Dhai AlDossary

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Dhai Al-Dossary Rania Al-Saif Sara Al-Sultan
Amal Al-Sweedany Rasha Al-Otaibi Manar Bubshait
Dr. Hana Al-Sobayel
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What Is Hydrotherapy? Indications
Contraindications General Health In
Children Common Diseases Precautions Treatment
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What Is Hydrotherapy?
Hydrotherapy is the use of water in the treatment
of disease.
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Indication Contraindication
Indication

• Tone up the body.

• Stimulate circulation, and the immune system.

• Bring relief from pain.

• Affects the skin and muscles.

• Stimulating nerve reflexes on the spinal cord.

Contraindication

• Open wound.

• Uncontrolled urinary incontinence.

• Urinary and bowel tract infections.

• Severe loss of sensation.

• Multiple sclerosis.

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Normal New Baby

• Free of congenital defects.
• Weight between 3-4 Kg, with head
  circumference between 34.1-35.8 cm.
• Breaths spontaneously.
• Overall healthy pink color.
• Heart rate between 100-140 beats/min.
• Has good tone of the skeletal muscles with the
  limbs flexed.

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Common Children Diseases

• Down Syndrome

• Asthma

• Juvenile idiopathic arthritis

• C.D.H.

• Cerebral Palsy

• Childhood Cancer

• Children with spasticity

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Cerebral Palsy
Cerebral Palsy (CP) is a term used to describe a
group of disorders affecting body movement and
muscle co-ordination. The medical definition of
cerebral palsy is a "non-progressive" but not
unchanging disorder of movement and/or posture,
Developed in brain in early pregnancy and
continues until about age three. Damage to the
brain during this time may result in cerebral
palsy.
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Cerebral Palsy
Depending on which areas of the brain have been
damaged, one or more of the following may occur
  1- muscle tightness or spasms. 2- involuntary
movement. 3- difficulty with "gross motor skills"
such as walking or running.  4- difficulty with
"fine motor skills" such as writing or doing up
buttons. 5- difficulty in perception and
sensation.
Medically it is important to remember that
Cerebral Palsy 1- is NOT
contagious 2- is NOT hereditary 
3- is NOT life-threatening
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Types Cerebral Palsy
(A) Classification By Number of Limbs
Involved 1- Quadriplegia - all 4 limbs are
involved.  2- Diplegia - all four limbs are
involved. Both legs are more severely affected
than the arms.    3- Hemiplegia - one side of
the body is affected. The arm is
usually more involved than the leg
.   4- Triplegia - three limbs are involved,
usually both arms and a leg.   5- Monoplegia -
only one limb is affected, usually an arm. 
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Types Cerebral Palsy
)B) Classification By Movement Disorder 

• Spastic CP- Spastic muscles become overactive
  when used and produce clumsy movements.
• Athetoid CP- Athetosis leads to difficulty in
  controlling and coordinating movement .
• Ataxic CP- ataxic CP have a disturbed sense of
  balance and depth perception.

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Causes of Cerebral Palsy
Factors which may cause cerebral palsy include

• multiple births (e.g. twins, triplets)
• a damaged placenta which may interfere with fetal
  growth  
• sexually transmitted infectious diseases, e.g.
  AIDS, herpes, syphilis, gonorrhea 
• poor nutrition 
• exposure to toxic substances, including nicotine,
  alcohol and drugs  
• Rh or A-B-O blood type incompatibility between
  mother and infant.
• chromosome abnormalities  
• biochemical genetic disorders  

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Causes of Cerebral Palsy
In early childhood, cerebral palsy can occur if a
young child's brain is damaged by

• Infections such as meningitis
• brain haemorrhages
• head injury following falls, car accidents or
  abuse
• drowning accidents
• poisoning

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Symptoms associated with C.P.

• Some of the following effects of cerebral palsy
  can occur depending on the particular area of the
  brain that has been affected
• Involuntary movement.
• Speech impairment.
• Seizures.
• Incontinence.
• Abnormal sensation and perception.
• Muscle spasticity.
• Difficulties in feeding or swallowing.
• Learning disabilities.
• Impairment of sight or hearing.

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1-) INVOLUNTARY MOVEMENT

• 10 of children with cerebral palsy have the
  "athetoid type". These areas of the brain
  normally process the signals that enable smooth,
  coordinated movementsDamage to these areas may
  cause a child to develop involuntary, purposeless
  movements, especially in the (face, arms, and
  trunk).
• These movements often interfere with speaking,
  feeding, reaching, grasping, and other skills
  requiring coordinated movements.
• For example, involuntary grimacing and tongue
  thrusting may lead to swallowing problems,
  drooling and slurred speech.

