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Physiotherapy in animals

The document discusses various aspects of physiotherapy, including its history, definition, aims, principles, categories, and methods. Physiotherapy originated in ancient times but was established as a modern science in the 19th century due to injuries sustained in World War 2. It aims to restore function and mobility through physical means without the use of drugs, using methods like heat therapy, massage, hydrotherapy, exercise and electricity.

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Dr. Urfeya Mirza Deptt. Of Vety. Surgery and Radiology
INDEX • HISTORY • DEFINITION • AIMS • PRINCIPLE • CATEGORIES • METHODS • LIMITATIONS • REFERENCES
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
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
• 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
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
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
CATEGORIES Depending on severity of the ailment: 1. Short term physiotherapy 2. Long term physiotherapy
Short Term Physiotherapy • Includes patients with minor neuromuscular-skeletal lesions like: - Simple soft tissue injuries - Simple fractures - Non traumatic lesions
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
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
Contd..  6. ELECTRICITY:  Electrostimulation  Transcutaneous Electric Nerve Stimulation (TENS)  Interferential Current Therapy (IFT)  7. ACUPUNCTURE THERAPY  8. CRYOTHERAPY  9. LASER THERAPY
1.COLD THERAPY
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
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..
2.Hydrotherapy
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
Picture showing constant agitation of water for hydrotherapy
Picture showing hydrotherapy treatment for limb problem
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
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
Picture showing swimming technique & pool specially designed for specific animal
Picture showing swimming technique & pool specially designed for specific animal
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
3.MASSAGE
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
• 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
Identification of Problem & application of slight friction
Methodical pressure & follow up (exercise and passive stretching)
CONTRAINDICATIONS:  Acute inflammation  Presence of foreign bodies  Existence of neoplasm  Weeping conditions  Infection  Recent fractures
4.HEAT THERAPY
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)
Different Designs of Heat-Therapy Packs Available
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
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
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
Infrared Therapy Ultraviolet Therapy RADIENT HEAT THERAPY A. RADIENT HEAT THERAPY:
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)
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
Infrared Lamp
Various Types
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
CONTRAINDICATIONS: Erythemal response Electric shock Injury to eyes Faintness Hypersensitivity followed by erythemia, wheal formation, local edema & blistering
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
Ultraviolet Lamps
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
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
C. CONVERSIVE HEAT THERAPY DIATHERMY Ultrasonic Therapy CONVERSIVE HEAT THERAPY
DIATHERMY Shortwave Diathermy Microwave Diathermy
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
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
ULTRASOUND THERAPY
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
Ultrasound Machine
Transducer
Types of Transducers
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
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
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
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
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
5. EXERCISE
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
Harness and Balance Pad
Hurdle Set
Giant Rocker Board
Giant Balance Disc
Donut and Donut Holder
Dog Treadmill
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
6.ELECTRICITY
ELECTRICITY Electrical Stimulation Transcutaneous electrical nerve stimulation (TENS) Interferential Current Therapy (IFT)
ELECTRICAL STIMULATION INDICATION: • Paralysis • Muscular atrophy TECHNIQUES: • Continuous currents (DC) - Galvanization • Induced currents (AC) - Faradisation • High frequent currents - Dorsogavalisation
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
ELECTRIC STIMULATION DEVICE
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
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
CONTRAINDICATIONS: • Over a gravid uterus • Over the heart • Over carotid sinus • In animals with pacemakers or seizures • Over tumours or infected areas
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
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
7. Acupuncture Therapy
• 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
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
When an acupuncture point is stimulated by the needle, it causes a release of endorphins and other endogenous substances with opioid analgesic activity
8.CRYOTHERAPY
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
Cold Packs Used
9. LASER THERAPY
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
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
Various Trigger Points
Laser Instrument
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
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
Contd. • Pictures – www.vetconm.com www.hulenhills.com www.redwingbooks.com www.azpetacupuncture.com indianrivermobilevet.com
Physiotherapy keeps you Moving……………. “THANK YOU” 123

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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 likeHippocrates & 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 isthe 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 ofdiseases 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 severityof 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. COLDTHERAPY  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.
  • 14.
    INDICATIONS: It is advisedin 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 ofcold 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.
  • 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 constantagitation of water for hydrotherapy
  • 19.
    Picture showing hydrotherapytreatment for limb problem
  • 20.
    MECHANISM: Hydrotherapy is thetreatment 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 limbproblems, 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 swimmingtechnique & pool specially designed for specific animal
  • 23.
    Picture showing swimmingtechnique & 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.
  • 27.
    MASSAGE MAY BEDEFINED 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 ofsuperficial 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.
  • 35.
    INDICATIONS: • Best appliedafter 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 ofHeat-Therapy Packs Available
  • 40.
    MECHANISM: • Heat therapyincreases 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 penetratesabout 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 generationof 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.
  • 44.
    INFRARED THERAPY INDICATIONS: • Subacute & 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 InfraredRays ? • 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.
  • 47.
  • 50.
    MECHANISM: • The infraredstimulates 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 toeyes Faintness Hypersensitivity followed by erythemia, wheal formation, local edema & blistering
  • 52.
    ULTRAVIOLET THERAPY INDICATIONS: • Generaltonic 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.
  • 55.
    EFFECTS: • UV rayspenetrate 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 HEATTHERAPY • 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 HEATTHERAPY DIATHERMY Ultrasonic Therapy CONVERSIVE HEAT THERAPY
  • 59.
  • 60.
    Shortwave Diathermy • Shortwavediathermy 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 • Theclinical 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.
  • 63.
    INDICATION:  Useful toget 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.
  • 65.
  • 66.
  • 67.
    MECHANISM/EFFECTS: 1)PHYSICAL PROPERTIES: a) Therapeuticfrequencies 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: Skinand 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/ Microstreaming/ 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 oftherapeutic 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.
  • 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.
  • 81.
  • 82.
  • 83.
  • 84.
  • 85.
  • 86.
    EFFECTS: • Mechanical movementof 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.
  • 88.
  • 89.
    ELECTRICAL STIMULATION INDICATION: • Paralysis •Muscular atrophy TECHNIQUES: • Continuous currents (DC) - Galvanization • Induced currents (AC) - Faradisation • High frequent currents - Dorsogavalisation
  • 93.
    ELECTRIC STIMULATION DEVICE: Electricstimulation 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.
  • 95.
    MECHANISM: • Clip andprepare 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 musclestrength • 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 agravid uterus • Over the heart • Over carotid sinus • In animals with pacemakers or seizures • Over tumours or infected areas
  • 98.
    TENS • Transcutaneous electricalnerve 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.
  • 101.
    • A keycomponent 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 acupuncturepoint is stimulated by the needle, it causes a release of endorphins and other endogenous substances with opioid analgesic activity
  • 107.
  • 108.
    Cryotherapy • Cryotherapy hasbeen 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.
  • 112.
  • 113.
    LASER (Light Amplification fromthe 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 : • Treatmentof 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.
  • 116.
  • 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 : • Essentialsof 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.
  • 123.