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Warm-water—A recreational therapy intervention: A case report

Tim Passmore, EdD, CTRS/L, FDRT, Taylor Gbur, BS, MS, Donna Lindenmeier, PhD, Taryn Price, PhD, ATC, Jonette Passmore, BS, CTRS/L, ATRIC


The use of the aquatic environment, as a modality and a setting for treatment, is well documented in healthcare literature.1-13 The application of aquatic interventions by recreational therapists has also been documented but to a lesser extent.14-19 The present case report will add to the recreational therapy literature related to the use of the aquatic environment and provide insight related to a 6-year-old male diagnosed with cerebral palsy and other conditions which have resulted in physical limitations from a southwestern community who participated in a 2-month warm-water intervention program provided by a recreational therapist dually credentialed in aquatic therapy.


recreational therapy, warm-water therapy, warm water intervention, recreational therapy intervention

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Myers K, Capek D, Shill H, et al.: Aquatic therapy and Alzheimer's disease. Ann Long-Term Care. 2013; 21(5): 36-41.

Munguia-Izquierdo D, Legaz-Arrese A: Exercise in warm water decreases pain and improves cognitive function in middle-aged women with fibromyalgia. Clin Exp Rheumatol. 2007; 25: 823-880.

Garopoulou V, Tsimaras V, Orologas A, et al.: The effect of an aquatic training program on walking ability and quality of life of patients with multiple sclerosis. J Phys Educ Sport. 2014; 14(1): 106-114.

Fisken A, Waters D, Hing W, et al.: Perception and responses to different forms of aqua-based exercise among older adults with osteoarthritis. Int J Aquat Res Educ. 2014; 8(1): 32-52.

Fisken A, Waters D, Hing W, et al.: Comparative effects of 2 aqua exercise programs on physical function, balance, and perceived quality of life in older adults with osteoarthritis. J Geriatr Phys Ther. 2015; 38(1): 17-27.

Bender T, Bálint G, Prohászka Z, et al.: Evidence-based hydro- and balneotherapy in Hungary—A systematic review and meta-analysis. Int J Biometeorol. 2013; 58(3): 311-323.

Bieuzen F, Bleakley C, Costello J: Contrast water therapy and exercise induced muscle damage: A systematic review and meta-analysis. PLoS ONE. 2013; 8(4): e62356.

Häuser W, Klose P, Langhorst J, et al.: Efficacy of different types of aerobic exercise in fibromyalgia syndrome: A systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2010; 12(3): R79.

Kaˉrklin¸a B, Declerck M, Daly D: Quantification of aquatic interventions in children with disabilities: A systematic literature review. Int J Aquat Res Educ. 2013; 7(4): 7.

Lai C, Liu W, Yang T, et al.: Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. J Child Neurol. 2014; 30(2): 200-208.

Langhorst J, Musial F, Klose P, et al.: Efficacy of hydrotherapy in fibromyalgia syndrome—A meta-analysis of randomized controlled clinical trials. Rheumatology. 2009; 48(9): 1155-1159.

Naumann J, Sadaghiani C: Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome: A qualitative systematic review and meta-analysis of randomized controlled trials. Arthritis Res Ther. 2014; 16(4): R141.

Iannucci L: Making waves with aquatic therapy. PT in Motion. 2012; 4(9). Available at Accessed March 15, 2017.

Mobily K, Mobily P, Lassard K, et al.: Case comparison of response to aquatic exercise: Acute versus chronic conditions. Ther Recreation J. 2000; 34(2): 103-119.

Mobily K, Verburg M: Aquatic therapy in community-based therapeutic recreation: Pain management in a case of fibromyalgia. Ther Recreation J. 2001; 35(1): 57-69.

Kelley C, Loy D: Comparing the effects of aquatic and land-based exercise on the physiological stress response of women with fibromyalgia. Ther Recreation J. 2008; 42(2): 103-118.

Broach E, Datillo J: The effect of aquatic therapy on strength of adults with multiple sclerosis. Ther Recreation J. 2015; 37(3): 224-239.

Broach E, Datillo J: Effects of aquatic therapy on adults with multiple sclerosis. Ther Recreation J. 2013; 35(2): 141-154.

Broach E, Dattilo J, McKenny A: Effects of aquatic therapy on perceived fun or enjoyment experiences of participants with multiple sclerosis. Ther Recreation J. 2007; 41(3): 179-200.

Silvestri J, Perone K: Aquatic therapy in spinal cord injury. Rehab Management. 2015. Available at Accessed January 25, 2017.

Allied-Services: Aquatic therapy. 2017. Available at Accessed January 25, 2017.

Amelia S: Aquatic fitness and rehabilitation at individuals with disabilities. Medicina Sportiva: J Roman Sports Med Soc. 2012; 8(4): 1951-1956.

Oeverman S: Why aquatic therapy? Brainlineorg. 2017. Available at Accessed January 25, 2017.

Burton L, Brigham H: Proprioceptive neuromuscular facilitation: The foundation of functional training. Functional 2013. Available at Accessed January 25, 2017.

Salzman A: How to define aquatic specialty techniques: Operational definitions. 2007. Available at Accessed January 25, 2017.

Kim E, Lee D, Kim Y: Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients. J Phys Ther Sci. 2015; 27(1): 213-215.

Movement is Therapy. Available at Accessed January 25, 2017.

Walker B: PNF stretching explained—Proprioceptive neuromuscular facilitation. 2017. Available at Accessed January 25, 2017.

Barta K: PNF stretching: A how-to guide. Healthline. 2014. Available at Accessed January 25, 2017.

Sharman M, Cresswell A, Riek S: Proprioceptive neuromuscular facilitation stretching. Sports Med. 2006; 36(11): 929-939.

Becker B: Aquatic therapy: Scientific foundations and clinical rehabilitation applications. PM R. 2009; 1(9): 859-872.

Robinson N, Lorenc A, Liao X: The evidence for Shiatsu: A systematic review of Shiatsu and acupressure. BMC Complement Altern Med. 2011; 11(1): 88.

Becker B, Cole A: Comprehensive Aquatic Therapy. 3rd ed. Pullman, WA: Washington State University, 2011.

Taber C, Thomas C: Taber's Cyclopedic Medical Dictionary. 1st ed. Philadelphia, PA: F.A. Davis Co., 1985.

National Heart, Lung, and Blood Institute: What is patent ductus arteriosus? Nhlbinihgov. 2011. Available at Accessed January 25, 2017.

Budelmann K, Piekartz H, Hall T: A normative study of cervical range of motion measures including the flexion–rotation test in asymptomatic children: Side-to-side variability and pain provocation. J Man Manip Ther. 2013; 24(4): 185-191.



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