Page 149 - Veterinary Laser Therapy in Small Animal Practice

Pointing light at musculoskeletal and neurological conditions: clinical applications 135

• Thermotherapy: local heat over elbows and thoracolumbar area.
• Passive exercises: joint mobilization, especially phalangeal extension of the four limbs, elbow
extension, and knee flexion. Assisted standing. Soon joint manipulation was not tolerated at home and
had to be discontinued.
• Active exercises: stimulating neck flexion to both sides, encouraging some walking over soft surfaces,
using surfaces with some height difference. Stimulating movement with food.
• NMES: biphasic pulsed wave; 50 Hz, to stimulate hamstrings, quadriceps, triceps brachialis.
• Owner education: adapt the house so F. can use other places rather than just the sofa. Cover the floor
with carpet or soft padding. Find a suitable cat scratcher to stimulate his desire to play and move, and a
small sandbox he can enter without help. Avoid falls from sofa.
• Outcome:
• Pain level was 4/10 after 1 week and 2/10 after 2 weeks. After the second week, F. was able to raise his
head to look into your eyes and take a couple of steps.
• During the next month he became more active and started to use the sandbox. On week 6, his elbow
ROM had improved to 85°.
• By the second month he was able to take small jumps, became more active, and engaged in playing. By
the fourth month he was able to jump up onto and down from the sofa. Overall, he became more active,
with less pain and more independence in his daily activities, which had a great impact in his quality of life.

Figure C14.1 Patient unable to stand up. Figure C14.2 Patient unable to extend Figure C14.3 Laser therapy
the neck. over the thoracic spinal
muscles.

Figure C14.4 Treatment with TENS.

Figures C14.5 (a–d) Patient now able to take some steps and jump into his carrier.
Spot No.
Area P (W) Tx time J/cm 2 Total J/Tx (cm ) W/cm 2 Tx/week Tx
2
a
Neck 5 2 min 8 600 5 1
1/week × 8
TL spine 5 2 min 10 600 5 1 weeks, then 1/ 12
month
Elbows 3 1.5 min 6 300 5 0.6
Note: TL, thoracolumbar.

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