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Physiotherapist report – Blue R
26^(th) August 2020
Subjective: Blue has had a recent spinal trauma and has since had no
motor capacity in bilateral hindlimbs. Owners are dedicated and able to
carry out some exercises to aid Blue.
Blue is crated and allowed onto the kitchen floor (tiled) advised to use
carpet off-cuts to prevent slips and aid traction to Blues hind-limbs
when positioning. Blue is able to be toileted out in a patio area –
hind-limb sling given to aid with this. Currently Owners are still
carrying out massage, proprioceptive tasks and ROM/postural set
exercises daily to aid with nerve input and mental stimulation while
maintaining joint fluid quality and muscle tone.
Objective: Significant trigger points and spasming bilaterally over the
shoulders as expected due to strain from locomoting with forelimbs. This
needs monitoring. Bilateral spasming down epaxials musculature,
approached with extreme caution and gentle massage was used and
tolerated on the cranial portions. T12-L3 palpable region where
temperature changes. Hypotonicity bilateral hind-limbs spasming in
biceps femoris of the RH.
Range of motion: Range of motion is good in all limbs no joint
restrictions palpated.
Action: LASER, massage and PMFT used alongside passive range of motion
and postural sets.
- Monitor weight
- Proprioceptive tasks – sponges, paper, brushes to be used all over
Blue for nervous input
- Assisted toileting – use command words sit and stand with placement
- Arrange Blues limbs to be in a natural posture where possible to aid
bloodflow and prevent spasms
- Massage and grooming to be done – mental stimulation and bloodflow
Becky Black
BSc(Hons) AdvCertVPhys ClinEd(AccMdx) RCH MIRVAP
Blue - Weekly Plan
Aims:
- Maintain comfort and hygiene levels
- Give stimuli to affected limbs
- Maintain mental stimulation and reduce stress
Toileting
With toileting, we are aiming to be able to reduce the time Blue is
lying in any wet spots and reduce the chances of Blue developing a
urinary tract infection from withholding urine.
It may be a good idea to have some non scented wipes/wet cloth to wipe
over Blue after toileting to protect against any infections developing.
Moving
As you are doing so well, continue using the towel to support Blues
hindlegs and maintain a straighter spinal posture. To help you may place
carpet or runners on your path where you need to move Blue to give him
some added traction on his legs and reduce stress.
Postural Sets- When moving Blue aim to move him into “normal” lying
posture. This can be flat out on his side, on in a sphinx position with
the hindlimbs tucked under and forelimbs straight out. This then makes
it easier to move Blue around into a sit or stand. (See end of Doc)
Grooming/Washing
Mentally spending some time giving Blue a sponge bath will aid hygiene
and mentally allow Blue to enjoy spending time with you, this also
allows for checking of the paws or body for pressure sores which may
mean Blue needs to be moved or turned more regularly. A good firm
vigorous brush will stimulate bloodflow and in turn decrease pain and
stimulate the hair/skin/muscles.
Mental stimulation
Using mashed banana or treats in cone/kong toys or puzzle feeders can
help Blue mentally have a challenge and keep the mind active while
washing or just to keep Blue occupied while you do house work/look after
baby.
Exercises/Manual work – Help function
Range of Motion – Increase Blood Flow
Here is a link to a range of motion exercise, this needs to be done for
as long as you can on each back leg (At least 20x cycles a day). This
gets blood flow to the hindlegs and ensures the muscles are maintained,
this also circulates joint fluid and keeps the joints healthy.
https://www.youtube.com/watch?v=hHXdqy__vJo
(1.50-2.50 is the only bit we need)
Massage
Starting from the shoulders firmly press and massage in a slow rhythm
towards the neck, stroke firmly along the back counting 1 and ,2 and ,1
and ,2 . This will relax these muscles that Blue is over using to
compensate. The hindlimbs we can using 2 fingers, tap briskly and
lightly over the legs, and use very fast brisk stokes to “wake” up the
nerves.
Texture work
Use several textures against Blues pads to give some stimulation, this
can also be done alongside the carpet runners to create paths (door
mats, bathmats) provide different sensations for Blue to walk over.
Other things to use could be:
- Nail brush bristles
- Cloths
- Sponges
- Newspaper balls
Toe pinches/tickles
This elicits muscle contraction and keeps the tone of the muscles
Aim for a few each day where manageable. It can be done by a tickle or a
slight pinch of the foot, this may occur as you do the texture work.
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From lying flat, treats can be used to encourage Blue around and then
his legs can be positioned as a sphinx facing forwards.
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From Sphinx position, either using the command “sit” or raising the head
with a treat, a sit position is reached (ensure not to try on a slippery
surface)