Group Hydrotherapy for Patients with MS

A Successful Program in Washington State

By Harriet Ott, CTRS,ATRIC

Other articles about our Aquatic Therapy Program (Hydrotherapy) focus on the participants in the program and how the hydrotherapy has influenced their lives. Harriet's article deals with the specifics of this program and answers most questions a potential participant may have.

The Multiple Sclerosis Association of King County (MSA) contracts with four community pools in King County and provides hydrotherapy classes for approx. 28 clients each week. Our groups range from 3 to 12 clients in the water at one time. Clients make a contribution to the costs on a sliding scale, based on ability to pay. The MSA subsidizes the remaining costs (MSA's subsidy for hydrotherapy last year was $10,000). The pools vary in temperatures from 81-86 degrees. All the pools have lifts and provide access to wheelchair participants.

Participation in MSA's hydrotherapy program begins with a phone-in registration to the main office (206-633-2606). The telephone interview asks for basic information on mobility, other diagnoses, medications, and physician. The MSA requires a physician's referral and a liability release signature from all participants.

Criteria for Participation

It is not necessary to have MS to participate in this program. Anyone with limited mobility or mobility problems is welcome to attend. The MSA has a limited ability to provide hydrotherapy volunteers to assist participants with transportation and/or to assist in the water. Demand for such volunteers usually exceeds the supply. Some participants come on public transportation, which they arrange on their own. Some participants have caregivers who provide transportation and dressing assistance.

While most of our clients are ambulatory with minor balance and walking difficulties, those who are wheelchair bound with poor lower extremity strength are also welcome to the program. Participants must be able to do a standing pivot transfer or be less than 200 pounds for a two-person lift from the wheelchair to the pool chair-lift. The level of function that we can accept into a given program is dependent on the availability of volunteers to assist in the water. Some of our participants have caregivers who assist with dressing only. When volunteers are not available, caregivers are asked to participate in the water program.

The Water Program

The aquatic program lasts for one hour. Participants are encouraged to work to their maximum potential. The exercises are performed in shoulder-depth water. We do a series of range of motion and stretching exercises. Resistive movements with bar-bells of various sizes challenges upper extremity strength. Non-weight bearing, lower extremity exercises are done with the help of floatation "noodles". We work on balance with activities at the wall and through water-walking exercises.

Adaptations to exercises are offered to challenge the variety of abilities within the group. Those participants without lower extremity control are set up with adaptive equipment for safety, and to allow maximum independence. I frequently use neck collars; both the blow-up and beanbag types sold by Bio-Energetics. For those who are able, we do some lap swimming either at the end or the beginning of each session.

Problems and Concerns

Our clients are often concerned with the water temperature, since very warm water (above 88 degrees) causes extreme fatigue in some of the MS participants. Therefore, the MSA offers its programs in cooler-temperature pools. For some participants, however, warmer temperatures do not exacerbate their symptoms and indeed, higher water temperatures (up to 90 degrees) can help to decrease spasticity and increase range of motion and relaxation. I counsel participants by encouraging shorter times in the water, and evaluating how they feel at the end of the session.

Fatigue is often a problem for MS participants, especially in the aquatic environment. Moving in the water feels so easy and offers so much freedom. Leaving the freedom of the water and returning to their normal environment is fatiguing for many MS participants. Thirty minute exercise participation for first-time clients is recommended.

Multiple diagnoses are another concern. The one that I look for most often is diabetes. Water exercise changes a person's blood sugar level significantly, and I always want to know who in my group has this additional condition.

The Goals

I asked participants what they felt were the benefits of the hydrotherapy program. Without any input on my part, they responded with all the goals I have for the group: Improvements in balance, endurance, mobility, and strength. Every group also mentioned the emotional and social support of meeting up with friends each week.

Stretching and exercising the body is very important for MS patients, and hydrotherapy is a wonderful, impact-free way to do so. I would encourage as many MSers as possible to participate in this or other programs developed for people with limited mobility.

If you would like to see a schedule of our current hydrotherapy classes, click here. If you need more information about aquatic therapy for patients with MS or this program, please contact Harriet Ott at 425-830-7746, or email me at harrietott@comcast.net.

Was this information helpful? Then please consider making a donation. We are a small, independent nonprofit agency and are dependent on donations from our supporters. Thank you from all the staff at the MSA.




