APPLICATION OF PHYSIOTHERAPY IN VETERINARY PRACTICE
Post no 1371 Dt 25TH August 2019
Compiled & shared by- DR RAJESH KUMAR SINGH, JAMSHEDPUR,9431309542,rajeshsinghvet@gmail.com.
Veterinary Physiotherapy involves the assessment and treatment of musculoskeletal and/or neurological conditions in animals. It combines movement analysis with knowledge of the anatomy of the neuro-muscular system in order to identify potential problems.
Animals, like people, respond to Physiotherapy. The purpose of physiotherapy is to restore and maintain mobility, function, independence and performance. Animal Physiotherapy, also known veterinary physiotherapy, is used to treat and prevent a range of problems animals can experience. While no two species are exactly alike, neither are two animals of the same species, which is why it’s so important to tailor the physiotherapy to the animal’s specific needs.
Physiotherapy may be defined as the use of physical techniques for the treatment of injuries and movement dysfunction.Physiotherapy has been proven as an indispensable aid in the recovery of many musclo-skeletal conditions, as evidenced by the extensive physiotherapy. Understanding animal behaviour is important for animal physiotherapists both to ensure safe handling of animals who may be in pain and therefore aggressive, and to facilitate a more complete and accurate assessment of the animal’s pain, which may be important both diagnostically and therapeutically. Many common conditions respond well to physiotherapy: Osteoarthritis, muscle imbalance/atrophy, joint & ligament injuries, hip & elbow dysplasia, back pain, paresis & paralysis, tendon injuries, wounds and lick granulomas. Before physiotherapy can commence, it is imperative that a veterinary diagnosis is obtained. This is necessary for two reasons: 1. Obviously, without a correct diagnosis the correct treatment cannot be administered. 2. The Veterinary Surgeons Act of 1962 makes it illegal for anyone to treat an animal without authorization from the veterinarian in charge of the case.Physiotherapy is a treatment of diseases using physical agents like fresh air, water, heat, cold, electric current, sound waves etc.
Animals, like people respond well to physiotherapy such that physiotherapy aims to maintain and restore:
– Normal range of movement in the musculoskeletal system where movement is restricted and painful.
– Limit the impact of injury and/or disease process.
– Optimize the healing process and accelerate return to function, independence and/or performance.
Subsequently, Veterinary Physiotherapists are experts in the release of muscle spasm and in the mobilisation of joints to gain pain relief and restoration of normal movement patterns. Manual techniques used include joint mobilisations and manipulations, massage and other soft tissue techniques such as reflex/reciprocal inhibition, myofascial release, trigger point release and acupressure.
Electrotherapeutic modalities such as laser, neuromuscular electrical stimulation, ultrasound, electro-magnetic therapy and TENS can also be used in conjunction with manual therapy to enhance its effects.
In addition, many animals require specific exercises to complete their rehabilitation especially after surgery or chronic musculoskeletal problems. A veterinary physiotherapist is able to devise individual exercise programs to help each animal to reach their full potential.
Finally, veterinary physiotherapists also give advice on adaptation to your animal’s environment that will help them perform tasks more easily. This can be especially helpful for older animals or for those who have recently had surgery.
In summary, Veterinary Physiotherapy is not an alternative but an essential adjunct to conventional Veterinary medicine.
Canine Physiotherapy is becoming increasingly popular amongst pet owners. Horses are probably the most common species to receive physiotherapy. As with humans, the purpose of equine physiotherapy is to restore and maintain mobility and performance. From osteoarthritis to managing neurological problems and from resolving performance problems to treating ligament or tendon damage, equine physiotherapy has many applications for horses. Again like people, horses compensate for pain by adopting a less painful way of moving. Although it is not much popular in India as compared to European countries but its gaining popularity gradually. The Indian vets now a days are taking keen interest in it .
What physiotherapy strategies can be used?
Physiotherapy strategies utilise the combination of different treatment techniques including:
• Movement Therapies; ranging from passive range of movement of limbs and joints (ie movement without ‘effort’), to assisted walking, to the obstacle course for the very advanced patient
• Manual Therapies; including hands-on graded mobilisation techniques to loosen joint stiffness or pain
• Soft Tissue Techniques; including massage techniques and myofascial release techniques aimed at loosening tensions in and between soft tissues. These different techniques can be used in both the land-based and water-based environments, such as the hydrotherapy setting, and application of such exercise regimes and hands-on techniques have consistently been demonstrated to improve the physical function of the veterinary patient
Application of physiotherapy treated techniques in the veterinary patient requires an in depth understanding of the patient’s anatomy, physiology and movement patterning, as well as typical behaviours and communication strategies. With these key points of knowledge, the therapist should be able to apply an effective physiotherapy treatment regime in most domestic species.
In physiotherapy methods like fomentation, massage, firing, diathermy and ultrasonic can be used
Fomentation
Fomentation done with moist heat (using cloth dipped in hot water & squeezed) or dry heat (using heated rice bran or sand bundled in a cloth). But moist heat is generally preferred because it has soothing effect.
