A seated underwater arm raise with resistance by a foam dumbbell performed in the AquaFit from Hudson Aquatic Systems, Angola, Ind. This exercise utilizes the  buoyancy of the water to assist the arm as it raises toward the surface of the water, and provides resistance as the patient lowers the arm into the water.

A seated underwater arm raise with resistance by a foam dumbbell performed in the AquaFit from Hudson Aquatic Systems, Angola, Ind. This exercise utilizes the buoyancy of the water to assist the arm as it raises toward the surface of the water, and provides resistance as the patient lowers the arm into the water.

By Natalia Farnsworth, PT, DPT, CAFS

Just as plants need water to grow, the physical therapy outpatient clinic can use aquatic-based technologies as a growth engine and flexible tool for unweighting and resistance applications. The strength of aquatic technologies as a competitive differentiator is what helped drive Agape Physical Therapy’s decision to bring these resource in-house and use them to treat the practice’s highly diverse clientele. Based in Rochester, NY, Agape has operated for more than 30 years; grown from a single office to its current footprint of six clinics in the Rochester area.

As part of its focus on providing the highest level of care for every patient, the practice strives to invest in technologies that allow its patients to recover fully from an injury or surgery. The practice has a combined array of PT gym capital equipment that includes five AlterG treadmills from Fremont, Calif-based AlterG Inc, a C-Mill from Norwell, Mass-headquartered Hocoma, and three types of aquatic therapy equipment that include multiple users as well as a single-chamber device, the AquaFit, from Hudson Aquatic Systems, Angola Inc. The combined applications of dry land and aquatic technologies help Agape’s therapists move their patients toward their goals through a versatile approach.

Versatile Treatment for Recovery

By following a philosophy of continuously reinventing itself and offering superior care, Agape has maintained its footing in a highly competitive business environment. The physical therapy technologies the practice has acquired have made a substantial impact in the practice’s ability to provide superior care, with a patient population ranging from youth sports participants to older adults working on balance and strength, and everything in-between. Among this varied clientele is a substantial portion who benefits from Agape’s aquatic services; specifically, individuals affected by arthritis in the lower limbs and by low back pain. The ability to provide aquatic therapy services has also been of benefit for the practice’s patients who are recovering from surgeries such as anterior cruciate ligament (ACL) rehabilitation and knee replacements. The integral aquatic therapy services taken on at the practice are reflected in the nearly 30% of Agape’s clientele who received aquatic-based services.

Product Resources

The following companies provide products for aquatic therapy:

Aquatic Access Inc
www.aquaticaccess.com

Endless Pools
www.endlesspools.com

Hudson Aquatic Systems LLC
www.hudsonaquatic.com

HydroWorx
www.hydroworx.com

Nespa Tiled Spas
www.tiledspas.com

NZ Manufacturing
https://nzcordz.com

Sprint Aquatics
www.sprintaquatics.com

Sure Hands Lift and Care Systems
www.surehands.com

SPRI Products
www.spri.com

SwimEx
www.swimex.com

By Popular Demand

The decision to expand Agape’s services with aquatic technologies was informed by several reliable indicators. Among those indicators was the frequency of inquiries made about aquatics by prospective clients, and the number of physicians who referred to Agape simply because the practice offered aquatics. These factors, along with the growing base of research about aquatic therapy, helped solidify the decision to bring aquatics to Agape. The practice subsequently has discovered that there was a substantial need for aquatics in the service area, and the modality allowed Agape’s therapists to provide more extensive care for their patients. By using the practice’s aquatic technologies, therapists can get patients mobile sooner following an injury once they are in water. Likewise, patients are also empowered to do much more in the water than they can do on land. For example, many patients can walk or run on the aquatic treadmill, but are unable to do so on land. Clinical benefits such as these, as well as the need to differentiate the practice in the market, led to the decision to invest in aquatic technologies at three of the practice’s six clinics.

Productive At Any Size

The practice’s Brockport, NY, location has a Ferno-designed aquatic therapy pool that can fit up to five patients at once. Additionally, Agape’s Gates location has a Hydro-track single-chamber pool while its Webster, NY, location has a single-chamber AquaFit. Time has demonstrated that both the large pool and single-chamber models are useful and provide excellent change and variability for the clientele who use them.

The large pool allows therapists to treat more than one patient at a time and permits the practice to offer pool fitness to its clients after they are discharged from physical therapy. In this pool, patients can use an underwater treadmill or use an open area for exercise. There is a large amount of variability in terms of exercises with this large pool. The large pool is much more to take care of, and requires consistent maintenance. It also requires supervision from a therapist in the same room as the pool, which can be difficult with busy schedules. It likewise requires someone in the room throughout the day when we have pool fitness clients.

After a patient steps into the chamber and the door locks, the therapist slowly fills the chamber to the desired height.

After a patient steps into the chamber and the door locks, the therapist slowly fills the chamber to the desired height.

A single exercise chamber, such as an AquaFit, allows the patient to have more individualized care, and each time the patient uses the single chamber, new water is pumped into it. This allows for better maintenance of the device. It is also much easier for the therapist to treat patients on land in the clinic as well as a patient in the pool because the single chamber takes up just as much space as a treadmill. It provides ease of access for both the patient and the therapist. While the AquaFit is the technology of choice for Agape, there are other single-chamber technologies on the market, including the 300 Series of self-contained units from HydroWorx, Middletown, Pa.

Adjustable Environment

The services provided at Agape have expanded considerably since the practice began to offer aquatic therapy. For example, the practice can offer aquatic fitness programs both in the large pool as well as the smaller single-chamber aquatic devices. This has allowed the practice to reach more clients in the community, from runners and those looking to lose weight, to overall fitness and maintenance programs. The pools provide underwater treadmill access as well as use of dumbbells and kickboards for resistance or buoyancy. These can be used in the single-chamber devices as well. Patients have the option to use the treadmill or stand in place to use resistive equipment. The AquaFit also offers an adjustable water depth for patients to either increase or decrease buoyancy and challenge them in various ways. This is simple to do and user-friendly for the therapist.

Aquatics have helped to differentiate Agape as a practice, and many referring physicians look specifically at the practice because of the abundance of aquatic therapies that are offered. The clinics are able to reach more patients, especially those who are unable to utilize land therapy due to conditions such as arthritis, fibromyalgia, severe low back pain, obesity, etc. Aquatics have also improved outcomes overall as a provider, and allow patients to notice significant pain reduction and reduce symptoms.

Water Works

Agape continues to grow, and aquatic technologies have been responsible for providing much of the thrust for that growth. Along that path, Agape’s therapists have found that the single-chamber devices allow for greater ease while treating multiple patients and also streamlining the flow of the clinic. The single chambers can fit into an existing clinic without having to do any remodeling, and the benefits and performance of this technology seem to provide a secure investment. As part of Agape’s vision for the future, the practice plans to place additional aquatic equipment at its new locations as a way to reach even more patients and provide this special service to the community. PTP

Natalia Farnsworth, PT, DPT, CAFS, has been practicing for more than 6 years. She received her doctorate from SUNY Upstate Medical University in 2012 and began practicing in Syracuse, NY, at St Joseph’s Hospital. She then relocated to Tuscon, Ariz, to continue her practice and began to specialize in functional movement and women’s health. After a few years, she relocated again to Manhattan and continued to grow her women’s health and pelvic health specialty, as well as expand her leadership experience. Farnsworth has relocated back to Rochester, NY, where she is executive director at Agape Physical Therapy. Her role is to grow and expand Agape in the Rochester area and beyond in addition to growing young leaders in the organization. For more information, contact PTPEditor@medqor.com.