Whirlpool Bath in Physiotherapy

The swirling water in a whirlpool bath provides comfort and relief from aches and pains, as well as helps improve many health conditions. The principle of whirlpool therapy is to combine the effects of temperature with the mechanical effects of water.

A Whirlpool bath is a tank that contains a jet of water or airstream allowed to produce turbulence in the water.

Aim of Whirlpool Bath

• Decrease swelling
• Control inflammation
• Promote wound healing
• Improve motion
• Decrease pain
• Decrease muscle spasm

Types OF Whirlpool Tank-

1. Low boy tank
2. High boy tank
3. Hubbard tank
4. Extremity tank

1) Low boy tank-

The Low Boy Tank can be used to allow an adult to sit in the tank and can range in capacity from 75 to 105 gallons.

2) High boy tank-

Sometimes referred to as a hip or leg tank, can allow for the immersion of both lower extremities. Capacity can range from 60 to 105 gallons

3) Full body immersion/Hubbard tank-

The Hubbard Tank has a greater potential for exercise during treatment due to its size and can accommodate a full-body treatment. Capacity can range anywhere from 200 gallons to more than 400 gallons.

4) Extremity tank-

The Extremity Tank is usually used for the upper or lower extremities and has a capacity of 10 to 45 gallons of water.

Structure of Whirlpool Tank-

Stainless steel is the most commonly used material for constructing the tank, but fiberglass and plastic tanks are also available as alternative options. The shapes and sizes of the tanks are also variable. The whirlpool’s turbine consists of a motor securely attached to the side of the whirlpool and suspended pipes for circulating water and air within the water.

The height and direction of the turbine determine the effect.

• To relieve pain and promote wound healing, the therapist can direct the whirlpool’s turbine toward the affected area.
• However, if the wound is hypersensitive or has excessive granulation tissue, the turbine should be directed away from the affected area.

There is a mixing tap to allow any desired away any desired water temperature; therapists typically use a temperature range of 36-41°C for whirlpool treatments, but when treating acutely inflamed structures, a cold whirlpool with a temperature range of 0-26°C is employed.

Effects of Whirlpool Bath-

The whirlpool bath combines the values of conductive heat and gentle massage, it gives a

• Sedative action.
• Relief of pain by stimuli that act through the pain gait mechanism.
• Relaxation of muscle spasms.

It also produces

• Vasodilatation
• Improving local arterial and lymphatic circulation.
• Softening of scar tissue.
• Breaking down old adhesions after fractures of sprains.
• Cleaning and stimulation of wounds.
• Mechanically removing dirt, dead tissue, and pus.
• Causing regression of the inflammatory process.
• Diminution of edema and effusion.

Technique of Application

• Fill the tank with water and set the desired temperature using the thermostat.
• Add an antimicrobial agent to the water if treating wounds.
• Make sure the patient is prepared for the treatment and not wearing any clothing that could get sucked into the turbine.
• If treating a wound, remove any dressings and take necessary measures to prevent infection, such as wearing gloves.
• Position the patient comfortably with the affected area immersed in water.
• Adjust the direction and aeration of the turbine as needed.
• Turn on the turbine and instruct the patient to exercise the affected area if directed for joint stiffness or edema without acute inflammation.
• Treatment time is typically 10-30 minutes, shorter for wound debridement.
• After treatment, remove the limb from the water and check thoroughly. Cover with a dry sheet to avoid chilling.
• If treating a wound, rinse with clean pressurized water and reapply dressings.
• Drain, rinse, and clean the whirlpool as per the direction of use.

Advantages of Whirlpool Bath

• Can be used for heating effects, exercise as well as wound dressing.
• Allows patient comfort.
• Weaker muscles can be exercised effectively.
• Allows movement along with heating, unlike other heating modalities.

Disadvantage of Whirlpool Bath

• The size of the tank limits its use.
• Risk of infection spread in wound treatments.
• The cost of cleaning and heating is more.

Indications

• Poor circulation
• Chronic edema
• Separate dead tissue
• Pain relief in amputations ( phantom pain)
• After removal of plaster cast (fractures)
• Stiff joints
• Infected wounds with added antiseptic agent
• Arthritis with stiff and swollen joints
• Poliomyelitis and paraplegia to improve circulation
• Traumatic and chronic inflammatory conditions
• Weak and painful feet
• As preparation to massage, passive stretching, and exercises

Contraindications-

• Feverish patient
• Recent skin grafts
• Circulation impairment
• active bleeding
• open wounds
• hemorrhage
• skin allergy