
the student.
Author
Your reading and study of WATSU for Children with Severe and Profound Disabilities by Wieser
can result in 2 ICATRIC/AEA approved CECs. First, study the article. Then complete the study guide
assignments as described below. Send your completed assignment and the course fee to Aquatic
Consulting & Education Resource Services, 7252 W. Wabash Avenue, Milwaukee, WI 53223. Study of this
article must be completed no later than March, 2009. Please allow 4-6 weeks for processing, and your receipt of
completion verification. Course fees depend on CEC verification requested. Fees are non-refundable.
ICATRIC = $30
ICATRIC = $24
AEA = $20
AEA = $16
Assignment Preparation All assignments must be typed. Handwritten material will not be accepted. Start with a cover
sheet including your name, mailing address, phone, e-mail address, and CEC article title. Then, begin another sheet of paper
and answer the following questions/complete the following applications. If answering a question, state the question prior to
supplying the answer. If documenting an application, state the application requirement and then provide your response.
Comprehension
1. WATSU stands for what two words?
2. WATSU promotes relaxation, enhances strength, and improves flexibility through what two types of experiences?
3. Why is working in warm water effective or beneficial? Give 3 reasons.
4. What three principals are the focus of this study?
5. Why is WATSU suitable for children with severe multiple disabilities? Give 3 reasons.
Application
List and explain the rationale behind 4 modifications in traditional WATSU as used with children in this study.
14
Example:
Total Alkalinity
Calcium Hardness
Water Temperature
pH 7.8
130
300
92 F
TDS
750
SI = pH +af + cf + tf - TDSf
SI = 7.8 + 2.2 + 2.1 + 0.8 - 12.1 = +.8
Water is oversaturated. The water could
be balanced by adding sodium bisulfate
to drop the total alkalinity to 100 ppm,
and by reducing the pH level to 7.2
using muriatic acid or carbon dioxide.
Well balanced water will increase
bather comfort, will help prevent the
formation of bathtub ring, and will
dramatically extend the life expectancy
of the pool and its components.
If calcium carbonate deposits and scum
rings still form on pool walls despite
your attempts to remove oils and keep
the water balanced , they can be
removed by scrubbing with tri sodium
phosphate (TSP), or with a non abrasive chlorine bleach based liquid
cleanser, using a 3M Scotch Brite pad.
If that doesn!t work, try using a fine
grit sandpaper or pumice stone. Do not
use muriatic acid to scrub off the stains,
because over time, acid will damage the
grout, will remove the plaster surface
and expose the gunite below, and may
etch the ceramic tile. Power grinding
may be the only way to remove the calcium build-up if you ignore it for any
length of time.
Author
Alison Osinski, Ph.D.
Aquatic Consulting Services
1220 Rosecrans St. #915, San Diego, CA 92106
(619) 602-4435
(619) 222-9941 (Fax)
alisonh2o@aol.com (e-mail)
http://www.AlisonOsinski.com (Web Site)
15
factor
0.5
0.6
0.7
0.8
0.9
Calcium Hardness
ppm
75
100
150
200
300
400
800
1000
factor
1.5
1.6
1.8
1.9
2.1
2.2
2.5
2.6
TDS
ppm
<1000
>1000
factor
12.1
12.2
Total Alkalinity
ppm
50
75
100
150
200
300
400
factor
1.7
1.9
2.0
2.2
2.3
2.5
2.6
also meet standards of content reliability and validity. If a publication publishes inaccurate, unreliable, invalid, or
illegal content a long list of negative
consequences can result, the least of
which is loss of readership, the greatest
of which is legal action resulting in
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What does this mean for professionals
potential authors in the field? First, it
means the editor wants your article to
be the very best article possible. The
editor will be there to help you not
because they like you, but because
helping you develop your article helps
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the publisher.
Most articles submitted for publication
require some re-write. Be prepared for
this process. Re-write will be easier if
Your topic is unique. Read before you
write. Submit an article on a topic
NOT recently in print. Take a fresh
viewpoint, explain a new technique,
describe your specific results, report
on the unusual.
Your writing is clear and understandable. Avoid jargon. Be specific. Give
examples and applications.
You carefully proofread your article
before submission. Look for
spelling errors (spell check will
not flag errors like using too
forto),
grammar errors (easy to make if
you are interrupted while writing),
run-on sentences (more than 3
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poor paragraph style (a paragraph
is 3-4 sentences including a topic
sentence),
lack of headings and sub-headings
(those section titles help the
reader organize thoughts), and
appropriate citations (even web-
16
Method
This was a qualitative study utilizing
focus groups, allowing participants to
present and discuss their views in
response to others (Krueger, 2000).
Focus group methodology was used
because it is time efficient and cost
effective in exploring a question thoroughly prior to data collection. Ethics
approval was obtained from the
University of South Australia Division
of Health Sciences Ethics Committee.
