An Aquatics-first Therapy Approach

Aquahab provides a room with a water view

Lisa Smith, PTA, Aquahab
Lisa Smith, PTA, has been with Aquahab since its inception in 1991. “We get to see a wide range of diagnosis, ages, functional levels, and we get to restore them back to a higher quality of life,” Smith said. “Aquahab not only offers a shallow therapy pool that is heated, but we also have one of the largest pools that people can perform hanging traction in, deep-water walking and running, and dynamic stabilization exercises for the core.”

Vol. 27 • Issue 10 • Page 21

Aquatic Therapy

Most private physical therapy practices that provide aquatic therapy offer such services as an adjunct to traditional land-based rehabilitation, usually in a smaller therapy pool or offsite facility. But Aquahab, a four-location practice in the Philadelphia region, has turned this model upside down, taking an aquatics-first approach to patient care, with “traditional” therapy assuming a supporting role.

“It’s sometimes difficult to find practices that provide true aquatic therapy,” said Colleen McGinley, DPT, vice president of clinical operations and business development at Aquahab. “Most of the time it’s offered as an add-on therapy, or an afterthought. We position ourselves as total wellness.”

Aquatic-first Philosophy

A physical therapist since 2001, McGinley has been in outpatient orthopedics for 15 years and arrived at Aquahab two-and-a-half years ago.

“I fell in love with the whole concept,” said McGinley, whose role with the company today is primarily a management one – staffing, budgeting, conferences, etc. – but she continues to play a treatment role as well.

Founded in 1991, Aquahab is celebrating its 25th year in business this fall. The company’s pool lineup includes both full-sized therapy pools and deep-water pools for traction, cardiovascular conditioning and stabilization programs. Water is kept at a therapeutic temperature of 92-94 degrees in the shallow pools, and 86 degrees in the deep-water pools. Depth, resistance and therapist assistance fluctuate based on the capabilities of the patient and the parameters of the multidisciplinary treatment plan.

A therapy staff of two dozen physical therapists and physical therapist assistants deliver treatment.

Complementary Business Model

Owner Les Littman founded the Aquatic & Fitness Centers in Philadelphia and Cherry Hill, N.J., in 1991 before growing the company to four locations and adding the rehabilitation business line as a separate entity. Despite the company’s name and reputation for being the premier aquatic therapy provider in the region, a robust list of land-based physical therapy services are provided as well — vestibular therapy, sports rehabilitation, TMD treatment, active release technique, IASTM, body mechanics and a “Back School” program are just a few.

“We live on land,” said McGinley. “As supportive as a water environment can be, we understand that the ultimate objective is returning function to patients’ lives, whatever form that may take.”

It can be a challenge educating new patients and referral sources that the company provides more than just water-based therapy. “We pride ourselves on being the premier provider of aquatic physical therapy, but we don’t limit ourselves to that modality,” stressed McGinley. Consistent community education and presentations to patient groups are part of the marketing plan.

Referrals from physicians and area health systems remain the primary avenue for patients entering the care stream at Aquahab. The two businesses complement each other — members of the fitness club are familiar with the facility and the therapy staff if they become injured or need physical therapy, while discharged patients receive a free month membership to AFC Fitness, along with two complimentary sessions with a personal trainer and a complimentary appointment with a licensed dietitian. This eases the transition to water-based fitness programs under clinician guidance and paves the way for full recovery and healthier lifestyles.

Periodic meetings with personal trainers keep therapists apprised of former patients’ progress and alert them to any setbacks. If a member desires physical therapy services, the therapy team will complete a complimentary screening and direct the patient to obtain a referral for treatment if advised. While Pennsylvania is a direct-access state, many insurance plans still require a referral, and state law stipulates that physical therapists can only treat a patient for 30 days before a prescription is necessary.

Benefits of Aquatic Therapy
Warm water facilitates muscle relaxation and increases peripheral circulation.
Viscosity of water provides resistance for strength training.
Warm water stimulates body awareness, balance, and trunk stability.
The reduction of gravitational forces in the pool allows the patient to stand and begin gait training and strengthening exercises without causing further damage to healing structures.
Warm water and buoyancy results in decreased pain sensitivity.
Improvement of patient morale and confidence can be established by providing a positive medium in which to function.

Source: AquaHab

Patient Populations

Stenosis and back pain, arthritis, hip and knee replacement, radiculopathy, chronic pain, tendonitis conditions and more respond to water-based rehab, said McGinley. “Aquatic therapy lets you start rehab sooner,” she said. “Athletes and post-surgical patients who aren’t yet ready for land-based treatment can get in the water and get moving.”

Aquahab positions itself as a provider of patient wellness, addressing all areas of a patient’s lifestyle from nutrition to stress management to exercise and preventive medicine. Monthly “check-ins” are encouraged for former patients and members of AFC.

For practice owners looking to expand with aquatic therapy services, but who may not have the capital or the physical space for the investment, McGinley recommends a business model similar to what made Aquahab a success. Find an existing aquatic facility not currently offering physical therapy, and enter into a mutually beneficial partnership.

“There are fitness centers looking to expand into the rehabilitation arena by partnering with physical therapists,” said McGinley, adding that not having to purchase, clean and maintain the pools and equipment is a major advantage in both time and money savings. “Once they see how quickly it catches on in the community and the volume starts to build, they realize the advantages. You can really position yourself as the go-to therapy destination in your area.”

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