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This page lists & briefly explains different interventions/aquatic therapy techniques that can be implemented into treatment sessions. This list is categorized by the purpose or specific skills addressed by the interventions/aquatic therapy techniques listed beneath them. Listed below each intervention is a brief description of how to implement it. This is not an exclusive list of all aquatic therapy interventions/techniques- this page simply serves to provide intervention ideas to OT practitioners whom are pursuing, just beginning, or currently providing aquatic therapy services. This list is not in any particular order. Interventions are listed under multiple categories when applicable. Number of repetitions/sets are not included.
Balance & Neuro Re-Education
Balance & Neuro Re-Education
Walking series
Place 3 lb ankle weights on the client, walk forward (2 laps- width of pool), walk backward (2 laps- width of pool), side stepping (2 laps- width of pool). Remove ankle weights for less stability or add movements of higher difficulty (walking on toes, high knees, adding in hip abduction, etc.) to grade up. Webbed gloves can also increase the challenge. Cue client to look up while walking- this can improve dependence upon assistive devices.
Marching in place
Have client bring one knee up as high as they can (without causing pain or discomfort) while maintaining balance and good posture. Cue to activate core muscles. Have client alternate legs. Client can hold onto side railing if needed for extra support. To grade up, add ankle weights or foam aquatic cuffs to client’s ankles.
Hip flexion (using foam ring)
Place foam ring around client’s R foot. Cue client to flex R hip while maintaining balance/put all weight through L foot. Client can hold onto side railing if needed. Repeat with foam ring around L foot. To grade up, have client let go of support/side railing.
Walking on balance beam
Place balance beam in shallow water. Have client walk across beam. Provide appropriate level of assist. To grade up, add foam aquatic cuffs to client’s ankles or provide less assistance.
Sitting on kickboard
Have client sit on kickboard and cue to maintain balance/activate core. Aim for 30 second repetitions. Provide appropriate level of assist or allow client to hold onto side railing. To grade up, have client let go of side railing or move forward/backward.
Ai Chi techniques
Shifting
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting)
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension)
Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
Dynamic standing balance activity
Have client stand on box in pool (water at chest depth), feet shoulder width apart. Instruct client to complete step-ups, alternating legs. Have client repeat this movement as many times as desired. Provide appropriate level of assist. To grade up, add foam aquatic cuffs to client’s ankles.
Core, Trunk, & Postural Stability/Strengthening
Core, Trunk, & Postural Stability/Strengthening
Supine floating (Bad Ragaz technique)
Place neck support ring under client’s neck, place one noodle beneath the knees, place other noodle underneath arms. Passively float the client side-to-side or have client activate obliques each time therapist moves client’s body side-to-side.
Marching in place
Have client bring one knee up as high as they can (without causing pain or discomfort) while maintaining balance and good posture. Cue to activate core muscles. Have client alternate legs. Client can hold onto side railing if needed for extra support. To grade up, add ankle weights or foam aquatic cuffs to client’s ankles.
Hip flexion (using foam ring)
Place foam ring around client’s R foot. Cue client to flex R hip while maintaining balance/put all weight through L foot. Client can hold onto side railing if needed. Repeat with foam ring around L foot. To grade up, have client let go of support/side railing.
Walking on balance beam
Place balance beam in shallow water. Have client walk across beam. Provide appropriate level of assist. To grade up, add foam aquatic cuffs to client’s ankles or provide less assistance.
Core stability/strengthening activity at pool railing (use foam dumbbells)
Have client stand facing the pool railing with foam dumbbells in each hand. Cue to slowly move dumbbells underneath surface of water, then back over the top of the railing. Provide assist as needed.
Sitting on kickboard
Have client sit on kickboard and cue to maintain balance/activate core. Aim for 30 second repetitions. Provide appropriate level of assist or allow client to hold onto side railing. To grade up, have client let go of side railing or move forward/backward.
Scapular protraction/retraction with white board
Have client hold onto sides of white board while standing- arms straight out in front/elbows fully extended. Cue client to slowly move board back and forth. Cue client to squeeze shoulder blades together when bringing board close to body and to activate core. To grade up, adjust the slats in the board (more slats closed = more difficult).
Ai Chi techniques
Shifting
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting)
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension)
Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
Halliwick method techniques/vertical trunk control movements
Supine to standing (provide neck support ring and appropriate level of assist as needed): Instruct client to slowly move from supine to standing position. Have client tuck hips/knees into chest while moving from supine to standing. Cue to activate core muscles.
