A therapist's training is the most crucial investment you make when starting an underwater treadmill therapy program and is
best accomplished before purchasing the unit. Training better ensures an educated purchase and is a sign of your commitment
to a comprehensive underwater treadmill therapy program. A skilled therapist has a repertoire of techniques that can be used
to benefit a patient: Where to stand and place hands, when to use assistive devices, and which devices to use are all factors
that can affect the success of a therapy session or program.
Having an experienced practitioner train a new therapist is the best way to ensure that an adequate level of expertise is
attained before initiating a rehabilitation program. Two certification programs teach animal rehabilitation: Animal Rehabilitation
Institute and Northeast Seminars (through The University of Tennessee). Both train licensed veterinarians, veterinary technicians,
and physical therapists and are a good resource for training existing staff or hiring an experienced therapist.
The therapist's body position can affect a patient's attitude and focus. The therapist may encourage forward progress from
the front, side, or rear of the patient (Figure 2). For an even gait, the patient should be facing forward at all times.
2. Note the treatment assistant's position while a patient walks backward on the treadmill.
A therapist can help a patient while it is on a treadmill in many ways. For example, holding the tail up with slight traction
can aid a patient that tucks its pelvis and has a reduced posterior stride. The therapist may also assist a neurologically
weak patient by standing behind it and squeezing the hamstring muscles at the end of the posterior phase of the stride to
achieve stronger forward motion in the anterior phase. In a scoliotic patient with spinal concavity on the right, placing
a hand on the right side of the pelvis and the left side of the rib cage can help the patient walk straighter.
When water's buoyancy is inadequate to maintain a proper topline and, thus, proper biomechanics, a harness (e.g. Walkabout Harness—Walkabout Harnesses; Help 'Em Up Harness—Blue Dog Designs; harnesses and strap accessories provided by
the treadmill manufacturers) can be placed on the patient. This harness is attached by a nylon strap or a bungee cord to either
an eyehook in the ceiling or a bar that is supported by the tank. The harness permits increased difficulty by allowing for
mild side to side and up and down motion that engages the trunk musculature. This assistance allows the therapist to work
with the patient's limbs without worrying about its balance.
Most assistive devices that help patients improve walking on land can also be used underwater, but be aware that the effects
may differ. For example, although weights might be used out of water to achieve increased flexion or resistance, balloons
or water wings are more appropriate underwater (Figure 3).
3. The patient is wearing a balloon to increase stifle flexion and increase surface area to amplify resistance.
Several commercial treadmills are available. The best way to evaluate a treadmill is to work with a functional unit after
receiving appropriate training. In addition, experienced practitioners who already use underwater treadmills may be excellent
sources of information about the ease of use and maintenance of a particular unit.
Companies that produce or distribute commercially available models and some that will build a custom model include: