Fit four paws
The ultimate goals of physiotherapy are similar for humans and animals. One of the major differences within the species is that with human physiotherapy the aim is generally to encourage movement through knowledge and guidance, whereas with animals, the aim is to restrict undesired and harmful movement and encourage beneficial movement and confidence.
A human can be told to rest a limb or muscle group, whereas an animal is often reluctant to cage rest and due to most animals skilful ability to adapt, quite often they will learn to compensate rather move correctly. Therefore the overall goals for animal physiotherapy are
a) To promote effective healing
b) To return the animal back to its previous level of exercise or work
c) To return to pain free movement
d) To minimise compensatory adaptation
e) To reduce secondary loss of function
f) To encourage quality movement
PEMF, or pulsed magnetic field therapy, can be used for soft tissue repair, reduction of inflammation and bone healing.
Some of the benefits of using PEMF are:-
Strengthening and conditioning
Improvement of circulation by vasodilation
Improves the synthesis of protein in the cells
The animal’s body consists of an incredible number of cells. These cells function by using electricity. Normal cells have a rest, or basic, potential that is necessary for cellular metabolism. Diseased cells have an altered rest state and this altered state can result in the attraction of more positive sodium ions into the cell and the movement of negative trace elements and proteins out of the cell. The net result is that liquid is attracted into the interstitial area and swelling or oedema occurs.
If these cells come into contact with an area of pulsating magnetic fields, the ions surrounding them will be influenced by the rhythm of the pulsation. The PEMF encourages the ions to return to their normal potential at an accelerated rate. This assists in reducing swelling and promoting healing.
Ultrasound therapy is the use of high frequency sound waves to promote an effect in the tissues of the body.
These waves are undetectable to the human ear and are transmitted from the ultrasound "head", through gel, into the body.
The benefits of ultrasound include
- increased blood flow
- a pain killing effect
- reduction in swelling
- breakdown of adhesions
- release of tissue spasms
- increase in joint mobility
- softening of scar tissue
- releasing contracted tendons
- treatment of soft tissue injuries
- increasing elasticity of muscles before stretching
There are two main types of electro-stimulation, macro and micro - current stimulation.
TENS and TES are commonly used for pain relief and for increasing muscle tone and strength.
Benefits of ES include
- increase of muscle strength
- increase in tone and re-education of muscle action
- increase in blood supply
- increase in muscle reaction speed
- increase in suppleness
- reduction in pain
- reduction in muscle spasm
- reduction of swelling
Phototherapy is the use of light to promote an effect on the superficial body tissues.
The light is applied to the skin by a machine and hand held applicator.
There are two main types of phototherapy, red and blue light.
Red light therapy consists of infra red and visible red light together which is effective in wound healing and cell proliferation.
If used over acupuncture points, the red light can stimulate endomorphic release and promote relaxation.
Blue light therapy can be applied to acute wounds and surgery incisions and has an effective antibacterial effect and promotes fast healing.
Thermotherapy is the therapeutic use of physical agents or means to heat or cool the body. It tends to work on a more superficial level than PEMF but has the advantage that it can be used at home with little cost.
The use of heat to soothe injuries is a natural instinct that many species has. The first thing that we do as humans when we receive an injury is to hold/heat the affected part. Similarly with cold, for centuries affected areas have been held under running water or bowls of water to soothe the pain.
Hot and cold therapy can be delivered to the body by many means including, dry hot/cool packs, wet hot/cool compresses, infrared, ice massage, contrast baths, vapour sprays, wheat wraps. They tend to influence superficial tissue to a depth of around 1cm
Heat therapy is usually used to treat chronic degenerative diseases, relax soft tissues and to warm up the body prior to exercise and stretching. It can be beneficial in cases of arthritis, muscles spasms tendon/ligament strains and spondylitis
By applying heat to the superficial tissues of the body, mediators are released such as histamine and prostaglandins which stimulate vasodilation. Pain receptors can be influenced to reduce nociceptor activity. Heat also increases the extensibility of fibrous tissue such as ligaments, tendons and scar tissue. This can lead to muscle relaxation and the chance to apply stretching and range of motion exercises.
The tissue temperature should be raised by at least3 degrees to be affective. Raising the temperature by over 45 degrees will have a detrimental effect.