Massage
Massage improves local circulation of blood & lymph reabsorption & prevents to certain extent muscular atrophy.Massage is done towards direction of venous & lymphatic flow. Massage is continued for 5-10 minutes at a time
Methods
1) By rubbing the skin with the tips of fingers or the hands in circular manners. 2) By methodical pressure consist of applying firm pressure on the tissue with the fingers of the hand or with the closed fist. 3) By individual compression of muscles. 4) Muscles by percussion consist of superficial or deep percussion of the tissue by striking the part perpendicularly with the fingers or with the closed fist.
Firing
Firing is done under regional or local infiltration anaesthesia. The piece of iron used for firing is called as
firing iron. Three types of firing iron can be used viz. line firing iron, bud point firing iron and pinpoint or needle point firing iron. Its methods like superficial line firing, bud point firing, needle point firing and mixed firing. Firing in cattle have to be done more deeply because bovine skin is thicker than horse. In dog firing is very rarely used.
Chemical cauterization
Chemical cauterization is done by touching the area of skin at different points (1/2’’ to 3/4’’apart) with a cork dipped in sulphuric acid.The effect is almost similar to bud point firing.
Diathermy
Diathermy is a method of heating the tissue in depth by passing through them with modified high frequency electric current.The alternating current (sinusoidal current having 5 lac cycles/sec) is used in arthritis, certain skin diseases, neuralgia, muscular atrophy, paralysis etc.
Types of Diathermy
1) Long wave diathermy-Oldest, now a days not using. 2) Short wave Diathermy- Most commonly used method oscillations from 10 to 100 millionper second applied through a spacing of air or rubber. This can be produced by tube apparatus. 3) Microwave Diathermy- Oscillations of 3000 million per second which are used for focusing single beam of electromagnetic ray from some distance to the region to be heated. This can be produced by magnetron oscillator.
Effect of Diathermy
Thermal effect:
1) The temperature distributed by the high frequency electrical energy is modified by physiological factors such as the temperature of the tissues. 2) As diathermy is applied an increase in blood flow may occur locally as a result of changes in the tissue temperature.
Method of application
(1) Heating in the electrical field (2) Heating in the electromagnetic field (3) Microwave heating
Clinical effects
1. Effect on circulation: a) Local effects: Active arterial hyperemia and increased flow of lymph b) General effects: Rapid dilatation of peripheral blood vessels increase in the pulse rate, respiration, perspiration, general body metabolism. 2. Effect on nervous tissues: Diathermy exerts a marked sedative effect on the irrigative conditions of sensory nerves (spasms and cramps).
Clinical uses
Placing of the electrodes directly over the heated parts prevents cooling by evaporation.Deep hyperemia causes an increased arterial flow with more oxygen and improved nutrition while the greater venous flow carries away larger degree the products of local metabolism. It promotes disintegration of inflammatory exudates and assists in their resort form by decreasing the swelling, relief of pain and restoration of the function clinically. The pain and spasm relieving effect of diathermy makes its use indicated in irritation of sensory and motor nerves. In traumatic and inflammatory conditions of bursa, bones and joints after the acute stage,in painful and exuberant callus formation and fibrous ankylosis and joint injuries, in post-operative adhesions in extremities,spastic conditions of the stomach, in the treatment of neuritis and certain conditions of neuralgia or myalgia and chronic infections.
Contra-indications
In acute inflammatory process accompanied by fever and suppuration, in tendency to haemorrhage, recent hemoptysis and malignant tumors.
Other techniques
Coupage
This is used to clear any secretion from the airway by gentle percussion of the thorax using cupped hands. Always work from the caudal end of the chest to the cranial end, this will encourage coughing and the removal of secretion. Always percuss both side of the thorax. Coupage should be performed gently and not cause lung damage. Generally 10 minutes 3 times daily is adequate
Hydrotherapy
Hydrotherapy has become an important part of the rehabilitation of many small and large animal conditions, as the recognition of the importance of rehabilitation after injury grows.Hydrotherapy is bene?cial for pain, function, self-ef?cacy, joint mobility, strength and balance. Baoyancy of water: These can be used to relieve pressure on affected parts. Used in downer cow syndrome if no muscle damage. Whirlpool Hydrotherapy: It is essentially a water bath in which an extremity or the entire body is submerged in either warm or cold swirling water. Irrigation: Irrigating the affected part with a stream of water through a house pipe is a simple and cheap method. Precautions can be taken like animal with recent skin grafts, acute edema, fever and marked circulatory disturbances should not be treated
Cold water application
Indications:
Acute congestion, acute inflammation and septic lesions with diminished blood supply.
Effects:
Hypothermia of tissues induces Vasoconstriction which helps to reduce inflammation and provide mild analgesia and decreases extravasations of blood. Reduce/prevent oedema, treat burns, decrease swelling pain, muscle spasms and tissue metabolism are also reduced.
