GLOBAL HEALTH AGING

In honor of National Physical Therapy Month, Global Health Aging is presenting a weekly four-part article series on water aerobics. This is Part 1 in this series. Click here to read Part 2.

Welcome to the 21st century and a new American Healthcare System. The advent of the Affordable Care Act (ACA) and its gaining foothold of functional acceptance in America presents an interesting opportunity for citizens who are making a paradigm shift: movement from managed health care to managed self care. Who will be making this shift? Citizens are moving into a realm of do-it-yourself healthcare management through many fields of allied health.

One such allied healthcare service is becoming more commonly prescribed and sought after: Aquatic Therapy. National collegiate teams and professional franchises have led the way as it is most commonly used in sports medicine. Patrons in private and public clubs, especially non-profits like YMCAs, are blazing new trails in aquatic practices, catching up with other countries around the world.

Whether it is prescribed or not, many patrons now choose to seek services outside the coverage of their insurance. In the 21st century, aquatic exercise and therapies are steadily growing with the aging of the baby boomer population. The trend is growing more rapidly in younger populations where an overuse injury from a favorite sport may occur. The younger “weekend warriors” are aware of the conditioning and rehabilitative outcomes from employing aquatic exercise and therapies in support of their favorite sport.

In today’s aquatic marketplace, how can new patrons, of any generation or experience, determine what is desirable in an aquatic program, facility or instructor? The industry is so new that standardization in practice is far from being established and even farther from being commonly known or accepted. Insurance regulations governing those who may be reimbursed for services are sorely misaligned. This means that many aquatic therapy participants can get insurance coverage for “aquatic therapy” but it may not be the best available instruction and care.

Knowing this about the industry now, three questions come to mind: What do you look for in an aquatic facility or program? And thirdly, who or what kind of person with what skill-set or credentials is most important when becoming a patron of aquatic therapy?

Since university degree programs and licensing in physical therapy do not instruct or test students in this aquatic modality, aquatic patrons need be guarded in their pursuit of care. Water exercise can be performed anywhere between high impact and totally suspended, meaning no contact with the pool floor. This variance assures that there is some effective form of aquatic therapy for all ages, most types of injuries, and almost any physical condition a person may need to address. Even speech pathologists are gaining advancements through aquatic environments.

Water therapies can be passive or active. An active therapy is something the patron does in response to the therapist’s instruction and it may ultimately become an exercise. A passive therapy is a physical maneuver or manipulation that the therapist does to the patron’s trunk, limb or extremity. More often than not, passive therapies are practiced only by those aquatic professionals specifically trained in aquatic therapies. They may or may not hold a degree or license in physical therapy.

As the aquatic industry continues to evolve, it can very well become its own discipline in colleges. Presently, there needs to be a lot more work put toward the effort of standardizing practices, quantifying outcomes and modifying insurance coverages. This will allow certified professionals even without degrees in physical therapy to be compensated or reimbursed for their services.

When practitioners universally understand and consistently use the properties of water to their fullest potential, then best outcomes for patrons will emerge.  Aquatic therapies will then become a first line application for preventative and restorative allied healthcare. For instance, physicians will prescribe pre-operative aquatic conditioning to keep the muscles, ligaments and tendons surrounding a surgical site as strong and healthy as possible. Doctors will also place post-op patients in water before commencing land- or weight-bearing exercises so that the supporting muscles, tendons and ligaments can begin moving sooner and speed the healing and recovery process from the surgery performed. The efficacy of aquatic therapy is growing exponentially, thanks to the wisdom of experience; once relegated to senior citizens. The positive experiences of seniors may now be shared by all ages with varying abilities and health constraints.

Felecia Fischell is an Aquatic Specialist with twenty-three years experience in aquatics. She leads aquatic classes and consults as an aquatic personal trainer and a swim instructor at the Franklin County Family YMCA in Virginia. Formerly the Founder of FunLife Aquatics Consulting in Maryland, Felecia presents at health fairs and has given aquatic presentations to high schools, Howard County Board of Education, Howard County General Hospital and Howard County Community College.