Cold therapy can help with arthritis, tendonitis, post op pain management and the reduction of inflammation
Applying cold leads to vasoconstriction which will reduce the blood flow in that area; this will also help reduce swelling. Cold will reduce cell metabolism. It can induce the hunting effect which is where vasodilation occurs around 20-40 minutes after the cold is removed. Pain messages are affected by the slower neural impulses and this can also help relieve muscle spasms
Complete rest following most surgeries is known to be detrimental to quality repair as tissue tends to heal shortened and scarred and function and strength can be compensated. Immobilization for longer than four weeks will result in deleterious effects on the joints, some of which can be permanent.
Therapeutic exercises are a non-invasive form of treatment which may be effective for the management of many neurological and musculoskeletal conditions. They provide a suitable way to introduce controlled stimulation to the tissues around the surgery site and assist in a full return to function. Therapeutic exercises can be carried out alongside machine and medication usage and some will be suitable for the owner’s application. The treatment considerations and choice of exercises vary with each stage of tissue repair. Therefore the patient should be monitored regularly for improvement or secondary problems and the treatment routine adapted. Overdoing the exercises in frequency or intensity could set the repair stage back. Any exercises suggested for owner participation should be displayed and the owner should have full knowledge of correct application and problems to watch out for. Therapeutic exercise selection will depend on the injury repair; status of the animal, ability of the animal and any unrelated conditions (such as obesity etc.) but all methods should be controlled, safe and effective. Ease of application,compliance of the owner and availability of equipment are also factors to consider. The exercises should also be enjoyable for the animal to prevent boredom and non-cooperation. The kind of animal being treated should also be considered. Dogs are usually happy to work for treats but cats may need a different approach and exercises which utilise their natural behaviours may be needed, for example, suspending string up high to encourage the cat to stand on its hind legs and stretch.
Therapeutic exercises are intended to
a) Improve muscle mass, tone and strength
b) Re-educate neurological pathways
c) Return to an active pain free
) Reduce the risk of further injury
e) Improve balance and stability
f) Improve cardio vascular efficiency
g) Give confidence in limb usage
h) Improve the rate of recovery
The types and methods of therapeutic exercises can be split into several key groups.
Passive movements - awareness and stretching – these include active and recumbent limb movements such as bicycling and reflex testing.
Stretching exercises- can include both passive and active moves and are not confined to limbs as lateral spinal flexion can encourage weight transference onto affected limbs and strengthen spinal and abdominal muscles.
Awareness can be applied to neurological cases by assisted weight shift where the animal is supported but stimulated to move his own foot to the correct position after being moved sideways.
Weight bearing - these can range from assisted standing to active weight distribution exercises. Support can
be given by slings, swiss balls or carts.
Balance and proprioceptive – this group includes weight shifting, wheel-barrowing and the use of wobble boards and swiss balls to improve stability and coordination.
Weight shifting - ranges from adjusting the centre of gravity when rolled on a swiss ball for a non-walking patient, to active standing and walking with selected limbs held by the physiotherapist to encourage weight transference onto the affected limb or limbs.
Exercise which develops proprioceptive skills can range from wraps and tape attached to the distal feet for awareness, to negotiating tests such as walking over poles and uneven surfaces.
Strength exercises - these can be used alongside weight bearing exercises and can include the use of stretch bands, limb and body weights. These exercises also include static exercises such as sit-to-stand and down-to-stand.
Active stamina and perceptive skills – for able patients walking over different surfaces, gradients and stairs can improve strength and stamina. Inclines load the hind limbs and can be used to tone and strengthen muscles. Also the use of treadmills, cavaletti and weave poles can assist in joint suppleness, flexion, and extension and stride length. Different surfaces can include long grass, sand, shallow water or pebbles, all of which will require core stability and understanding of unstable surfaces. Walking in figure 8s, decreasing circles and obedience square turns will assist in lateral movement and adduction and abduction of limbs.
Coordination and control skills – these can often be carried out by dog owners and include giving paw, waving, begging, weaving through legs, walking backwards, box standing and dancing.
Aquatic therapy – hydro-pools and hydro-treadmill exercises can be used to provide resistance to soft tissue and joints while supported in water. These exercises can improve joint ROM, stamina, muscle tone and strength.