Methods of Application
It is generally combined with compression bandage and rest, to limit the swelling. It is used during the first 24-48 hours after trauma. Each application should last for 10- 30 minutes with one hour application. For deep seated lesions like sprains, water at a lower temperature may be applied. Cold effect may be produced by blowing air. Evaporation of volatile liquids. Applications of ice packs.By running cold water on the affected part. Its techniques like running stream, whirlpool tub, wille boots,housing, cold bandaging, ice massage andcotton wool pads.
Hot water application
Indications:
Subacute and chronic inflammations.Recent inflammation after the acute stage has passed. Septic lesions in which the vitality of tissues lowered and they are threatened with deaths.
Effects:
Analgesia by softening and relaxing the tissues.Hyperemia ,exudation,interstitial infiltration, leucocytosis, phagocytosis. Reabsorbing of exudates.
Methods
The temperature gradually rises from 30-113°F or even 122°F without scalding. At temperature 113°F moist heat diminishes the resistance of the tissues. Hot applications must be frequently renewed by adding, occasionally, more hot water. It is impossible to maintain a local superficial temperature equal to that of the blood. Hydro thermoregulator regulates temperature of 107-113°F maintained for 12-24 hours with excellent effect.
Conclusion
Physiotherapy has immense potential as an alternative treatment. It is cost effective and nowadays, this important branch is also rapidly becoming a recognized tool in the prevention, cure and rehabilitation of many equine, canine and feline injuries.
FAQ ON PHYSIOTHERAPY IN VETERINARY MEDICINE
What is physiotherapy?
Physiotherapy, also known as physical therapy, involves the use of specific non-invasive treatments (massage, exercise, light, heat, cold, electricity, ultrasound, laser, magnetic therapy, hydrotherapy, etc.) to rehabilitate injured patients. The goal of physiotherapy is to return the patient to normal function as quickly as possible, and to restore the full range of movement and strength to injured body parts. The underlying principle of physiotherapy is that the least effective treatment for injury is excessive rest, and that stimulation of circulation through areas recovering from injury promotes an optimal rate and degree of healing.
What is the history of physiotherapy in veterinary medicine?
Although various forms of physical therapy have undoubtedly been used for centuries on animals, the foundation for its use as an applied science is very recent. The American Association of Equine Practitioners established a set of guidelines for the practice of physical therapy on horses in 1993.
On which species of animals is physiotherapy practiced regularly? Physiotherapy is practiced regularly on horses, especially equine athletes. As a form of treatment, it is beginning to be used in dogs, and could easily be applied to other animal species.
Who practices veterinary physiotherapy and do I need a referral?
Physiotherapists can only treat animals under the direct supervision of a veterinarian, following a veterinary diagnosis and in accordance with state or provincial veterinary regulations. Currently, there are no established courses of instruction for physical therapy in animals, and therefore there is no certification process to ensure competency.
If a veterinarian is performing the treatments, referral may or may not be necessary. If a non- veterinarian will be the therapist, the patient must be referred by a veterinarian, who will then assume responsibility for assessing and coordinating the patient’s care.
What conditions are most often treated with physiotherapy? Acute and chronic injuries are amenable to treatment. Electrical stimulation has been shown to relieve pain, minimize muscle atrophy (degeneration) secondary to disuse due to pain or immobilization, treat laminitis (a condition of the horse’s hoof), reduce tissue swelling, and speed healing of both open and closed wounds. Iontophoresis, which uses electricity to
Physiotherapy is commonly used after an animal sustains a fracture.
push therapeutic ionic substances into injured tissue, has shown promise in the treatment of various inflammatory conditions of the musculoskeletal system. Therapeutic ultrasound can be used to stimulate tissue repair and minimize the formation of scar tissue and adhesions. External application of ice and compression wraps is effective not only as a first aid treatment but also to break the pain-muscle spasm-pain cycle common to many musculoskeletal injuries. How can my pet benefit from physiotherapy? The appropriate application of physiotherapy will speed healing, relieve pain, and improve the patient’s likelihood of a full recovery.
How successful is physiotherapy? As a technique to reduce pain and speed healing, the various forms of physiotherapy can be very effective.
How safe is physiotherapy?
Physiotherapy has the potential for doing significant harm in the hands of individuals with inappropriate education and training.
What is the cost of physiotherapy? Comprehensive physical therapy requires an initial veterinary assessment and formulation of a treatment plan, which usually consists of a series of treatments. The cost of treatment will reflect both the equipment being used and the skill and experience of the practitioner and therapist. The actual fees are set by the individual practitioner.
Can physiotherapy be combined with traditional veterinary medicine? Physiotherapy is most appropriately used in combination with either traditional or alternative forms of veterinary medicine. A licensed veterinarian should formulate the overall treatment plan, following the appropriate diagnostic examination and assessment of the patient. Follow-up evaluations are necessary to determine the individual’s response to treatment and adjust the therapy accordingly. If your animal companion is receiving physiotherapy from an individual other than your regular veterinarian, that person must report directly to your veterinarian in order to provide coordinated care of your companion, to allow proper evaluation of treatment and to minimize any avoidable interactions or interferences.
