Modalities Used in Animal Physiotherapy

Original Editor - Alan Jit Ho Mak Top Contributors - Alan Jit Ho Mak  

Introduction

Modalities are the physical entities used a part of a treatment plan. Many of these modalities introduce an energy source to the body to stimulate or support the healing process. Fro instance, thermotherapy and cryotherapy, electoral muscle stimulation, laser therapy, ultrasound therapy, pulsed electromagnetic field therapy, extracorporeal shockwave therapy and hydrotherapy.

Crypotherapy (Superficial cold therapy)

Cryotherapy is most often used in the acute phase of an injury or immediately post operatively. It can also be used in exercise-related injury. Application of a cold pack to an area will reduce blood flow to that area. Cryotherapy has been shown to interfere with pain transmission. It also reduces oxygen demand from the surrounding tissues and will help reduce swelling. If cryotherapy is applied under pressure, this results in greater reduction in swelling and reduced pain scores.

Superficial Hot Therapy (Thermotherapy)

Superficial heat is often used in chronic conditions such as OA and can also be useful for reducing muscle spasm. It promotes blood flow to an area, reduces pain and increases joint and soft-tissue flexibility. Superficial heat will penetrate about 1-2 cm in depth. Sources of heat include a damp towel placed in the microwave, wheat bags, heat mats, gel packs heated in hot water and special hot packs that generate heat on the mixing of two chemicals. Again a towel or similar be placed between the hot pack and the animal's body.

Electrical Muscle Stimulation (EMS)

Electrical muscle stimulation is sometimes referred to as Estim or NMES (neuromuscular electrical stimulation). These are all the same thing. EMS is sometimes also referred to as TENS (transcutaneous nerve stimulation). Whilst both use the same machine, TENS uses completely different settings to achieve pain relief by stimulating the sensory fibres. EMS is used to reverse or reduce muscle atrophy by stimulating motor fibres.

Mobile units are most commonly used in veterinary physiotherapy. EMS machine consists of a small box with a battery and buttons for adjusting the settings and two sets of leads. Each set of leads has a pad at each end. The pads are placed at the top and bottom of the muscle and a current is passed. This causes the muscle to contract. Clipping of the furs and application of an aqueous gel are required to ensure a good contract. The kit comprises two set of leads, so that two muscle groups can be stimulated at the same time.

For instance, one pair of pads could be attached to the quadriceps muscle group and the other to the hamstring group of muscle. The muscle can be made to contract at the same time, in which case the joint will not move, or set contract alternately, in which case the stifle extends and flexes as each group contracts.

Laser Therapy

Lasers have been used or many years in human physiotherapy and are now beginning to make quite an impact in the veterinary market. Penetration is determined by wavelength. Wavelength is predetermined in each machine. Therapeutic wavelength range is 600-940nm. Lasers deliver engird (joules) that depends on the power (watts) of the laser and the time the laser is on. Class 3b lasers only have up to 500mW of power. The laser probe can be directed at the target joint or tissue and held in place while the dosage is delivered (normally measured in joules per centimetres squared). A Class 4 laser produces so much energy that the lead has to be held away from the patient and constantly moved in order to prevent burning. Health and safety for Class 4 lasers requires that all people in the room where lasers are used must wear protective goggles, the patient should be hooded, the doors to the room must be locked or a clear NO ENTRY LASER THERAPY IN PROGRESS sign must be displayed.

The effects of therapeutic lasers cause an increase in cell metabolic rate by affecting part of Kreb's Cycle in the mitochondria. The result is an increase in ATP production and cell metabolic rate. This increase in cell metabolic rate results in faster production of the material the cell manufactures. For example, fibroblast produce more collagen and chondrocytes produce more cartilage matrix.

Lasers also decrease the number of microorganisms, by increasing lymphocyte production, which can have a dramatic effect on granulating wounds and contaminated/infected areas.

Lasers also cause the local release of nitrous oxide, which causes vasodilation. Therefore, lasers increase the blood supply to an area. Lasers also reduce the production of prostaglandins and Cox-2 (cycle-oxygenase coenzyme-2) in the synovial membrane and synovial fluid and in so doing reduce joint pain. Lasers also reduce pain by reducing nerve firing at neuromuscular junctions. Lasers also cause the release of endorphins that enhance pain relief.

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