Various techniques of physiotherapy in animals

1. Dr. Urfeya Mirza
Deptt. Of Vety. Surgery and Radiology

2. INDEX
• HISTORY
• DEFINITION
• AIMS
• PRINCIPLE
• CATEGORIES
• METHODS
• LIMITATIONS
• REFERENCES

3. History
• Physicians like Hippocrates & later Galenus are believed
to have been the first practitioner of physiotherapy to
treat people in 460 BC
• Modern Physiotherapy was established in Great Britain
toward the end of 19th century
• Physiotherapy is a result of the Second World War.
During the Second World War, when a large number of
soldiers and civilians suffered injuries, the need for
putting them back on health track became imperative.
The number of injured persons was so large that acute
shortage of medicines was felt. The situation gave rise to
a new science of healing, now known as ‘Physiotherapy’.
Physiotherapy is the cheapest treatment without drugs

4. Definition
• It is the science of treatment of disease by exercise,
massage, heat, light, electricity or other physical
agencies. Use of drugs in this form of therapy is avoided.
When required, it can be administered from the neonatal
to the geriatric stage
• Physiotherapy, also referred to as physical therapy,
involves evaluating, diagnosing, and treating a range of
diseases, disorders, and disabilities using physical means
• Passive Physiotherapy directed toward the
alleviation of symptoms
• Active Physiotherapy directed toward restoration of
function by activity

5. • PHYSIOTHERAPY:
Treatment of diseases by physical method
• REHABILITATION:
Restoration of the functional utility of the affected part
Physiotherapy & Rehabilitation accelerate tissue
healing by galvanizing normal physiological
process so that the functional normalcy of an
affected part is restored faster

6. AIMS OF PHYSIOTHERAPY
• To correct deformities
• To make the joint movement more supple
• To prevent deforming tendencies
• To develop paralyzed muscles
• Faster healing
• Restore the functional ability
To treat disability and deformity
To correct disability and deformity
To prevent disability and deformity

7. PRINCIPLES OF PHYSIOTHERAPY
• Decrease pain & facilitate healing of inflamed & injured
neurological & musculoskeletal tissues
• Maintain normal range of motion in affected joints, e.g. hind
& fore limb
• Prevent soft tissue contracture & fibrosis in weak or paralyzed
limbs
• Prevent further disuse atrophy of affected musculature of
hind limb/fore limb during the healing process
• Improve strength & function of weak or paralyzed limbs
• Maximize post-surgical recovery & function of the patient
• Provide +ve psychological effects for the patient & owner

8. CATEGORIES
Depending on severity of the ailment:
1. Short term physiotherapy
2. Long term physiotherapy

9. Short Term Physiotherapy
• Includes patients with minor neuromuscular-skeletal
lesions like:
- Simple soft tissue injuries
- Simple fractures
- Non traumatic lesions

10. Long term physiotherapy
• Refers to more complicated diseases of musculoskeletal
origin
• Includes condition like:
Fractures of major bones
Spinal trauma resulting in physical disability and
complications like paraplegia, quadriplegia etc
Surgical procedures involving major joints
Chronic conditions like RA

11. METHODS
 1. COLD THERAPY
 2. HYDROTHERAPY
 3. MASSAGE
 4. HEAT THERAPY:
 Radiant heat therapy: (Infrared therapy, Ultraviolet therapy)
 Conductive heat therapy
 Conversive heat therapy: (Diathermy, Ultrasonic wave therapy)
 5. EXERCISE

12. Contd..
 6. ELECTRICITY:
 Electrostimulation
 Transcutaneous Electric Nerve Stimulation (TENS)
 Interferential Current Therapy (IFT)
 7. ACUPUNCTURE THERAPY
 8. CRYOTHERAPY
 9. LASER THERAPY

13. 1.COLD THERAPY

14. INDICATIONS:
It is advised in acute & hyperacute injuries, particularly
effective during the first 24-48hrs. after injury
TECHNIQUE:
Can be done by ice water immersions, ice packs, blowing
cold air, applications of volatile liquids & running cold
water
MECHANISM:
Cold therapy decreases local circulation results in
constriction of blood vessels. Reduced blood flow helps
to reduce oedema, haemorrhage & extravasation of
inflammatory cells. Reduced tissue metabolism may
inhibit effect of inflammatory mediators, pain, muscle
spasm & enzyme system

15. Therapeutic effects of cold occur at tissue temp.
between 15-19 deg. Cent.
 Each application should last 15 to 20 minutes and
there should be at least 1-2 hrs. interval between the
applications
 Cold application is generally combined with
compression bandage
Contd..

