Sorry guys, late post, I completely forgot about blogging!
I just wanted to quickly talk about hydrotherapy; a form of treatment prehaps we dont always think about right away. I have just really seen how beneficial hydrotherapy can be this prac and I thiught other people might not have had a chance to do hydro yet this year. I am doing my Rheumatology prac at Shents and I have both in and out pts. For the inpts the hydro is a god-send. I plead, beg, encourage and almost bully these patients into doing exercises and ambulating with me everyday because otherwise some of them do not even get out of bed for meals. They call us the physio terrorists and absolutely hate all land based exercise. BUT if you can manage to get them through the changing into bathers and being wheeled down to the pool they absolutely love it. With the pain relief provided by the warm water and the relief from gravity in the bouyancy of the water you can achieve so much more exercise than you can complete on land!
I give all these patients exercises for strength ROM and fitness and it is just amazing how much more they can achieve. And for these patients, and most of them were at Shents before my placement started and are still inpatients 5 weeks later just this daily exercise i think isso beneficial in preventing deconditoning and a loss of ROM that would definately occur if they were left doing only what they can manage on land.
For outpts too I have found hydro brings big improvements. I have had a few TKRs I have referred to twice or three times weekly hydro classes. Its great for when you have given the pt all the exs they can manage to remember as a HEP and they are a few weeks post and the wound is clean and the stitches out. Especially also for those patients who have adopted an antalgic gait pattern due to years of knee pain- its a great way to retrain even gait without the force of gravity.
Anyway take home message is dont forget hydro as a treatment option, I know I had a bit, we learnt it in second year! There are so many exercises you can make up and it's actually really fun- for the patients and us too!
2 comments:
I have found the most challenging thing about hydrotherapy is getting the patients to consent to go in the pool in the first place. Many patients are hesitant due to the belief they have to wear revealing bathers, and not being comfortable with this. Many patients also tell me of their friends ‘horror’ stories of not being able to walk after getting out of the pool as their legs felt too heavy. I have had more success in convincing people to come to hydro by first outlining the benefits and pain relief and assuring them they can work at there own pace especially for the first few sessions. Another good ‘selling’ point, is if patients are allowed to wear a tracksuit / t-shirt in the water.
As posted above hydrotherapy is a wonderful treatment tool, and it is a shame for patients to miss out due to self consciousness / friends tales.
Ali I'm right now in the same situation as you are in, in fact in the same place. I had the same issues in regards to convincing patients to be compliant with hydrotherapy. I even went into the trouble in staying back after hours to prepare exercises and finding articles to prove that hydrotherapy is beneficial for their condition. The patient was finally convinced and seemed agreeable in the last Rx session. However the results of all my efforts didn't equate to the end result. The patient self discharged for the next session when really they are no where near discharge. Therefore even though hydro is a great tool for Rx, it's up to the patient to have the final say.
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