Therapeutic Application of Hydrotherapy

Hydrotherapy is the application of water for therapeutic purposes, utilizing various water temperatures.

Different temperature ranges are used for different situations.  Water temperature, according to Scully refererence, is classified as follows:

    1. Cold:     55-65 degrees F
    2. Cool:     65-80 degrees F
    3. Tepid:    80-95 degrees F
    4. Warm:   96-99 degrees F
    5. Hot:       99-104 degrees F
    6. Very Hot: 104-110 degrees F

Warm water can be used to increase blood flow and circulation, increase metabolism, muscle relaxation, and ROM, and decrease muscle spasm.

Cold water can be used to decrease edema and hemorrhage by vasoconstriction to the area in contact with the cold.  Nerve conduction and muscle spindle firing are decreased resulting in a decrease in pain and decreased muscle spasm respectively.

When admistering a hydrotherapy treatment we need to be aware of any adverse conditions that may appear.  Skin pallor, shivering, dizziness, a rapid , weak pulse, headache, an increase in edema or decrease in ROM, hyperventilation and "seasickness".

In this section we'll discuss the hydrotherapy as being applied by a whirlpool bath.  A whirpool is a bath of water that can be agitated by an electric turbine.  There are a number of whirlpool tanks that are used depending on the area you would like to treat.

The Extremity Tank is usually used for the upper or lower extremities and has a capacity of 10 to 45 gallons of water.
The Low Boy Tankcan be used to allow and adult to sit in the tank and can range in capacity from 75 to 105 gallons. 
The High Boy Tank, sometimes referred to as a hip or leg tank, can allow for the immersion of both lower extremities.  Capacity can range from 60 to 105 gallons. 
The Hubbard Tank has a greater potential for exercise during treatment due to it's size and can accomodate a full body treatment.  Capacity can range anywhere from 200 gallons to more than 400 gallons. 
Another example of a Hubbard or Full Body Immersion Tank in a figure 8 pattern.  The pattern can allow for easy access to the patient.  Note that the larger tanks can also have more than one turbine for agitation.


There are several reasons why a whirlpool treatment would be indicated.  Burns if no agitation is used, open wounds for debridment purposes, post-operative orthopedic conditions where the water will add a bouyancy element to eliminate the weight of the extrmity for movement, and as a resistance force for exercise.

Contraindications include a feverish client, client with recent skin grafts, client with edema unless a lower water temp is used, circulatory impairments, infections that can be spread, cardiac and/or respiratory instability, hypertension, and active bleeding.  Also be aware of any malignancies that may metstasize especially if using higher temps.

For guidelines on administering a Whirlpool Treatment click HERE.  I got lazy and didn't want to type it all out so I just copied it from the 2200 Course Content site.  It may not come out all straight or pretty but you should be able to get everything you need.