16. 2.Hydrotherapy

17. INDICATIONS:
Downers cow syndrome (if muscles damage has not occurred),
conditions involving limbs problem
TECHNIQUES:
(a) Buoyancy of water: this is used to relieve pressure on effected
parts. The method is used in the form of an aqua lift system to
treat Downers cow syndrome if muscles damage has not occurred
(b) Whirlpool hydrotherapy: in this extremity or the entire body
is submerged in either warm or cold swirling water. The water is
kept in constant agitation & mixed with air by the action of turbine
thus producing a gentle massaging effect
(c) Irrigation: irrigating the affected part with a stream of water
through a hose pipe or by submerging part or body in warm/cold
water
(d) Swimming: it is another method of hydrotherapy

18. Picture showing constant agitation of water for hydrotherapy

19. Picture showing hydrotherapy treatment for limb problem

20. MECHANISM:
Hydrotherapy is the treatment of disease with water.
Water absorbs more heat per unit of weight than any
other substance. The solvent properties of water help
checking infection & accelerate wound healing by
removing dirt & necrosed tissue. A treatment time of 10-
30 min. is sufficient for this effect
CONTRAINDICATIONS:
1. Animal with recent skin grafts
2. Acute oedema
3. Fever
4. Marked circulatory disturbances

21. SWIMMING
INDICATIONS:
Conditions involving limb problems, helpful in recovering
from injury or operation, Downers cow syndrome (if muscles
damage has not occurred)
MECHANISM:
a) Swimming helps to improve general fitness & stamina,
improves muscle tone & is helpful in recovering from injury
or operation
b) Horse are usually swum in cold water to dissipate the
enormous amount of heat they generate under exertion
c) Swimming is an excellent form of exercise because most of
the muscles normally used in movement are involved.
Swimming results increased resistance to movement &
strengthens the muscles

22. Picture showing swimming technique & pool specially designed for
specific animal

23. Picture showing swimming technique & pool specially designed for
specific animal

24. HOT WATER APPLICATION
INDICATIONS:
i. Sub acute & chronic inflammations
ii. Recent inflammation after the acute stage has passed
iii. Septic lesions in which the vitality of tissues lowered &
they are threatened with deaths
TECHNIQUES:
Hot water, Hydro-thermoregulators
EFFECTS/MECHANISM:
i. Analgesia by softening & relaxing the tissue
ii. Hyperaemia results leucocytosis & phagocytosis in
septic wounds
iii. Reabsorption of exudates

26. 3.MASSAGE

27. MASSAGE MAY BE DEFINED AS MANIPULATION OF
SOFT TISSUES WITH HAND & FINGERS.
INDICATIONS: (with liniments)
Sub-acute & chronic inflammatory conditions
TECHNIQUES/METHODS:
• Slight Friction: Fingers of the hand is used in centripetal
direction. It gives feeling of warmth & has a numbing effect
• Methodical pressure: It is applied by firm pressure on to
tissue with the pulp of the thumb or with fingers or the hell of
the palm or with closed fist
• Individual compression of muscles: A portion of the
muscles is hold between the fingers & thumb & uniform
pressure is applied from its insertion towards its origin

28. • Percussion:
Consist of superficial or deep percussion of the
tissue by striking the part perpendicularly with the
fingers or closed hand
EFFECTS:
• Sensory nerve endings stimulated
• Liberation of histamine substances with local
hyperaemia results in dilatation of blood vessels
• Improves venous & lymphatic return by mechanical
assistances due to alternative pressure & relaxation
• Mechanical movement causes stretching & softening of
fibrous connective tissue

31. Identification of Problem & application
of slight friction

32. Methodical pressure & follow up
(exercise and passive stretching)

33. CONTRAINDICATIONS:
 Acute inflammation
 Presence of foreign bodies
 Existence of neoplasm
 Weeping conditions
 Infection
 Recent fractures

