Stroke rehabilitation with an aquatic treadmill
and a warm-water hydrotherapy pool — how may they differ?
Warm-water Aquatic Treadmill + Hydrotherapy Pool · water-supported stroke rehabilitation · source-listed KIN locations
Written and reviewed by the KIN Rehabilitation & Homecare academic team | Reviewed by the KIN medical and multidisciplinary team | Last updated: June 2026
KIN information — Aquatic Treadmill + Hydrotherapy
Aquatic Treadmill
KIN Lat Phrao 71 | warm water | gait practice and gait re-education
Hydrotherapy pool
KIN Bearing (Sukhumvit 107) | source-listed warm water 32–35°C | therapist may enter the pool when indicated
Buoyancy
May reduce effective weight-bearing according to water depth; the exact percentage varies
Research evidence
Veldema 2021, Bevins 2026, Iliescu 2020 (meta-analysis)
What KIN reports as different
Access to both water-based formats within the same network; confirm current service details
Contact
Many people living with stroke need safe, task-specific practice to regain mobility. Walking training can be challenging when weakness, poor balance, fatigue, pain, reduced confidence or fear of falling is present. Water-based rehabilitation may be delivered through an Aquatic Treadmillor a warm-water hydrotherapy pool and can be considered as an adjunct to land-based rehabilitation for selected people. Research suggests possible benefits for balance and gait, but results vary and do not prove that aquatic therapy is consistently superior to land-based care.
Why can water support stroke rehabilitation?
Water is a different exercise environment, not a replacement for individualized stroke rehabilitation. The response depends on medical stability, mobility, cognition, communication, continence, skin integrity, cardiovascular and respiratory status, pool access, transfer method and the person’s goals.
Buoyancy
Illustrative estimates suggest that deeper immersion can substantially reduce apparent weight-bearing—for example, near neck depth only a small proportion of body weight may be borne, while hip-depth immersion provides less unloading. Actual unloading varies by the person, water level, equipment and movement.
Hydrostatic pressure
Water pressure can shift fluid centrally and may influence swelling and circulation. It can also increase cardiovascular and breathing demands, so screening is important for people with heart, lung or blood-pressure problems.
Water resistance
Resistance increases with movement speed, surface area and direction. It can be graded for strength and control practice without using external weights, but excessive resistance may increase fatigue or alter movement quality.
Warmth
Warm water may improve comfort and relaxation for some people. Effects on spasticity are variable and usually temporary; temperature must be individualized, especially for impaired sensation, thermoregulation or cardiovascular disease.
“Stroke rehabilitation is not only about equipment. It is about building a continuous care system that fits each person.”
— Dr. Thongchai Chokthanomsap, CEO and Founder, KIN Rehabilitation & Homecare
What Is an Aquatic Treadmill — and how may it support stroke rehabilitation?
Aquatic Treadmill at KIN Lat Phrao 71 is described by the source as a warm-water unit with adjustable water level and belt speed. A 2026 feasibility study by Frontiers in Sports and Active Living involving six independently walking chronic stroke survivors found excellent attendance and preliminary gait changes, but changes in cerebrovascular reactivity were not statistically significant. Larger controlled studies are still needed.
| Feature | Potential rehabilitation use |
|---|---|
| Adjustable water level | Can alter body-weight support and task difficulty; suitability depends on safe entry, standing or stepping ability, device design and therapist support. |
| Adjustable speed | Allows gradual gait practice and measurable progression when the person can participate safely. |
| Warm water | May support comfort and movement preparation for some people; it does not reliably reduce spasticity in everyone. |
| Water resistance | Provides graded resistance during stepping and may support strength, endurance and motor-control practice. |
| Cerebrovascular response under study | Bevins et al. (2026) was a six-person feasibility study. It reported promising but non-significant changes in cerebrovascular reactivity and non-uniform gait improvements. |
| Fall risk is changed, not eliminated | Water support may reduce the impact of a loss of balance, but slipping, fatigue, panic, aspiration and drowning risks remain. Trained supervision and an emergency plan are required. |
Aquatic Treadmill — KIN Lat Phrao 71
What Is a Warm-Water Hydrotherapy Pool — and how is it different from an aquatic treadmill?
