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Thursday, May 24, 2018
Best Possible Outcomes
by Felecia Fischell, BS 

The excitement and the anticipation of attending the fifth International Conference on Evidence Based Aquatic Therapies (ICEBAT) had been growing inside of me for months.  Unsure who I’d meet, but, certain I needed to be there, my excitement multiplied when names like Bruce Becker and Johan Lambeck appeared in the “line-up” of keynote speakers.

Bruce I’d come to know through more than ten years of his posts in the “elist” of an aquatic association’s email bulletin board.  My library of these messages comprised a lot of very useful information about the medical considerations and justifications in aquatic practices. Many of those messages saved were answers to practitioners from Dr. Becker.

Johan I’d come to know about more recently through International Aquatics Facebook links and I quickly understood that he was a pillar in the international research and training circuits.

For me, best possible outcomes for my patients/patrons meant I would have significant opportunity to learn empirical evidence from the some of the latest published studies and have face-to-face conversations with aquatic leaders like these two industry icons. Not only would I learn but, as in past professional aquatic conferences, I could reaffirm what I’d already put into practice with my patrons.

To my amazement, the 5th ICEBAT in Las Vegas April 14-16 proved even more special as I discovered more international researchers and industry leaders whom I’d not yet known after 27 years in practice. People in my own backyard and abroad came together in a very intimate gathering at the Alexis Park Resort for 3 long days of lecture and practicum that widened my eyes to possibilities beyond my greatest expectations.

Keynote speakers from various countries presented their findings on such matters as end-stage dementia, neural plasticity and motor learning, therapies for end of life quality, appropriate applications for children with CP and cartilage health and repair.  Oral presenters and poster presentations were intermingled with pool practicums and equipment demonstrations that, in some cases were new to many and in some cases familiar to me.  What wasn’t familiar were vendors from other countries offering products and services like dolphin encounters as a therapy or in-water photography.  Familiar faces I’d met in other domestic aquatic conferences mingled among the international leaders and shared knowledge and experiences gave a wonderful cross-section of perspectives likely to have paralleled two major conferences typically held in May in Florida every year…a time which I could never attend due to personal obligations.

What I gleaned from all the presentations and research was simple:  the industry requires unification and some concrete basis of “assumed competency” and “common knowledge” that bridges between the practitioner (me), the trainer like Mary Wykle and Kiki Dickinson and the researchers like Ben Waller and Johan Lambeck.

To start, Paula Geigle’s opening keynote address emphasized a need for recording the specific parameters of dosing: a consistent and comprehensive documentation of what is taught in the water and how.  Specifically, each professional needs to record the following:

  • Cadence
  • Duration
  • Frequency
  • Intensity
  • Mode
  • Water Depth and temperature

At the top of this list, “cadence.”  Is it coincidence that Paula referenced it first and I find it THE most prominent controllable parameter of consistency for the participant?  Paula’s leading bullet was an affirmation for me that I continue to “set the pace” for my participant(s) by establishing the rhythm or speed either by music or verbal counting cue and sometimes both when cuing half-speed or double time.

Other keynotes spoke about using a metronome, but as a practitioner, in a true natatorium like a YMCA or Community Center, a metronome would likely be inaudible…especially to seniors!  The bass thump of 135 bpm Dynamix CD, however, would ultimately serve as my backdrop for tempo, half-tempo and double or even quadruple time, depending upon the moves.

Cadence…. really? What percentage of researchers know to focus on cadence?  Furthermore, how does it play in the parameter of intensity?  What then happens to the range of motion? Or level of exertion/RPE or HR?  What happens when you keep the cadence but perform the move a foot deeper below the surface?

Likewise, how many practitioners who were exercise certified in the early 1990s learned not to use sweeping arm movements through water and then overhead out of water and feel confused by the advent and endorsement of Aqua Zumba?

As an Ai Chi instructor, I have grown so holistically through this practice of coordinating breath with movement that I now incorporate it in ALL my teachings from personal training to boot camp or HIIT and deep water running or arthritis and mobility instruction.  How can a researcher in the industry lead an Ai Chi practicum and state that breath doesn’t matter?

Another practicum leader stated that he didn’t believe in stretching.  It has been an integral part of my cool down phase of instruction in virtually every class or personal training I have led in 27 years of practice.     I have no clinical data to back up my experience in leading arthritis classes, but, I feel certain that a stretch is imperative in this population.  Where is the evidence to support such a belief that it isn’t important?

Bottom line:  This conference will reconvene in two years in China.  Start saving now.   In a worldwide perspective, all can contribute, learn and be made stronger in the profession.  The intimacy of the gathering makes it somewhat elitist but also empowering.  In this setting, relationships can be established that foster progress for the industry in the world, not just in our country or region.  For us in the US, it seems we need to ‘catch up’ with some other countries who are leading our industry.  So too, I hope that 2020 vendors will include new players in the field like float therapy pools and Aquabases.  With the advent of full face mask snorkels, how many non-swimmers could overcome their fear of water?

 In the meantime, there is much work to be done by the practitioners.  If you are a professional in this pain management, quality of life sustaining field of aquatics, accept my call to action as gleaned from this conference…. document what you do!  Start today… develop your own case studies using the parameters of dosing outlined in Paula Geigle’s bullets.  Submit your findings to ICEBAT 2020.    Help the industry solidify the common knowledge and universal understanding to give our researchers the basis of direction for their next clinical trial and compilation of our collective experiential knowledge.

Aquatics is not only a great equalizer, it is more than pain management and sustaining mobility.  Aquatics heals and it strengthens.   Aquatics often offsets the progression of chronic conditions delivering results exceeding all other alternative modes.   Our industry needs to work together to enlighten the world to our secretive, undocumented realities and achieve the collective common goal of our patients’ Best Possible Outcomes.

Come to ICEBAT 2020 and share your experience, be validated in your knowledge and experience and bring your patrons to a higher level of Best Possible Outcomes for having been there.  I’ll be watching for you!



Twenty-eight years as a professional aquatic practitioner and industry maverick, Felecia Fischell took it upon herself to share with us her perceptions of attending the 5th International Conference on Evidence Based Aquatics (ICEBAT) held in Las Vegas in April.  A self-proclaimed "fish out of water," she has positioned herself in the in industry as a practitioner driven to attain "Best Possible Outcomes" for each patient, patron or professional in our growing field.  First teaching and then soon becoming AEA certified in 1994, she has written articles for Akwa, Global Health and Aging and ATRI and has even filed a patent for a waterproof wireless sound system for aquatic classes, ski teams and crew teams.  She has drafted edits for training manuals, reviewed professional aquatic textbooks, written in-services, marketed and sold aquatic programs and done real-time class design on cruise ships and in colleges and a regional YMCA.  She is AEA, ATRI, WSI and SSI certified with a BS in Human Ecology.  Now as an "empty-nester" she aims to solidify unification of our industry and travel the world expanding her following of aquatic enthusiasts who seek to improve their health and well-being.

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