PROJECT DESCRIPTION
The purpose of this doctoral capstone project was to increase competence in occupational therapy practitioners by developing educational materials to support the nontraditional professional practice area of aquatic therapy. Although there are many aquatic therapy resources available to practitioners, there has been a lack of resources specific to occupational therapy. The educational materials and content developed throughout this project will allow for an increase in the number of occupational therapists practicing aquatic therapy in order to promote optimal occupational performance among clients.
Areas of Focus: Education, Advocacy, and Clinical Practice
Area of Practice: Health & Wellness
Project Site: Riverview Health Rehab & Fitness in Noblesville, IN
Project Mission: To create educational content and resources in which occupational therapy practitioners utilize to become more frequent providers of aquatic therapy services.
Project Vision: Occupational therapists who safely and effectively practice aquatic therapy to promote optimal occupational performance among clients.
“Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.” Hebrews 13:16
Needs Assessment
- According to Franken et al. (2013), the aquatic environment can be used to treat a wide range of diagnoses and maintain overall health and wellness, but it is continued to be underused as a treatment modality in occupational therapy.
- Aquatic therapy educational resources from an occupational therapy perspective do not currently exist.
- Occupational therapy terminology is not utilized throughout current aquatic therapy educational resources and practice guidelines.
- There are many functional benefits provided through the water, and there is great carry over onto land. Significant reductions in pain and improvements in balance are seen. As a result of participating in aquatic activities, reduced pain enables clients to reach goals for occupational activities they want to accomplish on land (S. Neuber, personal communication, March 2, 2022).
- Although there is a fair amount of research on aquatic therapy, there is insufficient research on applying the principles and benefits of aquatic therapy to occupational therapy practice.
- There is a need for occupational therapy practitioners and students to become educated in aquatic therapy to use it more often as an alternative or additional treatment method for patients who may benefit from it.
Literature Review
- Individuals at risk for falls, with deficits in balance, deficits in postural control, neurological conditions, and those experiencing pain are among the various populations that can benefit from aquatic therapy. Improvements in the ability to complete activities of daily living (ADL), functionality, quality of life, and decreased fall risk are all proven benefits of engaging in aquatic therapy (Resende et al., 2008).
- Much evidence displays that aquatic therapy contributes to improvements in function, quality of life, and overall health (Franken et al., 2013).
- The physical properties of water can be used to increase strength, endurance, and range of motion, in addition to decreasing tone and re-educating specific muscle movements (Franken et al., 2013).
- An aquatic environment enables individuals at risk for falls to improve various aspects of strength and balance through completing exercises in a functional position, without the dangers associated with completing exercises on land (Devereux et al., 2005).
- Postural balance and weight-bearing abilities among stroke survivors have been found to improve by focusing on the patient's affected limb through the use of aquatic therapy (Noh et al., 2008).
Project Mentors
Expert Mentor: David Jackson, MBA, PTA
David served as my expert mentor throughout the doctoral capstone experience. He is currently the Outpatient Therapy Manager at Riverview Health Rehab & Fitness. David has much experience in aquatic therapy and was able to assist in the development of my skills and knowledge in this area of practice. David was always willing to answer my questions, provide me with feedback and suggestions, and ensured I was able to obtain much clinical experience in the pool.
Faculty Mentor: Reagan Bergstresser-Simpson, OTD, OTR/L, ADHD-RSP
Dr. Bergstresser-Simpson served as my faculty mentor throughout the doctoral capstone experience. She provided much guidance and support, ensured the project remained occupation-based, and provided expertise from an occupational therapy perspective.
Additional Project Supporters
Sarah Jarrett, PT, DPT, CBIS: Sarah played an important role in the development of my skills and knowledge within aquatic therapy. I was able to obtain much clinical experience in aquatic therapy under her supervision. Sarah is very passionate about aquatic therapy and provided excellent guidance and support throughout my doctoral capstone experience.
Brandee Lowe, PTA: Brandee also played an important role in the development of my skills and knowledge within aquatic therapy. I was able to obtain much clinical experience in aquatic therapy under her supervision. Brandee has 20+ years of experience as an aquatic therapist and I am very grateful for her guidance and support throughout my doctoral capstone experience.
Project Outcomes
- Completed 5 continuing education courses including Intro to Aquatic Therapy, Aquatic Therapy Basics- Principles and Benefits, Beyond the Basics- Putting Aquatic Therapy into Practice, Aquatic Interventions for the Upper Quadrant, & Documentation and Billing for Aquatic Therapy.
- Developed 2 occupation-based case studies demonstrating the knowledge gained throughout the clinical experience I obtained in aquatic therapy
- I created education plan content designed to support occupations performed "on land" following participation in an aquatic therapy program. This consists of 5 examples of aquatic therapy treatment sessions.
- Developed 9 educational resources for occupational therapy practitioners pursuing aquatic therapy
- Created 2 client resources for clients being referred to or discharged from aquatic therapy at Riverview Health Rehab & Fitness
- Developed a Powerpoint Presentation and presented the material to current OTD students at HU for the purposes of educating on this unique area of practice
- Created a website centered around aquatic therapy from an occupational therapy perspective
- Provided an in-service training for the staff at Riverview Health Rehab & Fitness on the details of this doctoral capstone project including the sharing of all educational resources created throughout my experience
“Do not withhold good from those to whom it is due, when it is in your power to act.” Proverbs 3:27
Future Implications
Impact on Occupational Therapy: The educational materials I created throughout the duration of this project serve to advocate for and promote an increase in the frequency of occupational therapy practitioners providing aquatic therapy services. I hope many OTPs are able to use these materials to practice aquatic therapy and consider implementing it as an alternative or additional treatment method to enhance client outcomes.
Impact on Career: I will continue to advocate for more OTPs to consider implementing aquatic therapy into practice, when applicable. I hope to continue to share my educational materials with others in the OT community.
Future Plans: Following graduation, I plan to practice in either an inpatient rehabilitation hospital or a skilled nursing facility. I would love to seek out an opportunity in the near future which allows me to work in one of these settings and also practice aquatic therapy.
Contact Information: abbey.schneider@sbcglobal.net
References
Devereux, K., Robertson, D., & Briffa, N. K. (2005). Effects of a water-based program on women 65 years and over: A randomised controlled trial. Austrialian Journal of Physiotherapy, 51, 102-108. https://doi.org/10.1016/S0004-9514(05)70038-6
Franken, L.E., Mische Lawson, L.A., & Santalucia, S. (2013). Aquatics: Promoting quality of life, health, and wellness. OT Practice, 18(6), 16-20, 22. https://doi.org/10.7138/otp.2013.186f2
Noh, D. K., Lim, J. Y., Shin, H.I., & Paik, N. J. (2008). The effect of aquatic therapy on postural balance and muscle strength in stroke survivors: A randomized controlled pilot trial. Clinical Rehabilitation, 22, 966-976. https://doi.org/10.11770269215508091434
Resende, S. M., Rassi, C. M., & Viana, F. P. (2008). Effects of hydrotherapy in balance and prevention of falls among elderly women. Brazilian Journal of Physical Therapy, 12(1), 57-63. https://doi.org/10.1590/S1413-35552008000100011
Credits:
Created with an image by Kira_Yan - "Pure blue turquoise water texture of the ocean sea with foam from and waves"