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Acupuncture
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Acupuncture is the insertion of very fine needles at specific points
in the body to create a physiological change. Acupuncture has
been used in human medicine for over 5,000 years, and in animals for
over 3,000 years. In the 1970's it was brought to the
United States where Americans quickly tried to disprove its'
theories. What they found surprised them...that acupuncture
was a viable medical option for many medical conditions. Among
their findings was data that demonstrated that individual
acupuncture points had thinner skin, a change in electrical
resistance, increased mast cells (which release histamine and other
chemicals), blood vessels and nerve endings directly under the
points.
When
an acupuncture needle is inserted, there is a cascade of reactions
in the body. Some of the chemicals released caused muscle
contraction (as if the muscle is "grabbing" the needle)
directly around the needle. If a needle is placed in a
non-acupuncture point, no muscle contraction takes place. The
reaction in the body can be altered by the time that the needles are
left in the body (the cascade of events is interrupted at different
points). Acupuncture in rehabilitation is used to relieve pain
and muscle spasms, and to increase nerve regeneration and
circulation. The different types of acupuncture used at TOPS
Vet Rehab include: 1) dry needle acupuncture ("normal"
acupuncture); 2) aqua-puncture (injection of Vitamin B12 into the
acupuncture points); 3) electro-acupuncture (a micro-current
connected from one needle to another); 4) laser-acupuncture (for
animals that cannot tolerate the needles); and 5) moxa-acupuncture
(the burning of a Chinese Herb over the needles to heat the
acupuncture point).
Watch Acupuncture Video Clip
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Animal
Chiropractic
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Animal chiropractic is a modality based on the biomechanics of the
spine and nervous system, which is used to relieve chiropractic
subluxations. The characteristics of a chiropractic
subluxation include:
- Loss of motion in the joints between the vertebrae
- Pain on pressure of the vertebrae
- Increased or decreased tone of the muscles surrounding the
vertebrae
- May include changes in temperature, swelling or scar tissue
The goal of animal chiropractic is to restore normal joint motion
with an "adjustment", and to aid in neurologic
reprogramming. Neurologic reprogramming can be thought of as
an improvement of the message that one nerve sends to another.
A chiropractic adjustment involves a controlled, high velocity
thrust over a specific joint, most commonly involving the joints
between the vertebrae (backbones). Depending upon the
duration and severity of the subluxation pattern, a series of
adjustments allows gradual restoration of the biomechanic and
neurologic function. Animal chiropractic is commonly thought
of for back and neck pain, but is often quite useful for animals
with an abnormal gait, which can be caused by a limb injury or pain
(ie arthritis).
At TOPS, we also may provide the chiropractic adjustments in the
warm water of our therapy pool, which allows an adjustment to be
made with decreased thrust and results in a more relaxed
patient.
Watch Chiropractic Video Clip
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Aquatic Bioelectric Therapy
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Aquatic Bioelectric Therapy is a new
form of treatment combining the benefits of whirlpool therapy with
the pain management benefits of electromedical
horizontal therapy. This represents an exciting new avenue
for providing pain relief for a variety of conditions. Since
incorporating aquatic bioelectric therapy into our regimen, we've
seen dramatic results as early as the first treatment.
Good candidates for aquatic bioelectric
therapy are those patients that:
- Have an acute injury
(sprains, strains)
- Are recovering from
orthopedic surgery (knees, hips, elbows, shoulders, etc.)
- Osteoarthritis and
rheumatoid arthritis
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Any type of chronic pain
For more information on this therapy,
check out the following websites:
VetSystems, manufacturer of
the WhirlpoolTx
Hako-Med, manufacturer of the
Hako-Med horizontal therapy delivery system |
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Cryo
and Heat Therapy
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Cryo and heat therapy is the
use of cold and/or heat over an injured or healing area of the body.
Following an injury there are two phases of inflammation: 1)
phase 1 inflammation, the breakdown period, which usually lasts 48 -
72 hours; and 2 ) phase 2 inflammation, the healing period.
Cryotherapy, the use of a
moldable cool pack or a bag of cold peas:
- Decreases nerve
conduction velocity (which decreases pain perception)
- Decreases the rate of
cytokine release (which decreases inflammation)
- Causes
vasoconstriction (decreased blood flow) followed by a rebound
vasodilation (increased blood flow)
- When used immediately
after surgery or an injury, decreases bleeding at the surface
and deep in the tissue.
Overall, cryotherapy is used to decrease pain and inflammation
and speed healing. Cryotherapy is typically applied for 10 minutes,
removed for 10 minutes, and then applied for 10 minutes for the
first 72 hours post-surgery or injury (phase 1
inflammation).
Heat therapy, the use of a moldable heat pack or warm, moist
towels:
- Increases the collagen's (healing tissue) ability to stretch
- Increases blood flow
- Decreases pain
- Increases enzyme activity (which speeds healing).