	Group Hydrotherapy for Patients with MS A Successful Program in Washington State *By Harriet Ott, CTRS,ATRIC* Other articles about our Aquatic Therapy Program (Hydrotherapy) focus on the participants in the program and how the hydrotherapy has influenced their lives. Harriet's article deals with the specifics of this program and answers most questions a potential participant may have. The Multiple Sclerosis Association of King County (MSA) contracts with four community pools in King County and provides hydrotherapy classes for approx. 28 clients each week. Our groups range from 3 to 12 clients in the water at one time. Clients make a contribution to the costs on a sliding scale, based on ability to pay. The MSA subsidizes the remaining costs (MSA's subsidy for hydrotherapy last year was $10,000). The pools vary in temperatures from 81-86 degrees. All the pools have lifts and provide access to wheelchair participants. Participation in MSA's hydrotherapy program begins with a phone-in registration to the main office (206-633-2606). The telephone interview asks for basic information on mobility, other diagnoses, medications, and physician. The MSA requires a physician's referral and a liability release signature from all participants. Criteria for Participation It is not necessary to have MS to participate in this program. Anyone with limited mobility or mobility problems is welcome to attend. The MSA has a limited ability to provide hydrotherapy volunteers to assist participants with transportation and/or to assist in the water. Demand for such volunteers usually exceeds the supply. Some participants come on public transportation, which they arrange on their own. Some participants have caregivers who provide transportation and dressing assistance. While most of our clients are ambulatory with minor balance and walking difficulties, those who are wheelchair bound with poor lower extremity strength are also welcome to the program. Participants must be able to do a standing pivot transfer or be less than 200 pounds for a two-person lift from the wheelchair to the pool chair-lift. The level of function that we can accept into a given program is dependent on the availability of volunteers to assist in the water. Some of our participants have caregivers who assist with dressing only. When volunteers are not available, caregivers are asked to participate in the water program. The Water Program The aquatic program lasts for one hour. Participants are encouraged to work to their maximum potential. The exercises are performed in shoulder-depth water. We do a series of range of motion and stretching exercises. Resistive movements with bar-bells of various sizes challenges upper extremity strength. Non-weight bearing, lower extremity exercises are done with the help of floatation "noodles". We work on balance with activities at the wall and through water-walking exercises. Adaptations to exercises are offered to challenge the variety of abilities within the group. Those participants without lower extremity control are set up with adaptive equipment for safety, and to allow maximum independence. I frequently use neck collars; both the blow-up and beanbag types sold by Bio-Energetics. For those who are able, we do some lap swimming either at the end or the beginning of each session. Problems and Concerns Our clients are often concerned with the water temperature, since very warm water (above 88 degrees) causes extreme fatigue in some of the MS participants. Therefore, the MSA offers its programs in cooler-temperature pools. For some participants, however, warmer temperatures do not exacerbate their symptoms and indeed, higher water temperatures (up to 90 degrees) can help to decrease spasticity and increase range of motion and relaxation. I counsel participants by encouraging shorter times in the water, and evaluating how they feel at the end of the session. Fatigue is often a problem for MS participants, especially in the aquatic environment. Moving in the water feels so easy and offers so much freedom. Leaving the freedom of the water and returning to their normal environment is fatiguing for many MS participants. Thirty minute exercise participation for first-time clients is recommended. Multiple diagnoses are another concern. The one that I look for most often is diabetes. Water exercise changes a person's blood sugar level significantly, and I always want to know who in my group has this additional condition. The Goals I asked participants what they felt were the benefits of the hydrotherapy program. Without any input on my part, they responded with all the goals I have for the group: Improvements in balance, endurance, mobility, and strength. Every group also mentioned the emotional and social support of meeting up with friends each week. Stretching and exercising the body is very important for MS patients, and hydrotherapy is a wonderful, impact-free way to do so. I would encourage as many MSers as possible to participate in this or other programs developed for people with limited mobility. If you would like to see a schedule of our current hydrotherapy classes, click here. If you need more information about aquatic therapy for patients with MS or this program, please contact Harriet Ott at 425-830-7746, or email me at harrietott@comcast.net. Was this information helpful? Then please consider making a donation. We are a small, independent nonprofit agency and are dependent on donations from our supporters. Thank you from all the staff at the MSA.
Home Disclaimer Privacy Policy Site Map Articles The Multiple Sclerosis Association of King County 753 North 35th St., Suite 208, Seattle, WA 98103 Phone: 206-633-2606 Fax: 206-633-2920 Email: info@msakc.org