Re: Hypertonicity of hind legs after head trauma [2 Attachments]

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Hi Dr. Talbot,For hypertonicity of the hindlimbs I would assist the dog into the "developmental positions", sternal, and square sitting with hind limbs flexed. Teach the owners how to position this way. If you can't flex the limbs initially, abduct leg to the side and then attempt to flex. This will bring the limb into a different plane of motion and it will be easier to flex this way.The owners can do this with the dog when they are sitting watching tv, etc... I think this us the single most important thing you can do from a physical point of vies to address the hypertonicity, sustained weight bearing in a flexed position. If the dog is able to transition appropriately from a sternal to sit and sit to stand, with legs flexed (and then stand to sit), this will also help to address the hypertonicity. First weight bearing in the flexed position, then transitioning between positions. Stand to sit will also do worlds of good, (weight bearing into a flexed position).My own pup had rigidity at hind limbs. Working on these simple exercises over time allowed her to decrease the rigidity and then we were able to strengthen her flexor muscles so she could actively counteract the rigidity.Good luck! Jeanine Freeberg, PT, DPT, C/NDTSent from my iPhone

Cranial electrotherapy stimulation (see article on CES in brain trauma ) AJPM Vol 8 No 4 October 1998. Also Parkinsons (other UMN conditions) study using dogs. See attached file with references. Ava Frick, DVM, CAC From: VetRehab [mailto:VetRehab ] On Behalf Of feluche75Sent: Friday, July 13, 2012 9:27 PMTo: VetRehab Subject: Hypertonicity of hind legs after head trauma Hi, I saw a 7 year old FS Boston Terrier today who ran into another Boston head first about 3 weeks ago. She was fine that day but was unable to walk the next day. She had an MRI that did not reveal anything but some edema. She was put on Pred, Robaxin and Gabapentin and is now able to walk but she has Severe hypertonicity of her hind legs. They are basically stuck in abduction. She cannot sit but just lays down like a frog and she walks with her hind legs like that. The front legs are normal. I cannot adduct them at all unless I massage them for a while. It is also difficult to fully extend her stifles and flex her hips. I showed the owner how to massage her and do some PROM at the same time. He will also do some moist heat and try to get her to swim in warm water in the bathtub. I remember reading somewhere about some techniques to help with extensor rigidity or hypertonicity like tapping on the muscles??? I did laser today but not sure if owner can come back for it more than once a week.... Any suggestions???Thanks so much, Felicity Talbot, DVM

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