M*
suggestions from the field
BURTON J. GROSSMAN, M .D., THELMA B. PENDLETON, and JUERGEN ROENNAU, M.B.A.
The mechanical principles and therapeutic applications of wading pools with parallel bars for underwater exercise and gait training are well known. In many physical therapy depart ments, however, the therapeutic advantages of this form of therapy are unavailable to the patient. The lack of availability can be attrib uted to four major reasons: 1. The wading pool is not installed in the facility because of lack of space or lack of structural support for a heavy water-filled pool. 2. The wading pool is not installed because of the great cost of a multidepth wading pool. 3. The use of the wading pool is hampered by the length of time necessary to change the water to reach the proper temperature or to fill the pool to the proper depth. 4. The use of the wading pool is neglected at times because the physical therapist or assistant is reluctant to undress, don a bathing suit, and enter the pool with the patient. In physical therapy departments where chil dren of different heights require various depths of the water, the problem is compounded. We addressed ourselves to these problems and designed and had constructed a compact under-
Dr. Grossman is Professor of Pediatrics, Pritzker School of Medicine, University of Chicago, and Medical Director, La Rabida Children's Hospital and Research Center, East 65th Street at Lake Michigan, Chicago, IL 60649. Mrs. Pendleton is Director, Physical Therapy Ser vices, La Rabida Children's Hospital and Research Center. Mr. Roennau is administrator of La Rabida Chil dren's Hospital and Research Center.
164
water exercise tank for all sizes of patients. This compact tank overcomes all of the above objections and is easily adapted to use in a physical therapy department for children.
Description of the Tank A diagram of the tank appears in Figure 1. The tank is constructed with a double wall of stainless steel with outside dimensions of 167 centimeters in length, 75 centimeters in width, and 115 centimeters in height (measured as height above the floor). The inside dimensions are 159 by 66 by 110 centimeters. Suspended at each end of the tank is a chrome-plated ladder with cross-bars spaced 9 centimeters apart to receive a stainless steel movable platform with a nonskid surface (Fig. 2). The platform can be set at the bottom of the tank or at any intermediate position along the height of the tank and can be slanted to allow ramp walking. Along the length of the tank are 3.3-centimeter diameter adjustable handrails which can be raised or lowered independently of the platform to accommodate a patient of any height. The tank is fitted with a dial thermometer for careful monitoring of the water temperature and with a 1.7-centimeter, chrome-plated, manual water mixer which provides a filling time of less than six minutes. The emptying time is approximately seven minutes. The level of the water can be changed quickly while the child is in the tank. A stainless steel platform, 35 centimeters high and 53 centimeters wide, with a nonskid surface runs along two sides of the tank. The PHYSICAL THERAPY
Downloaded from https://academic.oup.com/ptj/article-abstract/55/2/164/4567646 by University of Texas at Dallas user on 13 February 2019
Compact Tank for Underwater Ambulation
or school with ease. The tank is light enough so that it could be moved from floor to floor on a large elevator.
Fig. 1. Diagram of tank for underwater ambula tion.
tank plus the platform placed in the corner of a room takes up a space of only 220 by 128 centimeters, thus providing a major hydrother apy tank in a small area. The outer platform plus the small size of the tank allows the therapist and, if necessary, an assistant to have complete control of the patient. A tank similar to the one described could be portable and could be moved in and out of a small physical therapy department in a hospital
Fig. 2. Inside view of the tank showing suspension for walking ramp and adjustable parallel bars. Volume 55 / Number 2, February 1975
An overhead I beam-suspended, electrical hoist on a trolley, fitted with a body sling, is used for placing older children and heavy children into the wading tank. A wading harness can be attached to the hoist mechanism if necessary. Smaller children are lifted man ually into the tank and supported by hand until they gain confidence in the water. Children can be placed in the tank and treated by the therapist who stands on the platform along the side of the tank. The water is kept warm (29.5° to 35°C) so that the children do not become chilled or overheated. As the child gains confidence and strength, he is allowed to support himself in the water. A member of the staff is always on the platform when a child is in the tank. The quick and easy change in the water level provides control of buoyancy within fine limits. We have found that this control has speeded the patient's progress toward ambulation outside of the tank. Several types of patients have been referred for treatment in our tank: 1) patients with inflammatory joint disease who have been nonweight bearing because of muscle spasm and pain in the muscle groups controlling the hips, knees, and ankles, 2) postsurgical patients who have had surgical procedures on the feet or lower extremities and who have pain on weight bearing or have become weak from inactivity, 3) patients emerging from casts on the lower extremities who have muscle atrophy and stiffness, and 4) patients who have had pro longed bed rest with deformities of the feet, such as drop-foot, resulting from poor position ing while in bed. Additional referrals have been dictated by the particular needs of individual patients. The tank was designed by the authors and built by Ille Electric Corporation.* The empty tank weighs 782 kilograms; the filled tank, 1,936 kilograms.
* Ille Electric Corporation, 2245 Reach Rd., Williamspore, PA 17701.
165
Downloaded from https://academic.oup.com/ptj/article-abstract/55/2/164/4567646 by University of Texas at Dallas user on 13 February 2019
Use of the Tank
suggestions from the field
BURTON J. GROSSMAN, M .D., THELMA B. PENDLETON, and JUERGEN ROENNAU, M.B.A.