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Involuntary grimacing
Involuntary tongue thrust
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2-) SPEECH IMPAIRMENT

• refer to difficulties producing speech sounds or
  problems with voice quality. They might be
  characterized by an interruption in the flow or
  rhythm of speech, such as stuttering, which is
  called (dysfluency).
• People with C.P. have trouble using some speech
  sounds, which can also be a symptom of delay.
  They may say "see" when they mean "ski.
• Listeners may have trouble understanding what
  someone with a speech disorder is trying to say .

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3-) MUSCLE SPASTICITY

• One of the major characteristics of C.P. is
  spasticity, meaning that the muscles are stiff or
  rigid.
• If muscles or tendons remain tense for too long,
  joints become bent in a fixed rigid position
  called a contracture.

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4-) LEARNING DISABILITIES

• learning disabilities related to C.P. can range
  from mild to severe.
• Patients with a mild learning disability may only
  have difficulties with a couple of subjects in
  school.
• Patients with severe mental retardation, learn at
  a much slower rate and need special assistance.
• 5-) INCONTINENCE poor bladder control
• IT takes several forms
• Enuresis (bed wetting)
• Stress incontinence (urination during physical
  activity)
• Slow leak from the bladder

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6-) SEIZURES

• half of all people with cerebral palsy suffer
  from seizures.
• Seizures occur when there is abnormal brain
  activity (the brain attempts to send abnormal
  messages very close together).
• It affect people in different ways -some people
  may stop moving and stare, others may fall down,
  and Some seizures cause a person to fall and
  shake violently.

A baby with C.P having seizures while playing
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7-) DIFFICULTY IN FEEDING OR SWALLOWING

• many of the same muscles used for talking are
  also used for eating,so that people with C.P.
  have difficulty when they eat.
• This can cause C.P. patients to have a poor diet,
  leading to malnutrition, as well as poor growth
  and development.
• 8-) ABNORMAL SENSATION AND PERCEPTION
• Some children with C.P. have impaired ability to
  feel simple sensations like touch and pain.
• They may also have stereognosia (difficulty
  perceiving and identifying objects using the
  sense of touch). for example, would have trouble
  identifying a hard ball, sponge, or other objects
  placed in his hand while closing his eyes.

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9-) IMPAIRMENT OF VISION

• large number of children with C.P. have
  strabismus,( a condition in which the eyes are
  not aligned because of differences in the left
  and right eye muscles).
• When Untreated, this can lead to very poor vision
  in one eye and can interfere with certain visual
  skills, such as judging distance.

Left eye strabismus

Right eye strabismus
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Precautions

• Never leave a child with cerebral palsy
  unattended in a pool even if they know how to
  swim.

• Many children with cerebral palsy are at risk
  for seizures, which can be deadly in water.

• If a child should panic or cramp for any reason,
  their spasticity can quickly become very severe,
  impairing their ability to stay afloat.

• Keep in mind that progress will likely be slow
  compared to able-bodied children.

• Be patient.

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Treatment
The use of hydrotherapy techniques depends on the
PT and the diagnosis he did for the child. The PT
can use these methods for treating a CP child
1. Baths ? hot, warm, cold, saline, herbal baths,
contrast sitz hip baths, cold foot baths, 2.
cold friction rubs, cold body wrap, cold arm wrap
and cold leg wrap. 3. Watsu technique. 4. The
hydrotherapy pool ? by flotation devices.
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Finally

• Studies show that exercise for children with
  cerebral palsy (CP) is gaining popularity among
  pediatric physical therapists as an intervention
  choice.
• Exercise in water appeals to children with CP
  because of the unique quality of buoyancy of
  water that reduces joint loading and impact, and
  decreases the negative influences of poor balance
  and poor postural control.

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There's a place inYour heartAnd I know that it
is loveAnd this place couldBe muchBrighter
than tomorrowAnd if you really tryYou'll find
there's no needTo cryIn this place you'll
feelThere's no hurt or sorrow
There are waysTo get thereIf you care
enoughFor the livingMake a little spaceMake a
better place...Heal the worldMake it a better
placeFor you and for meAnd the entire human
raceThere are people dyingIf you care
enoughFor the livingMake a better placeFor you
and for me
We could really get thereIf you cared enoughFor
the livingMake a little spaceTo make a better
place...Heal the worldMake it a better
placeFor you and for meAnd the entire human
raceThere are people dyingIf you care
enoughFor the livingMake a better placeFor you
and for me
We could fly so highLet our spirits never dieIn
my heartI feel you are allMy sistersCreate a
world withNo fearTogether we cryHappy
tearsSee the nations turnTheir swordsInto
plowshares
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