Physical Rehabilitation for Dogs Part 2
Last week, I wrote about temperature therapy and how it is used in canine physical rehabilitation. Today, I will provide an overview of electrical stimulation, another physical therapy modality that has been used for years in human therapy and that is now becoming quite common in canine therapy as well.
Electrical stimulation, also known as “estim”, is exactly what it sounds like: the application of electrical currents to the body in order to stimulate a response. Estim is normally provided in one of two forms: neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS).
Neuromuscular Electrical Stimulation
NMES is most commonly used as a passive way to improve muscle strength in an injured dog. The electrical current from the device is used to cause muscular contractions, which in turn cause an adaptation response from the targeted muscle, and hence, a strengthening / toning effect. While these contractions are no replacement for actual exercise (both in terms of intensity and ability to strengthen and build muscle), they can be effective when an injured dog is unable or unwilling to contract the target muscles (typically post-surgery or injury).
NMES therapy is normally applied directly to the injured muscle. The electrode pads are placed on the target muscle, thus smaller pads are used on smaller dogs/smaller muscle groups and larger pads are used on larger muscles. Unlike with most humans, who lack fur, a dog might need to have its hair shaved to ensure proper contact.
Transcutaneous Electrical Nerve Stimulation
Unlike NEMS, TENS therapy is most often used as a pain relief modality. The idea is to provide sensory stimulation (versus muscular stimulation) in order to reduce pain perception in the patient, which will thereby allow the patient to better withstand their overall rehabilitation program.
TENS therapy can be particularly useful when the dog does not tolerate pain medications (e.g. due to gastrointestinal distress). In some cases, TENS will be applied during rehab exercises and mobilizations, allowing the patient to get through the session with minimal discomfort. Eventually, as the patent gets stronger and heals, they will be able to continue the therapy without the pain reduction provided by this form of stimulation.
Estim of either kind is generally a safe modality for dogs. However, it should not be applied to open wounds or skin legions, nor should it be applied to the trunk of a pregnant dog. Estim is also contraindicated on parts of the body with cancer or infections.
Interestingly, estim is not as effective on obese dogs due to the fact that fat tissue is not a good conduit for electrical current. Just another reason to keep your pet fit and trim.