34. 4.HEAT THERAPY

35. INDICATIONS:
• Best applied after acute inflammation has subsided
• Useful in reducing muscle spasm & pain due to
musculoskeletal injuries
• Used to increase joint & tendon mobility
• Accelerating the healing response of localized soft tissue
injuries
TECHNIQUES:
• Superficial heat may be applied with hot packs, hydrotherapy,
paraffin baths or moist air (penetration upto 1cm deep)
• Deep heat may be applied using radiant heat (heat lamp),
microwave or shortwave diathermy & therapeutic ultrasound
• Warm water, the most accessible method of heat therapy (wet
towel, water immersion, turbulator boot)

39. Different Designs of Heat-Therapy Packs Available

40. MECHANISM:
• Heat therapy increases local circulation, decrease pain,
reduce muscle spasm & increase tissue extensibility
• Local heat applications dilate blood vessels & stimulate
local circulation. Increased local blood flow help to
mobilize tissue metabolites, increase tissue oxygenation
& increase metabolic rate of cells & enzyme system
• As a rule, metabolic rate increases 2-3 times for an
increase in tissue temp. of 10 deg. C
• Increased blood flow & vascular permiability promotes
resorption of oedema

41. METHODS:
RADIENT HEAT:
It penetrates about 7-10mm deep into the skin. Emitted
by:
• Infrared Lamp(7700-8800 degree A frequency)
• Ultraviolet Lamp(2000-4000 degree A frequency)
CONDUCTIVE HEAT:
It has Superficial penetration to the skin e.g. hot water
bottles ,electrically heated pads, hot packs etc

42. Contd.
CONVERSIVE HEAT:
Therapeutic generation of local heat in body tissues by
high frequency electromagnetic current. Done by two
methods:
• Diathermy:
Method of heating the Tissues in depth (5cm) by passing high
frequency electric current. It is of two types:
 Shortwave diathermy with frequency A.C @ 27 million
cycles/second
 Microwave diathermy having high frequency electromagnetic
radiation @ 900 megacycles/second
• Ultrasonic wave therapy:
The ultrasonic waves are generated by a vibrating
piezoelectric disc. Alternative current of 1 million
cycles/second are used

43. Infrared
Therapy
Ultraviolet
Therapy
RADIENT
HEAT
THERAPY
A. RADIENT HEAT THERAPY:

44. INFRARED THERAPY
INDICATIONS:
• Sub acute & chronic traumatic & inflammatory conditions
• Traumatic synovitis, tenosynovitis & sprain
• Neuralgia, arthritis & rheumatic conditions
• Acute, sub-acute & chronic catarrhal conditions of mucous
membranes & sinusitis
• Infection of the skin, folliculate & furunculous
TECHNIQUE/SOURCE:
• Natural- Sunlight (60%)
• Low temp./Non-luminous/IR radial
• High temp./Luminous/Heat lamps
(distance- 2-3 feet, duration- 10-15 min)

45. What is Infrared Rays ?
• Infrared rays are electromagnetic waves (radiant
energy) of 770-1,00,000 mµ.
• 1500-12,000mµ
• It is emitted by low temp.
bodies like hot water bottles,
electric heating pads etc
Long wave
infrared
• 770-1500mµ
• It is emitted by sun,
incandescent lamps & high
temp. infraradiators
Short wave
infrared

46. Infrared Lamp

47. Various Types

50. MECHANISM:
• The infrared stimulates local circulation. Radiant heating
causes vasoconstriction of the capillaries & subsequent
release of vasodilator substances which again absorbed
thus more capillaries become active, hence the blood
circulation is increased
• Infrared exposure for a short time cause mild heating ,
result in relief of pain. While strong heat works as a
counter irritant stimulating the nerve endings

51. CONTRAINDICATIONS:
Erythemal
response
Electric shock
Injury to eyes Faintness
Hypersensitivity followed by
erythemia, wheal formation, local
edema & blistering

52. ULTRAVIOLET THERAPY
INDICATIONS:
• General tonic effects
• Chronic ulcers
• Tuberculosis
• Psoriasis, Acne
DIAGNOSTIC USE:
In dermatological cases with the aid of woods lamp to
detect fungal infection
TECHNIQUES:
• Natural- sunlight
• Mercury Vapour lamp
• Fluorescent sun lamp
• R.S. type suit lamp