Prone to standing: Only have client complete this movement if they are comfortable with putting their face in the water. While providing appropriate level of assistance, instruct client to slowly move from prone to standing position. Have client tuck hips/knees into chest while moving from prone to standing. Cue to activate core muscles.
Supine to prone (provide neck support ring and appropriate level of assist as needed): Only have client complete this movement if they are comfortable with putting their face in the water. While providing appropriate level of assistance, instruct client to slowly turn from supine to prone position while crossing arms across center of body. Have client stand up after getting into prone position. Be cautious of potential dizziness.
Prone to supine: Only have client complete this movement if they are comfortable with putting their face in the water. While providing appropriate level of assistance, instruct client to slowly turn from prone to supine position while crossing arms across center of body. Have client stand up after getting into supine position. Be cautious of potential dizziness.
Ai Chi techniques
(Sova, 2002)
Note. Adapted from “Ai Chi—what is it?”, by R. Sova, 2002, Palaestra, 18(3), p. 39+. (https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA92026892&v=2.1&it=r&sid=AONE&asid=3d820aa3). Copyright 2002 by Sagamore Publishing.
Halliwick method techniques
(Kastelijn, 2003)
Note. Adapted from Icons, by M. Kastelijn, 2003. (https://www.aqua-health.nl/pictogrammen-2020/). Copyright 2003 by Aqua Health.
Gross Motor Coordination
Gross Motor Coordination
Walking on balance beam
Place balance beam in shallow water. Have client walk across beam. Provide appropriate level of assist. To grade up, add foam aquatic cuffs to client’s ankles or provide less assistance.
Ai Chi techniques
Shifting
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting)
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension)
Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
Functional reaching activity
Place objects on the side of the pool at varying angles. Have client reach to obtain items while crossing midline. Can also have client reach straight out in front, behind, overhead etc. To grade up, have the client reach for floating/dynamic objects or weight shift while reaching for objects. This activity can also be done by placing objects on a floating platform or kickboard- have the client reach for the objects.
UE ROM/Joint Mobility/Strengthening
UE ROM/Joint Mobility/Strengthening
Supine floating (Bad Ragaz technique)
Place neck support ring under client’s neck, place one noodle beneath the knees, place other noodle underneath arms. Passively float the client side-to-side or have client activate obliques each time therapist moves client’s body side-to-side. While client is floating on back, complete PROM, AAROM, or AROM on client’s BUE.
Core stability/strengthening activity at pool railing (use foam dumbbells)
Have client stand facing the pool railing with foam dumbbells in each hand. Cue to slowly move dumbbells underneath surface of water, then back over the top of the railing. Provide assist as needed.
Scapular protraction/retraction with white board
Have client hold onto sides of white board while standing- arms straight out in front/elbows fully extended. Cue client to slowly move board back and forth. Cue client to squeeze shoulder blades together when bringing board close to body and to activate core. To grade up, adjust the slats in the board (more slats closed = more difficult).
PNF patterns
Have client stand in water at chest depth and perform various PNF patterns (D1- shoulder flexion/adduction/external rotation & D2- shoulder extension/abduction/internal rotation) using the RUE without any equipment. Repeat using LUE. To grade up, add wrist weights or webbed gloves.
Simulation of bathing/UB dressing
Have client stand in water at chest depth and hold onto small cup with R hand. Instruct client to fill cup with water and raise R arm over L shoulder while dumping water out. Provide appropriate assist level as needed. To grade up, add wrist weights.
UE ROM and stretching (use foam noodles)
Place neck support ring on client and instruct to lay on back. Place noodle beneath client’s knees. Have client flex shoulders overhead and hold onto noodle (arms shoulder width apart). Instruct client to slowly move arms side to side, up and down, etc. Provide appropriate level of assist.
Functional reaching activity
Place objects on the side of the pool at varying angles. Have client reach to obtain items while crossing midline. Can also have client reach straight out in front, behind, overhead etc. To grade up, have the client reach for floating/dynamic objects or weight shift while reaching for objects. This activity can also be done by placing objects on a floating platform or kickboard- have the client reach for the objects.
Ai Chi techniques
Have the client perform various Ai Chi movements:
Uplifting (shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended down at sides/palms pronated. Have client slowly move arms up and down through the water, keeping elbows as straight as possible throughout the movement (palms supinated while moving up).