To assist in the preparation for focus
groups, a short questionnaire was used
to establish demographics of Early
Intervention (EI) aquatic physiotherapy
groups offered at Novita. This questionnaire included such questions as day,
time and duration of the EI hydrotherapy group, how many children attended
the group, how many therapists attended the group, how the group was run,
and attendance rates. This questionnaire was distributed via email to all
physiotherapists employed by Novita.
Information gained from the questionnaire assisted in formulation of questions to be used in focus groups aimed
at exploring participant understanding
of the definition of aquatic physiotherapy, perceived benefits and downfalls,
potential barriers, structure of groups,
and carryover effects.
An information package was sent to
forty-one parents and fifteen therapy
staff involved in EI aquatic physiotherapy.
The information package included a
letter explaining the project and inviting participation, a consent form, and
a request to indicate a suitable focus
17
Results
Themes around the perceived benefits,
outcomes, and challenges of aquatic
physiotherapy emerged, and could be
classified into four main subgroups
relating to
Benefits for the child
Benefits for the parents
Benefits for the siblings, and
Barriers to participation.
Benefits for the Child
Parents mentioned a whole range of
benefits for their children, some of
which were similar to those highlighted
18
and
I guess the fact that parents want it twice
a week and we can only provide it once a
week I think is probably a good indicator
that there could be more services out
there.
In general, parents highlighted similar
barriers and challenges as outlined by
therapists. Interestingly, however, parents did not highlight travel as a barrier. This reflects the importance parents
place on aquatic physiotherapy as a
therapy modality.
I wouldnt care how far I had to travel,
if I had to come all the way here, Id come
here because you do it for your child
because your child needs that
Even when the timing of the group
clashed with other commitments and
routines, parents would rearrange their
schedules. This again reflects the value
parents place on aquatic physiotherapy.
Even the time Like [child] Even the
last time we were going, it really didnt
suit because that was when she wanted to
have a sleep but I wanted to go, so I
just sort of tried to drag her sleep time
out a bit or get her to have an early sleep
if she would and if she wouldnt Id just
keep her awake and shed just crash
after
Discussion
Parents perceived far greater benefits of
aquatic physiotherapy, and valued their
own and that of their childs involvement, more than did the therapists.
Parents perceived the benefits associated with their childs gross motor skills.
In contrast, therapists talked about the
social benefits for the child, siblings
and parents attending the group.
Barriers identified by therapists were
location and temperature of the pool,
difficulties with travel, and parents
being unable to fit it into their day.
While parents concurred with this,
their focus was more on fitting it in
with other siblings, kindergarten/school
commitments, and sleep times, rather
than on the issue of travel.
Understanding benefits and barriers are
an important component of behaviour
change theory (Talbot and Verrinder
19
2005). Patients need to perceive susceptibility and seriousness in their own situation, and then perceive benefits as
outweighing costs or barriers (Talbot
and Verrinder 2005). Therapists who
are focussed on encouraging all potential clients to attend aquatic physiotherapy need to design their programme to
reinforce benefits perceived to be of
greatest importance to parents, which
are essentially the outcome of improving gross motor skills. It may be that
therapists remain ambivalent about this
benefit as there is still no research to
support this claim.
In encouraging participation and dealing with the common problem of non
attendance the therapist needs to manage barriers to attending faceing parents. This appears to be primarily an
issue about timing of sessions for parents. To reduce a barrier for attendance
it is recommended sessions be scheduled to allow, as far as possible, for travel
time and school and kindergarten drop
off and pick up.
Limitations of this study are the small
number of participants in each focus
group, and the number of focus groups.
This was despite several recruitment
attempts and offering a range of flexible
times and venues for focus groups.
Although there may have been other
parents who were enthusiastic to participate in the study, this may have been
outweighed by high demands on their
time as a result of just managing their
every day life with a child with a
disability.
Recruitment of therapists was also
challenging as the therapists were predominantly part time and were based at
a number of different venues. It is also
possible a therapists lack of time and
resources were a barrier to their participation in the focus groups. In the
future, one alternative might be to
arrange individual interviews, either
face-to-face, or over the telephone.
However, an advantage of a focus
group over an interview method is it
allows a dynamic discussion, which
may be less likely to occur in an individual interview.
Smaller numbers did allow each participant sufficient time to discuss his or
Conclusion
This exploratory study showed parents
and therapists have differing views on
benefits of aquatic physiotherapy. Some
difficulties and practical barriers to
aquatic physiotherapy were identified.
This study highlights the need to conduct more rigorous clinical studies to
examine effects of aquatic physiotherapy for children with physical and/or
multiple disabilities so therapists can be
more confident and clear about promoting benefits to families.