53. Ultraviolet Lamps

55. EFFECTS:
• UV rays penetrate to a limited extent through body
surface
• UV rays cause erythemal production, pigmentation &
bactericidal effects
• Spectral band at 265.2 mµ produces maximum
bactericidal effects
• UV rays produce local/regional analgesia when it hits
nerve endings
• Usually 20 exposures are required for complete cure of
local infections

56. B. CONDUCTIVE HEAT THERAPY
• It has superficial penetration to the skin e.g. hot water
bottles, electrically heated pads, hot packs etc
• MgSO4 is used to enhance penetration (2 cups/gallon)
• It should be followed by massage with alcohol in which
75% heat is retained for 20-30 minutes
• More beneficial when used along with massage, exercise
or electric stimulation

58. C. CONVERSIVE HEAT THERAPY
DIATHERMY
Ultrasonic
Therapy
CONVERSIVE
HEAT
THERAPY

59. DIATHERMY
Shortwave
Diathermy
Microwave
Diathermy

60. Shortwave Diathermy
• Shortwave diathermy has
frequency A.C @ 27 million
cycles/second
• SWD is usually prescribed for
treatment of deep muscles and
joints that are covered with a
heavy soft-tissue mass
• SWD utilizes two condenser
plates that are placed on either
side of the body part to be
treated. Another mode of
application is by induction coils
that are pliable and can be
molded to fit the part of the
body under treatment

61. Microwave Diathermy
• The clinical indications for microthermy
are, more or less, similar to those for
short wave diathermy
• Microwave diathermy having high
frequency electromagnetic radiation @
900 megacycles/second
• It has two kind of heads:
(I) Circular
(ii) Rectangular
• Director selection depends on the shape
and the anatomical configuration of the
treated area

62. ULTRASOUND
THERAPY

63. INDICATION:
 Useful to get rid of stiffness & decrease in flexibility of
skeletal muscle
 It improves range of motion of the joints
 Improves circulation to the scar tissue
 Decreases pain & muscle spasm
 Stimulates the resorption of calcium deposits e.g.
splints, spondylosis
 Stimulates tissue repair by acoustic streaming &
promoting the healing of pressure sores by increasing
the rate of protein synthesis by fibroblasts & increased
lysosomal activity
TECHNIQUE:
The area to be treated should be clipped/shaved &
cleaned. Ultrasound gel are applied liberally & sound
head is placed over the skin. After setting required
frequency & time, sound head must keep on moving
slowly over the target area

64. Ultrasound Machine

65. Transducer

66. Types of Transducers

67. MECHANISM/EFFECTS:
1)PHYSICAL PROPERTIES:
a) Therapeutic frequencies of 1 MHz penetrates as
deep as 4-6cm into the tissues
b) Tissues with a high fluid content (blood, muscles)
will absorb sound waves better than less hydrated tissues
c) Nerve tissue has high coefficient of ultrasound
absorption. Thus, use of ultrasound in treating
peripheral nervous system is encouraged

69. 2) THERMAL EFFECTS:
Skin and subcutaneous fat can not absorb US well,
absorption takes place on the molecular level & protein
molecules are the major absorbers. So the skin surface
may remain cool while underlying structures are heated.
This unique characteristic is ideal therapeutic option for
treating nerves, ligaments, tendons, joint capsule &
muscles
CONTRAINDICATIONS:
Blood vessels in the path of interacting US waves could
suffer thermal damages. And when periosteum is
overheated, pain results

71. 3) CHEMICAL EFFECTS:
a) US waves result alternating cycles of compression ( area
of increased density & pressure) & rarefaction (area of
decreased density & pressure) in the area through which it
passes
b) Rarefaction forms air bubbles in the blood or tissue
fluids & expand because of the decrease in pressure. During
expansion, gas enters into the bubbles
c) In compression phase gas is flown out of the bubbles
d) Rarefaction & compression phase results in the gaseous
exchange, which exerts mechanical stress on the
surrounding called cavitation
e) Multifactorial benefits of cavitation:-
Increases cell permeability, it has electrolytic effect, useful in
the breaking up of calcified deposits, increasing in the
extensibility of fibrous capsule

