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Chapter 29: Physical Rehabilitation of the Neurological Patient 263

Figure 29.14 Paw placement stimulation exercise (3 of 3). The therapist
Figure 29.12 Paw placement stimulation exercise (1 of 3). The paw is helps the patient drop the limb and places it correctly for proprioceptive
dragged backwards for sensory and proprioceptive stimulation.
reinforcement as part of postural rehabilitation.

Figure 29.15 Cavalettis are recommended for encouraging the patient to
flex and be aware of one limb at a time. This is especially recommended for
correcting bunny‐hopping.

attention to the airways in patients with severe motor dysfunction
Figure 29.13 Paw placement stimulation exercise (2 of 3). Patients with and difficulty in floating; in addition, check the skin regularly and
decreased/absent proprioception will not place the paw correctly. prevent falls by providing an area of good traction around the pool,
Withdrawal reflex stimulation encourages the patient to pick up the limb especially while the patient is still wet. Listed here are some of the
and be aware of it. more common exercises of hydrotherapy performed in the UWTM
or swimming pool.

strengthening in a low‐impact manner. A life‐jacket is recom- Swimming Pool
mended for safety purposes in most cases. Dogs with skin issues or There are several types of pool but designing a pool at ground level
healing incisions may not be able to enter the water until healed. eliminates the use of a hoist and decreases the risk of falls. Exercises
There are some risks associated with hydrotherapy: aspiration in water provide an increased range of motion of the limbs with
pneumonia, skin reactions to the chemicals in the water, or falls regard to the type of gait in the UWTM [10]. Some patients may do
around the pool area are three of the more common ones. Pay special better in the pool than in the UWTM, so swimming will be chosen