WST motor-cognitive solutions in Lima, Peru

From 23 November 2022 until 27 November 2022
Water Specific Therapy Water Specific Therapy (WST) – previously known as Halliwick-therapy - is THE aquatic therapy concept worldwide, included in more than 50 published research articles, see at https://www.halliwick.net/en/literature/articles . WST covers virtually all neuromusculoskeletal ICF-goals including one of the most important topics in rehabilitation: from muscle strengthening, increasing range of motion, decreasing pain to postural control, core stability, agility and fall prevention. WST can be used to evoke subtle muscle contractions that are unable to generate on land. WST is applied from pediatrics to geriatrics and has been taught in over 50 countries. It is an aquatic therapy with elements of the Halliwick 10 point-programme swimming method that are used as pretraining for exercises that use the fluidmechanical properties of water: flow conditions (turbulence), waves of transmission and metacentric effects (using the change of gravity and buoyancy induced torques). A clinical question in WST could be: “can metacentric effects be used to train central stability in an ataxic patient”? WST was developed by a team of physiotherapists in Switzerland in the early seventies, supporting James McMillan in his efforts to develop Halliwick towards a “Halliwick-Therapy”. The development still continues, following contemporary issues in health care. Examples are executive functions, muscle power training or modifying neuroinflammation. WST = motor learning in water to be used on land whereas Halliwick = motor learning in water to be used in waterAquatic motor-cognitive therapy This is a very recent development, based on the emerging notion that movement is important for brain functioning: brain vasculature health and brain plasticity. Both moderate aerobic exercise and high intensity interval training (HIIT) increase blood flow, also in the brain. At comparable physiological intensities, brain blood flow is higher in water than on land. Higher flow velocities increase immune-metabolic activity of endothelial cells: supporting plasticity processes, e.g. related to executive functions. Executive functions are cognitive control processes, governing goal-directed motor control, especially during complex, novel or ambiguous situations. These situations can often be translated as playing/exergaming with therapeutic intentions, which also happens in enriched environments. In one sentence: the added immuno-metabolic effects of (intensive) exercise in water opens a door to include cognitive elements – especially executive functions - during motor control in complex situations. These situations often have an equilibrium component and might be difficult to achieve on land when working with patients with increased fall risk. A clinical question could be: “are you able to walk in 4 different ways, always 3 steps, and try to mix these 4 ways in as many ways as you can”? Memory and problem solving are the cognitive functions that are involved in this assignment of gait variability. It has become clear that important effects on neuroinflammation can be achieved, which might be of utmost importance in various life-style diseases.


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