Ideas for making your aquatics program suitable for everyone, especially people with special needs
BY MARK BLANK
Over the past 30 years aquatic therapy has moved from the deep recesses of locker rooms with those small old-fashioned whirlpool tubs to large facilities in their own right.
Today, more than ever, swimming pool access has
become the singular most important hurdle facing
Illinois park facility managers and aquatic directors.
And, as individual consideration has become a
necessity for addressing the increasing number of users
with special needs, so has having both specialized
access equipment and specific aquatic programs for
their therapy and recreation. Developing effective
programs for people with special needs as well as other
users seeking aquatic therapy and fitness workouts is
proving to be a significant and most important issue.
One obstacle in particular is that of equal access.
Making the pool available is only half the battle; ease of
use is a much harder conquest. Sometimes two or
more people may be needed for handling a special
needs student. A water-powered lift is usually necessary. Depending on the pool's size and time of day.
Limiting access to other users is at times unavoidable.
Perhaps the fastest-growing area in aquatics today is
implementing a set of specialty programs for physical
therapy and people with special needs. Something to
remember is that there are so many different ways of
using a swimming pool that making it anything you
need it to be is the key to success. While functioning as
a therapy pool for some, almost any pool can be used
for aquatic activities in which everyday users can help
to improve whatever sports they are in, at the same
time in another area others simply can recreate.
"The future of swimming pool facilities is going to
rely heavily on aquatic therapy and fitness programs,"
says Adolph Kiefer, owner of Adolph Kiefer and
Associates of Zion, Ill.
"The days of using swimming pools solely for
recreation and bathing are going to stay in the last
century.
"Today, there are more kids learning to swim than
ever before, swimming in clubs, participating in and
racing competitively. As they grow they'll teach their
kids, swim in masters programs, and look to exercise
in the water. They'll find physical rehabilitation in the
form of aquatic therapy."
Hoping to fill the void in the area of rehabilitation,
legions of physical therapists have turned to aquatic
therapy for its unique benefits. Over the past 30 years
aquatic therapy has moved from the deep recesses of
locker rooms with those small old-fashioned whirlpool
tubs to large facilities in their own right. Therapy
tanks and pools are commonplace in clubs, universities
and at professional sports team training centers.
Swimming facilities around the world have been
developing water aerobic or hydro-aerobic group
workouts, getting more sophisticated with each year.
And still, the popularity of aquatic therapy's growth is
dependent on the aquatic therapy professionals who
are constantly discovering new treatments and
developing new methods of therapy.
Aquatic therapy is described as using a series of
exercises and activities designed to take advantage of
the unique healing benefits of water. Because of the
buoyancy water provides, it lessens the pressure on
January/February 2000 | 23
SPECIAL FOCUS
muscles and joints, assists with movement and reduces
swelling caused by gravity. Without the pull of gravity
working against them, patients can exercise more
comfortably, and over time, increase their levels of
strength, tolerance, flexibility and endurance with less
pain and stress.
Aquatic therapy has proven to be an effective
treatment and rehabilitation for patients who have had
or have:
• Amputation
• Arthritis
• Chronic Pain
• Cognitive Impairments
• Decreased Conditioning
• Decreased Coordination
• Head Injury
• Knee, Hip or Shoulder Replacement
• Muscle Spasm
• Orthopedic Trauma
• Reduced Endurance
• Pediatric Developmental Delays
• Spinal Cord Injury
• Stroke
• Weakness or lack of muscle tone
"The goal of an aquatic
therapy program is to provide a
means for full fitness potential,
recreation as well as being a
social outlet," says Ruth Sova,
physical therapist and author of
Aquatics: The Complete Reference
Guide/or Aquatic Fitness
Professionals.
"Aquatic therapy will often
work a specific fitness component rather than attempt to
involve all components." explains Sova.
"Participants recovering from injury or surgery may
need to work toward muscular endurance. Patients with
gait problems may need to work strength or flexibility.
The medical professional should understand that the
decreased muscular strength or range of motion
resulting from chronic disease may not be significantly
increased. Decreased strength from disuse can be
improved."
"Participants involved in aquatic therapy realize an
abundance of benefits. They are able to move in the
water without pain and without getting hurt. Physical
fitness levels often increase and self-image will improve.
Additional therapeutic benefits of water therapy include
relaxation, variable resistance through limitless joint
angles and planes of movement and an increase in
abilities of daily living.
"In creating an aquatic therapy program for patients,
standard rehabilitation progression should be followed.
Participants should first work toward decreased pain
and swelling and then toward increased range of motion
and flexibility. Maintaining or increasing muscular
endurance and strength and then regaining balance
should follow. The ability to increase or maintain
cardio-respiratory fitness would be the final goal of the
program."
Says Sova: "As with any exercise program, participants should begin slowly. Gentle rhythmic movements
or calisthenics using their full range of motion and
emphasizing flexibility should begin the program.
Walking in different water depths while taking notice of
balance, gait, and proper ambulation can follow.
Increasing the walk to an easy jog is a natural progression after that."
Aquatic therapy professionals use a wide variety of
flotation and resistant devices that enhance programming. Many disabling conditions can be compensated
for by matching the individual to the proper piece of
equipment. Flotation vests and ankle cuffs have been
used on patients with varying disabilities; resistance
equipment ranging from mild resistance (aqua gloves)
to extremely resistant are also in use in different aquatic
therapy settings.
Access from the deck into the pool must be convenient for all participants. Stairs with well-designed
handrails and nonskid surface treatments on the pool
deck should all included in the therapy pool. Stationary
water powered lifts and newer battery powered mobile
lifts are currently available to provide safe and convenient access.
Adolph Kiefer believes that facilities need to offer
"safe water," areas that include ADA compliant
equipment. Improvements in access, entry and egress
from the pool as well as safe decking are essential to
success.
Says Kiefer: "Getting people to the pool and in the
24 | Illinois Parks and Recreation
IS YOUR AQUATIC FACILITY READY FOR EVERYONE?
water can, for people with disabilities, be very difficult
and hard on them.
"Providing as easy a way for them to get into and out
of the water is critical, if someone has a bad experience
at something, they won't come back at all. If we're
talking about physical therapy, every consideration for
the patients comfort must be taken for the treatment
to be successful."
Adds Kiefer: "Aquatic therapists have recently
advanced some wonderful new and innovative methods
for treating Fibromyalgia, orthopedic problems and
other fatigue syndrome diseases."
"Many facilities are hiring personnel to head their
own aquatic therapy and fitness specific programs.
"Aquatic therapy has only recently started to gain its
momentum. Not only is it about treatment to people
who need basic physical therapy and fitness; it's also
about helping those with special needs. These people
can sometimes feel intimidated by the everyday user
who is more able-bodied. The pool is one place where
they can gain self-esteem, move for themselves. Many
paralyzed people say the only times they feel like a
normal or whole person is when they're swimming or
in the pool. It's that important for them.
"If an aquatics program is to be truly successful,
there's a reason to make sure your program meets the
needs of everyone."
MARK BLANK
RUTH SOVA, M.S.
Adolph Kiefer and Associates
An SRA Perspective on Aquatic Therapy
Sarah Trembly, program manager at the Main/Niles Association of
Special Recreation in Skokie, oversees their curriculum for people
with special needs that is comprised of three basic programs:
lessons, swim team and aqua aerobics. The swimming lesson classes
are offered for people with disabilities of all ages, children to adult.
The swim teams are for adults with mental impairment and are
done in association with Special Olympics. The aqua aerobics
program is for adults of varying physical impairments such as
stroke, head injury, and orthopedic problems.
"The greatest challenge is in programming—trying to make the
experience as fun as it can be to keep the swimmers interested and
returning," says Trembly.
"The pool provides these individuals with an alternative to land-based therapy. The difference in atmosphere is maybe the most important aspect of aquatic therapy because people simply do not
equate water and being in the pool with therapy Therapy is
oftentimes something they know as hard, difficult and painful;
something they never look forward to doing. When they're in the
pool they think of their time in the water as fun or even recreation,
It's natural, a natural place, so they intuitively relax and honestly
enjoy themselves. Arduous tasks like lifting weights and stretching
are so much easier in water since the body's weight is reduced by
buoyancy.
Trembly says; "The biggest problem is that pools are so busy, and
there are so many things happening at once, it can be difficult to
get water space."
"Finding room to work with people while everyday users are
recreating is hard."
Many pool facilities with or without aquatic therapy programs
may be equipped with lift equipment or special wider steps for
getting in and out of die water.
Says Trembly: "A person who needs to use a pool lift generally
has more discomfort than someone who can walk down stairs. Also
it is sometimes awkward to transfer a participant onto an pool lift.
We try our best to provide as much comfort as we can in these
instances.
"Our aquatic therapy programs have really grown over the past
year, particularly the aqua aerobics classes for both people with
disabilities and for able-bodied people as well," adds Trembly,
"As the popularity for these programs increases, more pool
facilities with designated therapy areas or special therapy pools will
be needed."
--Mark Blank
January/February 2000 | 25
is a writer in the Chicago area who has written numerous articles on health and safety
issues for various health, sports and fire/rescue publications.
is rounder of the Aquatic Exercise Association, an international association of aquatic
professionals. She is certified by the Institute for Aerobic Research and gold certified by
IDEA. She is an internationally known speaker, author and consultant on fitness,
choreography, aquatic exercise, and the business side of fitness.
is the president and owner of Adolph Kiefer and Associates, a provider of swimming
equipment and apparel offering swimmers and the world of aquatics "everything but
the water" since 1947. The company has been an aquatics supplier to every Olympic
Games since 1948. Kiefer set a new world record winning the gold medal for the
100-meter backstroke al the 1936 Berlin Games, in 1960, he was appointed to John
F. Kennedy's Presidential Commission on Fitness and Industry, and was a member of the
first group to be inaugurated into the International Swimming Hall of Fame. Kiefer has
devoted his life to the pursuit of excellence in al! facets of swimming. For more
information, Adolph Kiefer and Associates, 800-323-4071 or www.kiefer.com.