References
Borrell-Carrio, F., Suchman, A., and
Epstein, R. (2004). The biopsychosocial model 25 years later: Principles,
practice, and scientific inquiry, Annals
of Family Medicin,. www.annfammed.org 2, 576-582.
Campion, M. (1991). Hydrotherapy
in Pediatrics,. 2nd ed, Oxford:
Butterworth- Heinemann Ltd.
Dumas, H & Francesconi, S, (2001).
Aquatic therapy in pediatrics: annotated bibliography, Physical &
Occupational Therapy in Pediatrics,
20, 63-78.
Geytenbeek, J. (2002). Evidence for
effective hydrotherapy, Physiotherapy,
88, 514-529.
Hall, J,, Bisson, D., & OHare, P. (1990).
The physiology of immersion,
Physiotherapy. 76, 517-521.
Krueger, R. & Casey, M. (2000).
Focus groups: A Practical Guide for
Applied Research 3rd ed, Thousand
Oaks, CA: Sage Publications.
Ruoti, R., Morris, D. & Cole, A. (1997).
Aquatic Rehabilitation, Philadelphia,
PA: Lippincott-Raven.
Talbot, L. & Verrinder, G. (2005).
Promoting Health: The Primary Health
Care Approach 3rd ed, Sydney,
Australia: Elsevier.
World Health Organization (2002).
Towards a Common Language for
Functioning, Disability and Health:
The International Classification of
Functioning, Disability and Health.
Geneva, Switzerland: WHO.
Survey Questions
Therapist Focus Groups
What do you think are the benefits
of hydrotherapy for this group of
clients?
Why do you think clients enjoy
hydrotherapy?
Why do you think the caregivers
of clients enjoy hydrotherapy?
Do you see any problems with the
use of hydrotherapy for this group
of clients?
Would you suggest any better
alternatives to group hydrotherapy
for this group of clients?
Why do you think there are differences in the format of the hydrotherapy groups between the different regional offices?
20
Authors
Margarita Tsirios, B Phys
Margarita Tsiros has a Bachelor of
Physiotherapy from the University of South
Australia, and a Graduate Certificate in
Research Methodologies, for which she was
awarded the Health Science Student of the
Year. She is currently completing a Bachelor of
Health Science (Honours). Margarita now
works as a Senior Physiotherapist at Novita
Childrens Services, and is also a Visiting
Researcher at the University of South
Australia. She can be contacted at
Margarita.tsiros@novita.org.au.
Gisela van Kessel, MS
Gisela van Kessel gained a Bachelor of Applied
Science (physiotherapy) at the South
Australian Institute of Technology in 1983 and
completed a Masters in Health Service
Management at Flinders University in 2001.
She has many years of clinical experience in
aquatic physiotherapy and now lectures and
supervisors honours research in aquatic physiotherapy at the University of South Australia.
She can be contacted at gisela.vankessel@
unisa.edu.au.
Susan Gibson, M.App.Sc.Physio
Susan graduated from the South Australian
Institute of Technology with a Bachelor of
Applied Science (Physiotherapy) in 1978, a
Graduate Diploma in Physiotherapy
(Paediatrics) from the South Australian
Institute of Technology in 1989, and completed
a Masters of Applied Science in Physiotherapy
(Paediatrics) at the University of South
Australia in 1993. Her areas of interest include
the promotion, and use of, research in clinical
practice in paediatric rehabilitation. Susan is
currently employed as the Research Senior
Physiotherapist, and has a clinical caseload at
Novita providing metropolitan and outreach
services for children with disabilities. She can
be contacted at Susan.Gibson@novita.org.au.
Parimala Raghavendra. Ph.D.
Dr. Raghavendra obtained her Ph.D. in speechlanguage pathology from Purdue University,
USA and has extensive clinical, teaching and
research experience in communication disorders and disability. Her current work focuses
on making research become an integral part of
high quality services, answering important
clinical questions through research, and promoting evidence-based practice in paediatric
disability. She can be contacted at
Parimala.raghavendra@novita.org.au
21
Parkinsons Disease
In 1999 Parkinson's is the most common neurodegenerative disease after
Alzheimer's Disease1. It is a chronic,
progressive disorder with no identifiable cause. It is estimated PD presently
affects 1.5 million people in North
America. As the population ages, the
prediction is that 1% of people over the
age of 60, and 2% of people over the
age of 70 will be affected with PD2.
There is no cure for PD. The fundamental defect in PD is a gradual loss of
brain cells, producing the chemical
dopamine, a neurotransmitter. This
results in messages from the substantia
22
associated with normal aging. If exercises are performed in water, the resistance
of water can be used for strength training. Regular exercise improves bone
health and postural stability, increases
flexibility and range of motion.10
Evidence also suggests that regular exercise provides psychological benefits such
as an improvement in mood and subjective well being.10 These general benefits
can also accrue to an individual with PD.
