The hydrotherapy environment allows for numerous progressions of exercise using the conventional method. An exercise can be progressed by working through the stages of buoyancy - assisted, neutral, and resisted. In each of these positions the following can be used:
1. Speed of the movement. In a buoyancy-assisted situation the limb is moved slower than buoyancy to make the exercise harder; for a buoyancy resisted position the limb is moved quicker through the water to increase difficulty.
2. Lever length. In a buoyancy assisted situation, the shorter the lever length, the harder the exercise, while in a buoyancy
Gait Re-education
Patients suffering from spinal pain and lower limb complaints will require some form of gait re-education. The warmth of the water and the support given in the upright position allows the patient a longer reaction time to correct their gait pattern. This is ideal in patients who can progress from non-weight-bearing through to full weight bearing by altering the depth of the water in which they are standing. A patient who is partially weight bearing (10%) i.e. with crutches and is able to immerse to C7 level (8% weight bearing) and practice a proper heel strike/push
off in the water. This is extremely difficult for the patient to do on land. Experts have determined the weight-bearing levels to be assigned at different depths of immersion with both the patient stationary and walking.
Ideally gait re-education is done on a flat surface in the Hydrotherapy tub. On a sloped-bottomed pool consideration must be given to the effect on the gait pattern especially if there is a leg length discrepancy.