- Increases muscle contractility and stretching capability
Like cryotherapy, heat therapy overall is used to decrease pain
and inflammation and speed healing. The difference is that
cryotherapy is used by itself during phase 1 inflammation, and heat
therapy is typically used along with cryotherapy during phase 2
inflammation. Heat therapy should be used no earlier than 72
hours post-surgery or injury. When cryotherapy and heat
therapy are applied together, they are typically done as
follows: cryotherapy for 10 minutes; heat therapy for 10
minutes; cryotherapy for 10 minutes. This sequence is repeated
up to 3 times daily.
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Electromedical Horizontal Therapy |
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Electromedical Horizontal Therapy is
described as being the cutting edge of pain management. The
electromedical horizontal therapy is delivered by a machine called
the Hako-Med. The Hako-Med delivery system can either be used
as a standalone form of treatment or in conjunction with the
Whirlpool TX. For injuries affecting a small number of joints
needing directed treatment to those joints, the Hako-Med is most
effective used in a standalone fashion. For generalized
conditions, such as pain throughout the body, the Hako-Med is used
as the delivery agent to the Whirlpool Tx to provide a therapy
called aquatic bioelectric therapy.
Just like the aquatic bioelectric therapy, the Hako-Med therapy is
used to treat:
- Acute injuries (sprains,
strains)
- Joints post-surgically
(knees, hips, elbows, shoulders, etc.)
- Osteoarthritis and
rheumatoid arthritis
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Any type of chronic pain that is localized rather than generalized |
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Exercises
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At TOPS Vet Rehab, exercises are an important part of the
rehabilitation services we provide. An exercise may be as
simple as doing passive-range-of-motion (PROM) to improve or
maintain a joint's flexibility, to ambulation exercises to retrain
an animal to walk. Exercises are often devised specifically for each
individual patient, so it is difficult to explain all the exercises
we may prescribe for a patient. Here are some general types of
exercise that we perform at TOPS:
- Passive range of motion (PROM) exercises increase nutrition
availability at the joint cartilage, stimulate new cartilage
production, and is used to increase range of motion at the
joint.
- Stretching exercises increase circulation and muscle
flexibility.
- Proprioceptive exercises are exercises used to help the
animal know where their feet are in space.
- Strengthening exercises (stairs, land
treadmill, hydro-treadmill, sit/stands,
etc.) are used to strengthen individual muscles or muscle
groups.
- Weight shifting exercises are exercises used to help the
animal shift their weight to the affected limb or side to make
the animal walk more balanced.
- Ambulation exercises are exercises used to reeducate a
paretic animal (severe loss of function of their limbs)
how to walk.
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Hydro-treadmill
Therapy
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Hydro-treadmill therapy in veterinary rehabilitation is the use of
an underwater treadmill for strengthening and re-education of the
dog's limbs. Hydro-treadmill therapy was originally developed
for rehabilitating race horses in the 1970's. Until the
mid-80's, this treatment option was limited to horses. In the
mid-80's the hydro-treadmill became available for human
patients. In 1998, TOPS Vet Rehab introduced the world to the
use of the hydro-treadmill for canine rehabilitation, thus providing
a new rehabilitation tool for canine patients. Hydro-treadmill
therapy provides the ability to strengthen the patient's muscles in
an environment of little to no pressure on the joints, due to the
buoyancy of the water. When placed in a warm water environment, it
also increases flexibility, mobility, and contractility of the
muscles, as well as circulation. The benefits of the
hydro-treadmill include:
- Earlier return to exercise
post-surgically
- Strengthening of the muscles surrounding painful
joints in arthritic patients
- Weight-loss.
Importantly,
it is frequently observed that an animal not using a limb on land
will use it in the water. When the patient walks on the
hydro-treadmill, they tend to move their limbs using an exaggerated
range of motion, providing additional therapeutic benefits. An
important additional benefit of this treatment method versus
traditional hydrotherapy, is that the variables (speed, resistance,
and depth) can be controlled which allows for a consistently
progressive therapy plan. It also allows the therapists to
introduce the patient to the water in a slow, controlled manner,
alleviating fear which helps the patient relax, and consequently
improves the results of the therapy session. Finally,
the hydro-treadmill allows us to combine other rehabilitation
therapies (ie passive range of motion, massage, chiropractic) with
the therapeutic benefits of the water. At TOPS Vet Rehab, our
hydro-treadmill is submerged in a pool, which allows us to add
whirlpool jets, which provide resistance during exercise and massage
following exercise.
Watch Hydro-treadmill Video Clip
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Land
Treadmill
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Like our hydro-treadmill
therapy, we also use a specially developed canine land treadmill to
increase strength, balance and coordination. This form of
therapy, while used less often than our hydro-treadmill therapy, has
advantages in some situations:
- Stimulation of bone growth and
strengthening
- Ability to vary rate of incline
and decline, thereby concentrating the effort to specific muscle
groups
- More beneficial at certain stages
of post-joint surgery rehabilitation (ie cruciates, hips,
elbows)
One of the limitations of the land
treadmill is that there is no ability to reduce pressure on the
joints as there is with the hydro-treadmill therapy. Therefore,
hydro-treadmill therapy is used primarily for patients with joint
pain, whereas land treadmill therapy is used primarily for
strengthening in the absence of pain, or reeducation of
balance.