There is growing evidence supporting
water exercise as a treatment method
for many other conditions, including
stroke, coronary rehabilitation and
other neuromuscular disorders such as
stroke or multiple sclerosis. This pilot
study, using descriptive measures, tests
of balance confidence and focus groups
attempted to show water exercise is
beneficial for individuals with PD to
help them maintain, and potentially
improve their physical and psychological well-being. Individuals with PD
should benefit from water exercise therapy because multidirectional hydrostatic pressure of the water on the body virtually eliminates falls, to which people
with PD are prone. Many people with
PD do not exercise because of the fear
of falling. Rehabilitation through water
exercise can provide a means for individuals with PD to maintain mobility
because they can exercise without the
fear of falling. Increased mobility will
enable them to remain independent for
a longer period of time, and costs to the
health care system could be reduced.
Symptoms of PD can be relieved
through a regular exercise program targeted to increasing strength, flexibility,
endurance, balance and mobility by
using simple functional movements.
Research suggests physical exercise of
moderate intensity leads to an increase
in the level of dopamine, which suggests an exercise program for individuals with PD would be beneficial.11,24 A
clinical trial conducted at the School of
Physical and Occupational Therapy at
McGill University confirms the value of
therapy in maintaining functional independence and in improving physical
and motor symptoms for persons with
PD. They perceived a significant
improvement in their psychological
wellbeing.12 Other studies have obtained
similar results with improvements to
Pilot Study
The hypothesis of this pilot study was
that water exercise would help alleviate
symptoms of Parkinsons Disease. The
assumption was that water exercise
would have beneficial effects on the
symptoms of PD. The hypothesis was
generated from previous studies involving exercise and other joint or neuromuscular disorders such as arthritis,
osteoarthritis and multiple sclerosis.
Methods
This study took place at the
Scarborough Young Mens Christian
23
24
Subject
1
Body Mass
Index
24.5
Minimum
Maximum
41.5+/- 6
30
50
94
Average
23.2
41.3+/- 9.5
20
55
88
19
25
50
100
30
15
40
76
Mean
24.2
22.5+/- 6.5
25
26
Pediatrics
PNF
Risk Awareness/Safety Training Cert.
The Safe Way
Shoulder Stabilization
Soft Tissue Injury Rehabilitation
Trunk Stabilization
Watsu
Featured Courses
Intro to Aquatic Therap and Rehab
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Ai Chi, Aquatic Feldenkrais, Bad Ragaz, Pilates, PNF, Halliwick, the
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Preventing hazardous situations around and near the aquatic
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plans, supervision, and techniques for responding to emergencies
within a medical/therapeutic facility. Gain a safety perspective on
water temperature, principles and properties of water, use of
equipment, and patient problems as they pertain to the therapeutic
environment.
Abstracts
Resisted training response in the water
(Water Force) for professional futsal
(soccer indoors) players.
The effect of water exercise on selected
aspects of overall health on a
fibromyalgia population.
Behavior of heart rate, at a constant
speed, in different positions of aquatic
cycling in young overweight adults.
Table of Contents
Abstracts
A404 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The effects of a 24-week deep water
aerobic training program on bone density.
A405 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Effects of an aquatic strength training program
on certain cardiovascular risk factors in
early-postmenopausal women.
A406 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Effect of three months detraining on endurance
and maximum isometric force in elderly subjects.
Articles
Resisted training response in the water (Water Force) . . . . . . . . . . . . . . . . . . 3
for professional futsal (soccer indoors) players.
Fabrcio Madureira, Mestre; Faculdade de Educao Fsica de Santos- FEFIS- UNIMES Santos-SP
Henrique Frana, Especialista, Rodrigo Vilarinho, Especialista;
Antnio Michel Aboarrage Jr., Mestre; Dilmar Pinto Guedes Jr, Doutorando
Abstracts
A404
The effects of a 24-week deep
water aerobic training program
on bone density.
E.Piotrowska-Calka,
B.Wajszczyk2J.Charzewska3
Dept. of Swimming and Life Saving,
Academy of Physical Education,
Marymoncka 34, 01-813 Warszawa,
Poland
2
National Food and Nutrition Institute,
Epidemiology and Norms Department,
Powsiska 61/63, 02-903 Warsaw, Poland
3
Dept. of Anthropology, Academy of
Physical Education, National Food and
Nutrition Institute, Epidemiology and
Norms Department
OBJECTIVE: The purpose of this study
was to determine the influence of prolonged deep water aerobic training on
bone mineral density (BMD). The following questions were formulated:
1. To what extent will deep water
aerobics have influence on bone
A405
Effects of an aquatic strength
training program on certain
cardiovascular risk factors in
early-postmenopausal women.