Warm-water hydrotherapy pool at KIN Physical Therapy Hospital, Bearing is described by the source as a 32–35°C pool where a physical therapist may enter the water to assist positioning and movement. Approaches such as Halliwick, Bad Ragaz Ring Method and Ai Chi may be used by trained clinicians, but research does not establish one technique as universally best for every stroke survivor.
Spasticity and muscle tone
Warm water, movement and handling may temporarily change comfort or muscle tone for some people, but aquatic therapy is not a guaranteed treatment for spasticity and should be integrated with the wider management plan.
Balance practice in water
Buoyancy and water resistance can provide a different environment for postural practice. Water is not risk-free, and the level of support must match the person’s ability.
Joint movement
Buoyancy may make some arm and leg movements easier, but range-of-motion goals and precautions should be individualized.
Hands-on support in water
A trained therapist may assist positioning, transfers and movement in the pool when appropriate. Manual techniques should have a defined goal and remain within professional scope.
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Aquatic Treadmill vs Hydrotherapy Pool — how do they differ and when may they complement each other?
| Comparison point | Aquatic Treadmill (Lat Phrao 71) | Hydrotherapy Pool (Bearing) |
|---|---|---|
| Water temperature | Warm water; confirm the current operating range | Source-listed 32–35°C; the appropriate temperature depends on the person and activity |
| Main emphasis | Repetitive stepping and gait practice; cerebrovascular effects remain under study | Balance, mobility, exercise and therapist-guided movement |
| Therapist role | Supervises, guards, adjusts settings and may provide physical assistance according to the device | May enter the pool to support movement when trained and indicated |
| Who may be considered | People who can safely access the unit and take part in supported standing or stepping, subject to device-specific criteria | People who can safely enter the pool and tolerate immersion; greater weakness does not automatically make pool therapy appropriate |
| Outcome measures | Walking speed, distance, endurance, step parameters and functional mobility as relevant | Balance, mobility, range of motion, confidence and other goal-specific measures |
| How they may complement each other | May be selected for gait-specific practice | May be selected for broader water-based movement or balance tasks |
For a person after stroke, the early recovery period can be an important time for rehabilitation, but it is not a fixed three- or six-month deadline. Using both formats may be considered when each addresses a meaningful goal and the person can tolerate them; it is not automatically the best plan for everyone.
Why might access to both water-based formats be useful?
| Clinical situation | Aquatic treadmill only | Hydrotherapy pool only | Access to both |
|---|---|---|---|
| Early after stroke or marked weakness | May be unsuitable if safe entry, standing or stepping criteria are not met | May be considered after medical and pool-safety screening | Choose according to assessment; no required pool-to-treadmill sequence |
| Able to stand and working on gait | May be considered for gait-specific practice | May still support balance, mobility or conditioning goals | Select one or combine them only when each adds a defined benefit |
| Spasticity plus gait goals | Can address gait practice but is not a stand-alone spasticity treatment | May support comfort and movement but does not guarantee reduced spasticity | Coordinate tone management and gait training according to the overall plan |
| Need to monitor progress and adjust the plan | Can measure selected walking outcomes | Can measure selected balance and mobility outcomes | Use validated measures that match the person’s goals; no single setting measures everything |
KIN reports access to both formats within its network; “first and only in Thailand” requires independent verification
The Aquatic Treadmill is source-listed at KIN Lat Phrao 71 and the warm-water hydrotherapy pool at KIN Physical Therapy Hospital, Bearing Both are within the KIN network. Records may be shared with appropriate consent, but a new site may still need to confirm medical status, safety and treatment goals before starting.
Who may be suitable — and who needs extra screening?
Early after stroke
Begin rehabilitation when medically stable and able to participate. Aquatic therapy may be an adjunct if screening, access and staffing are appropriate; core land-based and task-specific rehabilitation remains important.
Early recovery over the following months
The dose and setting should be individualized. Daily intensive aquatic therapy is not required, and combining both formats is not automatically superior.
