An Innovative Approach to Pediatric Aquatic Therapy By Cindy Freedman, MS OTR Are you looking to grow your pediat- ric aquatic therapy toolbox? Here are a few tips, ideas, and stories of inno- vative ways to work with your kiddos. At Swim Angelfish, we constantly look for new ideas on handling, equipment choices, and how best to help achieve our client’s goals. The other day, I worked with a four- year-old who had a stroke. I was try- ing many things to wake up her body and give her affected arm more input, with the goal of more motor move- ment. Despite my efforts, I could not get her to activate her affected arm. Usually, I put a small float on her forearm (because she cannot grasp it with her hand) and a half-pound wrist weight to increase her awareness of that arm. I discovered that moving the small float and weight more proximally to her upper arm increased her awareness of that side of her body and allowed enough scapular depression to propel in prone or supine. I have been doing pediatric aquatics for over 30 years. Why had I not thought to make that minor adjustment for other children? It was so miraculous, and she was so very proud of herself. You most likely love what you do in pediatric aquatic therapy, but sometimes it can still be challenging to reach goals due to significant obstacles. You may feel you have run out of ideas. Be open to creative and innovative ideas for sensory input to manage successful submerging and ways to prompt movement progressions. For example, when using a large buoyant noodle, you might need more streamlining or turbulence to get a child in a sitting position. Sometimes when you stop moving, it decreases the sensory input for your swimmer and can make it more difficult to get them in the correct body position. With the pediatric population, you can pick land-based activities to perform in the water, thus generalizing the skills to land. One option is the idea of swinging at the playground; incorporate a noodle and have them sit on it like a swing. Use this playground idea to create a social story where your client imagines they are on a swing. Then you can begin working on the anterior and posterior tilt of the pelvis while they swing. The magic and motivation of the water for the pediatric population make the impossible possible. AUTHOR Cindy Freedman is one of AEA’s amazing IAFTC 2023 Presenters. Click here to find out more about Cindy and the sessions she is offering. SAF AQUA® Relaxation – Vagus Nerve Stimulation By Joanna Apolinarska, MS The vagus nerve is the longest nerve in our body and is immensely import- ant for proper functioning. It activates the parasympathetic nervous system. It also influences heart rate and the digestive system, the respiratory sys- tem, and the ventral cavity. It simul- taneously controls the innervation of the posterior part of the cranium. It is responsible for both motor and sen- sory functions in numerous structures of our body. Moreover, vagus nerve connects our brain with our intes- tines, which to a large extent, deter- mines our immunity. The vagus nerve constitutes a driving force within our body that manages our rest, deacti- vates signs of anxiety, and influences our emotions. The main neurotransmitter used by the vagus nerve is acetylcholine, which has an anti-inflammatory function in our body. Acetylcholine regulates our breathing and manages function- ing of our lungs. Because its work is disrupted by, among other factors, an increased tension of the diaphragm, proper breathing (which unfortunately is still rarely practiced) allows for the stimulation of vagus nerve. The polyvagal theory, originated by an American psychiatrist and neurobiolo- gist Stephen Porges, must be mentioned. March / April / May 2023 | Akwa | 21 If we wish to protect our own health, as well as the health of our clients and those around us, we must be cognizant of how to regulate the ventral vagal system.
