Rehabilitation therapy for orthopedic conditions (Proceedings)
Apr 01, 2010
CVC IN WASHINGTON, D.C. PROCEEDINGS
There are numerous studies indicating the positive benefits of rehabilitation therapy following CCL surgery. In summary, rehabilitation therapy has been shown to improve muscle mass and attenuate muscle atrophy that occurs in the post-operative period, increase stifle joint ROM, especially extension, improve weight-bearing as measured by force plate analysis, and reduce the progression of osteoarthritis.
Rehabilitation guidelines following stifle surgery are structured to direct the clinician in returning dogs to pre-injury activity levels as quickly and safely as possible. Criterion-based protocols eliminate subjective progression through rehabilitation by dictating the milestones that must be reached in order to progress to the next phase. The rate of progression can differ between dogs and is dependent on the individual rate of healing and the demands of the dog's activity level. Also, clinicians should prescribe therapeutic interventions within each phase that are tailored to the patient's needs. Prescribing therapeutic interventions in a 'cookbook' fashion for each particular diagnosis is committing a disservice to the patient.
Cryotherapy (Ice compresses) following CCL surgery provides an excellent method to help control pain and inflammation in the immediate postoperative period. Not only is cryotherapy beneficial in the acute phase of tissue injury and inflammation, it is also advantageous after exercise and throughout rehabilitation when inflammation occurs. The effects of cryotherapy include vasoconstriction, decreased blood flow, reduced cellular metabolism and permeability, attention of traumatic or exercise-induced edema, and decreased muscle spasm. Another primary effect of cryotherapy is analgesia, which is thought to be a result of decreased sensory and motor nerve conduction velocity that occurs when nerve fibers are cooled.