The Arthritis Foundation Aquatic Program has been updated and the Instructor’s Manual has been revised. This exciting new edition is the sixth revision since its 1985 inception and is a collaboration with the YMCA of the USA. While designed for the instructor of Arthritis Foundation classes, this manual is an excellent resource for all aquatic fitness professionals. It contains a quick review of the common forms of arthritis along with teaching tips and lesson planning. More importantly, however, is the section on exercise descriptions.  There is one exercise per page with diagrams, progressions and precautions, as well as the equipment that may be utilized.

The manual is only available through the Arthritis Foundation Aquatic Program certification training. However, whether or not you teach Arthritis Foundation classes at your facility, the information in this manual will help you with all of your participants. The exercises themselves are well described. Change the intensity or power of the move and you have an exercise that can be used with any level participant. The sample lesson plans include designs for circuit, interval, deep and/or shallow options and even for a therapeutic pool with limited space and depth.

Conveniently divided into nine joint related categories and four types of activities, one can easily mix and match exercises for a well-balanced class that will work every major muscle group while being protective of the joints. The purpose of each category of exercise is also listed along with cueing reminders. The purpose such as balance, coordination, endurance – both cardiovascular and muscular, posture, range of motion, relaxation and strength are clearly related to the activities of daily living and the translation of water-based movements into land-based functionality. The exercise categories are; walking, neck, trunk, shoulder, elbow, wrist and finger, hip and knee, ankle and toe and deep water lower extremity and abdominal exercises; endurance, balance, stretching and relaxation. The last category is program enhancements.

The Arthritis Foundation instructor or class leader will be delighted to know that the revised program includes resistance equipment in addition to the expansion of deep water exercises. The temperature range has been raised to accommodate multi-use and therapeutic pools. The range is 83-90 degrees for the full program including an endurance component and 91-94 degrees (with a waiver) for therapeutic pools with no endurance component. The temperature guidelines are detailed in the new manual’s Logistics section.

Helen Tilden, RN, a national trainer for the Arthritis Foundation and National MS Society, has volunteered with the Arthritis Foundation since the early 80’s. She has been teaching Arthritis Foundation aqua classes since their inception. Helen, a past recipient of AEA’s Lifetime Achievement Award, chaired the revision committee in both 2005 and 2009. She explained that the program, always evidence-based, needed enhancement. The expansion of the deep water component and the addition of resistance equipment are two of the major revisions.

Non-swimming water safety techniques that include recognizing a participant in distress is part of a new “Principles of Water Safety” module. “How to Maintain a Safe Pool Environment” covers the following item regarding swimmers and non swimmers: Teach all participants how to recover to a standing or vertical position from both a face-down (prone) and a face–up (supine) position; practice this skill with all participants who go to deep water as well as those who stay in the shallow water. Under the heading “Monitoring Participants and Recognizing Distress,” it is recommended to use a teaching position that allows a clear view of the class at all times. Never turn your back on your class. (Teaching from the deck is among the first in the presentation teaching tips section.)

All instructors and leaders who teach the Arthritis Foundation Aquatic Program classes are now required to pass a swim skills test that involves swimming 25 yards, treading water for one minute and performing the recovery positions in deep water wearing a floatation device, such as a buoyancy belt or wet vest. Participants for deep water classes also have a skills test. They must be comfortable in deep water, state they can swim, float on their back and tread water and demonstrate both the prone and supine recovery positions in deep water while wearing a flotation device.

The new manual contains an abundance of references and resources, a glossary and suggestions for both easy neurobic and proprioception enhancement activities. Even the graphics have been updated to be multi-generational and ethnically diverse. The inclusion of 17 new exercises; the use of sports imagery such as kayaking, fencing and juggling in addition to baseball and golf; and the use of resistance equipment, such as gloves, paddles and upper body trainers give the program a more contemporary look and feel. The stretching exercises show the use of a noodle or the more recent innovation, a noodle bar. Its entire approach reminds the user that the participants with arthritis are as up to date as the rest of the exercising public.

Helen, when describing the revisions, talked about the numerous suggestions, requests and questions provided by Arthritis Foundation instructors and trainers. These were used as an outline for the potential revisions. Writing anything by committee is a daunting task. Think about the challenge of coordinating a bevy of aquatic exercise and sports training professionals with vast education plus physical therapists, occupational therapists, a medical illustrator, art director and of course an editor. Every exercise had to be evidence-based demonstrating its safety and effectiveness. It had to have the predicted effect on the body. The various therapists had to sign off that it was safe and useful. Not everyone on the committee’s external panel had water exercise experience. Keep in mind this committee process when browsing this user-friendly book of information. The committee’s achievement is that much more amazing.

The training for new instructors and those recertifying is also improved. It includes an online study course and pre-test before the in person training.

The focus areas of the Arthritis Foundation Aquatic Program remain self-responsibility and peer support.  The specific physical goals include reducing pain and stiffness, restoring or maintaining joint range of motion, maintaining or increasing muscle strength, improving balance and coordination, decreasing fatigue, increasing endurance and improving overall perceived health status.

Certified Arthritis Foundation instructors are always needed. Contact your local Arthritis Foundation chapter for the training nearest you. www.arthritis.org 

Special thanks to Helen Tilden for the excellent recertification training and for providing so much of the information for this article.

Beryl Michaels  teaches aquatic fitness for California Family Fitness, holds certifications from AEA, AFAA and the Arthritis Foundation, and is an approved trainer for AQx Sports.  Principle of JAYBEE Consultants, Beryl is a consultant to non-profit organizations specializing in organizational development and coaching for executive directors.  Contact her at jbconsultants@comcast.net