Physical rehabilitation: Improving the outcome in dogs with orthopedic problems - Veterinary Medicine
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Physical rehabilitation: Improving the outcome in dogs with orthopedic problems
Difficult, painful ambulation, whether resulting from orthopedic surgery or chronic pain, must be treated for an animal's optimal health. Explore the options and benefits of establishing a physical rehabilitation program.


VETERINARY MEDICINE


Common activities include assisted standing or walking, controlled leash exercises, treadmill walking, dancing, and wheelbarrowing, as well as sit-to-stand activities and stair climbing. Jogging, stepping over rails, pulling or carrying weights, playing ball, and exercising with therapy balls are also used.32 If patients are reluctant to use an injured leg, a syringe cap, coin, or marble can be taped to the bottom of the contralateral unaffected limb to help encourage use of the injured limb. Only use this stimulus intermittently because dogs will quickly become desensitized to its presence.

Assisted standing or walking


Figure 2. Towel or sling support is beneficial for a patient with a limited ability to stand and support its own body weight.
The ability to perform many of these activities depends on the patient's having adequate strength and flexibility to participate. These exercises are used if the patient is ambulatory or at least able to bear some weight. Patients that may not be able to stand or support their own weight may benefit from assisted standing. Even short periods of standing provide an opportunity to build strength; aid in proprioceptive training; improve circulation, respiration, and elimination efforts; and enhance a patient's psychological well-being.32 Short-term assisted standing and walking can be facilitated by using body slings or towels (Figure 2). The initial goals for walking should be to complete 10 to 15 steps per limb. Allow the patient to rest periodically, if necessary. Repeat this activity two to four times a day or as often as the patient is able. Some patients may progress rapidly. Dogs with conditions such as severe spinal cord injury may require more gradual increments of activity. In these cases, increasing activity 15% to 25% each week may be appropriate. Two- and four-wheel carts are available for extended rehabilitation efforts in patients with severe limitations. Carts are particularly helpful in patients with neurologic disease that have prolonged paresis.

Exercising with therapy balls


Figure 3. A peanut-shaped ball (e.g. PhysioRoll—Gymnic) may be used to challenge proprioceptive abilities or increase weightbearing on the forelimbs or hindlimbs.
Exercise balls or rolls come in various sizes and can be partially deflated to provide added stability and contour to an animal's body shape and size. These devices can be used for assisted standing exercises or to challenge the patient with various weight-shifting and weightbearing tasks. The exercise rolls are peanut-shaped and provide better lateral stability (Figure 3); they are ideal for larger dogs because patients are physically supported. Exercise balls are excellent for general stretching and to challenge patients' proprioceptive abilities by rolling the ball back and forth. Like most therapy sessions, exercises using therapy balls should be limited to 10 to 15 minutes or less depending on the patient's attention span and endurance. When straddling the ball, the animal should be able to touch the ground with all four feet. Weight and proprioception can be shifted to the hindlimbs by elevating the forelimbs and vice versa. Small movements of the ball challenge proprioception and encourage limb use. Slow movements and patient manipulation also encourage joint motion. Patients may initially be placed on the ball for two to five minutes; as strength and stamina improve, the length of time may be increased.


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Source: VETERINARY MEDICINE,
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