Physical Effects and Physical Effects and Medical Efficacy Medical Efficacy
in Medical Hydrology and in Medical Hydrology and HydrotherapyHydrotherapy
Physical effects of bathingPhysical effects of bathing
Mechanical effectsThermal effects
Mechanical effects of waterMechanical effects of water
Buoyancy Hydrostatic pressure (immersion) Viscosity
Effect of buoyancyEffect of buoyancy
RelaxationDecrease of muscle tension
Effect by immersionEffect by immersionEffect by immersionEffect by immersionHalf bathHalf bath Full bathFull bath
About 1000 ml of blood flows into the thoraxAbout 1000 ml of blood flows into the thorax
Air bathAir bath
Acute effects of immersionAcute effects of immersionAcute effects of immersionAcute effects of immersion
in haemo dynamic functionin lung functionin kidney functionin neuro-muscular functionin endocrine functionto the blood
Effect of immersionEffect of immersion
Heart rateHeart rate
Blood pressure
Blood pressure
DivingEffect of stand up
Effect in haemodynamic functionEffect in haemodynamic function
Increase of the central hypervolaemia Increase of the stroke volume and cardiac minute output Decrease of the heart rate Often decrease of the systolic blood pressure Increase of the central venous and pulmonary blood pressure Decrease of the peripheral resistance Decrease of the peripheral venous tonus and orthostatic
tolerance
Effect in lung functionEffect in lung function
Decrease of the vital capacity and functional residual capacity
Increase of the expiration resistanceDecrease of the expiration reserve volumeIncrease of the alveolar-arterial oxygen
differenceDecrease of the arterial oxygen pressure
Immersion effect in creatine clearanceImmersion effect in creatine clearance
Effect in kidney functionEffect in kidney function
Increase of the diuresis Increase of the natriuresis Increase of the kaliuresis Increase of the glomerular filtration Increase of the osmotic clearance Increase of the water-clearance Increase of the PAH-clearance (para-aminohippuric
acid)
Effect in neuro muscular functionEffect in neuro muscular function
Increase of the muscle relaxationDecrease of the reflective contractionIncrease of the mobilityDecrease of the oxygen consumption
Effect in endocrine functionEffect in endocrine function
Stimulation of the atrio-natriuretic factors (ANF) Suppression of renin, angiotensin, aldosterone,
epinephrine, nephrine Suppression of ACTH and cortisone Suppression of adiuretine (ADH) and prolactin Stimulation of the endogenous dopaminergic and
central opioid activity (ß-endorphins)
Effect to the bloodEffect to the blood
Change of haematocrit (first de- than increase)Change of plasma volume (first in- than decrease)Change of plasma viscosity (first de- than increase)
The bath diuresisThe bath diuresisThe bath diuresisThe bath diuresis
Peripheral liquid changePeripheral liquid change Renal effectsRenal effects
ImmersionImmersionDecrease of transmural pressure Decrease of transmural pressure
Increase of capillary re-absorptionIncrease of capillary re-absorption
Increase of plasma volumeIncrease of plasma volume
Central hypervolaemiaCentral hypervolaemia
Increase of ANFDecrease of ADH and RAAS
change of renal dynamic
Increase of ANFDecrease of ADH and RAAS
change of renal dynamic
Increase of diuresisnatriuresis etc.
Increase of diuresisnatriuresis etc.
IndicationsIndicationsof thermoneutral bathsof thermoneutral baths
Muscle relaxation and join relief– rheumatic diseases
Relaxant effect by sympaticolysis, suppression of stress hormones and muscle relaxation– Psycho-vegetative syndrome– Psycho-physical overloading– Convalescence
Indications Indications of thermoneutral bathof thermoneutral bath
Dehydration effect by improved capillary re-absorption and diuresis– Rheumatic diseases– Posttraumatic and postoperative state– Oedema
Training of vegetative-hormonal functions like blood volume-, blood pressure- and electrolyte regulation– Convalescence– Heart-circulation-regulation disturbance– Psycho-vegetative syndrome
Perception of thermal effects in Perception of thermal effects in waterwater
Cold: lesser than 32 °C Thermoneutral: 34-35 °C Warm: till 38 °C Hot: more than 38 °C
Effect of cold bathingEffect of cold bathing
Thermal stimuli for training of blood flow regulation – Functional disturbance of blood flow– Phlebopathy– Cardio vascular diseases
Thermal stimuli for training of inurity– Infect prophylaxis
Effect of cold bath on epinephrineEffect of cold bath on epinephrineby Bühringby Bühring
NephrineNephrine
0
200
400
600ng/l
1535
36,5
37oC
oC
0 10 20 30 40 50 60 70 min.Before
15 oCErwärmung bis 1 oC unter Rektaltemperatur
Water temperatureWater temperature
Body temperatureBody temperature
EpinephrineEpinephrine
Hormonal reactions by coldnessHormonal reactions by coldness
Local hyperaemia is a reaction of acetylcholine release. By cholinesterase no systemic effect results.
The consensual reaction results by release of nephrine and epinephrine, and the effect by circulation reaction.
The reactive hyperaemia results by release of histamine and inhibition of the cholinesterase in case of well supplied tissue with blood. The acetylcholine-hyperaemia period is longer. To get this reaction the cold stimulation should be not very strong.
Rules of coldness applicationRules of coldness application
Before application the hole body has to be comfortable warm.
The cold stimulation has to be short and strong.After application the body has to be mobilised
to warm up again,Between the applications a break of 2 to 3 hours
will be needed.
