July 2018: Aquatics & Traumatic Brain Injury



Content courtesy of the National Swimming Pool Foundation


Significant brain injury can be a world-stopping disorder which changes everything. Even minor incidences of concussion can produce long-lasting effects that are not realized for weeks, months or even years after the incident. Over 5 million Americans currently live out their daily lives with the shadow of long-term disabilities from brain injury lingering upon them. Each year, another 2.5 million people are affected in the US alone. Unlike progressive neurological conditions like Parkinson’s, dementia or multiple sclerosis, the effects of trauma are typically “once and done.” Unfortunately, the precipitating event (usually a fall, blunt trauma or car accident) often produces a dramatic and irreversible condition.

So what does the therapy pool offer these patients? First, immersion in water facilitates treatment of multiple sites simultaneously/ in rapid succession; it allows ease of positioning and access to patient’s body; and/or facilitates ease of handling of patient by therapist. This is quite useful when working with patients with significant mobility restrictions, spasticity and (in some circumstances) unpredictable actions. In the water, patients’ balance may be challenged beyond limits of stability in the water without the fear of consequences of falling often present with land-based balance training. The environment leads to improvement in balance reactions without the dangers associated with the alternative. It is possible to grade both weight bearing and resistance in water by altering depth of immersion and speed of movement, respectively. This allows patients with weakness the opportunity to gradually expand the work they perform in a self-selected pace. 

As is obvious to anyone who has ever stepped foot in a pool, exercise in water promotes more movement freedom and thus promotes improved motion, reduced stiffness and increased functional strength and mobility while diminishing the negative consequences of lack of movement. Finally, exercise in a therapeutic pool promotes normal socialization and promotes psychological well-being. Pool time is a fun experience and it does not feel like work or therapy. For all these reasons and more, aquatic therapy should be seen as the treatment of choice for the patient with a traumatic brain injury.


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