Front Matter

Chapter 8 Therapeutic Exercise 201

High fives

Purpose: Strengthen muscles of shoulder exten­
sion, abduction, and adduction as well as tho­
racic limb advancement.
Goal: The patient touches one front foot to the
therapist’s correct hand. The patient must learn
that his right foot must reach for the therapist’s
left hand no matter where the hand is placed.
Technique: The therapist shakes a cookie in a
closed hand until the patient paws at the hand, the
hand opens and the patient is rewarded. Next, the
patient is rewarded only when he uses the correct
foot. Once the patient understands the game, the
cookie is no longer needed, and the therapist can
place their hand in any position, encouraging
extension, abduction, or adduction, and encourag­
ing the patient to reach with the appropriate foot
to complete the exercise (Figure 8.25).

Neurological rehabilitation

The goal with patients with neurological dis­

ease is to challenge them, pushing them to their

limits but ending on a positive note with lots of

praise and encouragement. For the patient that

is unable to support his weight, gentle joint

compressions (described in Chapter 6) are used

initially.

Purpose: Stimulate proprioceptive fibers;

encourage joint fluid circulation; and enhance cir­

culation to adjacent tissues. This can be accom­

plished in multiple positions for each joint.

Tickling

Purpose: Minimize atrophy of flexors and

extensors of the limbs.

Goal: Cause flexion of entire limb by stimu­

lating the toes. In the pelvic limb, stimulate suf­

ficiently to cause not only flexion, but also a

secondary kicking of the limb into extension.

Technique: The therapist tickles or pinches

toes, pads, or fur between the pads until desired

effect is obtained.

Sphinx lying

This is a transitional posture between lateral

recumbency and sitting. Patients with neuro­

logical disease may present with restrictions in

multiple joints and spasticity or weakness.

Patients with cervical neurological disease

often present with thoracic limb extension and

weakness in shoulder flexors.

Purpose: Encourage appropriate posture

early in neurological rehabilitation to allow for

more normal transitions as function returns.

Goal: Achieve a posture with elbows caudal to

shoulders and full hip, stifle, and tarsal flexion.

Technique: The patient is positioned in this

posture, supporting him as needed.

Progression: Add rhythmic stabilization.

Tall sits

Purpose: Strengthen the core musculature.

Goal: Achieve a normal postured sit with

carpi under shoulders, feet appropriately posi­

tioned on the floor, and spine and trunk in a

normal orientation (not leaning in either direc­

tion and showing no kyphosis).

Figure 8.25 With “Hi‐5s” at an angle, the pectoral,
rhomboideus, and trapezius muscles are strengthened
along with the supraspinatus and biceps brachii. Source:
Photo by Whitney Rupp.