Lecture 29: Physical Rehabilitation (Exam 4) Flashcards
Define rehabilitation therapy
Use of noninvasive techniques excluding vet chiropractic for the rehabilitation of injuries in non human animals
List some types of rehab
- Thermotherapy
- Range of Motion
- Joint mobilization
- Massages
What are the goals of physical rehabilitation
- Restore, maintain, & promote optimal function (improve muscle strength & reduce atrophy)
- Improve the outcome of the px following major sx (increased rate of tissue healing & remodeling of scar tissue)
- Enhance the quality of life (Decrease pain/swelling/ muscle spasms & improve fitness)
T/F: Any px amendable to the handling & stress can do rehab
True
What does an ortho exam do
- Differentiate btw/ musculoskeletal & neuro conditions
- Identify which limb(s) the lameness originates from & localize the size
- Helps narrow down the dx test, formulate a treatment plan, & give the owner a prognosis
What should be done during an ortho exam
- Observe the px standing & moving (trot is best)
- Observe posture
- Palpate while the px is standing & recumbent
What is CREPIM
Crepitus, range of motion, effusion, pain, instability, myofascia
List what should be done during palpation
- CREPIM
- End feel of the joint
- ROM of Vertebrae
- Palpate the caudal vertebrae/muscles
- Proprioceptive placing
- Any painful area is done last
What should be done after the ortho exam
- DDx list made
- Consider imaging
- Tx plan deved
How should the neuro exam start
W/ the least invasive to most invasive
What is done during the neuro exam
- Observe from a distance
- CNS tested
- Postural reactions
- Spinal reflexes
- Palpation (muscle tone/mass)
- Nociception & pain
What are some active functional assessments
- Posture
- Gait/mobility
- Transfers (laying down to standing & vice versa)
- Muscle strength test
What are some passive functional assessments
- Passive range of motion
- End feel
- Goniometry
- Joint play
- Muscle flexibility
- Muscle girth
- Myofascial exam
Describe PROM
- “Passive range of motion”
- Start slowly w/ each joint for flexion, extension, abduction, adduction, & internal/external rotation
- Assess for pain, restriction, or laxity of ea. joint
- Compare to contralateral limb
What does end feel mean
Characteristic sensation felt by the examiner @ the end of a joint (like soft, firm, bony/hard, elastic, & empty)
What does empty end feel mean
The end of the motion cannot be reached & it is always abnorm
What is goniometry
- Joint angles are measured using goniometer
- Px is in lateral recumbency or standing
- Start w/ a base line and test to see if PT is helping with ROM
What is flexibility testing
- Eval the ability of the muscle to stretch
- Can be norm, increased, or decreased
- Helps to dev a stretching tx plan
What is muscle girth (circumference) measurement test
Measures to look @ muscle atrophy
What does the strength test determine
If there is weakness contributing to lameness
Describe a myofascial exam
- Determines myofascial trigger points
- Look for a local twitch response (pain response)
- Find by pincher or flat palpation
What are some envi modifications for the px that should be explained to the owner
- Flooring
- Bedding
- Stairs
- Nail/foot care
- Feeding station
When is cryotherapy used
- During the acute inflammatory phase (first 3 days)
- For post op pain or after exercise
How does cryotherapy improve mobility, min hematoma formation, & reduces muscle spasms
By reducing inflammation, edema, & pain
When is thermotherapy used
For px w/ chronic pain
How does thermotherapy remove accumulated metabolites
Increasing the tissue temp leads to vasodilation & increased BF
How does thermotherapy help with reducing overall stiffness
Helps w/ connective tissue extensibility & muscle relaxation
Describe massage therapy
- Provides pain relief, relaxation, & promotes circulation
- Useful for post exercise to reduce muscle soreness, in px w/ OA, & in px w/ edema
Describe therapeutic exercises
- Stretching
- ROM (passive & active)
- Aerobic condition or muscle strength & endurance training (walks, stair climbing, etc.)
- Can correct gat abnorms
What are the stages of tissue healing that are important to know to safely implement a exercise plan
- Inflammatory stage
- Reparative stage
- Remodeling stage
What are some goals of therapeutic exercises
- Promote weight bearing
- Improve balance & proprioception
- Improve ROM
- Improve strength & core muscles
Describe the FITT Principle
- Frequency (regularity of exercise sessions)
- Intensity (Difficulty level of exercises)
- Time (duration of exercise sessions)
- Type (rehabilitation exercise selected)
What is LASER
- Light Amplification by Stimulation Emission of Radiation
- Single wavelength that leads to a photochemical reaction in the cells
What are the 2 important parameters that impact LASER tx
- Wavelength - determines tissue penetration
- Power
What are the therapeutic effects of LASER
- Blocks pain transmission to the brain
- Increases release of endogenous opioids
- Reduction in inflammation
- Used to stimulate muscle trigger points & AP points
- Cellular stimulation helps wounds heal faster & tissue to regenerate
