Physical Therapy PDF - Instructional Module

Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE...

Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Total Parenteral Nutrition Patients unable to enterally absorb sufficient nutrients for more than 3-5 days, especially with apparent signs of malnutrition Severe prolonged pancreatitis when enteral feeding tubes are not an option Intolerance to enteral tube placement or force feeding Animals having a high nutritional requirement With an on-going protein loss (ex. patients with large draining wounds, open abdomen, or severe protein losing enteropathy) I. UNIT TITLE/CHAPTER TITLE PRINCIPLES OF THERAPY II. LESSON TITLE PHYSICAL THERAPY III. LESSON OVERVIEW The same with that of human medicine, physical therapy is needed and performed in veterinary practice to restore the function of an injured pet. Physical therapy enhances recovery from musculoskeletal injury, surgery, joint diseases and other debilitating conditions. It is also used for pain alleviations especially in chronic cases. It includes the use of massage, heat and cold therapy, swimming and other modalities. IV. DESIRED LEARNING OUTCOMES Perform different modalities of physical therapy V. LESSON CONTENT Physical therapy is an adjunct in the rehabilitation of musculoskeletal injury, neurologic and chronic diseases. It is an invaluable tool in animal rehabilitation following injuries. MASSAGE AND PASSIVE MOVEMENT Massage involves therapeutic manipulation of soft tissues and muscle by stroking, kneading, and/or percussion. It is mainly rooted on human medicine, which involves applying pressure to specific parts of the body. A few of the more common techniques include trigger-point massage, craniosacral therapy, acupressure, friction massage, and passive range of motion therapy. Massage Therapy is practice in some species such as: Horses- sports massage is used to prevent injury before competitions Small animals especially dogs and cats- passive range of motion is prescribed as a form of rehabilitation following certain injuries and orthopedic procedures Mechanism of Action: Massage focuses on soft-tissue elements-namely, muscles and the enveloping fascia. The neuromedulatory and homeostatic effects of massage likely pertain to parasympathetic nervous system stimulation. Indications: (with liniments) sub-acute and chronic inflammatory conditions In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 112 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Arthritis, joint problems, tore or over-extended muscles and ligaments, injury and surgery Both acute and chronic musculoskeletal injuries may respond to massage therapy, especially as a complement to other forms of specific treatment. Contraindications: Presence of foreign bodies Existence of neoplasm Massage is not recommended in the following conditions: – Acute inflammation – Cancer – Cardiac disease – Emergency care – Fever – Open lesions – Pregnancy – Zoonotic diseases General Effects of Massage: Mechanical Mobilization of skin and tissues Management of scar tissue Loosening of secretions Physiological Drainage of venous blood and lymph Afferent input- sedative or stimulatory Pain control Removal of noxious chemicals (circulatory effect) Release of endorphins Effects on musculoskeletal system Reduction of muscle fatigue and delayed onset muscle soreness (DOMS) Psychological Reduced tension and anxiety Improved relaxation Description of Various Massage Technique: Technique Stroking Hands glide smoothly over the body, maintaining contact with the skin. Starts proximally and ends distally when treating the limbs Effleurage Hands mould to the shape of the limb and maintain pressure throughout the movement. Starts distally and ends proximally, moving in the direction of venous and lymphatic drainage Kneading Tissues are squeezed, compressed and released in a rhythmical manner. Hands move in a circular motion. Picking-up Muscles are grasped, lifted, squeezed and released (squeezing) Wringing Hands move in opposite directions across the long axis of the muscle, stretching the tissues Skin rolling Fingers and thumb lift the skin, and roll the tissues forwards or backwards Frictions Fingers or thumb move superficial tissues over deeper ones, with increasing pressure Hacking The ulnar border of the little finger strikes the area being treated. Hands work alternately (pronation and supination) and fingers are kept relaxed In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 113 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Coupage Hands are cupped and wrists are loosely flexed and extended. Hands work (clapping) alternately and firmly strike the treatment area Shaking One hand holds the muscle, and vigorously shakes it Vibrations Hands hold around the area of chest being treated and lightly shake the chest. Vibrations are performed during the exhalation phase of breathing and the hands gradually move cranially. Benefits of Various Massage Techniques Major benefits Other benefits Stroking Accustoms cat to touch Useful for starting and finishing massage session Reduces tension and Provides a helpful link between different anxiety Lowers muscle tone techniques Effleurage Reduces swelling and Removes chemical by-products of inflammation edema Maintains mobility of soft tissues Stretches muscle Kneading Increases circulation Remove chemical by-products of inflammation Picking up and lymphatic flow Provide sensory stimulation and invigoration Wringing Mobilize soft tissues (fast technique) Relaxation and lowering of muscle tension (slow technique) Skin rolling Mobilizes skin and scar tissue Frictions Break down adhesion Local hyperemia Hacking Increase circulation Coupage Sensory stimulation (clapping) Loosen chest secretion and stimulate coughing (coupage) Shaking Increases circulation Provides sensory stimulation Mobilizes soft tissues Reduces adhesions Vibrations Loosen chest secretions and stimulate coughing Advantage of Massage: Promote socialization Enhance human-animal bond Help maintain the health of a pet that is kenneled Disadvantages: Massage is time-consuming to perform which may delay the much-needed veterinary care If is done incorrectly, massage can cause or intensify pain or muscle spasms, resulting in worsening of the original condition or in secondary injuries Passive Movement Movements of a joint made in a rhythmical manner through the full pain-free range. It is primary used to maintain or restore joint range/ muscle length, they also aid articular nutrition, stimulate mechanoreceptors and reinforce patterns of movement. These techniques are completely passive and require no active involvement of the animal, so will not prevent muscle atrophy or increase strength. They are generally used to maintain range postoperatively when an animal is incapable of moving the joint on its own or when active motion may be deleterious to the patient. Gait patterning is a form of passive movement whereby a limb is moved in a normal walking motion, and is particularly useful for neurological patients. In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 114 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Stretches add sarcomeres, units of fiber in muscles, to increase the muscles’ range. The use of passive movement techniques means that the animal does not need to use their own muscular effort or bear weight. Indications: - Conditions that have resulted in a decreased range of motion - Trauma from accident or surgery - Arthritis Contraindications: - If the exercises might lead to further instability or injuries – Unstable fractures – Unstable injuries of tendons or ligaments Benefits: - Increase joint mobility - Increased flexibility - Prevent adhesions - Remodeling periarticular fibrosis - Increased muscle and tissue extensibility - Decreased effects of disuse and immobilization Advantages: 1. It is performed when an animal is unable to move the joints on its own 2. Directly after orthopedic surgery 3. In disabled pets, to avoid contractures Disadvantages: 1. It cannot prevent atrophy of muscles 2. It cannot strengthen muscles 3. It cannot improve endurance Stretches: Also a passive movement that help to improve or restore full range to a joint or full length to a muscle. Whereas passive movements create elastic (temporary) deformation of tissue and maintain normal length/ range. During stretching, the tissue is moved slightly over the currently available ROM. HEAT AND COLD THERAPY - Heat and cold are used to relieve pain in acute or chronic conditions and in inflammatory disorders in both humans and animals. - Cold water first constricts the blood vessels and numbs the nerve endings; then it triggers a longerlasting dilation of the vessels. - Hot water first dilates the blood vessels and soothes the nerve endings; then it causes a longer-lasting relaxation of the tissues. Heat therapy - It is considered as the oldest form of physical therapy - Temperature sensitive nerve endings in the skin sends signal to the hypothalamus on the local temperature changes causing increased capillary permeability - Causes dilatation of blood vessels increasing blood flow to the site of injury - More oxygen and nutrients to reach the injured cells, supporting the growth of new, healthy