re: Contra-indications

[plums]

What are the contra-indications to hydro for staff? Somebody has suggested that the first 12 weeks of pregnancy or history of miscarriage was one.

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[seldebel]

Pregnancy sounds about right....my sister just had her baby...but during the pregnancy I was treating her for her LBP, and as part of my advise I suggested she give Hydrotherapy a go....when she asked the Dr he told her it was contraindicated...something to do with overheating the feotus.....I guess CI's for Hydro. is one of those grey areas that need to covered by the special interest group

[lynguy]

There was a suggestion some years ago that exposure to increased temperature during the first 3 months could cause foetal abnomalities, including increased chance of spina bifida - that was the medical advice which was spread around over the last 10-15 years but am not sure what actual evidence there is. One would also need to consider the chemcial effects of chlorine etc. I do know of a Physio who has lost all her body hair having worked daily in a pool for some twelve months - I am not a chemist to be able to work out why but it may help to run it by a biochemist.

[edmundleahy]

Pregnancy is a relative contra indication to using the pool. Case control studies have found that an increase in body temperature is associated with an increase in fetal malformations. To minimise this risk, core temp should not exceed 38 degrees C during pregnancy.

So don't go into really hot hydrotherapy pools. 28 - 30 degrees is ok. Having said this, I know of other physio's that specialise in hydrotherapy who have continued to work in hydrotherapy pools (about 34 degrees) well into there pregnancy without ill effects.

As for pool chemistry, it is a good idea to learn a little about pool chemistry, so you can sus out how safe a pool is before getting in. This is especially important if staff have sensitive skin. Bromine seems to flare up the skin more. there are some good courses around which can teach you about this sort of stuff.

[Dave]

i think youre right - my understanding is only the first trimester is a contraindication to hydro due to possible ill effects it may have on the foetus

[perfphysio]

This topic sounds of great interest and also offers some debate. Would you guys like physiobase to set up a live chat room about the topic where we/you can all get together and discuss it?? Also can someone point me to a National Association who has an effective Policy or Guideline on Pregnancy and hydrotherapy. I will include it in our clinical guidelines that physiobase is compiling as an online reference

thanks
richard