Physical Rehabilitation Modalities

Mara on underwater treadmill

Mara on underwater treadmill

Various physical therapy modalities may be prescribed for your pet, depending on the condition being treated. All modalities are available at our Animal Rehabilitation Center.

Custom fitted splints, braces, carts and even prosthetic limbs are available for your pet’s needs. These devices are used to support an injured limb while it is healing, to correct a deformity, to encourage correct limb use or to permanently replace severely injured or missing limbs.

Carts are made especially for your pet for a perfect fit. These carts are used temporarily or permanently for patients who are paralyzed or unable to walk without support.

We can help facilitate fitting and ordering of the carts. www.k9carts.com

lasertherapyLaser therapy repairs tissues through photobiostimulation. The cells in the injured areas use the energy of the laser to aid their healing. The intensity of the laser is less than that of lasers used in surgery.  It is the best modality to be used in cases of injury to the spine or the peripheral nerves. We recommend at least one treatment after any surgery.

The benefits of laser therapy include:

  • Decreased pain from muscle and joint soreness
  • Decreased symptoms of arthritis
  • Decreased muscular spasms
  • Increased blood flow
  • Accelerated wound healing

ultrasound_therapyIn therapeutic ultrasound, an electric current is applied to special crystals causing them to vibrate and emit pressure waves that are absorbed by the tissue. The continuous or pulsed energy produces thermal, mechanical, and chemical effects to the tissues.

Therapeutic ultrasound is commonly used on tendon and muscle injuries, and certain conditions resulting in decreased range of motion.

The benefits of therapeutic ultrasound include:

  • Increased circulation and aid healing
  • Increased elasticity and contractility of muscle fibers (to increase range of motion)
  • Decreased scar tissue
  • Decreased pain and muscle spasm
  • Decreased inflammation
  • Accelerated wound healing

tensTranscutaneous Electrical Neuromuscular Stimulation (TENS) is used mostly for pain management. TENS decreases pain and inflammation by providing a low-level electrical current which disrupts the normal pain perception pathways. The pulse rate and width can be controlled in order to deliver the desired effect. TENS also can be used to stimulate acupuncture points in order to achieve a body-wide response.

Neuromuscular electrical stimulation (NMES) is the administration of a low-level electrical current that decreases swelling, decreases pain and initiates activity of the muscles. It also helps with re-education of the limbs after orthopedic or neurological injury. Frequency, pulse duration, amplitude, waveform, on/off time, ramp and polarity of electrodes are all parameters that can be adjusted when using NMES.  Indications for use of NMES are muscle atrophy, swelling and pain.

NMES results in a muscle contraction. This is achieved by placing electrodes at the beginning and end of the muscle.  These muscle contractions can be used to mimic strength training for animals that are non-weight bearing or have limited use of one muscle or muscle group.  It can be used to prevent atrophy post-surgery or post-injury, or to increase strength for muscles that have been chronically underutilized.  NMES is commonly used in partially-paralyzed  dogs or in dogs who have undergone neurosurgery, before they are weight-bearing and during re-education of ambulation.

treadmillTreadmills are useful for reprogramming your pet’s way of walking (gait) and encouraging the use of an injured limb following surgery or injury. The action of the treadmill belt makes your pet’s strides longer and more exaggerated and also provides some energy so that your pet does not have to do all the work. It also promotes the use of more muscles due to the feeling of instability on the land treadmill versus walking on the ground.

Our land treadmill can be set to move on an incline to shift more weight onto the hind limbs, or on a decline to shift the weight to the forelimbs. It also can be used for reconditioning and weight loss. Inclined treadmill walking may be beneficial for rehabilitating cranial cruciate ligament tear patients because it provides a functional activity that increases knee flexion and quadriceps and hamstring activity with minimal weight force on the joints.

Exercises are an important part of the rehabilitation process and help maintain and improve flexion and extension of joints. These exercises are aimed to improve the flexibility of muscles, tendons and ligaments. They will also improve limb mobility without causing further injuries to the limb or other limbs. Exercises are often devised specifically for each individual patient.

Passive exercise involves the therapist moving your pet’s limbs to achieve a specific goal.  Examples of passive exercise that we perform at the Animal Rehabilitation Center are:

  • Passive range of motion (PROM) exercises to increase nutrition availability at the joint cartilage, stimulate new cartilage production, and increase joint’s range of motion
  • Stretching exercises to increase circulation and muscle flexibility
  • Proprioceptive exercises for muscle re-education and to help the animal know where their feet are in space. This is especially beneficial for animals with neurologic deficits
  • Ambulation exercises to re-educate a partially paralyzed animal to walk
  • Weight-shifting exercises to encourage proper balance and use of affected limbs

Active exercise involves your pet moving himself (with guidance from a human). While active exercise is in many ways are the foundation of physical rehabilitation, the exercises must never cause overuse strain or pain. We will devise an individualized plan for your pet with specific goals and frequent re-evaluations.

