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Flashcards in Physiotherapy Deck (39)
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What is the status of veterinary physiotherapy?

- RCVS Code of Practice for Vets
- Physios, osteopaths and chiropracters
- 19.12 The Veterinary Surgery (Exemptions) Order 1962 allows for the treatment of animals by physiotherapy, provided that the animal has first been seen by a veterinary surgeon who has diagnosed the condition and decided that it should be treated by physiotherapy under his/her direction.


What does 'physiotherapy' include?

'Physiotherapy' is interpreted as including all kinds of manipulative therapy. It therefore includes osteopathy and chiropractic but would not, for example, include acupuncture oraromatherapy.


Who does physio?

Nurses and vets with specific experience and training
Qualified physiotherapists with animal experience and/or holders of a conversion qualification


Therapeutic basis of physiotherapy?

- Physical techniques that have a direct impact on healing tissues
- Exercises that promote “proprioceptive learning”
- Overlap between the two
- Essential nature of integrating physiotherapy with the overall treatment plan
- Clients have a very high affinity for physiotherapy - but often limited evidence
- The cycle of examination, therapy and re-examination
- The therapist needs to be continually re-evaluating the patient, cataloguing changes and deciding on parallel evolution of the therapy with the changes


Massage - what are the direct impacts on tissue?

* Pain relief
* Decreased mobility
(Mechanical restriction, Post surgery, Disease)
* Preventative against injury in athletes and preparatory for performance
(Warm up, performance enhancement, Recovery from fatigue and soreness)


How does massage work? 4

- relaxation (continuous touching and palpation creates a sense of security and lowered stress)
- pain relief via lowered stress and possibility of endorphin release
- direct activation of neuropeptide release in nervous system
- improved circulation and lymphatic flow (especially vascular and lymphatic return)


Outline practical masage

- can be for an isolated area
- usually an area (e.g. limb)
- often coupled with ROM exercises as warm-up
- time consuming and physically demanding n therapiist


Methods - practical massage - 4

- stroking (start with this)
- effleurage (hands move distal to proximal with medium pressure)
- compression and wrining (Petrissage)
- Percussion


Outline petrisage/ compression and wringing

- high pressure targetted at individual mm
- compress and hold for 15 seconds


Outline percussion

- cupped hand or hacking over areas of increased tone
- specific attention to spasmic nodules (trigger points)


What does cryotherapy do?

- Affects vasculature (constriction) and nerves (analgesia) directly
- Can be used even when patient is not ambulatory (Early in acute treatment)
- Most effective in the management of acute inflammation
- About 20 minute treatments


Methods - cryotherapy

- As simple as a plastic bag with a water/ice mix covered with a tea-towel (thin cloth)
- Cryogel packs (re-freezable)
- Jackets and filler flasks
- Ice bath immersion
- Vapour coolant
- Use 20 minute treatments and monitor for frostbite!


What does thermotherapy do?

- Affects vasculature (constriction) and nerves (analgesia) directly
- Can be used even when patient is not ambulatory (Not in the acute phase - heat will make swelling, heat and pain worse.
- Once initial swelling has decreased heat helps vasodilation
- Heat packs (microwave), hot water bottles


Indication - range of motion and stretching

- diminishing the effects of disuse and immobilty (increasing limb flexibility, improving ROM of joints, reducing adhesions and thickening around joints, improving muscle extension)
* expect small gains to occur slowly but effectively


What does muscle ROM equal?

= functional excursion


What is passive ROM?

- Limb supported by therapist, joint isolated
- Single joint flexed and extended until limits of ROM are reached
- Alternatively all joints of a limb can be put through ROM together (functional pattern)
- 15-20 repetitions 2-4 times per day


When is passive ROM useful?

Early - before patient wants to stand


What is active assisted ROM?

Therapist manually assists limb movement to encourage patient to use fuller ROM


When is active assisted ROM?

- once patient starts to walk
- could also be used in pool


What is ROM?

- Patients that are walking or trotting more normally do not use full ROM
- Change exercise to encourage use of full ROM (Walking in water, Different surfaces e.g. Sand, vegitation, Exercise rails, tunnels, obstacles, stairs)
- Vary exercise appropriately for size of patient!


What does stretching do?

specific reference to taking joint past the normal ROM. Desgined to oppose shortening ot tissues and to break down fibrosis and adhesion. Largely in form of static stretching in animals!


Method - static strecthing

- Normally started with passive ROM
- Take the joint to the point of resistance and then firmly move to stretch
- Monitor pain – cause no more than mild discomfort
- Hold for 15 seconds and gently release
- Up to 20 times per session


What is prolonged static stretching?

- Similar level of stretch to static system
- Stretch is held for 20mins up to 4 hours using cast, splint or bandage
- Can also use variable devices like rubber bands and dynamic fixators


What is ballistic stretching?

- Series of short bouncing stretches
- More difficult to control
- Only appropriate in patients where pain is very well controlled
- Potential risk of injury


What are therapeutic exercises?

Vast variety of exercises that can be organised in relation to a specific problem targeted to a specific problem list


List types of therapeutic exercises

- Assisted standing, maximal assisted standing, active assisted standing
- Body Slings (Stabilise while taking initial steps, Relieves thoracic and abdominal compression, Carts and slings
Inflatable exercise rolls)


Aim - therapeutic exercises

to progress to standby assisted standing and finally to standing alone


Can electrotherapy, laser and ultrasound be used?

Yes - but specific equipment and training required


How does ultrasound work as a treatment?

Primarily works through a heating effect and has the capacity to heat deeper tissues but direct effect is difficult to monitor.


How long od you do ultrasound treatment?

short - 10 minutes

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