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Physiotherapy And Physical Rehabilitation To Improve The Mobility And For Pain Management In Postoperative Dogs With Thoracolumbar Intervertebral Disk Extrusion
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Abstract(s)
A extrusão do disco intervertebral toracolombar é uma condição neurológica comum na medicina veterinária. Ela ocorre quando o núcleo pulposo se projeta, comprimindo a medula espinhal e causando uma variedade de sinais clínicos, tais como dor toracolombar, paraparesia ou até mesmo paraplegia. Alguns cães não conseguem recuperar totalmente apenas com tratamento médico e/ou cirúrgico, evidenciando os limites das opções de tratamento disponíveis. Portanto, vários estudos avaliam novas estratégias que possam melhorar a recuperação e maneio da dor em cães com extrusão de disco intervertebral toracolombar. Entre estas novas estratégias, protocolos de reabilitação e fisioterapia estão a ser cada vez mais descritos e recomendados na medicina veterinária. O objetivo desta revisão é apresentar as técnicas fisioterapêuticas mais utilizadas e suas aplicações na extrusão do disco intervertebral toracolombar após hemilaminectomia. Estas técnicas incluem crioterapia, massoterapia, exercícios passivos e ativos, hidroterapia, eletroestimulação, campo eletromagnético pulsado, fotobiomodulação e ultrassons. A crioterapia é comumente usada após a cirurgia devido aos seus efeitos analgésicos, redução do edema e diminuição do espasmo muscular. A massoterapia, por sua vez, alivia a dor, promove a recuperação muscular através do aumento do retorno venoso e linfático, melhora a somatestesia e induz o relaxamento. Os exercícios passivos, ativos e a hidroterapia estimulam os movimentos voluntários, a coordenação, a força muscular, a rigidez articular e a proprioceção. Já a eletroestimulação é eficaz para aumentar a força, o tónus e a reeducação muscular, além de controlar a dor e auxiliar na cicatrização de feridas. O campo eletromagnético pulsado contribui para a redução da lesão da medula espinal, melhora a proprioceção e a incisão da dor após a cirurgia. A fotobiomodulação, por sua vez, estimula a regeneração axonal, acelera a cicatrização de feridas, reduz a inflamação e controla a dor. Por fim, os ultrassons são úteis no tratamento de condições musculoesqueléticas, como espasmo muscular, contratura, dor e cicatrização de feridas). Cada técnica pode ser usada isoladamente ou em conjunto para combinar a eficiência dos diferentes métodos. Estas técnicas são aplicadas diariamente, uma ou várias vezes ao dia, durante várias semanas. A análise de artigos científicos publicados demonstra a eficácia destas técnicas, as quais são cada vez mais utilizadas na prática médica atual. Estas técnicas permitem a recuperação dos animais mais eficiente e em menos tempo. Contudo, algumas revisões apresentaram limitações, tais como utilização de amostras pequenas nos estudos e avaliação simultânea de vários parâmetros , o que pode resultar em resultados não significativos. Desta forma, torna-se necessário a realização de mais estudos nesta área para avançar na utilização de fisioterapia na medicina veterinária.
