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Creating Optimal Healing m

WATSU for Children withwere and Profound Disabilities

of Aquatic PhysiotherapyChildren with a Disability:

ws of Parents and Therapists

'ater Exercise for Individualsrkinson's Disease: A Pilot Stui

Your reading and study of WATSU for Children with Severe and Profound Disabilities by Wiesercan result in 2 ICATRIC/AEA approved CECs. First, study the article. Then complete the study guideassignments as described below. Send your completed assignment and the course fee to AquaticConsulting & Education Resource Services, 7252 W. Wabash Avenue, Milwaukee, Wl 53223. Study of this

article must be completed no later than March, 2009. Please allow 4-6 weeks for processing, and your receipt ofcompletion verification. Course fees depend on CEC verification requested. Fees are non-refundable.

AEA Member discount 20%ICATRIC = $30ICATRIC = $24

AEA = $20AEA = $16

ICATRIC and AEA = $45ICATRIC and AEA = $36

WATSU for Children with Severe and Profound DisabilitiesA. Wieser

ACERS #ATJ507/AEA # 7122 H

CEC Study Guide

Assignment Preparation - All assignments must be typed. Handwritten material will not be accepted. Start with a coversheet including your name, mailing address, phone, e-mail address, and CEC article title. Then, begin another sheet of paperand answer the following questions/complete the following applications. If answering a question, state the question prior tosupplying the answer. If documenting an application, state the application requirement and then provide your response.

Comprehension -1. WATSU stands for what two words?2. WATSU promotes relaxation, enhances strength, and improves flexibility through what two types of experiences?3. Why is working in warm water effective or beneficial? Give 3 reasons.4. What three principals are the focus of this study?5. Why is WATSU suitable for children with severe multiple disabilities? Give 3 reasons.

Application -List and explain the rationale behind 4 modifications in traditional WATSU as used with children in this study.

Feature Column: Pool Problems

Therapy Pool "Bathtub" RingAlison Osinski, Ph.D.

Aquatic Consulting Services, San Diego, CA

Question: How do you prevent the"bathtub" ring from forming on thewalls around the edge of thepool? How do you remove it?

The "bathtub" scum ring that forms onthe pool walls at the waterline is usual-ly caused by a combination of twoproblems: oversaturated water and con-centrated oils at the water surface.

Scum rings form as organic debris,detergents, oils, and bather waste prod-ucts (including body fats and oils, sun-screen lotions, personal hygiene andhair care products) which are lighterthan water and float at or near thewater surface, come into contact withrough pool surfaces. In addition toforming scum lines at the water surface,

they contribute to the build-up of totaldissolved solids (TDS), reduce sanitizereffectiveness which promotes bacterialand algae growth, cloud water, clog car-tridge filters and diatomaceous earth fil-ter elements, and contribute to mudballformation in sand filters causingreduced filter effectiveness.

To prevent scum ring formation, con-sider using enzymes or absorbent foamproducts. Enzymes are catalysts thatstart or speed up chemical reactions.Enzymes are protein-like substancesthat form naturally in animal and plantcells, but synthetic enzymes have beendeveloped for pool use. Over severaldays, enzymes slowly digest and destroyoils in pool water by converting themto carbon dioxide and water. An initial

dose is added and then maintenancedoses are added to the pool on a weeklybasis.

Absorbent foam products can be usedin addition to, or instead of, enzymes tophysically remove oils from the waterand prevent scum lines from forming.Absorbent foam can be placed in thepool skimmer baskets, hair and lintstrainer, filter tank, or other locationwhich is inaccessible to pool patrons.Manufacturers of the products say thepatented molecular structure and celldesign of the foam allows it to absorbmany times its own weight in oil. Whenthe foam is saturated with oil, it turns adark color, becomes heavy and sinks.The foam can be replaced, or for a peri-od of time can be cleaned and reused.

October 2007 • Volume 9 • Issue 2 • Aquatic Therapy Journal 14

When water is unbalanced and has ahigher than desirable mineral satura-tion, excess calcium will precipitate outof solution and leave calcium scaledeposits, visible as unsightly, rough,white stains on the interior pool walls.This is especially noticeable on thewaterline tiles of pools with perimeteroverflow systems designed with skim-mers rather than rimflow, or fully orpartially recessed gutters. If body fatsand oils, and other organic debris arealso present, they will readily adhere tothe rough surface.