Juan C. Colado1, Pedro Saucedo2,
Victor Tella1, Fernando Naclerio3,
Ivn Chulvi1, Jose Abellan2
1
University of Valencia (Spain), 2Catholic
University of Murcia (Spain), 3European
University of Madrid (Spain)
Supported by PMAFI-PI-01/1C/04 from
Catholic University of Murcia (Spain).
Despite it being known that local muscular endurance training has a positive
influence on the prevention of various
physiological parameters associated
with certain cardiovascular risk factors
among early-postmenopausal women,
there are still few scientific studies that
have shown the influence of said activities when carried out in the aquatic
medium.
PURPOSE: To identify the effects of a
mineral density?
2. Do any changes occur in the women
exercising with aqua aerobics in comparison to the women not involved in
any physical exercises?
PARTICIPANTS: Two groups of
women, between the ages of 30-62 participated in this research. Additionally
the groups were divided: before
menopause (A2=6; 41.38,1yr; B2=10:
42.24,5yr) and postmenopausal
(A1=10; 54.64,5 yr; B1=9; 55.14,9yr).
METHODS: Group A participated in
a 24-week deep water training program,
exercising twice a week for 45 minutes.
Control group B was asked to provide
normal daily activity and not engage in
any physical exercises. Subjects in
group A were tested before and after the
24-week program and compared with
group B. Forearm bone mineral density
in the non-dominant arm was examined
using OSTEOPLAN+ p-DXA in the
mid distal and ultra distal section.
Information on dietary intake was
A406
Effect of three months detraining on endurance and maximum
isometric force in elderly subjects.
Author Block: Flvia G. Yzigi, Paulo A S
Armada-da-Silva. Faculty of Human
Kinetics, Oeiras, Portugal.
Email: fyazigi@fmh.utl.pt
Compared to what is known about the
effect of exercise programs on
endurance and strength capacities in
the elderly, the effect of detraining is
much less documented.
PURPOSE: The purpose of this study
was to evaluate the effect of 3 months
of discontinuation of participation in an
exercise program in elders on general
endurance and maximum strength of
the lower limbs.
METHODS: A total of 21 elderly subjects agreed to participate in this study.
The subjects (12 females, age 72.54.9
and 9 males, age 70.47.7 yrs) were
zxx
Article
Pre
69.73 (7.57)
[65.59; 73.87]
176.18 (3.97)
[174.01; 178.35]
14.67 (1.96)
[13.60; 15.74]a
59.40 (5.42)
[56.43; 62.35]c
Inter
71.07 (6.68)
[67.42; 74.72]
176.36 (4.23)
[174.05; 178.67]
14.34 (1.73)
[13.40; 15.29]b
60.82 (5.02)
[58.07; 63.57]d
Post
71.24 (6.56)
[67.66; 74.83]
176.55 (4.08)
[174.31; 178.78]
11.80 (1.26)
[11.11; 12.49]
62.80 (5.45)
[59.83; 65.79]
Pre
40.45 (5.72)
[37.33; 43.58]
20.09 (9.44)
[14.93; 25.25]
230.00 (21.33)
[218.34; 241.66]
28.36 (5.14)
[25.55; 31.17]
Inter
45.82 (8.95)
[40.93; 50.71]
32.45 (9.63)
[27.19; 37.72]b
270.00 (23.13)
[257.36; 282.64]c
32,82 (6.40)
[29.32; 36.32]e
Post
52.55 (11.49)
[46.27; 58.83]a
34.18 (7.05)
[30.33; 38.04]c
307.27 (26.49)
[292.80; 321.75]c, d
34.36 (6.53)
[30.79; 37.93]f
Pre
240.00 (19.07)
[229.58; 250.42]
12.19 (0.70)
[11.81; 12.57]
7.01 (0.75)
[6.60; 7.42]
2817.27 (238.14)
[2687.13; 2947.41]
Inter
246.91 (17.58)
[237.30; 256.51]
11.22 (0.42)
[10.99; 11.45]a
6.47 (0.21)
[6.35; 6.58]
2905.45 (134.80)
[2831.79; 2979.12]
Post
256.18 (17.76)
[246.48; 265.89]
10.79 (0.28)
[10.64; 10.95]b, c
6.38 (0.22)
[6.26; 6.50]d
2988.64 (176.89)
[2891.97; 3085.30]e
Bibliographical References:
Ferreira, R,L. Futsal e a iniciao. Rio de Janeiro:
Sprint,1998.
FIilho J, L,S. Manual de futsal. Rio de Janeiro: Sprint,
1998;
Giannichi, R,S. Avaliao e prescrio de atividade fsica. So Paulo: Shape, 2 edio, 1998.
GuedesJr., D. P. Musculao: esttica e sade feminina.
