EXERCISE THERAPYTITLE : METHODS IN HYDROTHERAPY PREPARED FOR : MADAM NOR AZIZAH PREPARED BY : NURDINA AFINI BINTI IZAMUDIN (031390) DATE OF SUBMISSION : 17th February 2013 HYDROTHERAPY 2/17/2013 BAD RAGAZ RING METHOD . Clients with paralysis and limitation of movement in the joints were treated by performing range of motion exercises while supported on fixed treatment boards in the water. supportive environment while enjoying the physiologic benefits of warm water.WHAT IS BAD RAGAZ RING METHOD ? The bad ragaz ring method is a collection of therapeutic techniques performed in the water that have been developed through years in the thermal waters of Bad Ragaz. and tone inhibition in water. Knupfer incorporated the concepts of the neurophysiology of training. . surface tension. and isotonically resisted exercises of agonist & antagonist muscle groups. turbulence. & progressive resistive exercises. and the thermal capacity of 92 degree f water to reduce pain. stabilization. and thermal capacity are used to facilitate rehabilitation in a program of relaxation. Germany were introduced to Bad Ragaz by Nele Ipsen. the method is used internationally for muscle re-education. Water’s unique properties of buoyancy. or rails were attached to the side of pool to provide a hand hold for clients exercising in the water. Switzerland. The modified technique was used for stabilization or active resistive exercises. In 1957. Straps were used to hold the client firmly in place. mainly a single plane of motion. and promote relaxation were understood as unique clinical strategies that differentiated water from land exercise. Still evolving. advances in techniques developed by Dr. surface tension. and developed exercises that consisted of simple chains of movement passing from joint to joint. increase soft tissue compliance. strengthening. turbulence. reduce muscle tone. Knupfers exercises refined the method into horizontal treatment technique in which the client was supported floating on his back by flotation rings around the neck and the pelvic region and under the knees & ankles. It aided use of closed kinetic chain exercise in a safe. spinal traction/elongation. After Knupfer. He contended that active movements away from and back toward the fixed point of the therapists hands facilitated stabilizing reactions adapted to the task circumstances. hydrostatic pressure. relaxation. the use of buoyancy. Knupfer of wilbad. naturally occurring movement synergies. Dr. Germany. South Africa.With the rapid growth & acceptance of proprioceptive neuromuscular facilitation (pnf). medical director at Bad Ragaz and his medical team refined and modified Knupfer’s exercises. Zinn. In 1967. physiotherapists Bridget davis and Verena laggatt incorporated Margaret Knott’s PNF patterns. England. Three dimensional diagonal movements were developed and added to knupfer’s original exercise pattern. and elsewhere. and is becoming popular in Switzerland. The method continues to evolve. Australia. . the United States. resulting in the technique known today as the Bad Ragaz Ring Method (BRRM). Relaxation 3. Tone reduction 2. Increasing range of motion 4. Strengthening 6. 9. Spinal traction/elongation 7. . 10. Preparation of the lower extremities for weight bearing.Goals of treatment BRRM provides infinite possibilities for variation of exercise for the neurologic. 1. Restoration of normal patterns of upper & lower extremity movements. Muscle re-education 5. orthopaedic. Improving alignment & stability of the trunk 8. & rheumatologic client. Improving general endurance 11. Training functional capacity of the body as a whole. Most patterns emphasize reciprocal movement patterns. or around the therapist. arms. and legs. there are three ways in which the therapist acts in relation to the client. Because of the . The client determines the resistance encountered by the setting the speed of movement through the water. away from. Promotes stabilizing contractions. Conversely movement can be assisted by a therapist pushing in the direction opposite to the client’s intended motion. Bad Ragaz Ring method exercises can be divided into patterns for the trunk. Reciprocal movements are not always emphasized with certain client conditions and circumstances. the patterns are performed in supine floating. In general. yet a few arm patterns are performed in prone and a few trunk patterns in side lying. • Isometrically: The client holds a fixed position while being pushed through the water by the therapist. This action leads to an increase in resistance to that movement. Bilateral