72. Acoustic streaming/ Micro streaming/
Micro massage:-
Ultrasound when passes through, liquid flow
along the cell membranes pushed by the
pressure of the sound wave. Thus, diffusion of
ions & metabolites across the membrane
improves. Change in membrane permeability to
sodium ions could be involved in the altered
electrical activity in nerves, resulting in pain
relief. Exchange of sodium & calcium probably
helps in reduction of muscle spasm

74. PHONOPHORESIS
• Use of therapeutic ultrasound to assist in diffusion of medication
through the skin
• Increases the diameter of skin portals to allow the medication to
pass through
▫ Pores
▫ Hair follicles
▫ Sweat glands
MECHANISM
• The deep heat from ultrasound waves causes your blood vessels to
get bigger
• This allows more blood to go to the area. Blood brings nutrients to
the area and carries away wastes
• This helps decrease inflammation in the area and helps in healing.
Hydrocortisone decreases the swelling and soreness in body tissues
COMMON USES OF PHONOPHORESIS
• Muscle soreness
• Tendonitis
• Bursitis

75. 5. EXERCISE

76. INDICATIONS:
• Joint stiffness
• Abnormal posture
• Spastic paralysis
• Orthopaedic problems
TECHNIQUES/METHODS:
• Passive exercise: the affected joint is grasped & its
flexon & extension is done for 10-15 times
• Active exercise: this includes walking, grazing & slow
running up

80. Harness and Balance Pad

81. Hurdle Set

82. Giant Rocker Board

83. Giant Balance Disc

84. Donut and Donut Holder

85. Dog Treadmill

86. EFFECTS:
• Mechanical movement of joint & muscles
improves venous & lymphatic return
• Sensory stimulation by keeping cortical
pathways open
• Mobility & range of movement of joints can be
increased
• Balance & coordination can be improved
• Improves cardiovascular & respiratory
capabilities

87. 6.ELECTRICITY

88. ELECTRICITY
Electrical
Stimulation
Transcutaneous
electrical nerve
stimulation (TENS)
Interferential
Current Therapy
(IFT)

89. ELECTRICAL STIMULATION
INDICATION:
• Paralysis
• Muscular atrophy
TECHNIQUES:
• Continuous currents (DC) - Galvanization
• Induced currents (AC) - Faradisation
• High frequent currents - Dorsogavalisation

93. ELECTRIC STIMULATION DEVICE:
Electric stimulation is the application of an electrical
current to tissue to promote healing. NMES devices
generally are pulsed current stimulators that may use
alternating or direct current waves. These devices may
be set for waveform, amplitude (magnitude of one electrical
wave), pulse duration (time during which the charge flows in
both directions), phase duration (time current flows from
baseline in one direction and back), pulse rate (number of
pulses delivered per second), duty cycle (ratio of on time to total
cycle time), ramp (allows gradual increase or decrease in
amplitude), and polarity

94. ELECTRIC STIMULATION DEVICE

95. MECHANISM:
• Clip and prepare the skin over the motor point with alcohol.
Apply gel to the skin, and place the electrode. Locate the
approximate motor point (area where the motor nerve enters
the muscle) for the targeted muscle. With the current on, move
the electrode to identify the precise motor point. Select the
parameters for electrical stimulation. First select a
wavelength. Set the pulse duration, which is directly
proportional to the duration of the contraction. Set the
frequency (which defines the number of pulses of electricity per
second) to determine the rate at which the muscle fibers are
stimulated. Set the duty cycle to 1 : 1 to enhance endurance or
at 1 : 3 or 1 : 5 for muscle strengthening. Set the ramp to
control patient comfort
• Generally NMES is applied for 15 to 20 minutes, one to
five times per week

96. EFFECTS:
• Increasing muscle strength
• Improving muscle tone
• Decreasing oedema and enhancing circulation
• Decreasing muscle spasms and pain
• Improves muscle strength by increasing muscle
contractile proteins
• Improves muscle endurance by increasing
vascularity, aerobic capacity & mitochondrial
size
• Electrical muscle stimulation may be used to re-
educate denervated muscle

97. CONTRAINDICATIONS:
• Over a gravid uterus
• Over the heart
• Over carotid sinus
• In animals with pacemakers or seizures
• Over tumours or infected areas

