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Physical Rehabilitation – What is it all About? Debbie Gross, DPT, MSPT, Diplomat ABPTS, CCRP Wizard of Paws Physical Rehabilitation for Animals, LLC Physical therapy or physical rehabilitation has a long history in human medicine and became very popular after World War I and with the polio epidemic in the United States. It is now commonplace for every human undergoing an orthopedic surgery, suffering from musculoskeletal disorders, neurological issues, or other common conditions receive physical rehabilitation. The multimodal approach of reducing pain, inflammation, and improving strength and function is now the standard of care. Dr. Steven Fox, director of pain management at Novartis Animal Health has stated ‘Multimodal management of canine osteoarthritis is rapidly becoming the standard of care. This approach integrates nonmedical modalities – weight control and exercise, EPA rich diets, and physical rehabilitation – with medical modalities (NSAIDs, chrondroprotectants, and adjunct drugs).’ In human medicine, the American Pain society issued a statement indicating that the multimodal approach should be practiced in all cases of osteoarthritis. Physical rehabilitation is appropriate for many cases commonly seen in the small animal clinic. Common cases are inclusive of osteoarthritis, cruciate disease, hip and elbow dysplasia, intervertebral disc disease, soft tissue injuries, degenerative myelopathy, post surgical orthopedic and neurological issues, wound care, and limb deformities. Any condition causing pain and dysfunction may be treated with physical rehabilitation to a degree. Postoperative conditions, such as cranial cruciate repairs, may begin to receive physical rehabilitation immediately after surgery with applications of cryotherapy, laser therapy, passive range of motion and controlled walking. Canine hip dysplasia may be treated with laser therapy, range of motion exercises, balance and proprioceptive activities, and strengthening through walking in water. Conservative management for intervertebral disc disease may consist of laser therapy, rhythmic stabilization for the spinal and abdominal musculature, active range of motion, and controlled leash walks. The primary veterinarian refers in appropriate cases to physical rehabilitation, and veterinarians and physical therapists and veterinary technicians depending upon the individual state practice act may perform treatments. Certificate programs exist to assist practitioners in beginning their knowledge on canine physical rehabilitation. It is important to perform a comprehensive evaluation on every rehabilitation patient that will be inclusive of functional deficits, range of motion, goniometry, gait evaluation, pain evaluation, and strength deficits. Often the dog may be presenting for a primary problem, but needs to have secondary and tertiary problems addressed.
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