The Acute Phase

Question 1

what is the difference between rehabilitation and palliation?

Answer 1

rehabilitation = return to function

palliation = treating clinical signs without expectations of a cure

Question 2

aims of the acute phase?

Answer 2

rest
- but consider enrichments/QOL

reduce pain
- analgesics (NSAIDs/Gaba) and therapies
- symptoms of pain (eg pacing/shivering/aggression) can cause further damage
- but no pain may also cause damage
- need to balance

promote healing
- immobilisation allows healing
- but no remodelling so arthritis risk

preserve muscle mass and increase joint ROM
- physio treatments
- protein diets

improve remodelling and maturation stages
- weight bearing
- but need support otherwise breakdown

enhance functional return
- immobilisation vs weight-bearing support
preserve ROM and muscle mass

Question 3

what is the underlying physiology of immobilisation?

Answer 3

muscles
- atrophy of type 1 slow-twitch fibres
- so reduced endurance

ligaments
- atrophy and decrease in strength, structure and mechanical properties
- so easier to damage and impact joint stability

cartilage
- reduction in proteoglycan
- so thinning/loss of cartilage causing joint damage and arthritis risk

bone
- reduced weight bearing reduces bone density
- loss of subchondral bone causes osteoporosis