Rehabilitation Flashcards
List 4 benefits of cryotherapy
• Local vasoconstriction, which decreases blood flow thereby decreasing swelling, interstitial hemorrhage, and inflammation.
• Reduction of enzymatic tissue activity and damage through inhibition of the release of histamine, protease, hyaluronidase, and collagenase.
• Reduction of cellular metabolism. This is important because decreased tissue oxygen requirements prevent secondary cellular hypoxic injuries.
• Reduction in pain perception. Analgesia and a reduction in muscle spasm occur due to a decrease in nerve conduction velocity.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 4 benefits of thermal (heat) therapy
• Vasodilation increases circulation to tissues, which increases tissue metabolic rate, improves tissue oxygenation, and decreases tissue edema and inflammation.
• Pain relief, which is mediated by an increase in the pain threshold.
• Decreased muscle spasm and relaxed muscle tone, which are thought to occur due to decreased muscle ischemia.
• Increased extensibility of soft tissue. Hot packing before stretching promotes flexibility and increases range of motion. When soft tissue is heated before stretching, the effect of the stretch lasts longer, and less force is required to maintain an effective stretch.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List the main precautions and contraindications to the use of heat therapy
• Protect the patient’s skin by wrapping the hot pack in a towel and checking the skin frequently. Discontinue heating if skin has white areas or red mottled areas.
• Do not use heat in areas of impaired sensation or with acute inflammation.
• Use with caution in obese, pregnant, and cardiac patients, as well as very young or very old patients
• Absolute contraindications include active bleeding, malignancy, fever, and open wounds.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List the main precautions and contraindications for the use of therapeutic ultrasound
• Avoid therapeutic ultrasound over cardiac pacemakers, eyes, the gravid uterus or testes, spinal cord after laminectomy, open epiphyseal plates, bleeding areas, and areas of infection or malignancy as this may damage tissue, induce parturition, or cause metastasis.
• Use caution over fractures; in areas of decreased circulation, temperature, or pain sensation; in sedated animals; in areas of boney prominences; and over metal implants as this may damage tissue.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is phonophoresis and how can it be used in veterinary patients?
“Phonophoresis is the delivery of pharmaceutical agents using TUS. It is commonly used in human physiotherapy, but rarely in veterinary medicine. It can deliver local anesthetics or dexamethasone into painful muscles after surgery or injury. Phonophoresis is used with muscle strain or painful muscles secondary to intervertebral disc disease surgery or medical therapy. Phonophoresis for these conditions is done using a compounded gel (dexamethasone 0.4%/lidocaine 0.1%). The settings currently used for phonophoresis treatments are 0.9 W/cm2, 1 mHz, 100% duty cycle, and 4 minutes per probe head that will fit in the area treated.22 Because veterinary patients are hairy, some therapists shave the area before TUS, whereas others use larger amounts of gel. However, Steiss and Adams have shown that ultrasound treatment applied through an intact coat considerably warms the coat with loss of thermal effects in underlying tissues.23”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 4 of the main physiologic effects attributed to laser therapy
• Chromophores in the cell mitochondria absorb the laser light energy, causing increased production of oxygen, adenosine triphosphate, and DNA; increased cell permeability; and decreased cyclooxygenase and prostaglandin E2 production
• Stimulation of stem cells.
• Promotion of tissue repair through angiogenesis, stimulation of fibroblast production and collagen synthesis, and growth factor release.
• Increased activity of leukocytes.
• Increased healing of nerves, connective tissue, and ligaments.
• Pain reduction through change in nerve conduction and increased levels of endogenous opiates or through stimulation of acupuncture points.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
When is NMES most useful (cases, timing)?
“NMES is most frequently used in rehabilitation of neurologic patients (particularly tetraparetic or paraparetic animals) because it stimulates motor nerve and muscle fibers (Fig. 11.9). NMES contracts muscles, reduces edema, and assists with wound healing. In a weight-bearing animal it can be used to increase the force of contraction. It can also be used to assist gait retraining after surgery or injury. It is generally performed daily, or at least three times weekly, and with an amplitude sufficient to cause contraction. Postoperative NMES works best if done in the first 1 to 4 weeks after surgery or injury and is of questionable value in cases of lower motor neuron disease.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the two times of ESWT deliveries and the three types of ESWT generators?
