Chapter 9 Aquatic Therapy 209Introduction
Benefits
Today, therapists, sports coaches and trainers
understand the many benefits of aquatic
therapy. Scientific research regarding the
physiology of human immersion in water and
applying the knowledge of water properties
to aquatic treatment has revolutionized
sports medicine (Thein & McNamara, 1992;
Ruoti et al., 1997).
Pain is a central and consistent symptom
for many canine patients and contributes to
the cycle of disuse atrophy and progressive
disability. Water‐based therapies help to make
movement more comfortable, offering prescrip-
tive exercise that is functional, mechanically
correct, and muscularly challenging without
being painful (Chauvet et al., 2011). A warm
water environment (86–94 °F/30–34.5 °C) offers
muscle relaxation that is soothing for many
conditions. This is enhanced by hydrostatic
pressure causing a swaddling effect on
immersed body parts (Thein & McNamara,
1992; Ruoti et al., 1997; Jadelis et al., 2001).
Aquatic therapy challenges balance and
coordination. Balance exercises can be
attempted earlier and more safely in water than
on land, providing early opportunities for limb,
trunk, and postural training, resulting in
improved strength, balance, and coordination
(Ruoti et al., 1997; Jadelis et al., 2001; Stager &
Tanner, 2004).
Aquatic therapy raises metabolism and
can help with weight loss, decreasing fat,
strengthening muscles, and reducing the
deconditioning effects of immobility (Ruoti
et al., 1997; Lavoie & Montpetit, 1986).
In humans slow, steady swimming burns a
higher percentage of fat than fast swimming.
Fast swimming uses carbohydrates and burns
500–700 calories per hour. Swimming, whether
slow or fast, can benefit patients seeking weight
loss or muscle gain (Stager & Tanner, 2004).
Swimming uses the body’s muscles more
completely than other activities such as
running. Heredity influences the distribution of
muscle fiber types, making some breeds great
sprinters and others slow, steady swimmers
(Stager & Tanner, 2004). The therapist should
design a combined aquatic therapy program
that focuses on the patient’s specific needs and
targets the appropriate muscle fibers. Human
studies demonstrate improvement in lean body
mass (especially lean leg mass), decreased body
fat and reduced waist to hip ratio when using
an underwater treadmill (UWTM) rather than a
land treadmill (Greene et al., 2009).
Passive range of motion in humans is
improved in water compared to on land
(Ruoti et al., 1997). Marsolais and colleagues.
(2003) reported that the active range of
motion, especially in the pelvic limbs, is
greater with swimming and with water walk-
ing than with land‐walking.PrecautionsSutures and staples are generally removed
prior to initiating aquatic therapy. Occasionally,
with the surgeon’s approval, the advantages
of early therapy outweigh the risks of
aquatic therapy prior to suture removal
(Tomlinson, 2013). When early aquatic therapy
is recommended, and sutures or staples are in
place, transparent film dressings such as
Tegaderm™ can be applied if the surface of the
skin is flat and shaved. A precautionary
treatment plan should be devised for patients
with respiratory problems, such as laryngeal
paralysis or exertional dyspnea, and those with
behavioral issues, such as mild aggression or
dislike of water. It is recommended that a thera-
pist be in the pool with the patients that may
have breathing difficulties while exercising in a
water environment (Carver, 2016). Aggressive
dogs can frequently be handled more easily in
the water as their confidence is reduced.
Swimming during pregnancy can be offered if
discussed with the primary veterinarian, and
can be designed so that the level of exertion is
appropriate. Swimming is not recommended
for dogs in the first 6 weeks post tibial plateau
leveling osteotomy (TPLO) or tibial tuberosity
advancement (TTA) due to the increased forces
that kicking places on the patellar tendon
(Monk, 2016). Patients with medially luxating
patellas can have difficulties with swimming as
the pelvic limbs tend to abduct and externally
rotate at the hip, causing increased medial drag
on the patella. The therapist should be aware of
this, and use manual techniques to prevent the