Nicky Pither, Physiotherapist at RNIB Pears Centre for Specialist Learning, outlines how water therapy can benefit children and young people with disabilities and health conditions...
Hydrotherapy involves stimulation and gentle exercise in warm water at a constant temperature of 32 degrees Celsius. Hydrotherapy pools tend to be purpose-built with a constant or very gradual water depth of around 1 metre. Pools usually incorporate multi-sensory equipment such as lighting and sound to stimulate the senses.
Hydrotherapy offers tangible benefits to the health and wellbeing of children and young people with a range of disabilities and health conditions:
- The warmth of the water has an effect on the individual neuro-muscular junctions which results in decreased muscle tone and decreased spasticity.
- Buoyancy of the water is used to assist movement of joints - which is either more difficult or painful on dry land.
- Movement in the water and water pressure helps to reduce residual lung capacity for children and young people with chest problems. This enables more efficient lung function and reduces the risk of chest infections developing.
- Creating turbulence around an extremity (i.e. arm or leg) can increase their awareness of the limb and help with mobility - both in the water and later on dry land.
- Multi-sensory environment helps stimulate the senses whilst calming children with sensory and learning difficulties.
At RNIB Pears Centre we offer specialist education, care and therapies to children and young people with complex needs and vision impairment. Additional needs we support include physical disabilities, multi-sensory impairment, significant learning difficulties and disabilities, autistic spectrum disorders, additional medical and health needs (including long-term ventilation or life-threatening or life-limiting conditions) and emotional and behavioural difficulties.
Hydrotherapy has always been part of our provision but until recently we had to go off-site for children to use a hydrotherapy pool at another local school. We were restricted in how often we could access this pool and reliant on minibus drivers being available to take more than one wheelchair user.
Although we worked hard to make hydrotherapy available for everyone that needed it, there were always serious challenges to accessing an external provider’s pool which meant that for many, it was just too risky to achieve. Local public baths are too busy and cold and don’t have ceiling hoist facilities. Other local hydrotherapy pools tend to be fully booked and only available at inconvenient times.
We wanted to enable our young people with complex needs to access water therapy on a regular basis. In 2015, we launched a fundraising campaign to raise money to build a hydrotherapy pool on our site. Thanks to generous donations from supporters including the Bradbury Foundation, Pears Foundation and local community groups our dream was made a reality and our on-site pool, the Bradbury Hydrotherapy Centre, opened in February 2017.
Since the new hydrotherapy pool has been open for use, the impact on our children and young people has been phenomenal. First and foremost, it’s enjoyable and fun! This has had an immediate positive impact on their psychological wellbeing.
Some young people have never been able to use a pool and are now enjoying regular sessions and experiencing the freedom of movement in the pool – whereas on dry land their movements are extremely limited. Also being able to move in the water improves their general physical stamina and lung function.
Others who tend to be in crisis for a lot of the time as they are overloaded by their sensory environment find that after 20 minutes of splashing and moving round in the pool they are a lot calmer and more able to cope in class.
Being able to get to and from the pool easily means that we can respond quickly to changes in young people’s fitness to swim. We can be flexible about timing to meet individual health needs, such as medication and therapy programmes. This would never have been possible with an off-site facility. So, for example, if a young person was initially unable to process the idea of going swimming as they arrive in school but after an hour in class lesson – they felt able to go they could go – whereas before they would have “missed the bus”.
All children and young people who are using the hydrotherapy pool have benefitted:
- Young people who are normally in their seating systems in their wheelchair for a lot of the day can experience freedom of movement in the pool.
- Others who don’t move much on dry land become active and really enjoy moving round the pool.
- Young people who have very limited movement and struggle to communicate when on dry land are able to vocalise or move their arms to indicate preferences whilst in the water.
- Passive physiotherapy programmes can be difficult to tolerate on dry land but in the water the young people with tight muscles and joints are much happier when their muscle stretches are incorporated into a fun or relaxing time in the pool.
We have been able to extend our outreach service to include hydrotherapy already and this work will develop to a greater extent over time. This allows us to share expertise whilst introducing other children to the opportunities that water therapy offers.
For more information about RNIB Pears Centre and to watch a short film showing the impact of the hydrotherapy pool, visit www.rnib.org.uk/pearscentre