472 Canine Sports Medicine and Rehabilitation
Carts
Wheelchairs or carts provide mobility for
patients with severe paresis or plegia. Carts
allow patients to maintain an exercise schedule,
to interact with clients and other pets, and to
eliminate in a more sanitary manner if they
cannot support themselves independently
(Figure 18.10).
Passive range of motion
Passive range of motion therapy assists in main
taining comfort and mobility. It is important for
patients that are recumbent or restricted in joint
motion secondary to neurological or orthopedic
conditions to maintain joint lubrication and
mechanoreceptor stimulation. PROM improves
extensibility of the soft tissues such as muscle
and the joint capsule to prevent adhesions from
forming in restricted joints (Figure 18.11).
See Chapters 5 and 6 for information on how to
properly perform PROM therapy.Improving strengthAfter pain management and mobility are
addressed, the next step in the physical reha
bilitation plan is to promote increased strength
and muscle mass in the geriatric patient.
Increased muscle mass will help maintain com
fort by acting as a shock absorber for concus
sive forces and provide more padding for
recumbent patients. Muscle has a higher meta
bolic rate than fat and will help to maintain a
leaner body weight in these patients.Therapeutic exercises
Therapeutic exercises for the geriatric patient
may focus on improving coordination, proprio
ception, and strengthening of the antigravity
and stabilizer muscles (see Chapter 8). Eccentric
exercises, where the muscle is contracting and
lengthening while being loaded, promote
greater gain in muscle mass as compared with
concentric exercises (Millis & Levine, 2014).
However, sarcopenia and its associated reducedFigure 18.10 Carts can provide improved mobility
and quality of life for patients with paresis due to
neurological injury.
Figure 18.11 Passive range of motion for dogs with restricted mobility can decrease pain, improve lubrication of the
joints, and decrease stiffness.