Thoracolumbar intervertebral disc extrusion is a common neurological disease in veterinary medicine. It occurs when the nucleus pulposus protrudes, compressing the spinal cord and causing a variety of clinical signs, such as thoracolumbar pain, paraparesis or paraplegia. Some dogs cannot fully recover following just medical and/or surgical management, highlighting the limits of available treatments options. Therefore, several studies evaluate new strategies that can improve recovery and pain management in dogs with thoracolumbar intervertebral disk extrusion. Among these new strategies, rehabilitation and physiotherapy protocol are increasingly being described and recommended in veterinary medicine. The aim of this review is to present the most commonly used physiotherapy techniques and their applications in thoracolumbar intervertebral disk extrusion following hemilaminectomy. These techniques include cryotherapy, massage therapy, passive and active exercise, hydrotherapy, electrostimulation, pulsed electromagnetic field, photobiomodulation and ultrasound. Cryotherapy is commonly employed post-surgery due to its analgesic effects, reduction of edema, and muscle spasm alleviation. Massotherapy, on the other hand, helps alleviate pain promotes muscle recovery by enhancing venous and lymphatic return, improves somatosensory perception and induces relaxation. Passive and active exercises, along with hydrotherapy, facilitate voluntary movements, coordination, muscle strength, joint stiffness and proprioception. Electrostimulation is highly effective in increasing muscle strength, tone and re-education, while also aiding pain control and wound healing. Pulsed electromagnetic field therapy contributes to spinal cord injury reduction, improves proprioceptive placement, and decreases post-surgical pain. Photobiomodulation stimulates axonal regeneration, accelerates wound healing, reduces inflammation, and aids in pain management. Lastly, ultrasounds are useful in treating musculoskeletal conditions such as muscle spasm, contracture, pain, and wound healing. Each technique can be used alone or in synergy to combine efficiency of the different methods. All these techniques are applied daily, once or several times a day, for several weeks. The analysis of the published articles demonstrates the effectiveness of these techniques, which are increasingly prevalent in current medical practice. These technics allow for a more efficient recovery of animals and in less time. However, some reviews have limitations, such as very small samples and evaluate multiple parameters simultaneously, which can sometimes render the results non-significant. Further studies need to be conducted in this area to advance the application of physiotherapy in veterinary medicine.
Thoracolumbar intervertebral disc extrusion is a common neurological disease in veterinary medicine. It occurs when the nucleus pulposus protrudes, compressing the spinal cord and causing a variety of clinical signs, such as thoracolumbar pain, paraparesis or paraplegia. Some dogs cannot fully recover following just medical and/or surgical management, highlighting the limits of available treatments options. Therefore, several studies evaluate new strategies that can improve recovery and pain management in dogs with thoracolumbar intervertebral disk extrusion. Among these new strategies, rehabilitation and physiotherapy protocol are increasingly being described and recommended in veterinary medicine. The aim of this review is to present the most commonly used physiotherapy techniques and their applications in thoracolumbar intervertebral disk extrusion following hemilaminectomy. These techniques include cryotherapy, massage therapy, passive and active exercise, hydrotherapy, electrostimulation, pulsed electromagnetic field, photobiomodulation and ultrasound. Cryotherapy is commonly employed post-surgery due to its analgesic effects, reduction of edema, and muscle spasm alleviation. Massotherapy, on the other hand, helps alleviate pain promotes muscle recovery by enhancing venous and lymphatic return, improves somatosensory perception and induces relaxation. Passive and active exercises, along with hydrotherapy, facilitate voluntary movements, coordination, muscle strength, joint stiffness and proprioception. Electrostimulation is highly effective in increasing muscle strength, tone and re-education, while also aiding pain control and wound healing. Pulsed electromagnetic field therapy contributes to spinal cord injury reduction, improves proprioceptive placement, and decreases post-surgical pain. Photobiomodulation stimulates axonal regeneration, accelerates wound healing, reduces inflammation, and aids in pain management. Lastly, ultrasounds are useful in treating musculoskeletal conditions such as muscle spasm, contracture, pain, and wound healing. Each technique can be used alone or in synergy to combine efficiency of the different methods. All these techniques are applied daily, once or several times a day, for several weeks. The analysis of the published articles demonstrates the effectiveness of these techniques, which are increasingly prevalent in current medical practice. These technics allow for a more efficient recovery of animals and in less time. However, some reviews have limitations, such as very small samples and evaluate multiple parameters simultaneously, which can sometimes render the results non-significant. Further studies need to be conducted in this area to advance the application of physiotherapy in veterinary medicine.
Description
Keywords
Campo Electromagnético Pulsado Crioterapia Electrostimulação Extrusão Do Disco Intervertebral Toracolumbar Fisioterapia Fotobiomodulação Hidroterapia Massoterapia Medicina Veterinária Ultrasom Cryotherapy Electrostimulation Hydrotherapy Massotherapy Photobiomodulation Physiotherapy Pulsed Electromagnetic Field Thoracolumbar Intervertebral Disk Extrusion Ultrasound Veterinary Medicine