patterns are further defined as symmetric or asymmetric.Technique Stressing the need for the therapist to provide stability for the client and still be flexible with application. • Isokinetically : Therapist provides fixation while the client moves through the water either toward. • Isotonically: The therapist acts as a “movable” fixation point. Ex: the client can be pushed or swung into the direction of his or her active movement. They can also be categorized as unilateral or bilateral. flexibility of the patterns and the adaptability of the technique. HALLIWICK METHOD . an almost infinite variety of exercises can be developed by the therapist to maximize client outcomes. for instance) independent movement and swimming. social and therapeutic aspects. and it refers to various activities performed in the water. However.WHAT IS HALLIWICK METHOD ? The Halliwick concept is an approach to teaching all people. The Hallwick concept may be regarded as a universal approach to teaching. (such as. and sets out the necessary fundamentals for learning. personal. it mainly focuses on subjects with physical and/or learning difficulties. . These benefits refer to physical. and to swim. focusing on those with physical and/or learning difficulties. to participate in water activities. to move independently in water. recreational. in particular. It is based on a belief in the benefits that derive from activities/exercises performed in the water. situations or tasks. In a new environment or situation. Balance Control . Mental Adjustment . Movement . The swimmer needs to learn a fine degree of balance control in order to prevent unwanted movements and achieve efficient postural control. . The ten points of the Halliwick concept are: 1. situation or task.refers to the ability to perform desired movements so as to accomplish an activity with efficiency and skill. These three concepts. Mental Adjustment :being able to respond appropriately to a different environment.refers to the swimmer’s ability to respond flexibly to different environments. Mental Adjustment. are the essential components of motor learning.The ten-point programme The Ten-Point Programme provides the basis for practical work by bringing together the fundamentals of the Halliwick Concept in an easy-to-follow logical structure. achieving/maintaining control is often difficult for the beginner and there may be excessive movement. The Ten Points are a process of development which leads to personal independence in the water through the essential components of motor learning.the ability to stay in control while maintaining or changing position in the water. Within the Ten Points we can see a process of development through mental adjustment. both through mental organization and physical control. balance control and movement which leads to personal independence in the water. The Halliwick Ten Point Program At the Halliwick concept you are asked constantly to solve your balance problems in trial and error situations through The Ten Point Program. The learner will need to develop the ability to respond automatically. independently and appropriately to a variety of situations in the water. The learning of breath control. Balance Control and Movement. Turbulent Gliding : a floating swimmer is moved through the water by an instructor without any physical contact between them. Longitudinal Rotation Control : the ability to control any rotation made about a sagittal-frontal (longitudinal) axis. 9. Upthrust : trusting the water and realize you will float and not sink. 3. Disengagement : an ongoing process throughout the learning by which the swimmer becomes physically and mentally independent. Transversal Rotation Control : the ability to control any rotation made about a fronttransversal axis. Balance in stillness | floating still and relaxed in the water. The swimmer has to control unwanted rotations but makes no propulsive movements. 6. 10. 7. 8. 4. 