Tyson

Physiotherapist report – Tyson Atkins Date: 20^(th) August 2019 Physiotherapy Report Subjective: History with vets: Tyson was presented with paresis of the left hind-limb, Osteoarthritic changes to the acetabulum and femoral head and spondylosis in the lumbar region. Owner reports Tyson has been knuckling his left hindlimb and has abrasions on the dorsal aspect of the limb. Objective: 45% hypotrophy of the left hind-limb including biceps femoris, quadriceps, gracilis, adductor and pectinius. Gait: Knuckling the left hindlimb 60% of the time, abrasion on the dorsal aspect of the left hind-limb. Reduced ability to flex and extend this limb in all joints. Abduction of the left hind-limb was seen around the stifle entering stance phase, which contributes to the muscle wastage. Increased weight bearing on the right hind-limb and left forelimb. Lateral landing on both forelimbs. Palpation: Hypotonicity was present in the hind-limb throughout including semitendinosus, gastrocnemius and semimembranosus alongside the hypotrophic musculature. Opposing musculature on the right hindlimb was hypertrophic and hypertonic (esp biceps femoris). Longissimus was very hypertonic and reactive along the lumbar region bilaterally. Range of motion: Protraction and retraction were within the normal range, Resented hip extension bilaterally and occasional vocalisation when approaching the left hind-limb. Stifle flexion and extension normal, the left stifle has reduced resistance and some crepitus occasionally felt when abducted. Action: Massage (responded well), Pulsating magnetic field therapy (200 constant), Phototherapy 3 minutes along longissimus dosri and latissimus caudal boarder. Kinesiotape applied to left hind-limb to offer additional proprioceptive input and to extend the digits on entering stance phase, and to support opposing stifle. Plan: Short Term: Maintain muscle mass and range of motion, reduce spasming in the epaxials. Long Term: Increase muscle mass of the left hindlimb and prevent injury to the right stifle. Exercises - 10 sit to stands daily ensuring the left toes are forwards. - 10 Rhythmical stabilisation weight shifting left to right - Walking on differing surfaces for proprioceptive changes - Use of heat pack on the lumbar area to reduce spasming and pain Date: 30/08/2019 Physiotherapy Report Subjective: As Above Objective: 45% hypotrophy of the left hind-limb including biceps femoris, quadriceps, gracilis, adductor and pectinius. Gait: Only knucking left hind-limb occassionally, abrasion on the dorsal aspect of the left hind-limb healing well. Abduction of the left hind-limb was still seen around the stifle entering stance phase, especially when tired. Increased weight bearing on the right hind-limb and left forelimb. Lateral landing on both forelimbs. Palpation: Hypotonicity was present in the hind-limb throughout including semitendinosus, gastrocnemius and semimembranosus alongside the hypotrophic musculature. Opposing musculature on the right hindlimb was hypertrophic and hypertonic (esp biceps femoris). Some hypertonicity in the lumbar epaxials. Range of motion: Protraction and retraction were within the normal range. Stifle flexion and extension normal, the left stifle has reduced resistance and some crepitus occasionally felt when abducted. Action: Massage, Pulsating magnetic field therapy (200 constant), Phototherapy 3 mins along longissimus dorsi and latissimus caudal boarder. Kinsiotape applied to left hindlimb to offer additional proprioceptive input and support while carrying out home exercises. Plan: Short Term: Maintain muscle mass and range of motion, reduce spasming in the epaxials. Long Term: Increase muscle mass of the left hindlimb and prevent injury to the right stifle. Exercises - 10 sit to stands daily ensuring the left toes are forwards. - 10 Rhythmical stabilisation weight shifting left to right and front to back if tired. - Continued walking on differing surfaces for proprioceptive changes - Use of heat pack on the lumbar area to reduce spasming and pain - Use of poles and surfaces in the home to encourage weight bearing Kindest Regards Becky Black BSc(Hons) AdvCertVPhys ClinEd(AccMdx) RCH MIRVAP Date: 17/08/2019 Physiotherapy Report Subjective: As Above Objective: Measured muscle mass of left and right hindlimbs from patella to distal semitendinosus insertion. Left approximately 5cm reduced muscle bulk. Gait: Only knucking left hind-limb very occassionally, abrasion on the dorsal aspect of the left hind-limb healing well. Abduction of the left hind-limb was still seen around the stifle entering stance phase, especially when tired. Increased weight bearing on the right hind-limb. Lateral landing on both forelimbs. Palpation: Hypotonicity was present in theepaxial musculature. Right hindlimb was hypertonic and hypertrophic. Left hindlimb was hypotrophic and hypotonic. Range of motion: Protraction and retraction were within the normal range. Stifle flexion and extension normal. Action: Massage, Phototherapy 3 mins along longissimus dorsi. Kinsiotape applied to left hindlimb to offer additional proprioceptive input and support while carrying out home exercises. Placed on biceps femoris to induce recruitment. Plan: Short Term: Maintain muscle mass. Long Term: Increase muscle mass of the left hind-limb and prevent injury to the right stifle. Exercises - 10 sit to stands on raised platform - 10 Rhythmical stabilisation weight shifting left to right and front to back if tired. - Use of proprioceptive aids around the home (poles) - Short Lead walks - Allowed to climb stairs aided by owner, if slow and placing each hindlimb in turn. Kindest Regards Becky Black BSc(Hons) AdvCertVPhys ClinEd(AccMdx) RCH MIRVAP