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Hydrotherapy- Make a Splash

What is hydrotherapy

Hydrotherapy is the use of water for rehabilitation, it must be carried out by a therapist with a Level 3 Certificate in Hydrotherapy for Small Animals (Winter, 2016). Hydrotherapy is usually done in either a swimming pool or an underwater treadmill; this is to ensure that the dog is in a safe, controlled environment (Prankel, 2008). The differences between the underwater treadmill and swimming is that the underwater treadmill encourages the dog to use a more normal gait (Dycus et al., 2017). The underwater treadmill mainly works the hindlimbs whereas the swimming pool mainly works the forelimbs. The temperature can be changed but should be around 300 and if an underwater treadmill is being used then the height of the water can also be changed in order to suit the individual and the problem that the animal is being treated for (McCormick, 2018). The water height will be adjusted to suit the size and conformation of the patient (Wild, 2017).


What it can be used for

Hydrotherapy can be used to treat neurological and orthopaedic conditions. The orthopaedic conditions can be those such as osteoarthritis caused by hip and elbow dysplasia. It can be used to treat soft tissue injuries and is also beneficial for weight loss (controlling obesity) and fitness programs (McCormick, 2018). It can also be used post-surgery and to treat injuries (Prankel, 2008).

Hydrotherapy can be used to treat these conditions because it can decrease pain whilst increasing range of motion (movement) of the joints (Handa et al., 2010). Kongtawelert et al. (2014) conducted a study on 55 dogs which supports this statement. The underwater treadmill will also help improve proprioception (balance and coordination), but also weight bearing and muscle strength (Cannapp and Sherman, 2007).


How it works

The properties of the water can help a weak animal to regain motor function and can also be used for strength and conditioning (Carver, 2016). The viscosity of the water will provide resistance which increases muscle strength, improves cardiovascular fitness and promotes weight loss (decreasing the water level (decreases buoyancy) and adding jets will progress this exercise further) (Prydie and Hewitt, 2015; Carver, 2016). The water can provide stability for the patient, if a underwater treadmill is used the belt speed can be changed to allow time for voluntary motor function, the therapist can also passively assist the patient to move the limbs in a functional pattern (Carver, 2016).

The temperature of the water can promote relaxation of the muscles (decreasing tension) and increase comfort for the dog (Carver, 2016; McCormick, 2018). Water is used in rehabilitation because the buoyancy will decrease any pressure and stress that is placed through the limbs (Prankel, 2008). The hydrostatic pressure will also reduce pain in swollen arthritic joints (Carver, 2016).

The water heights in the underwater treadmills can be adjusted. Lower water heights increase the range of motion of the joints and at higher water levels the weight placed through each limb is lower (Levine et al., 2010). This is because the animal tries to lift their limbs out of the water but also as they propel themselves through the water it can increase the flexion of the joints (Carver, 2016). The highest level of water should be around mid- femur, the dog should still be walking on the treadmill and if they try to swim then the water level should be lowered.

The three main water heights:

























(Dycus et al., 2017, pp. 834)

Both factors are useful in a rehabilitation program and it means that different heights of water can be used at different times during the treatment program. For example if you wanted to reduce the amount of force going through the limbs you could increase the water height, however if you wanted to increase weight bearing and range of motion you would have the water level lower. The ability to change the height of the water can make the underwater treadmill a useful tool in rehabilitation (Wong, 2011; Winter, 2016).


Contraindications

Hydrotherapy is suitable for most patients however it should be avoided if the dog has any open wounds, healing surgical wounds or skin diseases (Prydie and Hewitt, 2015). There are other contraindications as well, these include those such as heart, respiratory or airway diseases, diarrhoea or bitches in season. Finally, any patient that is showing signs of anxiety or fear should not take part (Prydie and Hewitt, 2015).


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References:

Canapp, Jr. and Sherman, O. 2007. The Canine Stifle. Clinical Techniques in Small Animal Practice, 22 (4), pp. 195-205.

Carver, D. 2016. Practical Physiotherapy for veterinary nurses. Chichester: Wiley Blackwell.

Dycus, D.L., Levine, D. and Marcellin-Little, D.J. 2017. Physical rehabilitation for the management of canine hip dysplasia. Veterinary Clinics of North America: Small Animal Practice, 47 (4), pp. 823-850.

Handa, S., Honda, T., Kamada, M., Kamioka, H., Kitayuguchi, J., Mutoh, Y., Ohta, M., Okada, S., Okuizumi, H., Shiozawa, N. and Tsutani, K. 2010. Effectiveness of Aquatic Exercise and Balneotherapy: A Summary of Systematic Reviews Based on Randomized Controlled Trials of Water Immersion Therapies. Journal of Epidemiology, 20 (1), pp. 2-12.

Kongtawelert, P., Nganvongpanit, K., Tanvisut, S. and Yano, T. 2014. Effect of Swimming on Clinical Functional Parameters and Serum Biomarkers in Healthy and Osteoarthritic Dogs. ISRN Veterinary Science, 2014, pp. 1-8.

Levine, D., Marcellin-Little, D.J., Millis, D.L., Osborne, J.A. and Tragauer, V. 2010. Effects of partial immersion in water on vertical ground reaction forces and weight distribution in dogs. American Journal of Veterinary Research, 71 (12), pp. 1413- 1416.

McCormick, W., Oxley, J.A. and Spencer, N. 2018. Details of canine hydrotherapy pools and treadmills in 22 hydrotherapy centres in the United Kingdom. Vet record, 183 (4). [Online]. BMJ journals. Available from: https://veterinaryrecord.bmj.com/content/183/4/128 [Accessed 20 February].

Prankel, S. 2008. Hydrotherapy in Practice. In Practice, 30 (5), pp. 272-277.

Prydie, D. and Hewitt, I. 2016. Practical Physiotherapy for Small animal practice. Chichester: Wiley Blackwell.

Wild, S. 2017. Canine cranial cruciate ligament damage and the use of hydrotherapy as a rehabilitation tool. Veterinary Nursing Journal, 32 (8), pp. 228-230.

Winter, R. 2016. Hydrotherapy and physiotherapy: what the RVN should know. Veterinary Nursing Journal. 31 (10), pp. 312-315.

Wong, E. 2011. Swim to recovery: canine hydrotherapy healing. Dorchester: Hubble and Hattie.

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