Cold sensitivityCold sensitivity
In the morning stronger than in the afternoon.In summer stronger than in the winter.By great difference of temperature stronger than
by slowly warming up.On big areas stronger than on smaller areas.In long-time contact stronger than in short-time.
Effect of changing cold-hot bathingEffect of changing cold-hot bathing
Thermal stimuli for training of vegetative-hormonal functions– Convalescence– Psycho-vegetative syndrome– Cardio vascular regulation disturbance– Metabolic disorders
Effect of hot bathingEffect of hot bathing
Muscle relaxation Increase of extensibility the structures of
connective tissue Analgesic Anti-inflammatory by overheating
– Rheumatic diseases– chronic-inflammatory diseases of the urogenital
system– Post acute after trauma conditions and operations on
locomotor system
Effect of hot bath on blood circulationEffect of hot bath on blood circulation by Barcroftby Barcroft
45
40
35
30
25
oC
0 10 20 30 40 50 60 70 80 90 100 110 120 min.
80
60
40
100
%Blood circulation in musclesBlood circulation in muscles
Water temperatureWater temperature
Heart rate in hot bathsHeart rate in hot baths
Heart rateHeart rate
Temperature of water
Temperature of water
Respiratory minute volume
Respiratory minute volume
Heat-transferHeat-transfer
Moving water: Convection– Quickly heat transfer
(stronger temperature sensitivity)
Not moved water or mud: Conduction– Slowly heat transfer (lower temperature
sensitivity)
Heart rate by coldness shockHeart rate by coldness shockDiving after Sauna in cold waterDiving after Sauna in cold water
Blood pressureBlood pressure
Increase of heart rate
Increase of heart rate
SaunaSauna ControlControl
Inure effect by stimulation of stress-proteinsInure effect by stimulation of stress-proteins
Stress-proteins are produced by– Heat shock– Environment stressors– Heavy metals– Inhibitors of the energy metabolism– Amino acids– Chemotherapeutica
Inure effect by stimulation of stress-proteinsInure effect by stimulation of stress-proteins
Stress-proteins are produced by– Normal cell grow– Cell division– Grow factors– Cell differentiation
Inure effect by stimulation of stress-proteinsInure effect by stimulation of stress-proteins
Stress-proteins are produced by– Diseases– Virus infections– Fever– Inflammations– Circulation disturbances– Hypertrophy– Oxidation– Cancer
Inure effect by stimulation of stress-proteinsInure effect by stimulation of stress-proteins
Stress proteins have chaperone and inure effects– in oxygen deficiency situations,– in defence of virus-infections,– in stimulation of the immune system,– in protection of endogenous proteins.
Risk of bathingRisk of bathing During immersion:
increased cardiac preload results in a decompensation riskBe careful by Cardiac rhythm disturbance and
Angina pectoris After immersion:
collapse trendBe careful by Venous disease and
orthostatic irregularity During bathing:
burdening of the respiratory and lung functionBe careful by respiratory insufficiency
Contra indications in bathingContra indications in bathingContra indications in bathingContra indications in bathing
Strong febrile and infective diseasesHeart-insufficiency stage III and IV (NYHA)Hypertension stage III (WHO)Acute skin diseases and large skin lesions
Hydrotherapeutic measuresHydrotherapeutic measures
WashingsAffusionsBathsWater steppingBrushingsPacks and wraps
Holding the tube to prove the Holding the tube to prove the water pressure for affusionswater pressure for affusions
Knee-affusionKnee-affusion
Arm-affusionArm-affusion
Over-affusionOver-affusion
Flash-affusionFlash-affusion
Upper part washingUpper part washing
Lower part washingLower part washing
Putting a wrapPutting a wrap
Breast-wrapBreast-wrap
Arm-wrapArm-wrap
Wet-socksWet-socks
Lumbar wrapLumbar wrap
Hay-sackHay-sack
Loam-packLoam-pack
Half-bathHalf-bath
Seat-bathSeat-bath
Foot-bathFoot-bath
Arm-bathArm-bath
Steam-bathSteam-bath
Water steppingWater stepping
Hydrotherapy in cardiac-circulation Hydrotherapy in cardiac-circulation problemsproblems
Functional tachycardia:– Cold compress, cold hand- or arm bath till 1 min., hand
joints 2 minutes under coldwater valve
Bradycardia:– Warm arm bath rising from 36 to 39 °C
Cramp in the leg:– Soft warm (37 °C) and cool (20-22 °C) changing washings
or affusions
Hydrotherapy in respiratory Hydrotherapy in respiratory problemsproblems
Strong cough:– Arm- or foot-bath rising from 35 to 40 °C
High fever (Pneumonia):– Cool breast-washings or -wraps
High fever (Infection):– Cool to cold serial washings (right and left leg, abdomen)
without wipe dry in the bed, repeated every 30 min.
Hydrotherapy in neuralgiaHydrotherapy in neuralgia
Acute sciatica:– cold compress to the lumbar region
Chronic sciatica :– warm-hot compress
Shoulder-arm-neck-pain:– hot compress, soft massage, neck roll
Sleep disturbance:– In bed cool washings and calf-wrap
Hydrotherapy in disturbancesHydrotherapy in disturbances of the abdomen of the abdomen
Colic without fever:– Hot packs
Kidney-bladder-colic:– Rising hot foot-bath or seat-bath
Conclusion in hydrotherapyConclusion in hydrotherapy Improvement of macro- and
microcirculation Improvement of cardiac output Improvement of oxygen supply Vegetative normalisation, stabilisation General inurity Improvement of the physical efficiency Stimulation of the stomach secretion Increase of the central excitability Increase of IgM-, a2-macro-globulin-,
complement C3-concentration
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