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Aquatic Therapy Pool Design Guide

HOW TO DESIGN A THERAPY POOL FOR THE USE OF UNDERWATER EXERCISE MACHINES

In general, most aquatic therapy pools are warm water pools (86F to 94F), with sufficient water depth (4' to 5' feet), so that a person standing in chest deep water will become buoyant, lessening the impact on the skeletal structure. Beneficial resistive movement is then performed utilizing the hydrostatic pressure and viscosity of water.

Modern Aquatic Therapy Pools are usually equipped with specific types of aquatic therapy exercise machines so that a user has a means of balance, stability and controlled movement while using the pool. Such exercise equipment usually consists of horizontal and vertical bars, parallel bars, underwater treadmills, underwater cycling bikes and other free standing exercise machinery.

Aquatic Therapy Pools have no specific size requirements and may be quite small since most aquatic therapy exercises are performed in a vertical position. What is most important is sufficient water depth for the user to become buoyant. Water depths for an aquatic therapy pools should be at least 4' feet deep, as an absolute minimum to properly immerse adult users for the most beneficial therapeutic aquatic exercise. Always ask for the exact maximum water depth of any pool and don't use the "wall height" specification given by the manufacturer as a water depth guide. The "wall height" is the exact height of the pool wall and not the water depth. A pool with a wall height of 52" inches may not offer enough actual water depth to be considered a properly designed pool for aquatic therapy and ideally, a pool with a level non-sloping bottom should offer a water depth of 4.5' feet (54" inches) to accommodate the widest range of users. 

Today, Aquatic Physical Therapists, who represent the largest group of professionals using aquatic therapy as a treatment modality are offering their patients an increasingly larger menu of aquatic therapy methods for rehabilitation.

Two of the most general and frequently used methods are deep water therapy where the patient is actually floating in a vertical position and chest deep therapy where the patient may be either standing on the pool bottom or sitting/standing on an underwater exercise device, such as an aquatic treadmill or aquatic bike. 

Deep water therapy normally depends on a floatation device attached to the user and sometimes hand or foot attached resistance devices to increase the resistance offered by the water. This type of full immersion therapy offers the least impact on the skeletal structure and is generally performed at water depths in excess of 6.0' feet.

Chest deep aquatic therapy is generally performed with the patient either standing or sitting with the water at chest depth. This type of aquatic therapy is often performed with free standing underwater exercise machines that offer the user controlled motion and a means for balance and stability so that very specific exercise movements can be performed immediately without the need to develop coordination skills necessary to perform the exercise properly.

Typical underwater therapy equipment may consist of horizontal and vertical grab bars, parallel bars, aquatic treadmills and aquatic bikes, preferably made from heavy duty, non-corroding plastic materials.

Aquatic therapy pools are either in-ground, above ground or partially above ground. Many different pool sizes, construction designs and materials are available to suit the differing needs of both individuals and organizations.

For health care organizations who will be treating a large number of patients each day, an in-ground pool is most practical, and one with a continuously sloping or tiered floor offering multiple water depth levels is ideal.

Health care organizations may utilize an above ground aquatic therapy pool, which is much simpler to install. These aquatic therapy pools usually have some degree of portability so that they may be moved from one location to another if circumstances dictate. Portability is sometimes the deciding characteristic for many smaller health care organizations who have leased premises.

Above ground, aquatic therapy pools should be judged by the following criteria:

* Does the pool offer a water depth of at least 4.5 feet;

* Can the pool components be brought through a standard doorway;

* Are the inner pool walls constructed from material that can not be punctured or chipped easily by any of the exercise devices you might use for aquatic therapy;

* Do the pool walls and floor have heavy insulation to maintain therapy temperatures without large expenditures in water heating costs;

* Is the pool supplied with a non-motorized aquatic therapy treadmill with a flat, non-sloping walking deck and a set of parallel bars.

Properly designed aquatic therapy pools will have one or more access means for ingress and egress into the pool. These access means consist of stairs, ramps and patient lifters. In-ground pools should be equipped with ramp type access means. Long ramps offering the lowest incline angle, which can accommodate the greatest number of patient conditions including the use of wheelchairs, is the ideal access means.

Access stairs are a fundamental component of above ground aquatic therapy pools and they should be constructed of superior grade materials with slip resistant finishes. Inner and outer stairs should be equipped with hand railings of at least 1.9" inches in diameter, which run continuously along the stair access route.

Water quality should be of paramount importance to all pool operators, commercial or residential. Water quality is an involved subject and a cursory discussion is offered here only.

A water treatment system generally consists of a circulation pump, filter, heater and sanitation system. Large aquatic therapy pools will normally be equipped with gas fired heaters, whereas small, properly insulated aquatic therapy pools may be equipped with an electric heater.

There are several filter types available for any given situation. For small aquatic therapy pools, a filter type cartridge will serve the purpose most simply and economically if the sanitation system also offers an ozone generating system with a properly designed ozone injection system to oxidize the smallest water contaminants.

The sanitation system is the only part of the water treatment system that should offer redundancy by having two independent sanitizing systems for the pool. Normally, this is executed with a chemical sanitizer, such as chlorine or bromine and with ozone gas, which is also a powerful sanitizer and a superior oxidizer of contaminants.