Enclosing (horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move arms to midline (horizontal adduction) and then back to starting position while maintaining form.
Soothing (unilateral horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct the client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) and then back to starting position while maintaining form. Repeat on other UE.
Shifting (same as soothing but with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension): Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
LE ROM/Joint Mobility/Strengthening
LE ROM/Joint Mobility/Strengthening
Marching in place
Have client bring one knee up as high as they can (without causing pain or discomfort) while maintaining balance and good posture. Cue to activate core muscles. Have client alternate legs. Client can hold onto side railing if needed for extra support. To grade up, add ankle weights or foam aquatic cuffs to client’s ankles.
Hip flexion (using foam ring)
Place foam ring around client’s R foot. Cue client to flex R hip while maintaining balance/put all weight through L foot. Client can hold onto side railing if needed. Repeat with foam ring around L foot. To grade up, have client let go of support/side railing.
Ai Chi techniques
Shifting
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting)
Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension)
Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
Dynamic standing balance activity
Have client stand on box in pool (water at chest depth), feet shoulder width apart. Instruct client to complete step-ups, alternating legs. Have client repeat this movement as many times as desired. Provide appropriate level of assist. To grade up, add foam aquatic cuffs to client’s ankles.
Endurance
Endurance
Walking series (use ankle weights)
Place 3 lb ankle weights on the client, walk forward (2 laps- width of pool), walk backward (2 laps- width of pool), side stepping (2 laps- width of pool). Remove ankle weights for less stability or add movements of higher difficulty (walking on toes, high knees, adding in hip abduction, etc.) to grade up. Webbed gloves can also increase the challenge. Cue client to look up while walking- this can improve dependence upon assistive devices.
Bicycles
Place 3 lb ankle weights on client and 2 foam noodles under arms. Instruct client to move legs in bicycle motion (while in deeper water). This activity is great for a cool-down at the end of a treatment session.
Flexibility
Flexibility
Calf stretch
Have client stand with palms against the wall and place one foot back, keeping that leg straight. Instruct client to lean forward to feel the stretch. Repeat on other leg. Aim for a 30 second-1 minute stretch on each leg.
Hamstring stretch
Have client place the heel of one foot on a step and instruct to keep leg straight. Have client lean forward to feel more of a stretch. Repeat on other leg. Aim for a 30 second-1 minute stretch on each leg.
Piriformis stretch
Have client sit on ledge (or stand, if able) and cross one ankle over the opposite knee. Instruct client to maintain a slight bend in the opposite leg to feel more of a stretch. Aim for a 30 second-1 minute stretch on each leg.
Quad stretch
Have client face away from railing or ledge in the pool and place one foot up. Instruct client to maintain a slight bend in the opposite leg to feel more of a stretch. Aim for a 30 second-1 minute stretch on each leg.
Simulation of dressing tasks
Have client sit in shallow water and perform hamstring stretch. Client can use railing to prop foot up and complete same stretch if unable or unwilling to sit in shallow water. If client has water shoes, have them practice donning/doffing shoes. Instruct client to use energy conservation techniques (sitting on ledge or on pool floor using figure 4 position, etc.).
UE ROM and stretching (use foam noodles)
Place neck support ring on client and instruct to lay on back. Place noodle beneath client’s knees. Have client flex shoulders overhead and hold onto noodle (arms shoulder width apart). Instruct client to slowly move arms side to side, up and down, etc. Provide appropriate level of assist.
Ai Chi techniques
Uplifting (shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended down at sides/palms pronated. Have client slowly move arms up and down through the water, keeping elbows as straight as possible throughout the movement (palms supinated while moving up).
Enclosing (horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move arms to midline (horizontal adduction) and then back to starting position while maintaining form.
Soothing (unilateral horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct the client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) and then back to starting position while maintaining form. Repeat on other UE.
Shifting (same as soothing but with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension): Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
Transfer Skills
Transfer Skills
Transfers
Have client sit in shallow water of the pool on ledge and perform sit to stands. Provide assist and cues for proper technique/form as needed. If able, closely simulate shower/toilet transfers by bringing a shower chair into the shallow area of the pool.
*Keep in mind that all of the interventions listed on this website aim to improve the skills required for all types of functional transfers on land.
