Factors affecting a patient ' s rehabilitation journey
Patient rehabilitation does not follow a set timeline , and it is useful to ensure that the client understands this from the outset . Targets can be set for the patient , with expectations of where we would like them to be by a certain stage in their rehabilitation journey , but their individual progress will depend on a variety of factors .
Patient response and behaviour
Animals respond in different ways to the experience of hydrotherapy – some thrive in the sessions and enjoy engaging with the therapist , while others are more excitable , fearful , apprehensive or resistant to the provision of support by , or contact with , the therapist . Patient responses are constantly monitored to ensure that the benefits of the therapy always outweigh any risks . While issues can usually be overcome , taking the extra time to build trust and confidence in some patients may increase the number of hydrotherapy sessions they need .
Patient age and general heath
Geriatric patients may find hydrotherapy more challenging than younger patients . This may mean that a geriatric patient takes longer to rehabilitate or needs more ongoing maintenance to support their condition .
All hydrotherapy plans need to be customised and are subject to the aforementioned factors – no two cases are the same because even if two animals present with the same condition , their behaviour or handling requirements could be completely different . All these factors need to be considered to ensure the safety of the patient and therapist , and to enable the animal to get the maximum possible benefit from the hydrotherapy sessions .
Benefits of the UTM versus pool swimming
Table 1 ( overleaf ) compares the advantages and disadvantages of using the UTM versus swimming in the pool for hydrotherapy . It also outlines what the two modalities can provide for patients , according to their specific needs [ 2 ] .
Case study
Malbec ( Figure 1 ) is a 4-year-old neutered female springer spaniel cross labrador retriever that is , at the time of writing , undergoing hydrotherapy rehabilitation .
The severity of the condition being treated , as well as the general health condition of the patient , will also have a bearing on their progress . For example , an overweight , large-breed dog with severe bilateral elbow dysplasia may need more extensive hydrotherapy than a medium-breed dog of a healthy weight with a unilateral elbow injury of the right forelimb . In this example , the overweight patient may not be able to swim in the pool safely until they have lost some weight , as the hydrostatic pressure of the water may constrict their internal organs , which are surrounded by fat [ 1 ] . By contrast , the patient with a healthy body weight may be able to start their hydrotherapy sessions sooner and , as only one limb is affected , they are likely to progress more quickly .
Owner engagement and compliance
Hydrotherapy is a team effort between the patient , the therapist and the owner , with all contributing to the progress and outcome of the treatment . It is therefore important to built a rapport with the client and to engage them in the patient ' s hydrotherapy plan . Clients may need to implement changes at home ( e . g . nonslip mats on the floor , use of a Y-shaped harness , lead training , dietary modifications and assisting the patient with prescribed exercises ). Without full commitment from the client , the patient ' s progress may be reduced or slowed .
Figure 1 . Malbec , the author ' s hydrotherapy patient .
Malbec ' s owners initially sought veterinary advice for intermittent right forelimb lameness . She subsequently had an elbow arthroscopy procedure performed on her right elbow . It is believed that Malbec ' s condition was the result of an injury , as the lameness was isolated to her right forelimb .
26 Veterinary Nursing Journal