Aquatic vs Land Therapy – What is the Difference?
by Bobbi Michels, PT, DPT
Kids Place West Pediatric Physical Therapist

Aquatic physical therapy, like land-based physical therapy, is part of the physical medicine and rehabilitation specialty involving the expertise and knowledge of a licensed physical therapist. Land-based therapy incorporates rehabilitation of an individual using therapeutic activities and exercises against gravity. In contrast, aquatic-based therapy applies much different therapeutic activities and exercises in a temperature-controlled body of water.

Aquatic therapy is professionally conducted in shallow water, usually 3-4 feet deep, with water temperature of 92 degrees Fahrenheit. Sessions will be held at our brand new, Buckeye clinic. The therapist assists the patient into the pool and maintains 1:1 contact while instructing the patient in appropriate therapies for their condition.

Aquatic therapy has been used for thousands of years, as far back as Greek and Roman times for relaxation, treatment of illness, spiritual cleansing, to assist in child birth, and improve mobility. Over the past ten years, research has demonstrated that aquatic therapy is effective in treatment of many conditions across the lifespan of individuals. Children as young as 6 months can benefit from treatment in an aquatic setting. A myriad of diagnoses are appropriate for treatment in the pool, including but not limited to Cerebral palsy, Parkinson’s, Duchene muscular dystrophy, osteogenesis imperfecta, post-surgical repair of hip, knee, and shoulder, spinal muscular atrophy, spinal cord injury, and Down syndrome.

Aquatic therapy can be used in isolation or combined with land therapy to optimize treatment outcomes. There are several advantages to aquatic therapy over land therapy. Treatment in the water decreases swelling and reduces weight bearing on painful and healing surgical joints. This allows people to perform strengthening exercises without pain and much earlier than when doing the same exercises on land.

Water molecules wrap around the body during submersion in water, improving body awareness by sending several messages to the brain all at once. The pressure of water on a person’s body allows them to exercise without an elevated heart rate because the heart is able to pump more easily in an aquatic setting compared to on land. Water submersion improves lung function by strengthening small muscles that help with breath control.

The attraction of water molecules to each other can be used to create resistance or be used to aid with movement through the water. Therapists use this concept to create a challenging work out for each individual treated in the aquatic setting. Resistance can be changed simply by changing the way a person stands in the water or by changing the speed in which they move.

Water molecules will help hold a person in place, which makes this medium an ideal place to work on balance. When you lose your balance in the water you have a longer time to recover because of the resistance of the water. Additionally, if you do happen to lose your balance, you get a bit more wet!

Research also has shown that aquatics improve coordination, balance, and gait. Exercises in water feel less difficult and more comfortable yet water resistance increases blood flow and balance support. Most of all, it is a very fun way to improve health and well-being in a supportive and therapeutic environment!

If you are interested in more information about aquatic therapy or scheduling an aquatic therapy session, please call our Buckeye clinic.

Becker, B. E., & Cole, A. J. (2010). Comprehensive Aquatic Therapy (3rd). Pullman, WA: Washington State University.