Equine practice and physical therapy

Equine practice and physical therapy

Physical therapy at Rochester Equine Clinic Condition treated Tendon & ligaments Back & sacroiliac Fractures Wounds Laminitis Joint contracture Shoulder injuries Lymphangitis & cellulitis Nerve damage Misc

Num 72 38 15 14 12 11 9 6 5 14

Modalities used Therapeutic ultrasound Phototherapy Pulsed electro-magnetic fields Manual therapy Electrical stimulation Radial shock wave therapy

Percent 36.9% 19.3% 7.7% 7.1% 6.1% 5.6% 4.6%

49.0% 29.6% 22.4% 21.0% 6.6% 1.0%

Speaking at the annual meeting of the Association for Equine Sports Medicine Patricia A. Quirion described how she and the practitioners at the Rochester Equine Clinic incorporate physical therapy into their equine referral practice. She said that the use of physical therapeutic modalities is a well-established component of human surgical and sports medicine practice, yet its routine employment in equine clinical practice remains uncommon. Until recently, equine physical therapy has been largely restricted to "performance enhancement" or as an alternative to traditional veterinary medicine, often in cases with only the poorest of prognosis, its advantages in improving the quality of tissue repair, enhancing function, decreasing inflammation and associated pain, and often reducing convalescence seem obvious, but the application of physical therapy from a practical and business perspective has yet to be closely examined. She reported that over a two and a half-year period, physical therapeutic modalities were applied to approximately 196 cases at the Rochester Equine Clinic. Cases underwent traditional clinical evaluation, utilizing adjunctive techniques, including radiography, ultrasonography, thermography, and nuclear scintigraphy. Following thorough evaluation individual physical therapy treatment programs were designed by the veterinarian and therapist, taking into consideration the severity, chronicity and specific nature of the injury or condition. Horses ranged in age from six months to 30+ years and treatment periods ranged from two weeks to six months in duration. Treatments were applied both ~n hospital and home environments. When therapy was carried o u t at home, regularly scheduled reexaminations were conducted throughout the treatment and recovery periods to monitor the progress and effectiveness of the treatment program. The capital outlay involved in establishing such a program can be significant. The initial investment cost as well as the cost of maintenance for each type of therapeutic equipment does vary considerably as does its usefulness and adaptability. Given the specific nature of our practice and caseload, we have found Therapeutic Ultrasound to be the most useful and cost effective, followed by Photo Therapy and Pulsed Electro-Magnetic Field devices. Certain injuries or conditions, however, may benefit and or require Electrical-Stimulation, Hydrotherapy or Shoc~ Wave Therapy for best results; therefore the inclusion of these modalities should be considered, regardless of cost-effectiveness, in establishing a well-rounded and comprehensive program. Other factors to consider when incorporating a physical therapy program into equine practice is cost to the client, both in terms of dollars and time. When deciding what therapies to offer to clients, it is important to determine at what cost this therapy will be made available, and if demand is likely to exist at that cost level, ff therapy is to be carried out at home, further consideration must be given as to the practicality and safety of the specific modalities in that environment. With insurance companies beginning to include physical therapy in their coverage client~, may be better able to afford the cost of these therapies; however, if therapy is to be carried out at home, factors such as availability of time and labor must also be considered. The goals in establishing this program were, and remain, to improve both the rate and quality of healing and palliative care for the cases treated and to provide clients with enhanced follow-up care as well as a more comprehensive treatment and rehabilitation program overall for their horses. Based on the results of the case~ treated and a detailed financial review of the program, we feel that these goals have been largely achieved and submit that physical therapy can prove to be a valuable scientific and economic asset to clinical practice. Rochester Equine Clinic PO Box 2071 Rochester, NH 03866-2071 603-332-6482

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JOURNAL OF EQUINE VETERINARY SCIENCE