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Physiotherapy and rehabilitation

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Abstract

Physiotherapy is involved with physical function, and physiotherapists regard movement and physical potential to be central to the health and well being of individuals. It is a ‘hands-on’ science-based healthcare profession concerned with the assessment, diagnosis and treatment of disease and disability through physical means. It is based upon the principles of medical science, and is generally held to be within the sphere of conventional (rather than alternative) medicine. Human physiotherapy is an internationally recognized discipline, and the positive benefits of physiotherapeutic intervention have been well documented. This chapter explains Veterinary physiotherapy; Legal restrictions; Role of the veterinary nurse; Indications for physiotherapy; Modalities and techniques; Physiotherapy in specific situations;

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Figures

Image of 4.2
4.2 The overlapping roles of the veterinary team involved in physiotherapy and rehabilitation.
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4.4 Effleurage massage. The effect of effleurage massage. As the hands exert distal to proximal pressure on the limb, venous blood is mechanically pushed towards the heart, increasing venous return. Valves in the veins prevent blood backflow. The lymphatic vessels also have valves, and effleurage moves lymph in a similar way towards the lymph nodes. As lymph is moved proximally, excess interstitial fluid is drawn into the lymph vessel, thereby reducing oedema in the distal limb. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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4.5 Kneading can be carried out using the heel of the hand or fingertips to apply the pressure. Pressure is applied and then released as the hands move in circles around the area being massaged. = Direction of hand movement; = Pressure applied; = Pressure released as hand glides over surface.
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4.6 Wringing massage.
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4.7 Skin rolling massage.
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4.8 Hacking massage.
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4.9 Shaking massage.
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4.11 Cold therapy using a cold compression unit. Once disconnected from the water container and tubing the animal is able to exercise with the sleeve in place.
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4.14 In the UK hydrotherapy is most commonly carried out in a pool. Using toys can increase motivation and enjoyment of the experience for the dog. Hydrotherapy can also take place on an underwater treadmill.
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4.15 Effect of water depth on effective bodyweight. Dogs standing on dry land have an effective bodyweight of 100%. As water level rises, the effective bodyweight drops. With water at the level of the hock, the limbs are bearing 91% of the bodyweight; at the level of the stifle, the limbs are bearing 85% of the bodyweight; at the level of the hip, the effective bodyweight is reduced to 38% ( ). Underwater treadmills can use this principle to good effect. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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4.16 Effect of water pressure. Dogs standing or swimming in water will experience increased pressure on those parts of the body that are deeper in the water. This effectively provides an effleurage effect by pushing swellings proximally and can be a useful method of controlling oedema. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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4.18 Laser therapy. A dog receiving laser therapy, via a cluster probe, to its gluteal muscles. Note the operator’s is wearing protective glasses. A variety of single (right) and cluster (left) probes are available for most machines.
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4.19 Application of neuromuscular electrical nerve stimulation to quadriceps and hamstrings, with the aim of achieving co-contraction of the two muscle groups.
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4.25 Postural drainage positions for the canine patient (area of the lung to be cleared: position to be adopted). Lateral segment of the left caudal lung lobe: left lateral recumbency. Hind end elevated 40 degrees. Left and right caudodorsal lung fields: sternal recumbency. Hind end elevated 40 degrees. Left and right caudoventral lung fields: dorsal recumbency. Hind end elevated 40 degrees. Left and right cranioventral lung fields: dorsal recumbency. Front end elevated 40 degrees. Left and right craniodorsal lung fields: sternal recumbency. Front end elevated 40 degrees. Right middle lung lobe: dorsal recumbency. A pillow under the right thorax raises the right side higher than the left. Hind end elevated 40 degrees and front end rotated one quarter turn to the left. Lateral segment of the right caudal lung lobe: right lateral recumbency. Hind end elevated 40 degrees. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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4.26 Physiotherapy for cats. Cats can benefit from physiotherapy treatments such as passive movements and massage. Cats are generally less tolerant of restrictive handling, but cooperation can be encouraged using toys and treats. Exercises such as dancing can help with hindlimb strengthening.
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4.27 This cart allows the dog freedom and independence whilst providing support for weakened hindlimbs. (Reproduced from the )
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4.28 A towel or a specially designed harness can provide effective support to the weak animal.