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Light
Therapy
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The Medlight device uses LED
lights to generate infrared energy in the form of low level, narrow
band light. We know it sounds complicated, but the
bottom line is that we use the Medlight for pain management and
wound healing. This former NASA technology was recently
released for public use, and is gaining wide acceptance in the
medical community as an alternative / supplement to other pain
management and wound healing techniques. At TOPS, we can
either deliver the treatment right at the clinic, or you can lease
the equipment from us and deliver the treatment in the comfort of
your home.
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Massage
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The type of massage we perform at TOPS
would most commonly be described as therapeutic massage. The
benefits of therapeutic massage for our patients mirrors those
benefits people receive:
- Improved circulation
- Reduction in muscle knots and
spasms
- Reduction in anxiety and stress
- Improved relaxation and sleep
- Reduction of pain
By doing each of the above, the
patients are put in a position to gain the most from the other forms
of therapy they are receiving. For example, if the patient
needs improved range of motion in a joint through passive range of
motion exercises, the relaxation, reduction
in pain, and reduction in anxiety will enhance the effect of the
exercises. For this reason, massage is usually used in
conjunction with other therapies we perform at TOPS. To
further improve the benefits of the massage for those patients
receiving hydro-treadmill therapy, the massage is
performed in our therapy pool, aided by the warm water and massage
jets.
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Neuromuscular
Electrical Stimulation
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Neuromuscular electrical stimulation (NMES) is the application of a
low level electrical current which results in a muscle
contraction. This is achieved by placing electrodes at
the beginning and end of the muscle. These muscle contractions
can be used to mimic strength training for animals that are
non-weight bearing or have limited use of a muscle or muscle
group. NMES is used to prevent atrophy post surgery or injury,
or to increase strength for muscles that have been chronically
underutilized. NMES is commonly used in paretic dogs or dogs
post surgically before they are weight bearing and during
reeducation of ambulation.
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Pulsed
Signal Therapy (PST)
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One of the unique treatment options we provide at TOPS Vet Rehab is
Pulsed Signal Therapy (PST). Pulsed Signal therapy is a new
therapy that has been used extensively in Europe for the treatment
of osteoarthritis, rheumatoid
arthritis, tendon and ligament injuries, etc. This
treatment has been used in Europe for over 20 years with over
100,000 patients. The manufacturer of the Pulsed Signal
Therapy machine, BioMagnetics Therapy Systems (www.pstvet.com), is currently
pursuing FDA approval for human use, and as such, current use is limited to
animals.
The PST treatment requires 9 consecutive treatments, which can be
administered once or twice per day. TOPS has two PST
options: 1) stationary unit located at TOPS; and 2) portable
unit for take home use. There are only small differences
between both units. Most importantly, both provide the same
clinical efficacy. The stationary unit is somewhat easier to
administer for the client, while the portable unit is slightly more
difficult to use but comes with the benefits of being able to
administer the 9 treatments from home.
For background on the principles of PST, it is believed that
there is an electrical field around each joint that plays an
important part in the continual regeneration of cartilage and
connective tissue. If osteoarthritis or inflammatory joint disorders
are present, there is a disturbance in this electrical field.
PST allows reconstruction of the disturbed electrical field, which
returns the natural regeneration capabilities and reactivates the
cartilage and connective tissue to increase production of
proteoglycans and collagen (the building blocks of cartilage) to aid
in repairing the cartilage defects. PST does this by pulsing
an electro magnetic field to the treatment area. To get
technical, this will simulate pressure on the joints, which will
pull hydrogen atoms out of the cartilage surface, stimulating
cartilage regeneration and cartilage cell reproduction. This
phenomenon is known as streaming.
In human clinical trials there was a significant improvement of
pain and "performing" activities of daily living" in
greater than 85% of treated patients. There are also
currently double-blind studies in the US which have recently been
completed in canine patients and are in the process of being
tabulated. TOPS Vet Rehab is currently conducting a clinical
trial for BMTS to explore additional treatment options beyond
medications and traditional treatment options for arthritis,
cruciate injuries, tendonitis, etc.
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Therapeutic
Ultrasound (and Phonophoresis)
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Therapeutic ultrasound is the use of sound waves which are passed
through tissue creating certain physiological effects. Though
the handheld probe looks similar to a diagnostic ultrasound probe (ie
the ones doctors use to see a fetus) this unit operates at a
different frequency and does not receive information back like the
diagnostic ultrasound. Therapeutic ultrasound used together with
medication is termed phonophoresis. Phonophoresis delivers the
medication through the skin, which allows the delivery at the local
level, reducing side affects related to oral or injectable
delivery. The uses of therapeutic ultrasound include:
- Increasing circulation
- Increasing contractility of muscle fibers (to increase range
of motion)
- Decreasing scar tissue
- Decreasing pain and muscle spasm
- Decreasing inflammation
- Accelerating wound healing
Watch Therapeutic Ultrasound Video Clip
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