So Paulo: Phorte, 2003
Guedes Jr, D. P.; Rocha, A.; Guerardi, F.; Madureira, F.
Treinamento de Fora no Meio Lquido. FIEP
Bulletin, v.73, p.86, 2003
Kolmogorov, S. & Duplisheva, A. Active drag, useful
mechanical power output and hydrodynamic force
coefficient in different swimming strokes at maximal
velocity. Journal of Biomechanics. v.25, p.311-18,
1992.
Maglischo, E.W. Swimming Fastest. Ed Human Kinetics,
2003
Ostonjic,S,M; Seasonal alterations in body composition
and sprint performance fo elite soccer players. Jornal
of Exercise Physioloy. v.6, v.3, 2003.
Rocha, A.; Guedes Jr, D. P.; Dubas, J.; Madureira, F.
Comparao do treinamento abdominal dentro e fora
da gua. FIEP BULETIN. v. 74, p. 323-326, 2004.
Sharp, R. L., & Costill, D. L. Shaving a little time.
Swimming Technique. v.1, p. 10-13, 1989.
Shikarenko,I; Golomasov,S. Futebol: preparao fsica.
So Paulo: Shape, 1997.
Toussaint, H. M., & BEEK, P.J. Biomechanics of competitive front crawl swimming. Sports Medicine. v.13,
n.1, p.8-24, 1992.
Vilarinho,R.; Rocha, A.; Gherardi, F.; Bulo, F.; Barboza,
M.; Dubas, J.; Madureira, F.; Guedes Jr, D. P. Modificaes morfolgicas decorrentes do treinamento de
fora no meio lquido, Revista Cientfica JOPEF, v.1,
n.1, p.27, 2004.
Vorontsov, A. R. & Rumyantsev, V. A. Foras resistivas
na natao. In Zatsiorsky, V. M. (Ed.) Biomecnica do
esporte: performance do desempenho e preveno
de leso. Rio de Janeiro: Guanabara Koogan, 2004.
Weineck,J. Treinamento Ideal, 9 edio; Rio de Janeiro:
Manole, 2000.
zxx
Article
Abstract:
This study had two aims: to confirm that subjects with Fibromyalgia Syndrome
(FMS) have higher stress levels than healthy subjects; and to determine the effect of
a water exercise class on the overall health of a study group diagnosed with
Fibromyalgia Syndrome (FMS).
To achieve the first aim, 18 FMS subjects were compared with 18 healthy subjects
using a questionnaire that measures life stress. To achieve the second aim, a separate study group of six women with FMS were treated at a community health-fitness
agency, using an aquatic group exercise program (Aquajoy) twice per week for 14
weeks. Integrated within the group treatment were techniques such as somatic exercises, passive stretches, progressive muscular relaxation, visualization, biofeedback
and cranial-sacrum relief. The program was designated specifically to treat the
physiological and psychological symptoms of FMS. Proper use of the water environment included both physiological elements (muscle relaxation, passive stretches,
body positioning and biomechanics of movement) and psychological elements
(body-mind connection using biofeedback, socializing and developing trust, security,
and self-esteem).
To achieve the first aim, the Stress Analysis Questionnaire was used. To achieve the
second aim, observations of overall health were collected based on self-reports from
the participants using both quantitative and qualitative information. Quantitative
measures observed participants perception of how they were feeling on several
aspects of health including sleep patterns, soreness, tiredness, overall pain, stiffness,
energy and strength, mood and loneliness, and overall well-being. These were measured on a six-point Likert-Type scale with a score of 5 meaning feeling very good
and a score of 0 indicating feeling very horrible. Qualitative information included
response to three questions: 1) What did Aquajoy do for you, how did it make you
feel? 2) Why did you participate in Aquajoy? 3) Any other comments?
Data analysis for the first aim compared the 18 FMS subjects with the 18 healthy
subjects a between group comparison. Data analysis for the second aim was performed by comparing scores for each subject on different aspects of overall health
during the course of the program a within group program.
Results demonstrated: 1) subjects with FMS had higher life stress than healthy subjects during the between group comparisons; 2) FMS subjects who were treated with
Aquajoy maintained their level of pain, improved slightly in stiffness and soreness,
and improved substantially in energy and strength, mood and loneliness and overall
health during the within group comparisons.
Evidence from this study suggests that aquatic exercise can aid the FMS population
by improving overall health. This may contribute to increasing quality of life and
improving the ability to cope with the disease.
October 2007 Volume 4 Issue 2 AEA Aquatic Fitness Research Journal
Background:
TERMS: The term, Fibromyalgia
Syndrome (FMS), is a combination of
the Latin roots:
FIBRO-connective tissue fiber;
MY-muscle; AL-pain; GIA-condition of;
SYNDROME-a group of signs and
symptoms that occur together which
characterize a particular abnormality.