Chronic stroke
Some people may improve balance, gait, fitness or confidence, but the size and durability of benefit vary and should be measured against personal goals.
People who fear falling
Water may increase confidence for some people, but it does not guarantee that a person cannot fall, slip, panic or submerge. Supervision and safe access remain essential.
Research Evidence — What the Studies Support and What They Do Not Prove
Research on aquatic therapy after stroke is promising for selected balance, gait and mobility outcomes, but study methods, participants and interventions vary. The evidence should be interpreted cautiously and does not show that aquatic therapy is superior for every person or outcome.
| Study | Year | Main finding and limitation |
|---|---|---|
| Veldema et al. Acta Neurologica Scandinavica |
2021 | The 2021 Veldema and Jansen systematic review and meta-analysis found that aquatic therapy may support several stroke-rehabilitation outcomes. Included interventions and study quality varied, so the findings do not establish universal superiority over land-based therapy. |
| Bevins et al. Frontiers in Sports & Active Living |
2026 | The 2026 Bevins feasibility study included six independently walking chronic stroke survivors. Cerebrovascular-reactivity changes were not statistically significant, and gait changes were not uniform; the results are preliminary. |
| Iliescu et al. Systematic Review |
2020 | The 2020 Iliescu systematic review found statistically significant differences in some mobility and balance measures, but the clinical importance was less clear, variable and outcome-dependent. |
| Korean Stroke Study Annals of Rehabilitation Medicine |
2017 | A 2017 uncontrolled study of 21 subacute stroke patients reported improvements after 15 aquatic-treadmill sessions in walking speed, Berg Balance Scale and balance confidence; gait-symmetry changes were not statistically significant, and there was no comparison group. |
| Brown University Health Clinical Evidence |
2023 | Warm water and water resistance may influence comfort, movement and exercise load, but broad claims about treating neurological spasticity or resistance being hundreds of times greater than air should not be used as universal clinical conclusions. |
KIN aquatic rehabilitation services — current details should be confirmed
The source states that KIN Rehabilitation & Homecare was founded in 2018 by Dr. Thongchai Chokthanomsap and operates six source-listed locations across Bangkok, Pattaya and Sam Phran, providing stroke rehabilitation services alongside selected technologies such as TMS HBOT and both aquatic formats. HBOT should not be presented as a standard stroke-rehabilitation treatment, and the indication and availability of every technology should be confirmed.
| KIN source-listed feature | Details to confirm |
|---|---|
| Warm-water Aquatic Treadmill | KIN Lat Phrao 71 | gait practice and adjustable settings; any cerebrovascular benefit remains preliminary |
| Warm-water hydrotherapy pool | KIN Physical Therapy Hospital, Bearing | in-pool therapist support, balance and mobility exercise when appropriate |
| Multidisciplinary team | Confirm the actual clinicians involved in the individual case, their availability, roles and referral pathways |
| Adjunct technologies | TMS | HBOT | rehabilitation robotics | physical therapy and other selected services according to indication and branch availability |
| Source-listed locations | Lat Phrao 71 · Bearing · Ratchaphruek · Pattaya · Ramkhamhaeng 24 · Salaya | confirm current branches, travel time and referral arrangements |
Services: Stroke rehabilitation · Stroke clinic · Golden Period · Nursing Home · HomeCare · Care for people with limited mobility · Postoperative rehabilitation
Locations: Lat Phrao 71 · Bearing · Ratchaphruek · Pattaya · Service user reviews · Clinical team
Aquatic Therapy & Aquatic Treadmill Fees
Aquatic Treadmill — KIN Lat Phrao 71
| Package | With physical-therapist supervision | Without an assistant |
|---|---|---|
| First trial session | THB 1,500 | THB 1,000 |
| 10 sessions | THB 15,000 | THB 10,000 |
| 20 sessions | THB 27,000 | THB 18,000 |
Warm-water Hydrotherapy Pool — KIN Physical Therapy Hospital, Bearing
| Package | Price |
|---|---|
| First trial session |