5. When balanced. This is dependent on both mental and physical balance control. Combined Rotation Control : the ability to control any combination of rotations. . Simple Progression and Basic Swimming Stroke : the development from simple propulsive movements made by the swimmer to a stroke which may be individual to each swimmer. Sagittal Rotation Control : the ability to control any rotation made about a sagittaltransversal (anterior/posterior) axis.2. other activities can be performed more easily. resistance. The benefits of the water along with Halliwick exercise program can: Strengthen connective tissue Increase flexibility Oxygenate muscle tissue Naturally increase mood Decrease depression and pain Helping you to sleep better . This may help to decrease pain and reduce stress. turbulence.BENEFITS OF HALLIWICK METHOD: The buoyancy. hydrostatic pressure and viscosity in the water help to ease pressure on the muscles and joints. and Massage for a True Mind/Body Water .WATSU What is Watsu Massage Therapy? Combining Water Therapy Experience. what you're left with is the fundamental essence of your being. for therapy and for stress and pain reduction make the Watsu the world's first form of Thermal Aquatic Bodywork. In addition the meditative states and connection it induces make Watsu more than bodywork. California. There is one characteristic that makes Watsu stand out from massage and so many other forms of bodywork is that it gives you the opportunity to go beyond the physical. Watsu Therapy = Water + Shiatsu Watsu began at Harbin Hot Springs. making it a true mind/body experience. WATSU THERAPY BENEFITS: . where Harold Dull came to teach the Zen Shiatsu he had studied in Japan Zen Shiatsu incorporates stretches which release blockages along our meridians. In the orient stretching is an even older therapy than acupuncture which focuses on points along these meridians. It strengthens muscles. Its use. When your body relaxes so deeply . and increases flexibility and range of motion.Watsu therapy consists of moves and stretches done to the breath while being held and floated by a Watsu practitioner in body temperature water. the channels through which our “chi” or life force flows.as it can in the warm weightlessness of Watsu . And when the body and mind are quiet. Harold Dull found these effects can be amplified and made more profound by stretching someone while floating them in body temperature water. like massage.the mind can cease its chatter. Watsu effects a greater increase in the range of motion than traditional methods. These changes may include: Decreased heart rate Decreased rate of respiration Increased depth of respiration Increased peripheral vasodilatation Increased smooth muscle activity (digestion) Decreased activation of striated muscles (skeletal) Decreased spasticity Decreased muscle spasm Decreased reticular activating system (RAS) activity Enhanced immune system response . Through quieting the sympathetic and enhancing the parasympathetic nervous systems. When the whole body is in continual movement. each move flowing gracefully into the next. there is no way to anticipate what's coming next and build up resistance. the body can move beyond those limitations fear would otherwise impose. Watsu promotes a deep state of relaxation with dramatic changes in the autonomic nervous system. Without pain. rocking and moving the whole body while stretching a leg or arm. New life is stretched into long neglected connective tissue and the restricted body is shown new possibilities of freedom. The sympatholytic effects of Watsu lead to enhancement of the parasympathetic nervous system Physiological changes then occur throughout the body. Watsu has profound effects on the neuromuscular system. By supporting. Watsu lessens the resistance that occurs when a limb is worked in isolation. Watsu helps decrease muscle tension and increase range of motion. AI CHI . The support of the water provides relief from compression forces in the joints. The movements through the water provide gentle stretching into all ranges for the spine and extremities while these joints are unloaded. .What is Ai Chi? Ai Chi is a water-based total body strengthening and relaxation progression that bridges East and West philosophies. Ai Chi is a thermal aquatic bodywork that takes advantage of the waters properties. physical. lower-extremity. to the incorporation of upperextremity. movement. fostering range of motion while challenging balance (safely) and facilitating core strength and stability. The series of movements is simple. and torso. Is ideal for creating improved range of motion and mobility. and integrates mental. It combines Tai-Chi and Qi Gong concepts with Watsu techniques. Is a perfect relaxation technique for highly stressed. and music are used to encourage a state of relaxed awareness. broad movements of the arms. and is performed standing in shoulder-depth warm water using a combination of deep breathing and slow. legs. over-challenged people. and spiritual energy. but effective and becomes meditative when performed repeatedly and coordinated with the breath. Water. Ai Chi is an efficient exercise program that: Increases oxygen and caloric