98. TENS
• Transcutaneous electrical nerve
stimulation (TENS) currently is
one of the most commonly used
forms of electro analgesia
• Use of TENS for various types
of conditions, such as low back
pain (LBP), myofascial and
arthritic pain, sympathetically
mediated pain, bladder
incontinence, neurogenic pain,
visceral pain, and postsurgical
pain

99. Interferential Current Therapy
• The four electrodes are
placed in such a way that
the two currents produced
cross each other in the
affected area. Where the
two currents meet, they
actually 'interfere' with
each other; hence the
name “interferential”
• This modality addresses
the issues of pain, spasm,
and inflammation

100. 7. Acupuncture Therapy

101. • A key component of traditional
Chinese medicine
• Involves stimulating points by
inserting needles that lie along
the body’s Meridian Channels –
called acupuncture points
• The acupuncture points for
animals are similar to those used
for humans
• The acupuncture points are
usually located near major
nerves, blood vessels or
lymphatic vessels
• Is a very safe treatment when
using clean technique and
single-use needles
• Is minimally invasive and has
only minor side effects
• Used to treat a wide range of
conditions

102. Indications:
• Musculoskeletal & Neurological Disorders
• Arthritis
• Intervertebral disc disease
• Traumatic nerve injuries
• Respiratory problems – asthma
• Skin problems – lick granulomas, allergies & dermatitis
• Gastrointestinal problems – diarrhoea & inappetance
• Reproductive problems
• Pain(orthopedic pain, muscle pain, emotional pain,
visceral pain and neuropathic pain)
• Surgical incisions
• Wounds & burns
• Soft tissue injuries

103. When an acupuncture point is stimulated by the needle, it causes a
release of endorphins and other endogenous substances with
opioid analgesic activity

107. 8.CRYOTHERAPY

108. Cryotherapy
• Cryotherapy has been a popular treatment to relieve pain
caused by injuries to tissues such as tendons
• Prostaglandin E2 (PGE2) is known to be a major
mediator of acute inflammation in tissues, which is
related to tissue pain. Cryotherapy is related to
downregulation of PGE2 levels
Indications
• To promote clotting and haemostasis
• To reduce pain and odema
• To reduce spasticity

109. Cold Packs Used

112. 9. LASER THERAPY

113. LASER
(Light Amplification from the Stimulated Emission of Radiation)
• Laser therapy provides a non-invasive, pain-fee, surgery-
free, drug-free treatment which is used to treat a variety of
conditions and can be performed in conjugation with
existing treatment protocols
• Relief and/or improvement is often noticed within hours
depending on the condition and your pet’s response
Cold laser therapy treats the surface of skin
Hot laser treatments affect deeper tissues
Mechanism :
It increase healing rate in wounds and burns
Decrease inflammatory edema
Increase healing response of fractures
Increase regeneration of damaged nerve by stimulating
axon sprouting

114. Indications :
• Treatment of arthritis, degenerative joint disease or hip
dysplasia
• General pain management (sprains, strains and
stiffness)
• Post-surgery pain (spays, neuters, declaws and other
surgeries)
• Skin problems (hot spots, lick granulomas, infections)
• Dental procedures
• Fractures and wounds (bites, abrasions and lesions)
• Ear infections

115. Various Trigger Points

116. Laser Instrument

120. LIMITATIONS OF PHYSIOTHERAPY
• The technique is yet to be standardized
• No specific instrument for veterinary
• Wide variation in skin and hair coat of animal
• Many techniques require general anesthesia
• Evaluation of therapy is very difficult

121. References :
• Essentials of veterinary surgery, A.VenuGopalan (8th
edition)- Page no. 129
• Leonard’s orthopedic surgery of dog and cat, J.W
Alexander (3rd edition)- Page no. 25-26
• Surgery essentials of clinical practice, George L Wardi,
George D Zuidema (4th edition)- Page no. 266-267
• Equine diagnostic ultrasonography, Norman W Rantanen,
Angus O Mc Kinnon (1st edition)- Page no. 577
• Equine medicine and surgery, Patrick T. Colahan, Joe
Mayhew, Alferd M Merritt, James N. Moore - Volume 2 (5th
edition)- Page no. 1729

122. Contd.
• Pictures –
www.vetconm.com
www.hulenhills.com
www.redwingbooks.com
www.azpetacupuncture.com
indianrivermobilevet.com

123. Physiotherapy keeps you
Moving…………….
“THANK YOU”
123