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Benefits of Aquatic Therapy for Traumatic Brain Injury (TBI)

Andrea Salzman, MS, PT

December 1, 2025

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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.


andrea salzman

Andrea Salzman, MS, PT

Andrea Salzman, MS, PT graduated from the University of Alabama at Birmingham with a Master’s degree in physical therapy. She has over 30 years of experience with hands-on care and training, specializing in geriatrics, patient motivation, aquatics, and musculoskeletal and balance disorders. She has presented 200 seminars, authored 300 PT articles, served as a PT-related journal editor, and was once featured on the cover of Physical Therapy magazine. Salzman has served as adjunct faculty at the College of St. Catherine’s (now St. Catherine’s University) for 8 years and as the Vice President of 10K Health, LLC, a temporary staffing agency, for a decade. She currently serves as the Director for Aquatic Therapy University and ATU Aquatic Therapy Seminars and has assisted hundreds of facilities during the start-up and training phases of their aquatic practice.

 


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