Although the term, Fibromyalgia (FM),
has appeared in literature for more than
100 years, the disease is still a mystery
and the medical profession has called it
many different names: chronic rheumatism, myalgia, pressure point syndrome
and fibrosis.
In 1987, The American Medical
Association (AMA) recognized FMS as
a true illness and major cause of disability. In 1993, the World Health
Organization (WHO) established FMS
as an officially recognized syndrome.
Currently, FMS is described as a specific, chronic, non-degenerative, non-progressive, non-inflammatory, truly systemic painful state of muscles and
fibrous tissue that causes widespread
fatigue, sleep disorders, stiffness, anxiety and chronic aching. FMS is referred
to as a syndrome because it is a set of
signs and symptoms that occurs together consistently (Mau, 1987). This does
not mean that FMS is any less serious
or potentially disabling than an ordinary disease.
CAUSES: The causes of FMS are
unknown, but current FMS researchers
have uncovered a number of clues as to
what triggers FMS or causes a predisposition. A physical stressor, such as the
flu, can lead to certain hormonal or
chemical changes that promote pain
and disturb sleep. Emotional stress is
linked to increasing rates of psychiatric
disorders like anxiety, depression and
distress which can trigger dysfunction
in the hypothalamus, pituitary and
adrenal glands if the stress is persistent
(McBeth, 2001).
In 2001, researchers discovered that
people with both the FMS and chronic
fatigue syndrome (CFS) were more likely to have experienced physical, emo7
Tue
Wed
Thu
Fri
Sat
Sun
Aquajoy
How do you feel in the following areas: (5) feeling very good; (4) feeling
good; (3) feeling fair; (2) feeling poor; (1) feeling very poor; (0) feeling very
horrible.
Total#
Sleep
Habits
Pain
Stiffness
Soreness
Energy/
Strength
Tiredness
Mood/
Loneliness
Total #
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Question 1 What did Aquajoy do for you, how did it make you feel? ____
____________________________________________________________________________
Question 2 - Why do you participate in Aquajoy? ________________________
____________________________________________________________________________
Question 3 Do you have any additional comments? __________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
health related. (statistically proven)
Having FMS is not affected by personality type, anyone may have it
(See Chart #2).
Based on our study group of 36 participants stress caused by finances is
related to stress caused by family.
Stress caused by health is related to
stress caused by lifestyle changes.
Chart #1
Average stress scores
Chart #2
Relationships of Stress
to Personality Type
Chart #5
Average Overall Pain
Total #
875.5
Total #
215.54
10
Ba
81.25
84.33
Week
Sleeping
Habits
Pain
Stiffness
Soreness
Energy/
Strength
Tiredness
Mood/
Loneliness
#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
#11
#12
#13
#14
23
23.8
24.6
27
26.5
21.5
28.5
28.5
27
35
35
32
31
34
26.2
19.2
19.2
20
22.5
19.2
20
27
22
19
20
24
26
20
19.5
22.3
20.5
18
20.75
20.25
22.5
28.75
23
18
19
21
33
21
21.2
21.2
21.4
21
23
22.5
18.5
24.5
23.5
26
23
21
24
21
21.4
21.6
20.6
21.5
23.7
25
22
25.5
24.5
26
24
27
28
28
25
21.25
20.8
21.25
28
22.5
21.5
26
23.5
27
24
26
28
28
25.6
28.2
27.6
22.25
28.25
28.5
30
33
30.5
35
35
35
35
35
Average level of Well-Being for the week is the addition of the weekly feeling average number of the study group based on symptoms of FMS.
Average
level of
Well-Being
#1
#2
#3
#4
151
#5
#6
172.7 159.45
#7
163
#8
#9
193.25 174
#10
#11
#12
#13
#14
186
180
186
205
187
After 14 weeks of rating themselves, the participants of the Aquajoy Water Exercise Program did improve in Average
Overall Well-Being. See Chart #3 showing the results of the Aquajoy class for a FMSP.
11
Discussion:
Conclusion:
Making a lifelong commitment to an
exercise program is an important aspect
of reduced medicinal treatment. Low
impact or non impact exercises and
activities have been advocated to
improve symptoms and well-being,
making an aquatic exercise environment an excellent medium for reducing
symptoms of FMS. The emotional/mind
component of the class is to stabilize
emotions, stimulate the central nervous
system and improve social participation
and relationships. The socio-psychological aspects of the class are to build
positive behavioral changes in very gentle ways and to create positive expectations, trust, respect and feelings of normalcy in an abnormal situation. Being
with others who are suffering and
working together to find relief dispels
the feeling of isolation. The physical/
body component of the class has the
goal to improve general fitness,
strength, endurance, increase circulation, oxygen consumption and prevent
injuries by improving the biomechanics
of movement. Improving posture for
12
relief of pain involves a conscious control over learned habits. This happens
by applying the powerful neurological
rule: less muscular effort produces more
sensory motor learning and physical
improvement.
