BPF Big Survey 2023 results on hydrotherapy
- The British Polio Fellowship
- 1 day ago
- 5 min read
For some people who contracted polio, hydrotherapy was a significant part of their rehabilitation, and led to a long enjoyment of water-based activities. When the body weight is supported by the water, the freedom of movement can also give a welcome, though temporary release from mobility restrictions.
As polio survivors age and possibly develop further weakness, they have to find suitable pools that fully accommodate their changing needs. Some great work has been done by the British Polio Fellowship's Northampton branch in getting regular hydrotherapy sessions set up with a physiotherapist. However, as fully accessible warm hydrotherapies close, access to these facilities is decreasing.
In the 2023 British Polio Fellowship (BPF) Big Survey, there were questions asking polio survivor's about their experiences with hydrotherapy aimed at finding out how many people would still want water-based therapy and what difficulties they face.
Over 1,000 people responded (average age 75 - see graph below), with 62% replies from women, compared to 37% men, some preferring not to say. Not everyone of these answered every question, so total numbers for each question are different.
Experiences with hydrotherapy
Not everyone had hydrotherapy as part of their original recovery after polio; 419 (49% of 857) did, 334 didn't and 104 didn't know. About the same proportion continued water-based exercise and/or swimming, with 169 (18% of 848) doing it regularly, 307 occasionally and 372 did not.
So about half of the polio survivors who responded did have hydrotherapy years ago and kept up some form of water-based activity afterwards.
However, 754 (88% of 859) do not do water-based exercise/swimming today.
What made people stop?
The motivation for including these questions in the survey was to see if any barriers to hydrotherapy can be reduced. 398 people selected issues that, in an ideal world, could be changed.
We listed some reasons people, along with space to give other issues - multiple answers could be chosen so numbers cannot simply be added together.
Not surprisingly, the most commonly selected response was accessibility (217) followed closely by the lack of a suitable pool nearby (173). Help was important for 119, and time slots, busy pools and fatigue were also problems. Comments under the 273 'other reasons' provided more detail.
What makes a suitable pool? Warm pools were needed by 66% of those who continued hydrotherapy or swimming (148 out of 223 replies), but 15% (34) did not, with 17 not sure and 24 had no preference. Good accessibility is needed. This includes not just better steps into the pool, but hoists, good non-slip surfaces as many were afraid of slipping, help to get to the poolside and into the water, warm changing rooms with wide seats for managing orthotics and safe well-lit access to the car park. Eleven people reported difficulty getting from the changing rooms to the poolside if they were without their special footwear or other mobility aids. Several commented on being knocked into in busy pools.
What makes a pool 'close enough'? Eight mentioned in the comments that they used to have a pool within reasonable distance but it has closed, some in the CoVID-19 epidemic which did not reopen. Available transport is also an issue, especially as some are no longer able to drive.
Not all people want to or are able to do water-based activities. Significant numbers selected 'don't want to' or ' too tiring' (242 people). Comments under the 273 'other reasons', for not wanting to, included both general reasons and reasons that could be related to prior polio.
General reasons included those who didn't feel they needed it and/or were doing other exercise or activities (13). Some disliked it (7) or had a previous bad experience (3). A range of other health issues such as leg ulcers, dressings, vertigo and incontinence prevented 12 people from using pools with 6 saying they were too old.
Responses which could be related to prior polio were those who said they were not able (23), that pain was increased (13), prevented by self-image/embarrassment (12) or had difficulty breathing in the water (6).
What type of pool did they use?
From the main selections most used public pools (90 out of 184 replies), the rest accessed other types (67), private pools (41), NHS hydrotherapy (19) and charity run pools (10). The other types detailed in the comments had fewer people reporting and included gyms, river/sea, school pools, disabled swimming clubs, hotels, hot tubs, and special needs pools. Two did exercises in their baths.
What next?
Hydrotherapy is a word used for a wide range of treatments and activities. For example, Science Direct says: Hydrotherapy is the external or internal use of water in any of its forms (water, ice, steam) for health promotion or treatment of disease."
The responses to the survey range from physiotherapist-led treatments in hospital pools, through using public swimming pools, sea bathing and exercises in the bath or hot tub.
While about 50% of respondents had hydrotherapy decades ago and continued for many years, 88% have stopped. For some, it is not longer physically possible, but about 400 people stopped because of issues that could in an ideal world be fixed. This shows there is a still a demand for hydrotherapy from the polio community that is not being met as shown by selected quotes below:
Would love to use but have lots of difficulties.
Found it so helpful for exercising and helped relax muscles for sleeping
Love swimming but would need considerable help and suitable facilities to access.
It kept me moving... helped with my mental health gave me respite from pain. And it only exercise
i could/can do without consequences.
I would recommend aquarobics to anyone who can manage it. Its great exercise and good fun
Love being in warm water.
I would love to do swimming but i would need help dressing. Unfortunately I have no female friends who can take me.
It is my only exercise as i cannot walk. Im a good swimmer and it keeps me fit and slim but i need the facilities of private pool.
its the best thing that I did.
There is also a wide variation in need from those who can still swim in the sea to those who need full assistance in special pools.
Next steps are to discuss these findings with a core group which would include aquatic physiotherapists, and people who are running accessible pools as well as polio survivors. We also need to check the current status of the 100 pools recommended in the answers and produce a list by area - this will be circulated to the polio community by email and on the website. This list should not just be specialised hydrotherapy pools, but other facilities such as sport centres, private or charity run pools and clubs that are 'friendly' to people with
limited mobility.
The BPF think an online discussion on this topic later in the year might be helpful to discuss ways hydrotherapy can help polio survivors and could explore other ways water-based activities can be made possible. For example, there may be aids that could help, or it might be possible to overcome any embarrassment polio survivors may feel in going to a swimming pool.
A big thank you to all who answered the survey questions - there is a lot of valuable information in the feedback which will help the BPF advocate for better access and help.
And finally, the link below may help to find hydrotherapy pools by area -
Frances Quinn BPF Trustee and polio survivor
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