Česky
Mr. Jurák, can you start by telling us what we can imagine by the term aquatherapy?
Aquatherapy, which we implement at the Centre for Mental Rehabilitation in Beroun, is a method that uses the water environment to relax and unwind the patient, in our case with mental problems. In the course of the therapy we build on the patient's level of motor skills acquired by moving on "dry land". To move in water we need a certain level of adaptation that is not inherent in humans. It is necessary to acquire it by learning. Therefore, we work primarily in the vertical position, using the physical properties of the aquatic environment, such as hydrostatic pressure and buoyancy and hydrodynamic lift and drag. Based on these conditions, we are able to use the aquatic environment to develop the most important skills, which are deepened exhalation and inhalation, orientation in space, flexibility, strength endurance, the sensation of water (in our case the sensation of water pressure and temperature on the skin) and many others. The aquatic environment influences the patients' emotions, has an effect on deepening relaxation and, as far as possible, has a social function.
Who can participate in aquatic therapy?
Basically anyone who has a doctor's referral and is hospitalized in our facility. We adapt the exercises to individual needs, whether someone cannot swim, has an aversion to water or, on the contrary, wants to learn to swim technically correctly. However, aquatic therapy is not a competition. It is not about performance, but about well-being and the development of movement skills and abilities within the individual capabilities of each patient.
What does a typical aquatic therapy class look like?
We divide it into three parts. The first part is guided. As I mentioned above, we work in a vertical position, with an emphasis on walking, running and jumping in different directions using hand movements. The second part is unguided, patients can continue to exercise or swim, most take the opportunity to go to the sauna and relax. And the third part is relaxation, we learn to release muscle tension, often just lying in the water, breathing and relaxing different parts of the body.
How is the water specific compared to, say, traditional therapy or moving on dry land?
The aquatic environment interacts with the human body and creates conditions that allow the human body to float near the surface. Gravity, which affects all movement on dry land, is reduced and minimally affects body position. These conditions result in a deeper physical and mental relaxation. People who cannot completely relax on dry land can suddenly do so in the water, which has a tremendous therapeutic effect. It gives many people a relaxation they can't get anywhere else. We are also able to do exercises in a lightened environment that some patients would not be able to do on dry land.
Do you have any experience of people overcoming themselves, even in spite of initial scepticism?
Yes, very often. I remember a lady who had wanted to learn to swim butterfly all her life. She was active, but she never mastered the technique. And at CDR, we took the plunge and she actually learned it. It's moments like that that confirm to me that it makes sense. Even people who don't like the water at first find out over time that it actually does them good. And if they don't, we respect that. It's perfectly fine.
Apart from the movement itself, what else does aquatic therapy bring to patients?
First of all, a change of scenery. A departure from the normal ward routine. The opportunity to do something new, useful and often enjoyable. Their mood improves, their self-esteem improves, they establish relationships not only with others but also with themselves. For some, it can mean the first positive experience of their own bodies. In addition, concentration and cognitive function are strengthened.
Is working with groups any different? For example, with patients with borderline personality disorder or OCD?
It certainly does. A specific approach is needed with these patients because they are often more introverted, less motivated, more fearful. We don't focus so much on developing fitness with them, but more on fine coordination of movement, relaxation and breath work. It's not about overloading patients, but creating a safe environment where they can breathe and mentally relax.
What are the patients' reactions? Are they happy to come back?
Yes, they often come back after the class themselves, say thank you and that it was so good for them. That it gave them something extra. They also welcome the fact that the experts are with them and make sure that they treat their bodies correctly in the water and don't hurt themselves by moving incorrectly. And that is the biggest reward for us.
You personally have a deeper relationship with water - you've studied it professionally, right?
Yes, I graduated from UK FTVS in Prague, I headed the swimming sports department, I lived and gained experience in Australia for some time. Water is my natural environment, but today, more than performance, I am interested in its therapeutic potential - how it can help people on their way to health.
What message would you give to people who are hesitant about aquatic therapy?
That they definitely don't need to worry about anything. Water accepts you as you are. And maybe it's where you'll find a new way to feel good again. And that's the goal of us therapists.
You're the leader not only of aquatic therapy, but of movement therapy as a whole. What can you offer your patients?
We focus on a wide range of physical activities. We offer patients the aforementioned aquatic therapy as well as exercise in a state-of-the-art gym, multi-function room and exercise room. Together with other experienced professionals (fitness trainers, physiotherapists) we teach patients how to work with their bodies, how to prepare a simple fitness program for large and small muscle groups. In the multifunctional room we practice fine muscle motor skills, flexibility, coordination and reaction speed. And in the gym, patients unwind through team and individual games. We also try to include new wards in the movement programme. In the near future, this will include a ward for the diagnosis and treatment of ADHD and other attention disorders, and a day ward for children and adolescents. We also want to include patients with functional mobility disorders in the programme.