Examples of active exercises:

  • Sit-to-stand
  • Dancing
  • Wheelbarrowing
  • Stair climbing
  • Cavaletti rails exercises
  • Theraband exercises
  • Physioball exercises
  • Balance board exercises
  • Weight-shifting exercises

Mobilization can be of great benefit to joints and allows for greater movement. Mobilization of the spinal column can provide relief from spasms and pain. The use of mobilization is important to restore function to many patients. There are grades (degrees) of mobilizations that a rehabilitation practitioner can apply to a joint depending on variables of the joint itself. Compression and distraction of the joints is used with stretching to achieve the desired range of motion without causing pain.

The benefits of therapeutic massage for our pets are similar to those benefits that people receive:

  • Increases circulation to improve healing
  • Decreases pain, swelling and edema
  • Reduces muscle knots and spasms
  • Reduces fibrous tissue and adhesions
  • Improves range of motion
  • Reduces anxiety and stress

Massage can be used for acute or chronic problems, but the pressure and intensity of the massage will vary with the level of pain. Massage stimulates lymphatic drainage and increases blood flow (improving oxygen delivery to tissues) and breaks down scar tissue. Massage also promotes mental and physical relaxation by increasing endogenous production of chemical compounds that help in decreasing pain. Massage therapy can be done concurrently with other modalities like transcutaneous electrical neuromuscular stimulation.

Conditions treated with massage:

  • Tight and contracted tendons
  • Ligaments and muscle injuries
  • Chronic inflammatory conditions
  • Scar tissue and edema
  • Post-surgery or trauma (recovery)

Cryotherapy (application of cold over an injured or healing area of the body):

  • Used during the first phase of inflammation that lasts 48 – 72 hours after an injury
  • Can also be used at any time after 72 hours when animal become suddenly lame after an exercise or exaggerated movement
  • Decreases the speed of nerve conduction, thereby decreasing pain perception
  • Decreases inflammation, and causes constriction of blood and lymph vessels followed by a rebound dilation of the vessels allowing increased blood flow through the injured area
  • When used immediately after surgery or an injury, cryotherapy decreases bleeding at the tissue surface and deep within the tissue
  • Reduces muscle spasms
  • Decreases formation and accumulation of edema (swelling due to excess fluid in tissues)

Heat therapy (application of superficial heat over an injured or healing area of the body):

  • Should not be used earlier than 72 hours post-surgery or post-injury
  • Recommended in many sub-acute or chronic conditions to reduce pain and inflammation and to increase blood flow.
  • Causes dilation of blood vessels, increases blood flow and increases lymphatic and venous drainage
  • Decreases pain
  • Increases beneficial enzyme activity (increase in metabolism which speeds healing)
  • Increases muscle relaxation and stretching capability
  • Increases elasticity of fibrous tissues and helps in stretching of shortened tissues like joint capsule

At Animal Surgical Clinic of Seattle, our underwater treadmill is designed specifically for veterinary use and uses water to support your pet’s weight while walking. It provides the ability to strengthen the patient’s muscles in an environment of little to no pressure on the joints, due to the buoyancy of the water.

Benefits of hydrotherapy on the underwater treadmill:

  • Decreases recovery time after surgery
  • Improves arthritis through low impact exercise
  • Improves cardiovascular fitness
  • Assists with weight loss
  • When used with warm water (85-90 degrees), it also increases flexibility, mobility, and contractility of the muscles, tendons and ligaments.

Swimming where the paws are not touching a surface is considered less specific and does not provide as much joint extension and range of motion as the underwater treadmill.  In addition, the variables (speed, resistance, and depth) can be controlled in an underwater treadmill, allowing for a consistently progressive therapy plan.

The treadmill can be used in the very early stages of re-learning proper movement; the higher the water level, the more of your pet’s weight is supported.  Filling up the water to the shoulder joint level will decrease the dog’s effective weight to only 38%. We frequently observe that a dog that will not use one of its limbs on land will use the the limb in the water.  As strength and correct movement improves, the water level is lowered as the dog is able to bear more of its own weight.

The water resistance on the limbs as the dog walks in the water causes him/her to work harder to move. This hard work will build up muscles and endurance without causing any joint pain.  When the patient walks on the underwater treadmill, they tend to move their limbs using an exaggerated range of motion, providing additional therapeutic benefits.