tissues - Faster clearing of excess fluid out of the area along with dead cells and other debris - Loosens muscle fibers, tendons and ligaments - Increases joint and soft tissue flexibility - Relaxation of muscle spasm - Pain relief In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 115 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Heat therapy may be transmitted by: Conduction o Examples: hot packs, paraffin, hydrotherapy Convection o Hydrotherapy, air temperature Radiation o UV lamps, Infrared Heat Application Superficial - Heating agents used heats the skin and subcutaneous tissues to a depth of 1- 2 cm - Skin temperature can be increased up to 10ᵒC or more but tissues at 1cm in depth are raised at less than 3ᵒC and 1ᵒC in tissues at a depth of 2cm or less. - Can be applied with the use of hot packs, heat wraps, warm water hosing, whirlpools, paraffin baths, circulating warm water blankets, electric heating pads, infrared lamps, electric heating beds - Heat source is applied for 15-20 minutes to promote hyperemia Indications: - Muscular spasms - Muscular stiffness - Stiff joints - Promote wound healing Contraindications: - Non-ambulatory patient - Acute phase of injuries - Circulatory problems in general - Impaired sensation - Heat injury - Infections - Malignant tumors Different Methods of Heat Applications: Duration of heat application: ▪ 20-30 minutes Do not apply heat for longer than 30 minutes at one time. Too much heat applied too long can irritate nerve endings and result in neuralgia, a dull to severe ache in the nerve endings. ▪ Hot packs ▪ Pack is soaked in boiling water; can retain heat for up to 20 minutes ▪ Hot water bottles ▪ Wrap bottle with a towel to avoid direct contact with the animals body ▪ Hot towels ▪ place towel in boiling water, wring to dry ▪ Apply to the area of injury for 20 minutes, secure it with bandage if applicable ▪ Infrared lamps ▪ Wavelengths are absorbed by water in tissue, the molecules in water become more excited and begin to vibrate creating thermal or heating effect. Longer wavelength of over 1000 nm are readily absorbed by the water in the tissue. ▪ Photoacceptor molecule within the cell called cytochrome c oxidase absorbs the photons and accelerates the production of adenosine triphosphate (ATP) for cell repair. ▪ Near Infrared treatment- 600-1000nm when applied to damaged cells using low energy lasers or light-emitting diode (LED) arrays, these specific wavelengths have been shown to promote tissue repair and modulate pain. In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 116 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 ▪ Damaged cells have a hard time making the energy they need to repair themselves, and light therapy gives them the fuel they need to repair and regenerate cell components, foster mitosis, restore homeostasis and reduce inflammation. ▪ Light therapy provides not only a temporary increase in circulation but also increases new capillary formation. These treatments help tissue and nerves heal up to 50% faster with less scar tissue, while reducing pain caused by injury, arthritis or other inflammatory conditions. ▪ Far Infrared Radiation- over 1000 nm wavelength ▪ Indications: o General malaise o Post trauma o Following surgery o Sprains and muscle stiffness o Colic o To stimulate acupuncture loci ▪ Contraindications: o Impaired sensation ▪ Technique: o Remove all metal object on the animals body (collar or harness fittings) o Position the animal ensuring that the animal will not get in contact with the lamp if it moves. o Rays should strike the body surface at an angle of 90ᴼ o Contact time: minimum of 15-20 minutes ▪ Infrared plus acupuncture ▪ Lamps are placed 18-24 inches from the body surface to heat needles already in place ▪ Electric heating pad ▪ Artificial source of light ▪ Cradle solarium o Indications: o Malaise o Injury o During winter o Contraindications: o Light- sensitive conditions o Technique: o Position the lights ensuring most of the body parts are able to receive light rays at an angle of 90ᴼ and approximately 20-30 inches away o Start exposure 3-5 minutes daily and work up to 15-20 minutes over a 3 week-period ▪ Poultices ▪ Application of moist heat produced by a semisolid mixture of various substances and applied to the body while hot. ▪ Treatment of arthritis, rheumatism and other inflammations. ▪ Allow poultice to remain on for 15 to 30 minutes, depending on the body parts being treated. o Young growing animals- 10 minutes ▪ Do not apply poultice directly on skin eruption. ▪ Example of poultice: o Onion, cabbage and cottage cheese- use to draw toxins out of