Many, many years ago, when I first began working with children, I did a hydrotherapy course – looking at how to best provide therapeutic activities in water. Over the subsequent years I have been able to use this knowledge to some degree, but as an NHS practitioner in an area with no access to a hydrotherapy service it became less and less a part of my everyday practice. Thus as time went on I gradually forgot the theory that I had learned, and began to modify treatment techniques without really analysing why I was doing what I was doing. That can be a good way of ensuring that specific clients get a tailored programme, but in terms of using evidence-based-practice and justifying treatment techniques it can become a bit “wooley”.
The clients I now work with at Susan Pattison Therapy Services find movement on land very challenging, but within the pool environment they may thrive – one client is able to use leg movements to do lengths of the pool on her back, though she has minimal functional activity out of water (and she LOVES it!). Thus it became clear to me that to provide best practice when treating these clients in the pool, I had to remind myself what best practice was. I spent time reading journal articles and publications, but there is nothing like going on a course to get up-do-date with current legalities and treatment techniques.
In the time between doing my ‘hydrotherapy’ course and now the name was changed to The Aquatic Therapy Association of Chartered Physiotherapists (ATACP), and clarification was made that Aquatic Therapy is a form of water based therapy that is carried out only by suitably qualified physiotherapists. Non-specialist physiotherapists may still carry out ‘hydrotherapy’. But the ATACP notes that the term ‘hydrotherapy’ is also used for the very different practices of colonic irrigation and spa bathing. ‘Hydrotherapy’ may also be carried out by carers or teaching assistants in homes or special schools, who may not have the underpinning knowledge of anatomy and physiology.
In order to ensure this specialist knowledge an accredited Foundation and Assessment process was developed. At the beginning of October I therefore went on a two-day ‘Foundation Course in Aquatic Therapy’ It was held at Alder Hey Children’s Hospital, run by their specialist Susie Harrison, an accredited tutor for the ATACP.
The course was split between classroom learning and practical sessions in the pool. I was reminded of the relevant physical properties of water; the effects of buoyancy, turbulence and the metacentre on a body; and the way to use this knowledge to create treatment programmes to e.g. strengthen, stretch, activate muscles, or relax my clients. Understanding of the effects of immersion on the physiology of the human body has moved on considerably in the past 15 years (due to investment in the space programme apparently), following the course I am more confident in the safe screening of clients prior to Aquatic Therapy. Additionally my understanding of Health and Safety Legislation and its implications for aquatic therapy is up to date.
Throughout the course we all took turns at being the model for Susie to demonstrate the techniques. I really struck lucky when volunteering to be the model for the session on relaxation – wow, that was a treat!
The other great thing about going on a course is being able to speak to other therapists, in this case from throughout England, and share ideas/concerns about the profession. As one of two paediatric physiotherapists at Susan Pattison Therapy Services (Jayne Hallford being the other ), based at least 60 miles apart, we don’t get the opportunity to meet up as often as we would like.
So how will this change things for me? Well I am now super-enthused full of new ideas about how to create more interesting water based treatment sessions for my clients. Having recently done some work which gave me more of an insight into how aquatic-therapy is viewed by the legal profession and those determining compensation amounts, I am committed to ensuring my treatment techniques are evidence-based and well documented to demonstrate how beneficial, and often crucial, aquatic therapy can be.
I look forwards to sharing my knowledge with the rest of our team at a future training day – get your swimsuits ready everyone!