Physical Therapies

Question 1

T/F - you legally require a ‘permission to treat’ to have physio on pets?

Answer 1

True

Question 2

Why do we refer for physio?

Answer 2

• Lak of mov and function
• First line tx for ortho and neuro conditions e/g/ OA
• When surgical or medical management not appropriate
• When surgical intervention is required but there is limb disuse, atrophy or loss of function

Question 3

Responses to injury?

Answer 3

• Return to pre-injury functuon not automatic
• Left unattended the neuromuscular changes will lead to biomechanical alteractions and unwanted forces on the injured tissues - >long term can lead to a degenrative process

Question 4

Assessmen does an assessment includE?

Answer 4

• Identifying source
• Assess integrituy of involved tissues and structures
• to determine the patients ability to perform ADL

Question 5

What subjective measures to assess?

Answer 5

• Age
  Past medical hsitory
• MEdication
• Aggravating and easing factors
• Functional compromise
• Past and present activity levels

Question 6

What objective measures to assess?

Answer 6

• Gait
• Transfers
• Posture
• Stairs
• ROM - acitve
• ROm passive
  Neuro testing

Question 7

What does a rehab plan look like?

Answer 7

Question 8

What different tx modalities do we have ?

Answer 8

• Manual therapies
• Electrotherapy
• Exercise therapy

Question 9

Describe manual therapies

Answer 9

• Passive mobilisations
• Soft tissue stretches
• Accessory mobilisation
• Trigger points

Question 10

Benefits of Passive ROM (PROM)

Answer 10

• Reduces risk of contractures
• Maintenace of muscle elasticity
• Inc synovial fluid production
• Maintaining joint ROM

Question 11

What electrotherapy options are there?

Answer 11

• Laser
• Neuromuscular stimulation
• Ice therapy

Question 12

Describe Muscle Stimulation

Answer 12

 Muscle fibre metabolism stimulation is
frequency specific.
 Voluntary contractions recruit small, slow
twitch, oxidative, type 1 muscle fibres
first.
 Muscle stimulated contractions recruit
large, fast twitch, glycolytic, type II
muscle fibres first.

Question 13

What Contraindications to muscle stimulation

Answer 13

• Impaired sensation
• Infection
• Malignancy
• thrombotic detachment
• Joint damage

Question 14

When is muscle stim most beneficial?

Answer 14

When used in conjunction with voluntary contractions

Question 15

What does LASER stand for & what does it do?

Answer 15

(Light Amplification by Stimulated Emission of Radiation)
- Light absorbed
- Chromophores absorb photons in mitochondria
- Light energy is transformed into biochemical energy

Question 16

Contraindications to LASER?

Answer 16

• Malignancy
• Eyes
• Preganncy
• tHyroid
• ePilepsy

Question 17

Describe the rehabilitation program?

Answer 17

• Exercise key
• Tailored exercised to injury
• Must be progressive
• Must be timely

Question 18

What must exercise programs be?

Answer 18

Individualised, Safe, effective, aim to reduce likelihood of compensation

Question 19

What are the 4 key components of Exercise Therapy?

Answer 19

• Balance (optimsie nerve reactions)
• Strength (inc muscle forces)
• Endurance (inc the Cv system)
• Flexibility (maintains elasticity)

Question 20

Describe Core stability

Answer 20

• Postural stabilising muscles help keep body upright
• SMaller muscles, mainly over joings
  Large n° of proprioceptive fibres

Question 21

By inc core, what is enhanced?

Answer 21

balance reactions

Question 22

Core & the lumbar spine?

Answer 22

• Abdominals provide support and control mov in a highly mobile area
• Ideal to have a good core in lumbar region - lots of mov emanates from there
  poor core > hypermobile > injury > poor quality mov of all 4 limbs

Question 23

Clinical implications of hydrotherapy?

Answer 23

• Function
• Mobility and joint range
• Pain and muscle tone
• Muscle strength

Question 24

CIs to hydrotherapy ?

Answer 24

• Pulmonary problems
• Infection
• Epilepsy
• Unstable fracture
• Incontinence?

Question 25

Describe the Assessment part of Hip dysplasia conservative management

Answer 25

 Gait – shortened stride, stopping++, slow transfers  Muscle Atrophy – middle gluteals and pectineus  Palpation – pain in the above groups  ROM – reduced extension  Soft tissue flexibility – tight iliopsoas  Strength – poor 3 leg stand, poor endurance

Question 26

Rehab plan for hip dysplasia?

Answer 26

 Pain management (laser, acupuncture, hands on, HEP of massage and PROM)  Mobility ( home environment, exercise advice, hydrotherapy, stretches)  Maintain/improve strength ( poles, balance exs, hydro, muscle stim, core work, quads and gluteals)  Assistive devices

Question 27

Assessment for degenerative myelopathy?

Answer 27

- Dragging HLs - Difficulty with functional transitions - - ataxia - Reduced conscious proprioception

Question 28

Rehab plan for Degenerative myelopathy?

Answer 28

 Poles/weaves  PROM/massage  UWTM  Acupuncture  Assistive devices

Question 29

Assessement for Medial Patella Lux ?

Answer 29

 Reluctance to jump  Hip hitching type gait  Intermittent skipping during transitions  Muscle atrophy of quads and hamstrings  Tightness of gracilis and hamstrings  Poor posture – increased flexion of L/S and coxofemoral joints

Question 30

Rehab plan for Medial Patella Lux?

Answer 30

 Reduce pain and swelling (laser, ice, acupuncture, massage)  Increase soft tissue flexibility (stretches, massage)  Strengthen (targeted exercises, muscle stim, hydro, UWTM)  Gait re-education

Question 31

Femoral head and neck excision assessment?

Answer 31

 Weakness of gluteals, hamstrings and quads  Reduced ROM and pain – hip extension  Tightness of iliopsoas  Altered gait - PWB, poor stance posture

Question 32

Rehab aims of FHNE plan?

Answer 32

- Reduce pain, - Inc weightbearing - Inc hip extension - Hip and core strengthening

Question 33

Rehab plan for FHNE?

Answer 33

 Weight bearing – weight shifts, slow walking, cavalettis  ROM – PROM, stretches  Improve proprioception – wobbleboard  Improve strength – muscle stim, theraband, inclines, step ups, sit to stand, zig zags