Page 249 - Zoo Animal Learning and Training

29 Physical Rehabilitation

of the Neurological Patient

María Pérez Hernández and Ruby Lynn Carter

Introduction Neurorehabilitation
Many veterinarians in the neurology field have felt the need to Unlike rehabilitation, NR pursues recovery beyond musculoskeletal
improve postoperative care for the neurological patient. Although restoration. NR also pursues neurological recovery and includes
veterinary physical therapy started more than 30 years ago, its cred- additional exercises for the patient with neurological deficits. The
ibility has only been widely recognized during the last 10 years. patient’s complete history should be considered in order to plan
There is only a slight difference in the definitions of “physical individual functional recovery according to each specific brain,
therapy” (applied in humans) and “rehabilitation” (applied in spine or neuromuscular injury, and should also take into account
veterinary medicine). the house environment and owner’s willingness to handle the pet at
• Physical therapy includes the examination and evaluation of home and guarantee quality of life.
human patients with impairments, functional limitations, Another concept must be introduced for a complete understand-
disability, and other health‐related conditions to determine a ing of NR. Neuroplasticity, or brain plasticity, is characterized as the
diagnosis, prognosis, and intervention as defined by the American spontaneous ability of neurons to adapt to a new environment by
Physical Therapy Association. transforming neural pathways (“rewiring”) in response to changes
• Rehabilitation is the set of noninvasive techniques, excluding that have occurred in the process of a neurological injury and dur-
veterinary chiropractic, for the rehabilitation of injuries in non- ing recovery. Spinal injuries may force the patient to move differ-
human animals as defined by the AVMA House Delegates. ently, change its environment, or develop different sanitary habits.
According to these definitions, the rehabilitation should be Neuroplasticity will occur after the repetition of a new pattern and
performed by a licensed technician or physical therapist, certified it can be either positive or negative. This is a very important con-
or not in rehabilitation, under the supervision of a veterinarian, cept to keep in mind when beginning NR in order to prevent bad
whereas in human medicine supervision by a doctor might not be habits and promote function and positive recovery. For example, a
needed if the therapy is performed by a physical therapist. These patient that suffered a severe back injury and remained paraplegic
concepts may be modified in different countries, with disagreement with intact nociception after surgical intervention will tend to move
about who should perform the rehabilitation and the regulation of by dragging its rear, and recovery might take longer because the
rehabilitation centers with regard to preventing intrusiveness and patient does not try to walk on all four limbs even after recovering
the employment of unqualified personnel. some motor function. Days or weeks of repetition of this new pat-
Rehabilitation includes all noninvasive physical therapies used in the tern will encourage negative neuroplasticity and therefore institute
functional recovery of orthopedic and neurological patients, as well as a bad habit, also called maladaptative change or compensation, that
management and performance of geriatric, overweight, or sport dogs. might be difficult to reverse.
In this chapter, we focus on rehabilitation that aids recovery from nerv- Understanding that the nervous system has neuroplastic mecha-
ous system injury, also termed neurorehabilitation (NR). nisms allows us to recognize how it tries to repair itself [1]. Listed

Current Techniques in Canine and Feline Neurosurgery, First Edition. Edited by Andy Shores and Brigitte A. Brisson.
© 2017 John Wiley & Sons, Inc. Published 2017 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/shores/neurosurgery

257