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Benefits of Aquatic Therapy for Traumatic Brain Injury (TBI)

Andrea Salzman, PT, MS

December 1, 2025

Question

Why is aquatic therapy an effective treatment for individuals with traumatic brain injury (TBI)?

Answer

Aquatic therapy provides a unique environment that enhances rehabilitation outcomes for individuals with traumatic brain injury (TBI). The buoyancy of water reduces gravitational forces, making it easier for patients to engage in movement and balance exercises without the fear of falling. This is particularly beneficial for individuals with TBI, who often experience motor control deficits, muscle weakness, and impaired coordination. The supportive nature of water allows for safer mobility training, enabling patients to practice weight-bearing activities, gait training, and postural control without excessive strain.

In addition, the hydrostatic pressure of water enhances circulation, which can contribute to improved cerebral blood flow. Research indicates that immersion in thermo-neutral water facilitates oxygen delivery to the brain, supporting neurological recovery. Water resistance also provides natural, progressive strengthening for weakened muscles while reducing spasticity and promoting relaxation. The multisensory stimulation from water immersion aids in sensory integration, a crucial factor for patients with TBI who may struggle with proprioception and spatial awareness. With these advantages, aquatic therapy serves as a valuable component of a comprehensive rehabilitation program for TBI recovery.

This Ask the Expert is an edited excerpt from the course, "Aquatic Therapy for the OT and PT: Emphasis on Traumatic Brain Injury (TBI),” presented by Andrea Salzman, MS, PT.

Continued and its subsidiaries provide professional education authored by qualified Subject Matter Experts for continuing education purposes. These materials are intended for educational purposes and do not constitute medical advice or a substitute for individual clinical judgment. Continued is not a clinical healthcare provider; the licensed professional is solely responsible for ensuring that the application of any techniques or information presented is within their legal scope of practice and jurisdictional requirements.


andrea salzman

Andrea Salzman, PT, MS

Andrea Salzman, MS, PT, is the Founder and CEO of the Aquatic Therapy Foundation, Inc. (launched in 2026) and has served as the Executive Director of Aquatic Therapy University (ATU) since 2010. She graduated from the University of Alabama at Birmingham with a Master’s degree in physical therapy.

With over 30 years of experience as a licensed physical therapist, hands-on clinician, and educator, Salzman specializes in aquatics, geriatrics, patient motivation, and musculoskeletal and balance disorders. She has trained physical, occupational, and speech therapists worldwide in evidence-based aquatic therapy across pediatric, adult, neurologic, orthopedic, and cardiopulmonary populations. As a consultant, she has assisted hundreds of facilities during the start-up and training phases of their aquatic practices.

Salzman’s diverse background includes a decade as Vice President of the temporary staffing agency 10K Health, LLC, and eight years as adjunct faculty at St. Catherine University. A prolific contributor to her field, she has presented over 200 seminars, authored 300 articles, and served as Editor-in-Chief of the American Physical Therapy Association's (APTA) Journal of Aquatic Therapy. Her industry honors include being featured on the cover of Physical Therapy magazine and receiving the APTA's Judy Cirullo Award in recognition of her leadership and contributions to aquatic therapy practice.

Her life's work emphasizes translating the therapeutic properties of water into clinically defensible, functionally relevant interventions for all who find themselves standing at the water's edge.

To access ATU's global clearinghouse of information, visit www.aquatictherapyuniversity.com.

 


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