Les Littman of AquaHab Physical Therapy Cites Successful Patient Outcomes as Evidence of the Advantages of Aquatic Therapy for Individuals with Total Knee Replacements
(Cherry Hill, N.J.) – According to new research findings and an AquaHab Physical Therapy case study, aquatic therapy appears to be highly beneficial for patients who have undergone a total knee replacement (TKR). A research team in Germany determined that patients who begin aquatic therapy just six days after a TKR are likely to experience improved results.* Lead researcher, Thoralf Liebs, theorized that the pressure of the water helps reduce fluid buildup in the knee joint, thereby resulting in less pain. AquaHab Physical Therapy – a multi-clinic practice serving the Greater Philadelphia area – saw similar positive outcomes for a patient who had undergone a TKR in both knees, according to a recent case study documented by Tate Rice, Director of AquaHab Physical Therapy.
The subject of the AquaHab Physical Therapy case study was referred to the clinic in October 2011, after having a TKR of the right knee earlier in the month. He subsequently underwent a TKR of the left knee at the beginning of November. His past medical history included a total hip replacement in 2009 and a lumbar laminectomy in 2008, as well as hypertension and Multiple Sclerosis (MS). While AquaHab Physical Therapy offers both aquatic and land therapies, the patient’s therapist determined that he would be best served by an aquatics-based program due to his high subjective report of pain, history of severe back pain, and MS-related balance issues. The referring surgeon was consulted and approved the treatment plan.
Among the goals of the treatment were improving the patient’s strength, endurance, and range of motion while minimizing his pain. His movements were affected by the severity of his pain, so he was submerged in chest-deep water to minimize the force of gravity and his own body weight while focusing on proper gait technique. As his strength improved and pain decreased, he was able to transition to 4 feet deep water to increase the joint load, and was eventually able to walk on land without difficulty. He followed a similar process for stairs, beginning by climbing up and down steps in deeper water and progressing to 4 feet deep water over time. Upon completion of his physical therapy, he was able to manage the full flight of stairs in his home without pain – an important achievement given that his bedroom and bathroom were located on the second floor.
The treatment plan devised by AquaHab Physical Therapy also addressed other deconditioning and balance issues. The patient had been inactive for more than a year due to osteoarthritis of the knee and chronic back pain, and had become deconditioned. By exercising in the pool, he was able to complete 15 to 30 minutes of continuous aerobic exercise without pain, thereby building up his activity endurance. He was also able to work on his MS-related balance issues in the pool without the risk of falling or injury. His physical therapist started him out with the aid of assistive equipment, which was phased out as the patient’s balance improved. In addition, the therapist performed manual stretching after each aquatic session, which helped to increase the patient’s range of motion, and developed a home exercise program that helped the patient maintain his progress and momentum between visits.