September 2017: Respiratory Compromise

SPOTLIGHT ON AQUATICS & RESPIRATORY COMPROMISE

THE POOL IS CUSTOM-MADE FOR TREATING PULMONARY COMPROMISE

Content courtesy of the National Swimming Pool Foundation.

Recent publications which show how water works for respiratory compromise.

For many years, the pool was considered verboten for some respiratory compromised client. However, vertical (read: upright) exercise in water has been shown to be as safe -- or even safer -- than its land-based counterparts under many conditions.
Not only is pulmonary compromise no longer considered a contraindication, therapists are intentionally placing their respiratory patients in the pool. Why? Because immersion in graded pressurized environment (i.e., the pool) can provide a progressive pulmonary challenge unlike any other.

It's amazing to think of how the human body deals with pressure - even out of water. At sea level, there are 14.7 pounds of air (1 Atmosphere) pressing against every square inch of the human body. This means that before a person immerses even one toe, each inch on his body is pounded by 14.7 pounds of molecules. As divers put it, we should be crushed to death!

However, inside our bodies are molecules that push back with an equal - or even greater - force. For instance, every time your heart pumps, it creates a pressure on your arterial vessels of approximately 120 mm. Even when the heart rests, there remains an intrinsic outward pressure of approximately 80 mm. You may know this more commonly as blood pressure (the normative 120/80 used as the example).

So what happens when we enter the pool? The pressure pushing inward on our bodies increases as depth increases. Even the casual swimmer instinctively recognizes the power of pressure as ear pain whenever diving down to the bottom of the pool. Scuba divers experience this to a much greater extent, doubling the amount of pressure from 1 Atmosphere to 2 Atmospheres of pressure within the first 34 feet of a dive.

This hydrostatic pressure drives fluid to the large vessels of the lungs (creating a 60-percent increase in the work of breathing) and creates a mechanical barrier to ribcage expansion. All before the first exercise is performed. With the proper instruction, the resulting pressure gradient can be used to create an amazing therapeutic training effect. How?

Read the articles below and find out!

RECENT ANNOTATED REFERENCES

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Tito, C., & Burton Hess, J. (2017). Aquatic Therapy for a Patient with Postural Orthostatic Tachycardia Syndrome: a Case Report Recommended Citation Aquatic Therapy for a Patient with Postural Orthostatic Tachycardia Syndrome: a Case Report. Internet Journal of Allied Health Sciences and Practice Jul, 15(3), 1–11. Retrieved from http://nsuworks.nova.edu/ijahsp

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