the dirty wounds and especially out of boils o Mustard- joint pain, rheumatism and neuralgia Therapeutic Cold (Superficial Cold Therapy/ Cryotherapy) - Commonly used in acute phase (within 24 -72 hours) of an injury, immediately post-operatively, or exercise induced injury - Cold reduces swelling and acts as a local anesthetic In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 117 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 - Lowers cell metabolism and causes vasoconstriction and decreased nerve conduction velocity, which results in an increase pain threshold - When blood flow is decreased, the swelling begins to dissipate, releasing pressure on delicate nerve endings, which further reduces pain and muscle spasm - Cold stimulates cutaneous afferent nerves that act reflexively on the motor neuron, decreasing its firing and reducing the irritability of the nerve-muscle junction. - Decreases pain by numbing the sensory nerve endings ▪ endogenous opioids (endorphins, enkephalins) act on opioid receptors on both the presynaptic (primary afferent) nerve terminal and the postsynaptic cell (2nd order neuron) to decrease nociceptive neurotransmission ▪ presynaptic actions include a decrease in Ca2+ conductance that results in decreased neurotransmitter release Benefits: -Lowers cell metabolism and causes vasoconstriction and decreased nerve conduction velocity, which results in an increase pain threshold ▪ When blood flow is decreased, the swelling begins to dissipate, releasing pressure on delicate nerve endings, which further reduces pain and muscle spasm ▪ Cold stimulates cutaneous afferent nerves that act reflexively on the motor neuron, decreasing its firing and reducing the irritability of the nerve-muscle junction. ▪ Decreases pain by numbing the sensory nerve endings - Reduces oxygen demand from the surrounding tissues and will help reduce swelling - It causes a 10ᵒC drop in skin temperature after 15 minutes cold application and similar drop of temperature in the subcutaneous tissues after 30 minutes application. A decrease in temperature of muscle will take a longer time. Indications: - Musculoskeletal trauma ▪ Sprains ▪ Muscle strains - Contusions - Post-surgical swelling and pain ▪ Femoral head and neck ostectomy ▪ Tibial plateau leveling osteotomy (TPLO) ▪ Tibial tuberosity advancement (TTA) ▪ Tendon and ligament injuries ▪ Fracture repair ▪ Osteochondritis dissecans (OCD) ▪ Osteoarthritis - Burns Examples of Cold Therapy: - Styrofoam cup filled with water and then frozen - Ice immersion - Ice packs - Application of cold water from a hose - Running stream - Whirlpool tubs - Wellie boots - Cold bandaging - Frozen gamgee or cotton wool In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 118 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Duration of Cold Application Acute Stage 3 to 10 minutes Prolonged 10 to 30 minutes Very Prolonged Chronic Cases 3 to 15 minutes Prolonged (according to the size of the swelling) Example: 3 to 10 minutes Direct application of ice: Ice Massage 15 seconds to 3 minutes Application of ice on sensitive body parts: face or groin Note: Duration of application depends on the size and nature of the injury. When using cold on an open, bleeding wound, do not apply it for more than 10 to 15 minutes because it will interfere with coagulation. Ice massage is given for up to 20 minutes several times a day combined with compression wraps Contraindications: - Open wounds - Fractures ▪ Areas where there may be involvement of nerve: sensory r motor Contrast Bathing - This technique is usually used after the time has elapsed where cold therapy will no longer be effective. It is an excellent method of increasing circulatory flow, decreasing swelling, contusions and speeding the elimination of tissue exudate - Application of cold and heat ▪ Apply cold for 3 minute, then heat for 3 minutes, for a duration of 20- 30 minutes ▪ Causes blood vessel to alternately constrict then dilate, creating a vascular pump that helps increase blood flow and dissipate inflammation - Indications: ▪ Soft tissue damage ▪ Hematoma ▪ ‘filled’ joints ▪ ‘filled’ legs - Contraindications: ▪ Open wounds ▪ Infections HYDROTHERAPY - Utilizes warmth, buoyancy and resistance of water in a controlled environment to provide an optimal setting for cardiovascular conditioning and rehabilitation - Mechanism of Action: - Water immersion induced an increase in methionine- encephalin plasma levels and, conversely, suppressed plasma - endorphin, corticotropin and prolactin levels. - Buoyancy of water assists in supporting the patient’s weight which reduces the force of stress