The mind/ body connection component
works via somatic exercises. The water
is slowing down the movement increasing reaction time. This enhances awareness for use of the senses (sight, hearing,
balance and touch). Then, in conjunction with movement, the sensory motor
learning process improves, which in turn
improves the biomechanics of movement. In this study we focused on
screening several aspects of overall
health and improvement over 14 weeks,
attending an Aquajoy class every
Monday and Thursday.
From results based on self-screening, we
established that the structure and
method of teaching the Aquajoy water
class benefited the FMS population
through the method of relieving symptoms. All participants in the study did
improve overall health. After 14 weeks,
the participants experienced better sleeping habits, less pain, stiffness and soreness, as well as reporting more
energy/strength. They reported feeling
less tired and reported feeling more fulfilled at an emotional level of health.
zxx
References:
1. Clark, SR; Prescribing exercise for Fibromyalgia
Patients, The American College of Rheumatology
1994 0893- 7524/94
2. Cousins, Norman. Anatomy of an Illness: As perceived by the patient, New York w.w. Norton & co.,
1979
3. Devin, J. Starlanyl MD.; The Fibromyalgia Advocate,
New Harbinger Publications, INC. 5676 Shattuck
Avenue, Oakland, Ca. 94109
4. Devin, J. Starlanyl MD., Mary Ellen Copeland, MS
MA.; Fibromyalgia & Chronic Myofascial Pain
Syndrome a Survival Manual, New Harbinger
Publications, INC. 5676 Shattuck Avenue, Oakland,
Ca. 94109
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Article
Introduction:
Prospective studies show that accumulation of fat and physical ineptness are
risk factors for the development of several diseases (Machado; Sichieri, 2002,
Maranhao Neto et al, 2005). The rise of
obesity is causing an increased need to
control and to measure some variables
during the performance of exercises, for
instance the hemodynamic variables.
13
Sample:
The study was conducted with eight
volunteers, four males and four females,
with ages ranging from twenty to thirtythree years, with Corporal Mass
Indexes (IMC) varying from 28.4 to
29.6 Kg/m2. As criterion for inclusion
in the study, the participants should
have a healthy appearance, with a minimum of three months of practice in this
specific modality and characterized as
overweight according to the classification of the American College of Sports
Medicine (ACSM, 2000).
Procedures for data collection:
An analysis was performed and the
RPar-q questionnaire was administered.
Corporal mass and stature were measured with the aid of a digital scale provided with a stadiometer, with accuracy
of 0.05 kg (Filizola, Brazil).
Data Handling:
The definition of the dataset profile
required an estimate of the locations central tendency measures. Initially, the variables were evaluated in relation to their
proximity to the Normal Distribution,
using the Shapiro-Wilk Test (Costa Neto,
Results:
Figure 1 shows the results of the average HR values in each one of the minutes analyzed. It is speculated that
hydrostatic pressure and the tendency
for body flotation, caused by the water
properties, facilitates blood displacement to the central area of the body
when submitted to immersion. This
may increase systolic volume and
reduce HR (Becker; Cole, 2000; Graef;
Kruel, 2006). However, the hypothesis
that the positions with smaller immersion gradient would induce a larger CF
response was confirmed.
In minute one, the higher average
values of the variable HR were found
in position three (155.13 bpm). In
positions one (128.75 bpm) and two
(130.37 bpm) the average values were
close. Position four presented average
values of 137 bpm.
In minute two, position three demonstrated the highest average values
(165.75 bpm). Position two showed
values of 142.38 bpm for HR, while in
position four the subjects presented
average values of 146.00 bpm. In position one the smallest measures were
recorded (139.25 bpm).
The heart rates measured in minute
three were 145.25; 149.63; 172.00 and
147.25 respectively for positions 1, 2, 3
and 4.
The statistical test showed significant
differences in minute one of position
three for positions one and two (p =
0.00). In minute two, differences were
14
References:
1. Avellinni B.A; Shapiro, Y.; Pandolf, K.B. Cardiores-
Activities in the pool attract a heterogeneous clientele to workout in an entertaining and pleasant way, including a
perception of less effort if compared to
exercises on land. Therefore it becomes
important to have control over the
characteristics of the aquatic space as
well as its different modalities and their
applicability. u
15
Conclusion:
The society we live in has many diverse
problems, among them the issue of
overweight and obesity. Nutrition
habits, inactivity, genetic and hormonal
problems are some of the most common
causes for the rise in total corporal
weight in individuals.
When associating aquatic cycling to
overweight individuals, posture adjustments and adaptation of the intensity of
the class sessions are required for better
training adequacy and safety of the
practitioners.