The mechanical principles and therapeutic applications of wading pools with parallel bars for underwater exercise and gait training are well known. In many physical therapy depart ments, however, the therapeutic advantages of this form of therapy are unavailable to the patient. The lack of availability can be attrib uted to four major reasons: 1. The wading pool is not installed in the facility because of lack of space or lack of structural support for a heavy water-filled pool. 2. The wading pool is not installed because of the great cost of a multidepth wading pool. 3. The use of the wading pool is hampered by the length of time necessary to change the water to reach the proper temperature or to fill the pool to the proper depth. 4. The use of the wading pool is neglected at times because the physical therapist or assistant is reluctant to undress, don a bathing suit, and enter the pool with the patient. In physical therapy departments where chil dren of different heights require various depths of the water, the problem is compounded. We addressed ourselves to these problems and designed and had constructed a compact under-
Dr. Grossman is Professor of Pediatrics, Pritzker School of Medicine, University of Chicago, and Medical Director, La Rabida Children's Hospital and Research Center, East 65th Street at Lake Michigan, Chicago, IL 60649. Mrs. Pendleton is Director, Physical Therapy Ser vices, La Rabida Children's Hospital and Research Center. Mr. Roennau is administrator of La Rabida Chil dren's Hospital and Research Center.
164
water exercise tank for all sizes of patients. This compact tank overcomes all of the above objections and is easily adapted to use in a physical therapy department for children.
Description of the Tank A diagram of the tank appears in Figure 1. The tank is constructed with a double wall of stainless steel with outside dimensions of 167 centimeters in length, 75 centimeters in width, and 115 centimeters in height (measured as height above the floor). The inside dimensions are 159 by 66 by 110 centimeters. Suspended at each end of the tank is a chrome-plated ladder with cross-bars spaced 9 centimeters apart to receive a stainless steel movable platform with a nonskid surface (Fig. 2). The platform can be set at the bottom of the tank or at any intermediate position along the height of the tank and can be slanted to allow ramp walking. Along the length of the tank are 3.3-centimeter diameter adjustable handrails which can be raised or lowered independently of the platform to accommodate a patient of any height. The tank is fitted with a dial thermometer for careful monitoring of the water temperature and with a 1.7-centimeter, chrome-plated, manual water mixer which provides a filling time of less than six minutes. The emptying time is approximately seven minutes. The level of the water can be changed quickly while the child is in the tank. A stainless steel platform, 35 centimeters high and 53 centimeters wide, with a nonskid surface runs along two sides of the tank. The PHYSICAL THERAPY
Downloaded from https://academic.oup.com/ptj/article-abstract/55/2/164/4567646 by University of Texas at Dallas user on 13 February 2019
Compact Tank for Underwater Ambulation
or school with ease. The tank is light enough so that it could be moved from floor to floor on a large elevator.
Fig. 1. Diagram of tank for underwater ambula tion.
tank plus the platform placed in the corner of a room takes up a space of only 220 by 128 centimeters, thus providing a major hydrother apy tank in a small area. The outer platform plus the small size of the tank allows the therapist and, if necessary, an assistant to have complete control of the patient. A tank similar to the one described could be portable and could be moved in and out of a small physical therapy department in a hospital
Fig. 2. Inside view of the tank showing suspension for walking ramp and adjustable parallel bars. Volume 55 / Number 2, February 1975
An overhead I beam-suspended, electrical hoist on a trolley, fitted with a body sling, is used for placing older children and heavy children into the wading tank. A wading harness can be attached to the hoist mechanism if necessary. Smaller children are lifted man ually into the tank and supported by hand until they gain confidence in the water. Children can be placed in the tank and treated by the therapist who stands on the platform along the side of the tank. The water is kept warm (29.5° to 35°C) so that the children do not become chilled or overheated. As the child gains confidence and strength, he is allowed to support himself in the water. A member of the staff is always on the platform when a child is in the tank. The quick and easy change in the water level provides control of buoyancy within fine limits. We have found that this control has speeded the patient's progress toward ambulation outside of the tank. Several types of patients have been referred for treatment in our tank: 1) patients with inflammatory joint disease who have been nonweight bearing because of muscle spasm and pain in the muscle groups controlling the hips, knees, and ankles, 2) postsurgical patients who have had surgical procedures on the feet or lower extremities and who have pain on weight bearing or have become weak from inactivity, 3) patients emerging from casts on the lower extremities who have muscle atrophy and stiffness, and 4) patients who have had pro longed bed rest with deformities of the feet, such as drop-foot, resulting from poor position ing while in bed. Additional referrals have been dictated by the particular needs of individual patients. The tank was designed by the authors and built by Ille Electric Corporation.* The empty tank weighs 782 kilograms; the filled tank, 1,936 kilograms.
* Ille Electric Corporation, 2245 Reach Rd., Williamspore, PA 17701.
165
Downloaded from https://academic.oup.com/ptj/article-abstract/55/2/164/4567646 by University of Texas at Dallas user on 13 February 2019
Use of the Tank
