Physical Therapy for Neurologic Conditions
Rehabilitation therapy is a key component of recovery from neurologic disease. Each patient requires a rehabilitation protocol designed specifically for the patient's neurologic condition, owner expectations and level of participation, and expertise of the professional canine rehabilitation team. Initial therapy for nonambualtory patients may include standing exercises, range of motion, pain control, toe pinch exercise, aquatic exercise, and basic rehabilitation care. Sling assisted walking with foot protection, cavalettis, and physio ball balancing are used commonly for ambulatory patients. As recovery progresses, stair climbing, carrying or pulling weights, resistance band walking, swimming against resistance, and exercises specific to the home environment are added. Modalities such as electrical stimulation, ultrasound, cryotherapy, and heat therapy are useful additions.
Paralysis, limb weakness, degenerative myelopathy, IVDD, decreased activity tolerance, strengthening/conditioning and incontinence.
Laser, shockwave , ultrasound, acupuncture, massage , stretches, supervised exercise, hydrotherapy and owner instruction are a few examples of how physical therapy can help your neurologic dog. We also offer the Assisi Loop PEMF for pain management.
Update on Ella's Progress.....
Ella is a 9-year-old FS chocolate lab that had an IVDD event at T12-T13 in June 2014. Within 48 hrs of the event, Ella had a left hemilaminectomy. She has been severely paraparetic since June, using only her forelimbs for walking. Her owners purchased a wheelchair to help her get around.
When we first saw Ella, she had severely atrophied hindlimb muscles and delayed reflexes in her left hindlimb. Her right hindlimb reflexes were normal. Both limbs exhibited very strong extensor tone. Her shoulder muscles were very tense and hypertrophied. She suffered from frequent urinary tract infections due to upper motor neuron bladder complications. She was able to maintain a standing position if we placed her hindlimbs for her, but only for approximately 15 seconds before falling over.
We focused on ways to help reinforce Ella’s proprioception and strengthen her hindlimbs. We used the underwater treadmill to help her walk, in which she had excellent and purposeful motion of her limbs, but ataxia was evident as she crossed her paws. We also used electrical-stimulation (e-stim) of her HL muscles to help initiate contractions in her atrophied hamstrings, gluteals, quadriceps, and gastrocnemius muscles. Exercises to increase tactile stimulation to her back paws were used both in-clinic and at home.
Since starting rehab last month, Ella has increased her endurance in the treadmill from 3 minutes to over 10. She is still too paretic to walk solo, but her hindlimbs are stronger with daily e-stim, and she is able to stand for more than a minute on her own. We are currently practicing postural transitions (sitting to standing, for example), and she is doing better every day. At the time of this writing (January 2015), we hope to have her walking again within the next 3-4 months.