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an inTeRlink feature article

Aquatic Therapy Certification

Laurie Jake CTRS, CEDS

What is it exactly, and do I need it?
Water is the most abundant element of our body. 72% of our body is made of water. For centuries the medical community and the public have recognized the healing properties of water. Water's resistive qualities and the human body's natural buoyancy combine to allow therapy and exercise without putting unnecessary stress on muscles and joints. Water is the ideal method in which to exercise or rehabilitate the body. Water provides an environment, which reduces body weight by 90%, decreasing stress and impact on the body. Warm water also reduces spasticity and relaxes muscles allowing individuals to move with greater mobility and less pain. By using underwater exercise in a pool, individuals gain the benefits of exercise without the compressive forces associated with the gravity of a land exercise setting. This type of aquatic fitness is ideal for persons suffering from arthritis, all kinds of injuries, and neurological disorders. Underwater exercise provides additional benefits from the increased confidence participants feel when they are in the water away from the pull of gravity.

The freedom of movement made possible by water does wonders for morale. The buoyant water supports the body and lessens the effects of gravity, allowing a person who may not be able to walk or move on land to achieve ambulation in water. This creates a wonderful training ground for skill development and muscle re-education.

Relieving pain and returning the body to its pre-symptomatic condition is what Aquatic Therapy is all about. With the water's buoyancy and the absence of gravity to hold back movement, the length of a patient's rehabilitation process dramatically decreases. The Aquatic Therapy and Rehabilitation Institute defines Aquatic Therapy as "The use of water and specifically designed activity by qualified personnel to aid in the restoration, extension, maintenance and quality of function for persona with acute, transient, or chronic disabilities, syndromes or diseases". Many healthcare disciplines work in pools including; Recreational Therapists; Physical Therapists; Occupational Therapists; Exercise Physiologists; Massage Practitioners; Kinesiotherapists and others.

Certifications for aquatics are varied, but generally can be separated into these categories;
1. Intervention specific certifications, ie individuals who are certified in Halliwick, Bad Radgaz, or Watsu are examples of interventions. There are usually classes or workshops that offer these certifications
2. Population specific certifications like MS or Arthritis, One of the most popular examples is the The Arthritis Foundation Aquatic Program (AFAP). This is a recreational program co-developed by the Arthritis Association and the YMCA of the USA, the Arthritis Association offers workshops on a regular basis and offers a certification for this program.
3. Aquatic Therapy & Rehab (ATRIC) Industry Certification, through the International Council for Aquatic Therapy and Rehabilitation Industry Certifications. This certification was originally offered through the Aquatic Therapy and Rehabilitation Institute. ATRI offers continuing education courses at conferences and workshops that advance the knowledge and skills of aquatic therapists and aquatic specialists.
4. Aquatic Fitness Certification, the most well known is the Aquatic Exercise Association (AEA) which also offers many specialized certifications.
5. Adapted Aquatics Instructor training through AAHPERD
6. Basic aquatic certifications, including WSI (Water Safety Instructor) and Lifesaving through the Red Cross.

With such a variety of options it is difficult to know which one is best if you plan to treat your clients in the water. For this article I have chosen to highlight what I consider to be the most comprehensive certification for aquatic therapy, the ATRIC. Obtaining this certification adds a new dimension to your practice as a recreational therapist and it can enhance your potential in the ever-changing world of health care. This certification allows you to use the term "ICATRI Certified" or the initials "ATRIC" after your name. It shows that you meet the minimum qualifications in the Aquatic Therapy and Rehabilitation Industry beyond your other formal training. There are many CTRS's across the country who have achieved this certification, as well as Physical and Occupational therapists and other aquatic industry professionals.

The International Council for Aquatic Therapy and Rehabilitation Industry Certifications (also known as ICATRIC or "the council") states on its website that it is "an organization that focuses on the merit and worth of aquatic therapy certifications as measures of provider competence while protecting the consumer of aquatic therapy services."

The Council establishes standards that recognize competent, knowledgeable professionals in aquatic therapy and rehabilitation. This multidisciplinary certification program is internationally recognized and provides a formal review of the education, experience and qualifications of aquatic therapy practitioners.

The examination tests the six basic Standards of the Aquatic Therapy and Rehabilitation Industry:
· Movement Mechanics and Science which make up 21% of the exam.
· Aquatic Principles which make up 22% of the exam.
· Aquatic Therapy Principles and Methods which make up 31% of the exam.
· Professional Responsibility which make up 14% of the exam.
· Health and Safety which make up 14% of the exam.
· Legal Considerations which make up 4% of the exam.

Before sitting for the exam, the candidate must document and submit the following prerequisites:
The candidate must -
1. Show current certification in CPR and First Aid training within the last 4 years through documentation, certification, license, or education.
2. Show documentation of training in basic water rescue skills within the last 4 years.
3. Have thirty hours of documented training specific to aquatic therapy and rehabilitation.
4. Provide documentation of one of the following:
A. An undergraduate or graduate degree in exercise science, biology, pre-med, physical education, recreation, or a related field.
OR
B. An unrelated undergraduate degree, plus three years experience working 25-30 hours (or 3000 hours total) in aquatic therapy and rehabilitation.
OR
C. Without a degree, an approved water fitness certification and five years (or 5000 hours) working in aquatic therapy and rehabilitation.
For more information contact International Council for Aquatic Therapy and Rehabilitation Industry Certification: www.icatric.org or call 425-444-2720.
Aquatic therapy certification may not be right for everyone who treats his or her clients in the water, but it is a good way to demonstrate a certain level of knowledge and skill for an aquatic therapy practitioner. Obtaining this certification is a big commitment of time and money, but for the people who have invested both, they believe it has helped to make them better therapists.

Here are some resources for additional aquatic info:
www.atra-tr.org (ATRA's Aquatic Therapy Treatment Network)
www.atri.org (Aquatic Therapy and Rehabilitation Insititute)
www.usswim.org (click programs then click adapted, for info on adapting strokes for disabilities)
www.aeawave.com (Aquatic Exercise Association)
www.aquaticnet.com (Aquatic Resources Network)

Article reprinted with permission of the author. All rights reserved.