placed on the joints. ▪ By decreasing the amount of joint stress it is easier and less painful to perform exercises. - Viscosity of water produces resistance which allows strengthening of the muscle without putting weight on limb In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 119 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 - Hydrostatic pressure produces forces perpendicular to the body’s surface, this pressure provides joint positional awareness to the patient resulting to improved patient proprioception. ▪ hydrostatic pressure increases lymphatic drainage and can help reduce pain, swelling and inflammation and improve joint position awareness. Hydrotherapy aids in case of: ▪ Arthritis ▪Bruise s ▪ Bursitis ▪ Corns ▪ Dermat itis ▪ Desmiti s ▪ Greasy heel - Injury prevention - Sprains and strains - Injury rehabilitation - Swollen joints - Laminitis/ founder - Synovitis - Ligament injuries - Tendon injuries - Mud fever - Tendonitis - Rain scald - Thrush - Shin splints - Windgalls/ puffs In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 120 of 113  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Underwater treadmill Advantage of suing underwater treadmill ▪ Water temperature and level can be adjusted quickly ▪ Walking surface of the treadmill can be tilted in some machines allowing the animal to walk on inclined plane ▪ Walking speed can be adjusted ▪ Movement of limb can be observed and assessed from outside of the unit ▪ Therapist can encourage proper limb movement Limitation - Cardiovascular compromise, hypotension or hypertension - Epilepsy - Unhealed surgical incisions without a waterproof cover - Open, infected or draining wounds - Active gastrointestinal disease (fecal incontinence/ vomiting) - Elevated body temperature/ infection - Respiratory compromise or distress - Advanced debility - Kennel cough in dogs (contagious) SWIMMING - Movement in water is easier due to the buoyancy and water resistance created by water, enabling the animal to carry out non-weight bearing exercises which relieves pressure on joints, reducing pain and encouraging movement - Mechanism of Action: - Water immersion induced an increase in methionine- encephalin plasma levels and, conversely, suppressed plasma - endorphin, corticotropin and prolactin levels. - A combined effect of the properties of water such as buoyancy, hydrostatic pressure, resistance, immersion - Indications: - Post-operative rehabilitation for orthopedic and neurologic conditions ▪ Ex. Following CCL repair ▪ Osteoarthritis - Behavioral and obesity-related problems In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 121  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 - Cardiovascular conditioning - Young active dogs on restricted exercise of 113 - Pools for swimming should be kept at sub-thermal temperatures: 27-32°C. - Exercising in colder water may cause an increased work of swimming and increase oxygen uptake due to shivering, as well as difficulty contracting muscles. - water should not be too warm, due to the thermal load on the body, the risk of fatigue and exhaustion. - Limitation: - Cardiovascular compromise, hypotension or hypertension - Epilepsy - Unhealed surgical incisions without a waterproof cover - Open, infected or draining wounds - Active gastrointestinal disease (fecal incontinence/ vomiting) - Elevated body temperature/ infection - Respiratory compromise or distress - Advanced debility - Kennel cough in dogs (contagious) MAGNETIC FIELD THERAPY - Also known as magnetic therapy used for treatment of medical conditions which involves the use of magnetic field generated by either permanent magnets or pulsed electromagnetic fields - Magnets comes in different sizes and strength - Degree of benefit and the effect itself depends on the magnetic device’s magnetic field characteristics such as intensity and field gradient, as well as the duration of use and placement of the magnet. - Duration of treatment varies with type of magnet and condition being treated - Magnets works by means of lines of force, measured and quantified in units called gauss, and a therapeutic magnets measure anywhere from 300-5,000 gauss Two classification of magnet: 1. Static/ Permanent magnet - comes in strips, bars, and beads, and are often taped or glued to specific areas of the body for prolonged periods of time - weakest form of magnotherapy; magnet gives out a very weak magnetic field In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 122  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 2. Pulsed Electromagnetic field magnet (PEMF) - pulses of electromagnetic energy are delivered