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PTA Viewpoint FINAL.Indd ptaviewpoint by Sarah Olson, PTA, LAT Get Wet! How one PTA took the plunge to advance her career options. fter graduating from Gustavus patients were seen only in the water. This is a timed code; PTAs should report Adolphus College in Minnesota Others were assigned a combination of one unit for every 15-minute interval of A with a degree in athletic train- water and land exercises. Eventually, the aquatic physical therapy. ing, my life’s path took me to the Mojave “water” patients, if able to tolerate, were The more experience I’ve had working Desert. Having grown up in Wisconsin, I permitted to increase their activities and with the properties of water and taking found that to be an extremely warm envi- begin the transition to land exercise. continuing education courses specific to ronment for a Midwestern girl! Swimming Over the next few years, I took a variety aquatic techniques, the more I’ve learned pools were wonderful places to beat the of specific courses to enhance my aquatic about the value of water beyond its role heat. While living in the Southwest, I took skills, loading my aquatic therapy toolbox in un-weighting exercise and serving as an water aerobics classes. Little did I realize with hydrodynamic principles and intro- alternative venue for activities that typi- then that I was dipping my toes into my ductions to therapeutic exercise specific to cally are land-based. Water can be used, for future career setting. aquatic therapy that included deep-water instance, as a floating table and as a three- I later went back to school in La running, trunk stabilization, as well as ele- dimensional medium. Crosse, Wisconsin, to become a physical ments of other aquatic techniques found in therapist assistant (PTA). After graduat- Bad Ragaz, Halliwick, and Ai Chi. Aquatic Therapy ing, I was hired to fill a PTA position Working in a rural health care setting, at a sports medicine clinic that includ- one sees a variety of diagnoses, including Techniques ed aquatic therapy. I quickly discovered orthopedic injuries, chronic pain, fibromy- Through exposure to these different that my knowledge of exercise, anatomy, algia, and general weakness. Aquatic ther- experiences and concepts, I was led in the physiology, and the properties of water apy is an ideal environment in which to direction of Watsu® and completed all the provided the background I needed to get treat patients with nonspecific symptoms requirements to obtain a certificate as a started working in the aquatic environ- and is billed under CPT code 97113 for “Watsu practitioner.” ment. Soon I was implementing physical aquatic therapy with therapeutic exercise. continued on page 44 therapy aquatic exercise programs, under the supervision of a physical therapist (PT), for athletes who’d had surgery and needed to stay conditioned for their spe- cific sports. Thanks to the buoyancy of water, the athletes with whom I worked could get a head start on exercise at a cardiovascular conditioning level while maintaining weight-bearing restrictions. In 2001, I changed jobs and began working at a rural hospital that just had built an aquatic therapy pool. After the PT completed the patient evaluation and plan of care, many patients would begin their rehabilitation in the pool with me. At first, I was the only PTA in the water, working 5 half-days a week, work- ing with a new patient every 45 min- utes. Depending on the diagnosis, some Olson works with a patient, using the facilitated aquatic therapy technique known as Watsu. 42 ● March 2009 PPTATA VViewpointiewpoint FFINAL.inddINAL.indd 4242 22/12/09/12/09 11:52:01:52:01 PMPM ptaviewpoint continued from page 42 Watsu. This technique—the name is general conditions and physical-emotion- an abbreviation of water shiatsu—is facili- al traumas. To learn more, visit www. tated aquatic therapy that incorporates aquaticintegration.com. the stretches and principals of Zen shiatsu The PT and I both currently use both while using the properties of water. Since Watsu and AI with our patient popula- New In Open Door: its conception in 1980, it has evolved tion to meet specific goals related to pain into one of the most recognized somatic management and relaxation. People in pain Joanna Briggs Institute (JBI) therapies and is offered at clinics and spas tend to avoid physical activity, but this can JBI Evidence Summaries include throughout the world. It promotes neuro- limit their range of motion and hasten 1,600+ standardized summaries of muscular reeducation, using gentle move- muscle tightness, weakness, and emotional existing evidence on health care ment of joint and soft tissue. stress. As time goes, patients who don’t interventions and activities. Each summary covers one intervention During a Watsu session, the patient is exercise will experience muscle spasms and and includes: the question, the clinical held and supported while being moved, muscle guarding. Use of aquatic therapy bottom line, evidence characteristics, floated, and gently stretched in 94-degree can interrupt this pain cycle. best practice recommendations, and references. Access: 2006 to date. water. The buoyancy and hydrostatic pres- sure of water helps to support and increase JBI Best Practice Information Just a Sampling Sheets provide access to key issues circulation as the body is continually and recommendations culled from moved. Each move flows smoothly into Techniques such as Watsu and AI offer systematic reviews and presented in the next. PTAs opportunities to compassionately 4-page information sheets. Access: 1997 Holistically, Watsu emphasizes trusting support and cultivate patients’ ability to to date. the body to seek its own natural balance. tap positive resources within themselves. JBI Systematic Reviews focus on the During a session, the practitioner’s aware- Other aquatic therapy techniques may feasibility and effectiveness of health care interventions. Published in the ness is drawn to the patient’s breath and provide additional options for relaxation Journal of Evidence-Based Healthcare natural movement. The concept is that the and therapeutic exercise in an environment (JBI Reports), each peer-reviewed entry experience of deep relaxation and nurtur- that can maximize the benefits of both is regularly updated. Access: 1998 to date. ing can facilitate a meditative/intuitive state Eastern and Western concepts of treatment that helps alleviate pain and facilitate resto- and healing. How do you access JBI? ration. Those who can benefit from Watsu Aquatic therapy is an environment Go to Open Door, access ProQuest, click include people who are experiencing stress/ in which PTAs can successfully develop on the Publications tab, and type in tension, muscle spasticity, muscle guard- focused skills while providing directed “Briggs” for a list of these JBI databases, OR run your search as usual and look ing, limited range of motion, and chronic interventions. Those who are looking for for the JBI resources in your results. pain. Evidence on Watsu can be found on an opportunity to develop new and inno- APTA’s Hooked on Evidence and Open vative alternatives for therapeutic exercise Door links at www.apta.org. would do well to take a close look at Bookmark www.apta.org/opendoor for online access to vital clinical Aquatic Integration. AI is an this practice area, which benefits a range research, whenever and wherever you approach to hydrotherapy that com- of patients spanning from athletes, to need it. Visit often for full-text access to bines eastern meridian and point work people who’ve had total joint replace- research and articles from more than a thousand leading clinical and academic with myofascial release, proprioceptive ments, to individuals who are experienc- publications on topics critical to clinical neuromuscular facilitation, and breath ing chronic pain. PT practice. work. The concept is that by helping the patient relax the body and mind through Sarah Olson, PTA, LAT, is employed at Vernon Memorial Healthcare in Viroqua, Wisconsin. Questions? E-mail [email protected] stretching and breathing awareness, the or call 800/999-2782 (ext 8534). resulting deep relaxation and movement Open Door is an APTA members–only benefi t. in the water creates an environment that promotes the patient’s development of inner awareness and potential for positive change. AI employs water’s buoyancy, warmth, and resistance to address both www.apta.org 44 ● March 2009 PPTATA VViewpointiewpoint FFINAL.inddINAL.indd 4444 22/4/09/4/09 111:37:161:37:16 AMAM.
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