A Team Approach to the Aquatic Continuum of Care.

A Team Approach to the Aquatic Continuum of Care

Norton CO, Jamison LJ. Woburn, MA 01801-20141, Butterworth-Heinemann Inc, 2000, paperback, 184 pp, illus, ISBN: 0-7506-7168-8, $24.95.

The recent growth of aquatic rehabilitation has occurred through the efforts of a diverse group of professionals, including physical therapists, occupational therapists, recreational therapists, massage therapists, exercise physiologists, and athletic trainers. These health care professionals have recognized the value of the aquatic environment in injury recovery, fitness development, and health management. This innovative text is the first in the aquatic arena to provide a comprehensive, interdisciplinary approach to the aquatic continuum of care. In proposing to use the Lyton model to create the continuum of care, the authors explore the relationships among these health care professionals and propose a "creative structure for program development" that maximizes the strengths and training of each discipline.

The incorporation of the Lyton model and the related concepts creates a treatment environment that minimizes duplication and maximizes accessibility of service for both the patient and the professional. In addition, the authors address the issues surrounding appropriate referral, licensure, registration, and other related topics. This concisely written and well-organized text will be a valuable resource in the effective creation and use of a multifaceted aquatic program.

After a brief introduction on the therapeutic use of water in chapter 1, chapter 2 introduces the Lyton model for the aquatic continuum of care. A circular model with the client at the center, the Lyton model addresses licensed treatment, fitness, and wellness while providing a clear delineation of and between different providers of aquatic services. The description of the Lyton model is followed by case study applications, including goals for each discipline. The authors effectively use a wide range of diagnoses in applying the model, demonstrating its broad-spectrum appeal and flexibility.

Chapter 3, addressing licensure, registration, certification, and title acts, provides the framework for efficient and effective use of the team approach to care. By identifying the differences among licensure, certification, and registration, the authors help the reader understand the scope of practice, privileges, and limitations of each practitioner. The continuum of regulation (state, national, professional) is discussed in general, followed by an outline of regulations for each discipline organized by profession. Chapter 4 completes the book's framework and consists of 2 sections. Section 1 briefly discusses the hydrodynamic principles of water and the physiological effects of immersion. Section 2 outlines specific aquatic rehabilitation techniques and identifies opportunities for interested professionals to gain training in these areas.

The remaining chapters of the text, chapters 5 through 12, specifically describe the skills and training of each team member, and how each will contribute to the rehabilitation goals of the patient. The professionals covered include physical therapists, occupational therapists, massage therapists, kinesiotherapists, athletic trainers, exercise physiologists, certified therapeutic recreation specialists, and aquatic exercise instructors. Each chapter discusses the core concepts of education, qualifications, and related training as well as the role of that professional in the continuum of care and the application of the Lyton model. Pertinent issues for each discipline, such as barriers to practice, liability, and appropriate referrals, are also discussed. Each chapter concludes with that professional's role in the treatment of a patient introduced earlier in the text. This structure provides a very effective illustration of how a multidisciplinary approach to the aquatic continuum of care is carried out, because it follows an injury from the acute phase through to fitness to wellness.

A Team Approach to the Aquatic Continuum of Care provides a practical overview of the disciplines involved in the aquatic continuum of care as well as the appropriate information to make a multidisciplinary approach to care the most effective it can be. By describing the service provided by each team member and how each member interacts with other team members, this text provides guidelines designed to maximize the therapeutic outcome for the client. This book will be a valuable resource for any professional providing therapeutic aquatic services.

Christine A McNamara, PT Cornell University Ithaca, NY

Ms McNamara is a staff physical therapist and coordinator of the clinical education and aquatic physical therapy programs at Cornell Physical Therapy.