In addition to aesthetic problem ofwaterline stains, the excess calciumdamages heater elements, pool circula-tion system equipment, and restrictswater flow though the recirculationlines. Calcium carbonate build-upinside pipes will cause an increase invelocity as water is forced through asmaller diameter opening. Friction loss-es will increase, pressure will increase,flow will be reduced, and energy con-sumption will increase. Water maybecome cloudy and take on a "milky"appearance, particularly if pH is alsohigh. Sanitizer effectiveness will bereduced, and algae growth mayincrease. This is particularly a problemin warm water therapy pools becauseunlike most elements, calcium is less,rather than more, soluble as tempera-ture increases.

To prevent the problems caused byexcess calcium, monitor the water bal-ance and calculate the LangelierSaturation Index regularly. The LSI isused to keep the pH, total alkalinity,calcium hardness, water temperature,and total dissolved solids in balance,preventing the water from becomingaggressive or oversaturated. Dr.Langelier , a professor at the

University of California, Berkeleydevised his formula and chart in the1930s to help prevent scale build-up inclosed systems like boilers, but the for-mula was adapted and has been usedsuccessfully by pool operators fordecades.

To find the LSI, use your test kit andtesting instruments to find each of thefive values (pH, total alkalinity, calci-um hardness, water temperature andTDS). Saturation index equals pH plusthe alkalinity factor, plus the calciumhardness factor plus the temperaturefactor minus the TDS factor. Writedown the actual pH value found. Thenfor the remaining four values, find thecorresponding factor on the chart. Addor subtract the factors to or from thepH value. If an actual value is notfound on the saturation index chart,do not interpolate since there is nodirect linear relationship between thevalues. Rather, move to the next high-er value and use its factor. If cyanuricacid has been added to stabilize thewater , divide the cyanuric acid levelby 3, then subtract this interferencefactor from the total alkalinity readingprior to calculating the saturationindex, (see chart below)

If the sum obtained is zero, the water isbalanced and chemical equilibrium hasbeen achieved. A tolerance of plus orminus 0.3 is allowable for commercialpools. Negative values indicate corro-sive water, while positive values indi-cate likely calcification and scale forma-tion. If the saturation index formulaindicates that the pool water is not bal-anced (not equal to zero, plus or minus0.3), make the appropriate chemicalcorrections, starting with total alkalini-ty, then followed by pH, temperature,calcium hardness, and TDS.

Example:Total AlkalinityCalcium HardnessWater Temperature

13030092° F

TDS 750SI = pH +af + cf + tf - TDSfSI = 7.8 + 2.2 + 2.1 + 0.8 - 12.1 = +.8

Water is oversaturated. The water couldbe balanced by adding sodium bisulfateto drop the total alkalinity to 100 ppm,and by reducing the pH level to 7.2using muriatic acid or carbon dioxide.Well balanced water will increasebather comfort, will help prevent theformation of "bathtub" ring, and willdramatically extend the life expectancyof the pool and its components.

If calcium carbonate deposits and scumrings still form on pool walls despiteyour attempts to remove oils and keepthe water balanced , they can beremoved by scrubbing with tri sodiumphosphate (TSP), or with a non abra-sive chlorine bleach based liquidcleanser, using a 3M Scotch Brite® pad.If that doesnlt work, try using a finegrit sandpaper or pumice stone. Do notuse muriatic acid to scrub off the stains,because over time, acid will damage thegrout, will remove the plaster surfaceand expose the gunile below, and mayetch the ceramic tile. Power grindingmay be the only way to remove the cal-cium build-up if you ignore it for anylength of time. *

AuthorAlison Osinski, Ph.D.Aquatic Consulting Services1220 Rosecrans St. #915, San Diego, CA 92106(619) 602-4435(619) 222-9941 (Fax)alisonh2o@aol.com (e-mail)http://www.AlisonOsinski.com (Web Site)

Langelier Saturation IndexSI = pH + alkalinity factor + calcium hardness factor + temperature factor - TDS factor

Temperaturedegree factor66 0.577 0.684 0.794 0.8105 0.9

Calcium Hardnessppm factor75 1.5100 1.6150 1.8200 1 .9300 2.1400 2.2800 2.51000 2.6

TDSppm factor<1000 12.1>1000 12.2

Total Alkalinityppm factor50 1.775 1.9100 2.0150 2.2200 2.3300 2.5400 2.6

15 Aquatic Therapy Journal • October 2007 • Volume 9 • Issue 2