Common Rehabilitation Modalities Flashcards
describe low-level laser therapy, including mechanism of action, its effects on patients, appropriate clinical situations where its use is indicate, and the benefits and potential risks
define: light amplification by stimulated emission of radiation
MOA: photobiomodulation, where light interacts with cytochrome-C chromophores cells and causes stimulation and other biochemical changes such as ATP formation, but can be disrupted by other chromophores, like melanin, hemoglobin, and water
clinical application:
-more common with soft tissue injuries
-clip the hair and typically use a class IV laser
-little evidence of its efficacy, especially in small animals
describe extracorporeal shockwave therapy, including mechanism of action, its effects on patients, appropriate clinical situations where its use is indicate, and the benefits and potential risks
definition: sound waves of a lower frequency than ultrasound with minimal tissue absorption and no thermal effect
MOA:
-in tendon/ligament/soft tissue: neovascularization and release of growth factors
-in bone: microfracture of trabecular bone and release of growth factors
primary effects: compression and tension as shockwave travels through the tissue
secondary effects: cavitation bubble produced during the tension phase that deposit large amounts of energy after collapse, release high energy water jets, and produce high temperatures
clinical impact: analgesia and stimulates healing
contraindications:
1. immune diseases
2. infectious arthritis
3. neoplasia
4. neurologic deficits
5. gas filled cavities/organs
6. pregnant animals
describe cold therapy physiology (6) and contraindications (5)
physiology:
1. vasoconstriction decreases deposition of inflammatory cells and mediators
2. decreased local cellular metabolism
3. decreased histamine release
4. decreased swelling and edema
5. decreased muscle/nerve activity
6. pain relief (due to reduced conduction because of inactivation of sodium channels
contraindications:
1. frostbite (duh)
2. cardiac/respiratory distress
3. open wounds
4. ischemic areas (duh)
5. direct application over nerves
describe heat therapy physiology (5) and contraindications
physiology:
1. vasodilation causes increased removal of inflammatory factors
2. increased local cellular metabolism
3. increased tissue elasticity
4. increased muscle relaxation
5. pain relief
contraindications: uncommon to have contraindications
describe therapeutic ultrasound, including effects, pros and cons, gel types. indications and contraindications
effects:
-used primarily for thermal (heating) effects: improved blood flow, tissue elasticity, and increased metabolic rate
-also has athermal effects: tissue repair, bone healing, faster inflammation resolution
pros: local heating of DEEPER tissues in a short tx time
cons: dosage difficult to monitor and transducer (coupling medium) has to contact the skin, but the transducer is required for use
gel types:
DO use: water-soluble ultrasound el
do NOT use:
1. electroconductive gels
2. lanolin based compounds
3. mineral oil
4. OTC creams and lotions
main clinical indications:
1. soft tissue shortening: contracture, scarring
2. subacute/chronic inflammation
3. pain
avoid with: pacemakers, eyes, repro parts, contaminated wounds, new incision, new fractures, after cold application, under heavy sedation, etc. just use common sense
describe electrical stimulation therapy, including the 2 types and their uses, prep, and contraindications
2 types:
TENS: transcutaneous electrical nerve stimulation: PAIN relief, NO muscle contraction
NMES: STRENGTHENING, induces muscle contraction
-must prep the skin to reduce ohmic resistance unless using needle electrodes
contraindications: anywhere you don’t want electricity
describe aquatic therapy, including mechanism of action, its effects on patients, appropriate clinical situations where its use is indicate, and the benefits and potential risks
basic principles:
1. hydrostatic pressure: opposes tendency of blood and edema to pool in extremities
- buoyancy: reduces pain during exercise by minimizing weight bearing on joints
- viscosity and resistance: viscosity decreases anxiety and prevents falling, resistance helps build muscle
- water temperature: warm (86-94) is safe and good for all the reasons why heat therapy is good
benefits: improve strength, muscular endurance, cardiovascular conditioning, improve ROM
underwater treadmill: increase ROM with flexion AND extension
swimming: just increase ROM of flexion
indications:
1. neurologic disease
2. ortho disease
3. weight loss
4. fitness and conditioning
contraindications:
1. acute biceps tendonitis (don’t want to move those)
2. early stages of fracture healing/repair
3. cardiac disease
4. respiratory conditions
5. open wounds or infections (ew)
6. incontinence or diarrhea (double ew)
what are the goals of rehab? what goal must be achieved first?
- pain reduction- MUST treat pain first; animal will not want to do anything if painful
- increase ROM/felxibility
- proprioception/neuromotor control
- strength
- endurance
what tools can be used to achieve the goals of rehab?
for very weak/debilitated:
1. assisted standing
2. slings
3. physio rolls
4. weight shifting
core strength:
1. sternal lifts
core and hindend strength:
1. lumbosacral tuck/sit to stands
2. tail pulls (lateral and caudal)
3. dancing for dogs
core and forelimb strength:
1. wither pulls
2. wheel barrowing for dogs
axial skeleton flexibility
1. back wiggles
2. weaving
PROM!!!
Active range of motion:
1. walk over poles
2. walk up stairs
3. underwater treadmill
core strength/flexibility (cookie stretches):
1. lateral bending (horse)
2. ventral flexions (horse)
3. hip flops (dog)
what are 4 rules of thumb for rehab? (not LO)
- animal should stand square
- hold stretches for 10 seconds
- 5 reps, 1-2 sets
- perform exercises 3-4 day/week
what are the goals of balance training?
- improve core strength
- promote proprioception
- improve response to destabilizing forces
- reduce risk of reinjury