to the affected area in a series of treatments that each last up to an hour. - Works quicker and penetrate deeper into the animal’s body due to stronger electrical current it produce compared to permanent magnet Two types of polarity of magnet: 1. Unipolar magnet - Magnets that have north on one side and south on the other 2. Alternating magnet/ Bipolar - are made from a sheet of magnetic material with north and south magnets arranged in an alternating pattern, so that both north and south face the skin. - This type of magnet exerts a weaker magnetic field because the alternating magnets tend to oppose each other. How does it work? - “Magnetic energy is absorbed in the blood due to the iron content contained by hemoglobin. This energy travels through the blood stream causing blood vessels to dilate, increasing blood flow, increasing oxygenation and eliminating toxins thereby restoring the pH levels of the blood cells and tissues” (Kelly, M. https://www.pethealthcare.co.za/). - It is believed that the body has a natural magnetic and electrical field and molecules in the body have a small amount of magnetic energy in them. If the magnetic energy is out of balance, putting a magnetic field near the body, it is believed the body will regain balance and regularity (https://www.webmd.com/). of 113 - “The animal’s body has a natural electric current running through it caused by the electrically charged particles of a cell (ion). Ions affect the metabolism of the cell. By using a magnet, a weak electrical signal is transmitted to the affected area by the magnetic field which interacts with the ions, increasing the blood flow and therefore the productivity of the cells. This leads to an increase in oxygen utilization and nutrient transport within the cells reducing healing time and pain” (Williams, J.) Indications: - Used to enhance healing from injuries and wounds - To treat chronic conditions such as tendonitis, degenerative joint disease, hip dysplasia, vertebral disease, and lameness caused by other musculoskeletal or neurologic conditions Contraindications - Fresh wounds - Pregnant patient - Patients with pacemakers - Cancer - Presence of infection In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 123  Republic of the Philippines NUEVA VIZCAYA STATE UNIVERSITY Bayombong, Nueva Vizcaya INSTRUCTIONAL MODULE IM No.: IM-VCLIN 1-1STSEM 2021-2022 Pulse Magnetic Field Therapy Devices NEUROMUSCULAR ELECTRICAL STIMULATION (NMES) - a low-voltage electrical impulse is used during rehabilitation of animals mainly horses and dogs after incurring injury or disease that results in muscle wastage or dysfunction - a device is attached to the animal via electrodes which are placed either side of a specific muscle group - Frequency, pulse duration, amplitude, waveform, on/off time, ramp and polarity of electrodes are all parameters that can be adjusted when using NMES. Indications: - swelling and pain - It can be used to prevent atrophy post-surgery or post-injury, or to increase strength for muscles that have been chronically underutilized. - commonly used in partially-paralyzed dogs or in dogs who have undergone neurosurgery, before they are weight-bearing and during re-education of ambulation - used with performance animal to help improve the health of damaged muscle after extensive training - How does it work? - The electrodes placed at the beginning and end of the muscle transmit an electrical signal to the group, stimulating the nerves in the muscle with electrical impulses stimulating the group of muscles to contract and relax building muscle functions and tone. - These muscle contractions can be used to mimic strength training for animals that are non- weight bearing or have limited use of one muscle or muscle group. TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION - Uses low-voltage electrical impulses; pulse rate and width can be controlled in order to deliver the desired effect. How does it work? - Mild electrical impulses blocks the pain signals that are received by the brain or because electrical stimulation of the nerves induces the body to produce the natural painkillers, endorphins, which block the pain perception. Indications: - Pain relief - To stimulate muscle contraction to prevent muscle atrophy after nerve injury or paralysis - Muscle strengthening during recovery from injury such as cruciate ligament disease In accordance with Section 185. Fair Use of a Copyrighted Work of Republic Act 8293, the copyrighted works included in this material may be reproduced for educational purposes only and not for commercial distribution. NVSU-FR-ICD-05-00 (081220) Page 124