Image of Passive movement of the stifle joint. The therapist takes the joint into full extension.
Passive movement of the stifle joint. The therapist takes the joint into full extension. Passive movement of the stifle joint. The therapist takes the joint into full extension.
Image of Passive movements in functional patterns. The limb is moved around in a bicycling fashion, simulating the normal gait pattern.
Passive movements in functional patterns. The limb is moved around in a bicycling fashion, simulating the normal gait pattern. Passive movements in functional patterns. The limb is moved around in a bicycling fashion, simulating the normal gait pattern.
Image of Stretch being carried out to the carpal extensor muscles.
Stretch being carried out to the carpal extensor muscles. Stretch being carried out to the carpal extensor muscles.
Image of Two-joint muscle stretching. Combined stretch into hip flexion and stifle extension being carried out to the hamstrings.
Two-joint muscle stretching. Combined stretch into hip flexion and stifle extension being carried out to the hamstrings. Two-joint muscle stretching. Combined stretch into hip flexion and stifle extension being carried out to the hamstrings.
Image of Gym balls and physiotherapy rolls can help an animal achieve functional postures and movements, such as standing.
Gym balls and physiotherapy rolls can help an animal achieve functional postures and movements, such as standing. Gym balls and physiotherapy rolls can help an animal achieve functional postures and movements, such as standing.
Image of Sit to stand for a large dog.
Sit to stand for a large dog. Sit to stand for a large dog.
Image of Wheelbarrowing: a good exercise for forelimb strengthening.
Wheelbarrowing: a good exercise for forelimb strengthening. Wheelbarrowing: a good exercise for forelimb strengthening.
Image of Dancing: a good exercise for hindlimb strengthening.
Dancing: a good exercise for hindlimb strengthening. Dancing: a good exercise for hindlimb strengthening.
Image of Assisted standing. A towel or harness can provide a weak animal with the opportunity to mobilize. Assisted standing and walking can help with motivation in addition to strengthening limb muscles and improving balance.
Assisted standing. A towel or harness can provide a weak animal with the opportunity to mobilize. Assisted standing and walking can help with motivation in addition to strengthening limb muscles and improving balance. Assisted standing. A towel or harness can provide a weak animal with the opportunity to mobilize. Assisted standing and walking can help with motivation in addition to strengthening limb muscles and improving balance.
Image of Weight shifting. The dog is gently pushed in different directions to stimulate balance reactions.
Weight shifting. The dog is gently pushed in different directions to stimulate balance reactions. Weight shifting. The dog is gently pushed in different directions to stimulate balance reactions.
Image of Three-leg standing. Raising one limb forces the dog to adjust its weight bearing through the remaining limbs, and helps with strength, balance and proprioception.
Three-leg standing. Raising one limb forces the dog to adjust its weight bearing through the remaining limbs, and helps with strength, balance and proprioception. Three-leg standing. Raising one limb forces the dog to adjust its weight bearing through the remaining limbs, and helps with strength, balance and proprioception.
Image of Treating/baiting. Treats can be used effectively to improve spinal mobility, balance and weight bearing. With the treat held to the side, the spine laterally flexes and weight is shifted to the contralateral limbs.
Treating/baiting. Treats can be used effectively to improve spinal mobility, balance and weight bearing. With the treat held to the side, the spine laterally flexes and weight is shifted to the contralateral limbs. Treating/baiting. Treats can be used effectively to improve spinal mobility, balance and weight bearing. With the treat held to the side, the spine laterally flexes and weight is shifted to the contralateral limbs.
Image of Balance pads/wobble cushions. Very useful equipment for the re-education of balance and proprioception.
Balance pads/wobble cushions. Very useful equipment for the re-education of balance and proprioception. Balance pads/wobble cushions. Very useful equipment for the re-education of balance and proprioception.
Image of Weaving around obstacles helps improve balance, weight shifting and spinal lateral flexion. Increasing the difficulty of the course improves the animal’s ability to cope.
Weaving around obstacles helps improve balance, weight shifting and spinal lateral flexion. Increasing the difficulty of the course improves the animal’s ability to cope. Weaving around obstacles helps improve balance, weight shifting and spinal lateral flexion. Increasing the difficulty of the course improves the animal’s ability to cope.
Image of Step overs. Stepping over obstacles is a useful exercise to improve stride length, balance and joint ROM. The height and width of the obstacles can be increased to encourage greater joint flexion and extension, but take care not to raise them too high or the animal may simply jump over them.
Step overs. Stepping over obstacles is a useful exercise to improve stride length, balance and joint ROM. The height and width of the obstacles can be increased to encourage greater joint flexion and extension, but take care not to raise them too high or the animal may simply jump over them. Step overs. Stepping over obstacles is a useful exercise to improve stride length, balance and joint ROM. The height and width of the obstacles can be increased to encourage greater joint flexion and extension, but take care not to raise them too high or the animal may simply jump over them.

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