Use of Hydrotherapy in the Treatment of Head Injuries
The number of people sustaining head injuries has increased steadily in recent years. These injuries can arise from automobile, sports or work related accidents. What ever the cause or type of head injury people who survive the accident are frequently left with a number of problems that affect normal functioning and require prolonged treatment. The problems which result from the injury are numerous, complex and tend to change in nature over time. They can be physical, emotional, intellectual and behavioral including personality changes, difficulty in controlling emotion, and varying degrees of intellectual impairment. When taking head-injured persons into water the hydrotherapist need to be aware of the sudden and sometimes violent fluctuations in affect that can occur. In spite of this, Hydrotherapy has a part to play m the treatment of the head injured in the sub-acute phase when consciousness begins to improve.
Goals of treatment during the sub-acute phase of the head-injured:
(a) reduce spasticity and promote relaxation,
(b) encourage movement.
(e) improve head control,
(d) improve respiration and breathing control,
(e) develop stability, balance and coordination
(f) re-educate functional activities
Contraindications
Lack of continence in the head injured is an important contraindication. One of the criteria for treatment is that the person remains continent consistently for two hour periods. In some instances there is a requirement that the person wears some form of protective garment beneath the swimwear. Another contraindication is that of an open wound that cannot be covered. Patients with open contagious infections should not be given hot tub based therapy. The presence of a tracheotomy need not preclude treatment in the water provided a complete seal can be achieved over the opening.
Goals of treatment during the rehabilitation phase of the head-injured:
(a) reduce spastisty
(b) encourage greater mobility, coordination and independence,
(c) maintain and improve head control,
(d) maintain and increase respiration and breathing control
During this rehabilitative phase, hydrotherapeutic activity in water should become less of an individual occupation. The person should be introduced to group work as not only does this provide greater motivation and stimulation, but it also encourages socialization.
The joy and freedom of independent movement that can be achieved in water when such movement is difficult or impossible on land should not be denied those who remain severely disabled.