“ESWT can be delivered as focused or radial shock waves. Focused shock waves converge on a small target point and do not expose surrounding tissues to the same peak pressures as the focused point. There are three types of focused shock wave generators:
- piezoelectric, which uses crystals to generate the shock wave;
- electromagnetic, where magnetic fields produce the shock wave;
- electrohydraulic, which uses a high-voltage spark gap that causes plasma bubble generation. In the latter, expansion and collapse of the bubble produces the shock wave.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the limitations/requirements and typical protocol for ESWT?
“Application of ESWT requires heavy sedation or light anesthesia because the procedure is painful. The area to be treated needs to be clipped and ultrasound gel applied as a coupling agent. The direction of the application and length of time depends on the condition and body part treated. In general, most conditions require 500 to 1000 shocks, with two treatments 3 to 4 weeks apart. Adverse effects can include bruising, petechiae, and pain. These patients commonly require nonsteroidal antiinflammatory drugs after treatment. Precautions and contraindications for ESWT are provided in Box 11.16.26”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
How and how often is PROM performed? In what cases is it most useful?
“PROM is necessary for all rehabilitation patients but is particularly useful for the nonambulatory patient. It can be accomplished with the patient in lateral recumbency, over a therapy ball or peanut, or in a sling or cart to maintain a standing position. The latter two allow gravity to pull the limbs down and provide sensory input to the limbs. Each limb should be done separately and at a minimum of three times a day. It is important to move all the joints of each limb when doing PROM, not just the joints on the affected limb. When performing PROM, the origin of the muscle is stabilized and the insertion moved (Fig. 11.11). A 30-second passive stretch is usually adequate. The stretch must be effective and not painful. Neurologic and postoperative patients are at risk for contractures of tendons and ligaments, which can be mitigated by PROM. Caution should be used when performing PROM in animals that are geriatric, have decreased sensation, or are in pain or when it is done immediately after surgery. Forceful PROM can damage bone and cartilage (Video 11.4).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What are the main types of Soft Tissue Massage (STM)
“Effleurage is long slow strokes with light to moderate pressure that runs parallel to the muscle fibers. It is often used at the beginning of the massage.
- Petrissage is short, quick strokes with moderate to deep pressure that is parallel perpendicular, or across the direction of the muscle fibers. Wringing, skin rolling, and kneading are all part of petrissage. Tapping on the muscle, or tapotement, is done with fingertips to stimulate weak muscles (Video 11.3). Friction or cross friction massage is performed by applying moderate pressure to scars, tendons, and ligaments to break up scar tissue. It can be performed perpendicular to the tendon, along the tendon, or circularly over the tendon and is usually done for 5 to 10 minutes.
- Trigger point therapy is a technique that applies digital pressure to a trigger point, which is a firm, tender area of muscle. Trigger points can be treated with pressure, dry needling, or injection.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
What is Proprioceptive Neuromuscular Facilitation? When/how is it best employed?
“After stretching and PROM, it is important to reeducate unresponsive muscles. In general, these are muscles that are antagonistic to those shortened through contracture, or by spasticity. This reeducation process takes place through PNF patterning. PNF is used to simulate movement patterns that are ingrained and functional. Common patterns include walking, running, scratching, sit to stand, movement from lateral to sternal recumbency, kicking back, and turning. PNF patterns can be done in any position depending on the disability. One example of PNF patterning is passive walking or running, which is often performed in paretic dogs in an underwater treadmill (UWTM) with a therapist moving the legs and placing the dog’s feet. Use of therabands to assist in gait patterning is another example of PNF patterning. To be effective these patterns should be repeated multiple times per day”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
List 5 exercises used to straighten the front limbs
High-five salute
Wheelbarrow
Stairs (down)
Play bow
Digging
List 5 exercises used to straighten the rear limbs
Sit-to-stand
Backwards walking
Side Stepping
Incline walking
Standing with elevated front legs
Ladder walking
What is PRP?
“Platelet-rich plasma (PRP) is an autogenous fluid concentrate composed primarily of platelets and white blood cells used to accelerate healing of tendon, ligament, bone, and other tissues.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
