Rehabilitation of Vestibular Disease

Rehabilitation has an important role to play when caring for a pet affected by vestibular disease. Our chartered physiotherapist initially undertakes a thorough assessment of your dog and then formulates treatment aims and goals which is compiled into a rehabilitation treatment plan uniquely designed for your dog. The degree to which an individual is affected can vary from patient to patient, possible aims and treatment options are listed below. It is essential than on going evaluation and adjustment of the care program takes place.

 

Aims of Rehabilitation

In the initial days following diagnosis of vestibular disease:

  • Provide supportive management of postures and transferring from one position to another
  • Increase sensation and awareness of body position
  • Maintain soft tissue flexibility

 

Following on from this and depending on your pet’s progress, the aims might include:

  • Improve core stability
  • Further raise awareness of body position and posture and posture
  • Advance functional transfers of weight
  • Facilitate supportive gait patterns

 

Once good recovery is established further aims are defined:

  • Continue to strengthen core muscles
  • Further enhance gait patterns including pace
  • Enhance exercise tolerance and cardiovascular fitness
  • Return to normal function or how to manage any residual disabilities

 

Physiotherapy Treatment Options

A major component of physiotherapy treatment is the advice that can be given especially in the initial phase after diagnosis. Handling techniques, home environment advice, exercise restriction and the use of assistive devices are essentials and will be taught and demonstrated by your pets physiotherapist.

Soft tissue massage and sensory stimulation are key and can be taught so you are able to perform them at home. In addition, an appropriate home exercise program (HEP) can be invaluable even early on. Specific exercise therapy allows stimulation of body awareness and strengthening of essential muscle groups. Hydrotherapy can be introduced for strengthening, gait re-education, core stability promotion and improving cardiovascular fitness.

It is necessary however that your pets home exercise and physiotherapy program is assessed and adjusted frequently to ensure the correct treatment plan and care is being provided. This will be performed throughout your pets hospitalisation (should that be required), or through out outpatient rehabilitation centre here at the hospital.

The following table gives an example of a rehabilitation plan which may be designed in the management of a patient with vestibular disease

 

Physiotherapy Aims Physiotherapy Treatment options
0-2 weeks Management (if at home) including Support posture and transfers Correct positioning.Advise owners about correct handling techniques.Advise re floor surfaces if at home/advice re slings or walking aids if required/exercise restriction.
Increase sensation and awareness of body position Soft Tissue Massage,Proprioceptive facilitation
2-4 weeks Improve Core stability Home exercise program
Progress awareness of body position, maintaining soft tissue length and flexibility. Home exercise program to progress proprioceptive facilitation and sensory input techniques eg brushing, massage, tapping, passive mobilisations and stretches.
4-6 weeks Increase sensation and awareness of body position and improve gait. Home exercise program to include gait and balance challenges such as weave poles, steps, gradients.
6-12 weeks Increase exercise tolerance Advise re progressive exercise, increasing exercise levels, consider land and water based exercises.
Continue to increase Core stability Home exercise program
12 weeks + Return to full function or advise re management of residual deficits described by neurologist. Progress to off lead exercise and previous exercise level

 

Fitzpatrick Referrals