Front Matter

Chapter 9 Aquatic Therapy 223

central pad. If the patient grows accustomed to
the band, a new configuration is used.

Harnesses

Almost all patients wear harnesses in the
UWTM for control without putting tension on
the neck. Patients that like to lean forward can
be pulled straight back, forcing them to increase
the use of their pelvic limbs (Figure  9.16). For
patients that lag back, a leash or bungee cord
can be attached to front of the harness.

Reins

A leash can be draped across the thoracic inlet
and held like reins in two hands to prevent the

patient lunging and pulling. A gentle tug back

as the patient starts to lunge discourages

the  action and decreases the chance they will

attempt it again.

Figure 9.14 Flippers are devices used as tarsal flexion
assistance devices. As they put strain on the toe flexor
muscle and tendons, the rubber bands should come off
the toes when the flippers are not being used. The tarsus
piece can stay on the patient between exercises.

Figure 9.15 To enhance proprioception when just an

elastic band around the foot is not enough, the band can

be placed over the foot, twisted into a figure 8,

and wrapped around the two middle toes.

Figure 9.16 This patient is trotting in the water at

5.4 mph at elbow height. Maximal resistance with

minimal buoyancy creates a truly athletic workout.