Michael Miceli he was ready to begin rehabilitating muscles damaged by Guillain-Barre syndrome - and his physical therapist suggested he try an aquatic workout - back in 1990.
And, contrary to popular opinion, not everybody in South Florida, including Miceli, has a pool.So Miceli began "borrowing" his friends' pools. The problem was Miceli's paralysis was so extensive he couldn't get in and out of the water without help. And most of his friends' pools had curved sides, without a proper space to hold onto during the workout.
Based on what they saw as an obvious need, Miceli; his girlfriend, Kim Moore, and his physical therapist, Debbie Devol, decided to design their own aquatic rehabilitation center.
"Out of bad things, good things happen," says Moore.
And Water Works Aquatic Physical Therapy Inc. is the good. The Naples, Fla., facility specializes in aquatic therapy for clients with a variety of conditions, including arthritis, back pain, stroke, joint replacement and coordination problems.
The Water Works pool is 20 feet by 47 feet, with straight sides all around and a hydraulic chair lift to help patients in and out of the water. It's a Medicare-licensed aquatic outpatient rehabilitation facility, the first in Florida.
People enjoy working out in the water, and the more they enjoy the program, the more likely they are to stick with it, Devol says. The idea of exercising in warm water - which relaxes the muscles, helps eliminate spasms and increases blood flow to tissues - is attractive to patients who might find a normal rehabilitation routine tedious or painful.
Patients who are coming back after joint reconstruction or other surgery find they have less pain when they exercise in the water, Devol adds. When the water is chest level, about 50 percent of a person's body weight is supported, which is especially helpful for those who have had back surgery or back pain.
The water workout also is popular for those with sports injuries, such as muscle tears. An underwater treadmill allows patients to practice their gait or work on weak leg muscles. Or they can work on building back their strength through resistance training - not by lifting weights, but by pushing floats under the water.
While most Water Works patients are older adults, children also come to the facility for medical problems that range from injuries from a car accident to cerebral palsy. Unless they're afraid of the water, patients generally are open to the water therapy, says Dr. Sean Kelly, a Naples, Fla., physician who specializes in physical medicine and rehabilitation.
Although the benefits of a "wet" rehabilitation program are many and are well known in Europe, Devol says, in this country it has only become popular in the past few years.
"When I was in school 19 years ago, they didn't talk about water therapy," she says.
But now she receives calls from physical therapy students who want to work aquatic rehabilitation into their clinical rotation. And the aquatic section of the American Physical Therapy Association is the fastest-growing, she adds.
Insurance plans will cover the cost of the water rehabilitation program if it's doctor-prescribed, and most Water Works clients are referred by their physicians.
Patients usually come two to three times a week for an individualized workout program. There are three full-time physical therapists on staff and one part-time physical therapist; two massage therapists; one physical therapy assistant; and three rehabilitation technicians. A speech therapist and occupational therapist also are on contract.
There's always a lifeguard on duty, and most patients get one-on-one attention in the water. "I don't think anybody ever feels rushed," Moore says.
Each patient's rehabilitation program is put on a laminated card that they take into the pool with them, and because many people have a recreational pool available to them, they can continue to do the exercises after their rehabilitation here is over.
"But we often have trouble discharging patients," Moore says. "They just don't want to leave."