Pediatric Aquatic Therapy: Understanding the 7 Principles of Water

Most therapists don’t get much if any formal training in aquatics, especially when it comes to pediatrics. This is unfortunate because many kids—particularly those with neuro-motor impairments—can benefit greatly from aquatic therapy.

How can aquatics impact your pediatric clients?

• It increases compliance in children who have trouble staying on task.
• It increases motivation by introducing novelty.
• It improves endurance in children who fatigue quickly or are obese.
• It allows for practice opportunities for children with poor static and dynamic balance.
• It offers independent mobility to children who are missing this on land.

Taking Advantage of Water Principles for Successful Functional Outcomes

Which qualities of water make it such an effective therapy medium?

1. Buoyancy

So much more than floating, buoyancy allows for hands-on elongation and strengthening. It also allows for decreased weight bearing (including following surgery) and increased upper extremity weight bearing (including making it effective for torticollis treatment).

2. Therapeutic warmth

The warm temperature of the water helps decrease spasticity, offering an opportunity for strengthening therapies.

3. Viscosity

The viscosity of water allows for slower movement. In turn, this provides children with more time to react to balance challenges and making them more willing to challenge their balance. The viscosity of water also offers the opportunity to perform functional activities without assistance. For instance, a child who walks on land with a reverse walker may be able to walk in water using only a long buoyant bar.

4. Surface tension

Water’s surface tension offers resistance, which helps to increase strength. It also helps improve body awareness.

5. Hydrostatic pressure

Water pressure helps decrease edema, which is particularly beneficial following surgery. The pressure also increases stroke volume, which leads to improved cardiac output.

6. Refraction

Because vision is limited or altered in water, proprioception is promoted.

7. Turbulence and flow

Increasing resistance allows for increased strength and endurance as well as improved balance.

You can learn more about aquatic physical and occupational therapy in the MedBridge course, “Pediatric Aquatics for the Child with a Neuro-Motor Disorder: Principles and Precautions.” Once you do, you’ll know how to more successfully utilize water principles to meet your clients’ goals efficiently and with a lot of fun!