consumption through correct form and positioning in the water. and finally total body involvement. The Ai Chi progression moves (kata) from simple breathing. trunk. tendons.AI CHI THERAPY BENEFITS: Ai Chi is widely recommended especially for high stress and other disorders that limit movement or energy and as such it is an important activity in our wellness program. Ai Chi can be a way to get your body moving. Ai Chi can help reduce muscle weakness. muscles and ligaments. relaxed movement and increased blood flow to joints. and promote flexibility and strength. as it can improve physical and mental health. while minimizing the effects of stress symptoms. widespread pain as well as joint stiffness. The warm water allows for slow. . increase your energy. It can also minimize problems associated with conditions such as polymyalgia rheumatica and rheumatoid arthritis. Ai Chi Physical Movement Principles Ai Chi movements can be used to improve movement efficiency of people suffering from: Chronic pain Arthritis Fibromyalgia syndrome (FMS) Chronic obstructive pulmonary disease . Ai Chi can minimize problems such as: Anxiety Fatigue Depression In Traditional Chinese Medicine (TCM). Problems with the flow of chi are linked to disease. Ai Chi along with acupuncture is believed to promote the circulation of chi. life energy) moves through your body.In terms of mental health. and TCM practitioners believe that restoring its proper flow will bring about good health. keeping you vital and healthy. chi (Qi. With that training. Ai Chi can also promote relaxation with people who are coping with high stress levels. Many of the Ai Chi benefits come from breathing and exercise. Ai Chi is flowing. you will achieve a unity of movement and consciousness. Awareness of the mind's presence in the various parts of the body is taught through the techniques of Ai Chi. fitness. requires no equipment. Move naturally until the motions flow easily. with no straining. arthritis. round movements executed with a profound inwardly directed focus. because the philosophy and breathing in Ai Chi are similar to those of landbased Tai Chi. and allows the hair and face to stay dry. This head-out position is important for non swimmers who would benefit from exercise in the water. Balance deficits Diabetes Multiple sclerosis (MS) Other neurological and orthopedic problems Ai Chi can be used in groups or individually. and longevity than through physical training alone. gently. diabetes. and balance impairments. By eliminating all other thoughts. The expanded range and cardiovascular benefits that arise from Ai Chi training have proved beneficial for patients with chronic pain. It requires a non-judgmental attention to self. as well as effects related to the relaxed contemplative state. many of the benefits seen in Tai Chi are applicable to Ai Chi. Ai Chi should be done slowly. . Move with the water (muscles and joints will relax and eyes become partly closed). Additionally. soft. and quietly. chronic obstructive pulmonary disease. you can acquire greater degrees of health. Repetition allows us to do this.Repetition: Deep relaxation can only occur when you feel stable in the water and confident in your ability to follow the progression. rather than the precision and rigidity of traditional exercise. and are effective in relieving: Backaches Headaches Stiffness in the shoulders and neck After Ai Chi positioning is taught. and organic. . In Ai Chi. They improve digestion and remove sluggishness. not for evaluating success or failure. natural. continual movement and slowness are taught. The repetition in Ai Chi is for relaxation. the focus is on tranquility. and then breathing is incorporated. Twists created by the trunk stability movements are neutralizing. cleansing. Correct alignment is crucial. Pelvic mechanics and alignment. The challenge for those who are addicted to outward movement is a change in perspective. google.aqua4balance.my/url? sa=t&rct=j&q=bad+ragaz+method&source=web&cd=5&cad=rja&ved=0CEIQF jAE&url=http%3A%2F%2Faquatictherapyinindia.UR2lwqWl6Sq 2.com/Fitness-and-Exercises/ai-chi-thermal-aquaticexercises.d.com/Therapy-and-Bodywork/watsu-therapy/howwatsu-therapy-affects-our-body-and-mind.REFERENCES 1. http://www.html#.42452523.com.UR2lQKWl6Sp 4.aqua4balance.com%2Fp %2Fbad-ragaz-ring-method-bad-ragazring.blogspot.aqua4balance. http://www.html#.html#.com/Fitness-and-Exercises/halliwick-concept-thermalaquatic-exercise-program. http://www. http://www.bmk .UR2jTqWl6So 3.html&ei=xdQcUaryEsmciAexyIHwCA&usg=AFQjCNG0XBPSqs5LzMrlM txcAqWkGS-AUQ&bvm=bv.