Physical Therapist Assistants in Aquatic Therapy

For many patients, aquatic therapy is a safe and effective form of rehabilitative therapy that alleviates strain on the joints, muscles, and bones and provides support for the body.

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Like other forms of physical therapy, aquatic physical therapy is an evidence-based specialty area. Physical therapist assistants that practice aquatic physical therapy provide services designed for treatment, rehabilitation, prevention, health, wellness, and overall fitness.

Interventions in aquatic physical therapy include:

  • Therapeutic exercise
  • Functional training
  • Manual therapy
  • Breathing strategies
  • Electrotherapeutic modalities

Therapies may also utilize assistive, adaptive, protective, orthotic, and supportive devices and equipment.

Aquatic physical therapy is ideal for patients across the lifespan, many of whom suffer from disorders and conditions affecting the musculoskeletal, neuromuscular, integumentary, and cardiovascular/pulmonary systems. The goal of physical therapy in aquatics is to improve and maintain:

  • Function
  • Flexibility
  • Body mechanics
  • Postural stabilization
  • Balance, coordination, and agility
  • Gait and locomotion
  • Relaxation
  • Muscle strength
  • Endurance

The Unique Benefits of Aquatic Therapy

Aquatic therapy is often the preferred form of treatment for patients experiencing weakness due to an injury or disability, as the natural buoyancy of the water reduces stress on the body, allowing patients to complete exercises with less pain and fewer restrictions. The natural pressure of the water also provides patients with resistance that serves to strengthen the muscles while also reducing soft-tissue and joint swelling.

Aquatic therapy has a number of major benefits:

  • Helps promote functional awareness of body position, balance, and stability
  • Provides patients with the confidence needed to move and begin restoring movement and function
  • Provides an environment where patients can move relatively pain-free

Just a few of the patient types that benefit from aquatic physical therapy include:

  • Patients who have difficulty walking or bearing weight
  • Patients with chronic pain (e.g., fibromyalgia, arthritis, etc.)
  • Patients with spinal dysfunction
  • Patients with neurological conditions
  • Patients with pregnancy-related musculoskeletal pain
  • Patients with joint replacements
  • Patients with spinal cord injuries
  • Patients who have suffered a brain injury or stroke

As opposed to general aquatic exercise, aquatic physical therapy requires the skills of a licensed physical therapist and physical therapist assistant because:

  • The patient has impairments or disabilities that aquatic physical therapy may minimize or eliminate.
  • The patient has the potential to improve functional outcomes/goals so as to improve quality of life and increase independence.
  • The patient’s standard of care and related treatment services require the implementation of aquatic physical therapy.

Job Duties of Licensed PTAs in Aquatic Physical Therapy

Aquatic physical therapist assistants—under the guidance and direction of licensed physical therapists—oversee aquatic physical therapy programs, which include performing examinations and evaluations designed to establish:

  • A functional diagnosis
  • A prognosis for functional recovery
  • A physical therapy plan of care

Aquatic physical therapist assistants provide physical therapy to patients in a safe, aquatic environment, often pools and spas located in gyms or community centers. Their work is part of a collaborative plan of care with the end goal of improving land-based function.

Aquatic physical therapist assistants have a thorough understanding of:

  • Water safety
  • Risk management
  • Hydrodynamic principles
  • Various aquatic therapy techniques


Becoming an Aquatic Physical Therapist Assistant : Education, Training, and Certification

Because of the highly specialized knowledge required to provide aquatic physical therapy, the Aquatic Physical Therapy Section of the American Physical Therapy Association offers a Certificate in Aquatic Physical Therapy Clinical Competency (CAPTCC) for both physical therapists and physical therapist assistants.

The CAPTCC is the only optional certificate program sponsored by a component of the APTA designed for the aquatic physical therapy professional. Note: This certificate is in addition to—not in lieu of—the standard route to state licensure for physical therapist assistants, which includes the completion of an associate degree in physical therapist assisting.

The CAPTCC program is a course of study that provides candidates with the skills, knowledge, and competencies necessary to provide evidence-based care for patients in an aquatic environment. Candidates for the CAPTCC must complete a practical and written examination upon completion of the program.

Candidates must complete six online learning modules through the APTA Learning Center and a three-day pool course to complete the certificate series:

  • Aquatic Physics and Historical Perspectives
  • Physiology of Immersion
  • Critical Thinking and Aquatic Interventions
  • Pool Chemical and Safety
  • Risk Management Issues
  • Aquatic Billing and Documentation

In addition to achieving the CAPTCC, licensed physical therapist assistants can pursue professional recognition by achieving the American Physical Therapy Association’s Recognition of Advanced Proficiency in Aquatics, a unique program designed to reward physical therapist assistants who have achieved an advanced level of proficiency in the specialty area.

To qualify for the APTA Recognition of Advanced Proficiency Program, candidates must be a current APTA member, have at least 5 years of professional experience, and have achieved advanced proficiency in aquatics in four categories:

  • Education
  • Continuing Education
  • Job Performance
  • Community Service/Leadership

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