Shower: It is an application of water by an apparatus that drives or throws water upon the surface of the body or any part of it. It permits variations in the striking pressure, the number of streams of driven water, the total quantity of water and the temperatures of the different streams of water used.
Jet Shower: The simplest form of shower is a single stream of water applied through a device identical to a garden hose and having an adjustable nozzle. The operator stands at a distance of three meters (nine feet) from the back of the client and directs the flow of water between the shoulder blades, up and down the back and up and down the extremities. The operator may start with the water at a neutral temperature and lower or raise the temperature. The operator may also raise or lower the pressure of water or increase his distance from the client for more or less stimulation.
Fan Shower: The fan shower differs from the jet shower only in the shape of the projected stream. Although this can be accomplished with a fan-shaped nozzle, in practice it is usually achieved by placing the thumb over the water as it emerges from the fully opened nozzle opening so that the water "fans" out. Some operators like to alternate the fan and jet shower during its application by using the finger control.
Rain Shower: Water pipes can be arranged in many ways and with many outlets in a circular, triangular, or quadrilateral fashion so that water may be thrown against the body at many different levels and at different intensities and temperatures. Such a shower has been called the horizontal rain or needle shower.
Scotch Shower: this is another way of saying alternate shower. The operator works at a distance of three meters (nine feet) or more from the client near a water control panel. The operator holds a water hose and is able to vary the pressure and the temperature of the water. The usual procedure is to throw hot water at the client from one to three minutes and follow it by cold water for one fourth to one sixth the time of the warm application. The temperature range of the hot water is from 38ºC/100ºF to 50ºC/122ºF, and that of the cold water is from 13ºC/22ºF to 22ºC.71ºF. The Scotch Shower begins with hot water at only 38ºC/100ºF applied for one minute, followed by cold water at 27ºC/80ºF applied for 10 seconds. Each day the hot water can be made a degree hotter until 40ºC/104ºF is reached and the cold water 11ºC/51ºF colder until 1.5ºC/34ºF is reached. The duration and rate of change must be guided by the response of the client.
The Scotch Shower is usually given to persons for whom an increase in mental alertness is desired or to those who feel the need of a "tonic" shower.
Vichy Shower: This is a technique developed in Vichy, France, which is given in the recumbent position (the Aix-les-Bains is given in the sitting position). The client is supine on a canvas cot, which is covered with a sheet of perforated rubber and an air pillow to support the head. The Shower may be prescribed as tonic or sedative. For the tonic shower, a fan spray is applied to the sides of the trunk and the abdomen, avoiding as much as possible the gall bladder area, at a temperature of 36ºC/97ºF at the beginning, which is raised in three to five minutes to 41ºC/105ºF. The shower is followed by a short, partial jet spray in the standing position. For the sedative shower, the water is applied to the abdomen at a temperature of 36ºC/96ºF to 37ºC/98ºF with virtually no pressure for two to four minutes in a circular or spiral motion. This shower is usually followed by one in the standing position, as mentioned for the stimulating type.
Methods and Recommendations of Spa Therapy
There was a time when the principal treatment at a spa for rheumatic diseases was waters and peloids. This has changed. Spas use all other recommended methods including all forms of physical and drug therapy simultaneously. This complex spa treatment is especially indicated in more serious cases. The term cure (French) and Kur (German) in connection with spa therapy does not mean "healing", but as in Latin, TREATMENT or therapeutic course.
Acute rheumatic diseases are not suitable for spa treatment. A client who suffers an attack of acute rheumatic fever must not be admitted to a spa "cure" until three months after all clinical and laboratory tests show no signs of activity.
The most important INDICATIONS for spa treatments are inflammatory and degenerative disorders of the locomotor system. Spa therapy must be considered as a more or less significant part of the overall therapeutic plan and by no means as a medication which can replace or make superfluous all other forms of after-care. Chronic rheumatic diseases usually require medical care for years to avoid deterioration. The spa "cure" must be extended to at least four weeks and some times to seven weeks, shorter periods are usually unrewarding.
Of the inflammatory joint diseases, RHEUMATOID ARTHRITIS is most often referred for spa therapy. Its management consists of administration of thermal baths daily or every other day, according to the general condition of the client. Similarly, the duration and temperature of the baths must be adapted to the individual or delayed since vigorous treatment given too early can provoke an exacerbation. The reaction of the rheumatoid arthritis to the first baths must be followed as a guide to prescription changes. The first week of treatment is a kind of touchstone for the entire "cure". The reaction of the client decides whether further treatment will be mild, moderate or intensive. If there is an elevation of temperature, elevation of the sedimentation rate or fatigue, further treatment is at a relatively low temperature for short periods. Dry blanket packs after the bath are shortened or omitted completely and bed rest is prescribed for the whole morning.
On the other hand, when the baths of the first week were for no more 20 minutes at a temperature of about 37ºC/99ºF, the duration and temperature are increased. Baths are often alternated with peloid applications on a part of the whole of the body. Even if the client tolerates the strongest treatment, at least one day of rest, free of any treatment is ordered. A thermal pool where REMEDIAL EXERCISES are done under supervision is indispensable to the program. The integration of all forms of treatment based on clinical and laboratory responses will attest to the skill of the consulting physician.
In spas where only peloids are available, peat or moor baths and topical packs are applied alternately.
THERMAL MUDS ARE FOUND ONLY IN AREAS WHERE THERE ARE NATURAL THERMAL SPRINGS.Ankylosing spondylitis is another inflammatory joint disease which can be benefited by spa treatment. The management of theis disease in the spa is similar to that of rheumatoid arthritis, the difference being that even more attention must be devoted to therapeutic exercises in this condition, for these reasons: A. Ankylosis of the spine can be delayed and possibly prevented by exercise, B. Atrophy of the dorsal muscles can be avoided by daily remedial exercise, and C. Dorsal kyphosis can be prevented or halted by a good exercise program. Sufferers of this ailment should be referred only to those spas where there is a competent staff of physical therapists, a pool of the right temperature, size and construction for underwater exercises.
Complex Spa Therapy
Spa therapy is an institutional program which combines regular treatment with the natural remedial resources of a health resort. The sojourn at the watering place is no longer a distraction and relaxation combined with some baths, mud and drinking. It is a serious attempt to enable the man who cannot undergo a systematic course of treatment at home, owing to the haste of 20th century living to devote a period of four weeks to receive thorough medical care. During that period, he is asked to follow a prescribed diet, to take regular meals, walks and in short, to lead a healthy ordered life with sufficient sleep. The client should also learn what to do in the months to follow. The client should accept a schedule of daily exercise, preventive positioning during sleep, and the need for a sensible diet.
SPA PROGRAMMING Spa therapy is a complex procedure resulting in many different stimuli acting on different joints of the body through thermal, chemical, medicinal and last but not least psychological functions.
At every spa there is a variety of material agents supplemented by artificial conditions. The natural factors which are always important are the directic and balneologic. In addition, there are the pools and (physical) spa therapy departments which not only offer hydrotherapy but alsso all other physical agents. Just as there is no routine prescription for drugs and diet, there is no routine prescription for spa therapy-programming. The program must be adapted to the condition of the client and then modified, depending upon their response to it.
It is often practiced that clients are given a booklet that indicates instructions for the spa program – bath, drinking of water, if any, duration of rest period, the occurrence of bed rest, sleep, a detailed diet, the recommended sports and recreational activities.
The booklet also contains a regimen to be followed at home.
It is not possible to give a general since it is a composite, which is related to the knowledge of the program participant, the person's level of activity, and a thorough understanding of the natural therapeutic agents of the spa combined with the programmer's skills to use them.
