What Is Hydrotherapy and Who Can It Help?

A quick tour through the practice and its benefits

The simplest way to describe hydrotherapy? It’s the use of water for therapeutic purposes.

Of course, the art itself is much more involved. How is the water use, and at what temperature? Which patients and what conditions see the greatest benefits? What level of evidence exists for the practice? Are there any contraindications? 

Chances are you’ve indulged in hydrotherapy at one point or another, as its definition includes steam baths, saunas, whirlpools, and the alternation of hot and cold showers. 

History

The idea of hydrotherapy has been present since ancient cultures, usually simply involving the belief that bathing in general was a way to cure sickness. It wasn’t until the 19th century that the art we know today began to round into form. 

At the time, the practice of medicine was considerably more primitive, and hydrotherapy was used to induce ‘crises.’ Water would invade any cracks or imperfections in the skin, which would flush out the impurities. A ‘crisis’ basically meant that pus from a would rise to the surface of the skin. 

Other discoveries of the time recommended drinking water as a remedy for just about any disease. Vincent Preissnitz was a German who became his town’s consulted physician by merely ‘curing’ his broken ribs with a regimen of bandaging and drinking large quantities of water. 

It was Father Sebastian Kneipp, a monk from Germany, who would become recognized as the father of modern hydrotherapy. Kneipp believed that hydrotherapy at the time was too violent a process – the induction of crises could often take months or even years – and he sought a process more soothing to the patient that also addressed emotional and spiritual needs. His methods gained simplicity at a time when medical practice was becoming more and more complicated, often leaving the layperson in a state of confusion when consulting a physician.

At the time, much of hydrotherapy involved the use of cold water. Hot water in therapy was popularized in the 1850s, primarily through the idea of Turkish baths.

As time went on, hydrotherapy was thought to be useful in the treatment of mental illness, and for a short time people attempted it as a potential cure for alcoholism. Today, the alternation of hot and cold showers has shown experimental evidence in reducing injury by reducing swelling. Ice baths or cold water immersion are regularly used by certified athletic trainers or physical therapists to improve blood flow in athletes with injuries or even general soreness.

Who Can Benefit?

Over the years, physical therapists and other professionals have expanded their repertoire to include hydrotherapy, while attempting to discover new patient groups who may benefit from the practice. Earlier this year, a study showed positive effects for patients with Parkinson’s disease.

The study, entitled “The Effects of Hydrotherapy on Balance, Functional Mobility, Motor Status, and Quality of Life in Patients with Parkinson’s Disease: A Systematic Review and Meta‐analysis” was published in Physical Medicine & Rehabilitation and showed that hydrotherapy offers significant benefits in balance and mobility when compared to land-based therapy.

Tremors, muscle stiffness and fear of falling often combine to create a sedentary lifestyle for patients with Parkinson’s, but the water provides a safer atmosphere where the fear of lost balance or even a fall is literally cushioned by the safe landing spot. As such, therapy sessions can last longer, and with lessened fears, patients are more able to fully engage in the recommended exercises. 

The meta-analysis performed to address the gap in research as to the effectiveness of hydrotherapy involved the researchers searching seven online databases for any studies conducted through the end of 2017. They found some 19 studies, including eight randomized controlled trials, utilizing patients between the ages of 54 and 78 with disease durations anywhere from three to 10 years. 

In short, five of the eight randomized controlled trials showed that hydrotherapy had significant benefits in balance and mobility, whether or not it was combined with medication or land-based therapy. Another three studies showed similar findings, but were not included due to lack of a control group. While two studies did not show benefits from hydrotherapy, the good outweighed the bad in the minds of researchers, who wrote, “hydrotherapy, combined or not with other therapies, may improve balance and functional mobility of patients with [Parkinson’s] when compared to land-based therapy alone or usual care.” 

Contraindications

Again, this is an area where modern research has done wonders. The main recommendations these days are for the very young and the elderly to avoid cold baths, while keeping people with diagnosed heart issues away from saunas. 

Perhaps the greatest area for emphasis is simple hygiene. A few years ago, a MRSA (methicillin-resistant Staphylococcus aureus) outbreak in an NFL locker room was attributed in part to the sharing of towels and other equipment and raised questions about the cleanliness of these items. Locker rooms, obviously, are areas where moisture accumulates due to the presence of whirlpools, hot tubs and other hydrotherapy-utilized equipment.

For the everyday patient, however, a growing body of research shows the usefulness of hydrotherapy in daily life for soothing relaxation. With an increasing body of evidence for its usage in treating conditions like Parkinson’s disease, the future is indeed bright for this form of therapy.

SOURCES: Physical Medicine & Rehabilitation, Parkinson’s News Today, VeryWell Health

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