Since 2010, the Americans with Disabilities Act has required all public pools, wading pools and spas to become accessible to all people, no matter their ability. The ADA mandates that large pools with more than 300 linear feet of pool wall should have two accessible means of entry, with at least one pool lift or sloped entry. For smaller pools, with less than 300 linear feet of pool wall, one accessible entry is required.
Pools where a sloped entry isn’t possible can offer an aquatic chair lift instead. An aquatic chair lift is essentially a robotic arm that works as a crane to safely move an individual in and out of the pool.
Bou Lahoud said her first experience swimming was different than before her accident. Her physical therapist carefully lowered Bou Lahoud in the pool with a remote-controlled chair lift.
“I had to tread water harder, I had to put weights on my legs to help keep them under me, and when I was swimming, it was all upper body strength,” she recalled.
“When I saw a recording of me swimming, I laughed because I looked like a frog! My legs were just flinging behind me as I swam,” she said.
The following summers, she incorporated swimming into her therapy routine. She swam, semi-walked in the water and felt “weightless again.”
Nevertheless, Bou Lahoud has visited public community pools without a chair lift.
“That is definitely disappointing because not every patient [with a spinal cord injury] knows how to transfer to the floor and push themselves into the water. That is an unnecessary risk when there is an easy solution!” she maintained.
After hard work and physical therapy, Bou Lahoud has seen significant improvements in her muscles and motor abilities, despite doctors telling her she would never walk again. She can take steps with the help of ankle foot orthopedics braces and a walker.
Elements of access
For Cara Fox, a 35-year-old disability advocate in Montreal, accessibility means more than the means to get in and out of the pool. At a local charity, she worked one-on-one with individuals achieving goals that ranged from brushing their teeth to helping them get a job. When a new indoor pool opened nearby, there were concerns about the facility’s accessibility.
“They had automatic faucets but soap and paper towel holders that were installed out of reach to anyone in a wheelchair,” Fox told MedTruth. “They had automatic doors but only for the door leading into the changeroom. The door to the pool was manual.”
Worse still, the pool’s water chair was in total disrepair due to the salted and chlorinated water. When Fox went to pool management, they told her “a new chair would be too expensive and that if my client needed it to enter the pool they would have to purchase it themselves.”
As a result of this experience, Fox recommends consultations with facilities before deeming them accessible.
“There are many elements of accessibility that do not occur to able-bodied people,” said Fox. With swimming, she said, “We do not think much about how we will get in and out of the pool, but the reality is that if there was a reason we couldn't, we would be effectively barred from that experience. Unfortunately, that is what happens to a lot of people with disabilities.”
It’s essential for folks of all abilities to feel welcome, especially if a place touts itself as being accessible, Fox maintained. She believes staff should be trained and the facility should be monitored for proper maintenance.
“Anything less demonstrates that a person has to sacrifice a part of their dignity in order to participate in a community activity with everyone else,” said Fox.
If a pool isn’t ADA compliant, filing a complaint or a lawsuit can result in an investigation, fines and new accommodations. ADA cases are on the rise, with 10,206 filed in federal courts as of November 2019.
Sensory therapy
For many of the individuals that Fox worked with, swimming was a highlight of their week.
“For some of them, it represented gaining confidence,” and for “many people with autism, the sensation of water is thrilling and delightful and can be a sensory therapy,” she noted.
Aquatic exercise is becoming more popular as a non-conventional therapy for strengthening muscles and encouraging movement, while reducing pain, stiffness and the risk of falling. A 2019 review found the therapy improved the quality of life of patients with Parkinson’s disease and reduced movement issues.
“The old, the young, able-bodied or disabled people can enjoy and reap the benefits of water,” Ingrid Marschner, a physical therapist at Gaylord Specialty Healthcare in Connecticut, told MedTruth.
Buoyancy, viscosity and hydrostatic pressure are unique to water and can improve resistance, activate muscles and maintain blood pressure. And water is beneficial for all types of people — not just those who use chair lifts or need assistance.
Some patients who visit the therapy center haven’t been able to walk in months or even years, Marschner said. The pool allows folks to begin to heal without fear of hurting themselves.
“People who are acclimated to the water are less afraid to fall and have more time to regain their balance since gravity is not pulling them to the floor,” she explained. “Ultimately, the goal is for these skills to be transferred over to the world of gravity.”