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An Urban Experience
Changes in muscle length can occur quickly in recumbent animals, or in patients that have recently undergone surgery when they may not be moving limbs through their full ROM, or if a patient is none weight bearing for a period of time the flexor muscles will become short and tight, and the opposing extensor muscle groups will become long and weak.
In recumbent patients stretches should begin on day one. Flexor, extensor, and internal rotator muscle groups should be stretched at least twice daily. Each stretch is held for 15 seconds, the patient is given a few seconds to rest then the stretch is repeated three times in total. Following stretches, If the patient is resting in lateral recumbancy, a wedge should be placed between the thoracic and pelvic limbs to prevent adductor / abductor muscle imbalance. Recumbent patients tend to become tight in the adductor muscle groups, and weak in the abductor muscle groups. Correct positioning following stretches can help to prevent muscle imbalance from occurring.
Stretches can be performed with the patient lying laterally or in standing. If the stretches are performed in standing, the patient will need to be supported at the trunk. The operator will use one hand to support at the origin of
the muscle being stretched, with other hand a pushing force will be applied at the insertion of the muscle. The muscle should be stretched until resistance is felt in the muscle, then at this point the stretch should be held for 15 seconds and repeated 3 times. Stretching should not be uncomfortable for the patient. Pre-warming a muscle will improve the elasticity of the tissues, thus improving the range of the stretch. This may be useful if the patient is cold, has muscle spasm, or has developed muscle contractures.
Musculoskeletal outcome measures
• Measure Joint ROM
• Assess muscle length
• Pain score
• Functional measures (Independent positioning, able to sit, stand and mobilise with assistance)

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