Deck 5: Hydrotherapy: the Use of Water As a Therapeutic Agent

Question 1

Which of the following is true about the physiological effect of water on nerve conduction velocity?

A) Increased nerve conduction velocity is proportional to hydrostatic pressure.
B) The effect depends primarily on the temperature of the water.
C) There is a decrease in nerve conduction velocity for body parts immersed in water.
D) Nerve conduction velocity adjusts upon entering the water, resulting in a generalized relaxation response.

Answer 1

B

Question 2

Which of the following is an absolute contraindication for pool therapy?

A) Fear of losing balance or sinking in water
B) History of seizures currently under control with anti-seizure medication
C) Impaired cognitive function
D) Decompensated congestive heart failure

Answer 2

D

Question 3

Which of the following is true with regard to the effects of water on the cardiopulmonary system?

A) There is better lung expansion in water than on land, resulting in decreased respiratory rate.
B) Immersion in water has no measurable effect on blood pressure.
C) Perceived exertion is a better measure of patient effort than heart rate when exercising in water.
D) Most patients tolerate the cardiopulmonary system changes best when they enter and exit the water as quickly as possible.

Answer 3

C

Question 4

Immersion of a body part in deep water may affect circulatory dynamics because of the effects of which of the following properties of water?

A) Viscosity
B) Hydrostatic pressure
C) Laminar flow
D) Buoyancy

Question 5

A somnolent patient may be better able to participate in an aquatic therapy session if

A) There is relaxing music playing in the background.
B) There is assurance that the chlorine level is adequate.
C) The water temperature is relatively cool.
D) The water temperature is relatively warm.

Question 6

Your patient is a 64-year-old female with chronic back pain. Which of the following is the most appropriate hydrotherapy intervention for this patient?

A) Floating on her stomach in a pool while performing arm and leg raises
B) Swimming laps in a pool using standard overhead freestyle stroke
C) Sitting in a low-boy whirlpool with warm water with the agitation directed at her back
D) Floating on her back in a pool while performing arm and leg exercises

Question 7

Resistance to movement when standing in a pool and performing arm-lowering exercises in the water is provided by which of the following properties of water?

A) Cohesiveness
B) Friction
C) Buoyancy
D) Density

Question 8

How can excessive edema formation in the hand be prevented during an upper extremity whirlpool treatment?

A) Increase the temperature of the whirlpool to the maximum tolerable to increase venous return.
B) Avoid a completely dependent position and perform active range-of-motion (ROM) exercises during the treatment.
C) Let the hand hang down as much as possible to take advantage of increased hydrostatic pressure at greater depths.
D) Keep the limb relatively still to minimize oxygen demand in the extremity.

Question 9

Which of the following patients would be most appropriate for a warm whirlpool at 37°C?

A) A 76-year-old male with stiffness of his left wrist 3 months after a Colles fracture
B) An 18-year-old female basketball player who sprained her ankle 2 days ago
C) A 48-year-old male with hip stiffness who had a total hip replacement 2 weeks ago
D) A 36-year-old female with bilateral knee pain after running a marathon yesterday

Question 10

Why is the use of whirlpools to treat open wounds no longer recommended?

A) Water causes vasodilation of blood vessels, resulting in increased bleeding of wounds.
B) Loss of body fluids into the water can result in dehydration.
C) There is an increased risk of infection and damage to fragile tissue in healing wounds.
D) Most patients cannot tolerate the mechanical effects of water on their wounds.

Question 11

Which of the following correctly describes the use of PLWS for treatment of an open wound?

A) Controlled pressure of pulsations maintained between 4 and 15 psi
B) Cleansing of wound bed with maximum irrigation forces up to 30 psi
C) Delivery of antiseptic via pulsations of water into all areas of the wound
D) Lavage of wound tissues with strong suction to increase blood flow into the wound

Question 12

Which factor will affect cardiopulmonary function the most during hydrotherapy?

A) Volume of body exposed to warm or cool water
B) Viscosity of the water
C) Presence or absence of muscular pain
D) Patient's body type and mass

Question 13

A 38-year-old male with cerebral palsy is referred for balance and gait training secondary to severe balance and endurance problems that were the result of a medication reaction used to treat anxiety. Which of the following is true regarding pool therapy for this patient?

A) Pool therapy is contraindicated for this patient because of his severe balance problems.
B) He would likely benefit from exercise on a treadmill in a pool to improve endurance.
C) Pool therapy can be used to improve endurance, balance, and gait.
D) He cannot begin pool therapy until his anxiety is controlled by medication.

Question 14

If your patient has an in-dwelling catheter can he or she participate in pool therapy?

A) No, in-dwelling catheters are a contraindication for pool therapy.
B) Yes, however, all catheters must be removed prior to entering the pool.
C) No, patients with open wounds cannot enter a therapeutic pool.
D) Yes, however, all catheters must be clamped and fixed prior to entering the pool.

Question 15

You have been using pulsed lavage with suction (PLWS) for a patient with a noninfected venous ulcer. You have noted no increase in new granulation tissue in the wound for 1 week. Which of the following is most appropriate at this time?

A) Increase treatment pressure to 20 psi and continue daily PLWS treatments.
B) Discontinue PLWS and consult with the patient's physician.
C) Debride 50% of the granulation tissue and resume PLWS.
D) Discontinue PLWS and start warm whirlpool treatments for the wound.

Question 16

A 66-year-old woman fell and sprained her left wrist 2 days ago. Today she will begin physical therapy for the sprained wrist. She has pain and moderate swelling of the wrist, and she is unable to perform active ROM exercises because of pain with movement. Which of the following would be an appropriate hydrotherapy treatment for her wrist today?

A) High-boy whirlpool with water temperature of 38°C with maximum agitation
B) Small whirlpool with water temperature at 25°C with low agitation
C) Low-boy whirlpool with water temperature at 80°C with moderate agitation
D) Pool therapy to enable patient to exercise while her left wrist is healing

Question 17

The "dive reflex" causes which of the following physiological responses when most of the body is immersed in water?

A) Increased heart rate
B) Peripheral vasodilation
C) Shunting of blood to vital organs
D) Decreased blood flow to the brain

Question 18

Which of the following patients will most likely have the greatest ability to float in water?

A) A 200-pound female with low bone density
B) A 150-pound male without air in lungs
C) A 110-pound female with high bone density
D) A 200-pound male with air in lungs

Question 19

Which of the following will increase the amount of resistance to limb movement in water?

A) Moving a limb slowly in the water
B) Raising the limb upward in the water
C) Moving a limb quickly in the water
D) Keeping the limb close to the surface of the water

Question 20

Which of the following is an electrical safety rule for hydrotherapy interventions?

A) Patients should not touch the turbine, including the on/off switch, when it is running.
B) Whirlpool turbines should only be plugged into two-prong electrical outlets.
C) Ground-fault circuit interrupters are required for large whirlpools but are unnecessary for small ones.
D) Multiple electrical devices, such as whirlpool and electrotherapy devices, can be used simultaneously on a patient provided that at least one of the devices is grounded.