ADL Task Simulations
ADL Task Simulations
Simulation of dressing tasks
Have client sit in shallow water and perform hamstring stretch. Client can use railing to prop foot up and complete same stretch if unable or unwilling to sit in shallow water. If client has water shoes, have them practice donning/doffing shoes. Instruct client to use energy conservation techniques (sitting on ledge or on pool floor using figure 4 position, etc.).
Simulation of bathing/UB dressing
Have client stand in water at chest depth and hold onto small cup with R hand. Instruct client to fill cup with water and raise R arm over L shoulder while dumping water out. Provide appropriate assist level as needed. To grade up, add wrist weights.
*Keep in mind that all of the interventions listed on this website aim to improve the skills required for ADL task performance on land.
Functional Mobility Skills
Functional Mobility Skills
Walking series (use ankle weights)
Place 3 lb ankle weights on the client, walk forward (2 laps- width of pool), walk backward (2 laps- width of pool), side stepping (2 laps- width of pool). Remove ankle weights for less stability or add movements of higher difficulty (walking on toes, high knees, adding in hip abduction, etc.) to grade up. Webbed gloves can also increase the challenge. Cue client to look up while walking- this can improve dependence upon assistive devices.
*Keep in mind that all of the interventions listed on this website aim to improve the skills required for functional mobility on land.
Pain Management/Joint Relaxation
Pain Management/Joint Relaxation
Supine floating (Bad Ragaz technique)
Place neck support ring under client’s neck, place one noodle beneath the knees, place other noodle underneath arms. Passively float the client side-to-side or have client activate obliques each time therapist moves client’s body side-to-side.
AquaStretch
There are 4 steps included in this technique- play, freeze, pressure, and move. Have your client “play” with their body and the way it moves in order to find specific areas in which they are experiencing pain. Next, have your client “freeze” their body or joint in the exact position in which they feel pain. Then, the therapist provides “pressure” (with thumb/fingers/hand) in the specific area in which the client feels pain (myofascial release). Instruct the client to verbally guide you to those spots. Finally, have the client “move” their body/the specific areas in which they were experiencing pain. Repeat on as many areas of the body as needed.
Tone/Spasticity
Tone/Spasticity
Supine floating (Bad Ragaz technique)
Place neck support ring under client’s neck, place one noodle beneath the knees, place other noodle underneath arms. Passively float the client side-to-side or have client activate obliques each time therapist moves client’s body side-to-side.
Ai Chi techniques
Uplifting (shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended down at sides/palms pronated. Have client slowly move arms up and down through the water, keeping elbows as straight as possible throughout the movement (palms supinated while moving up).
Enclosing (horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move arms to midline (horizontal adduction) and then back to starting position while maintaining form.
Soothing (unilateral horizontal shoulder adduction/abduction): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct the client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) and then back to starting position while maintaining form. Repeat on other UE.
Shifting (same as soothing but with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes slightly outward with arms extended out to the side and shoulders flexed at 90 degrees/palms supinated. Have client slowly move one UE at a time, crossing midline towards other UE/hand (horizontal adduction) while weight shifting onto LE (side of body the UE is crossing midline towards), and then back to starting position while maintaining form. Repeat on other UE/LE.
Rounding (bilateral horizontal adduction/abduction with weight shifting): Have the client stand (water at chest depth) with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn to L side with feet pointing towards L side and L foot out in front. Have client flex shoulders to 90 degrees out at sides, then slowly move arms in together (maintaining elbow extension) while weight shifting onto LLE/bringing both arms into midline, and bringing RLE straight out in front of body (hip flexion). Have client then move RLE back behind LLE, flex R knee and keep L knee extended out in front. Client should move arms into horizontal abduction as they are moving RLE backwards. Repeat on other side.
Balancing (weight shifting with shoulder flexion/extension): Have the client stand (water at chest depth), with legs a little more than shoulder width apart and knees slightly bent. Instruct client to point toes outward with arms fully extended down at sides. Have client turn towards L side and L foot out in front. Have client weight shift onto LLE/extend RLE backwards while flexing shoulders out in front of body (slightly lean body forward). Then have client extend arms backwards while slowly extending RLE out in front of body. Repeat on other side.
PNF patterns
Have client stand in water at chest depth and perform various PNF patterns (D1- shoulder flexion/adduction/external rotation & D2- shoulder extension/abduction/internal rotation) using the RUE without any equipment. Repeat using LUE. To grade up, add wrist weights or webbed gloves.
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