Early Locomotor Training in Tetraplegic Post-Surgical Dogs with Cervical Intervertebral Disc Disease

Abstract

Locomotor training (LT) is task-specific repetitive training, with sensorimotor stimulation and intensive exercises that promote neuromuscular reorganization. This study aimed to observe if LT could be initiated safely in the first 3–15 days after surgery in tetraplegic C1–C5 IVDD—Hansen type I dogs. This prospective blinded clinical study was conducted at two rehabilitation centers in Portugal, with 114 grade 1 (MFS/OFS) dogs, divided by the presence of spinal hyperesthesia into the SHG (spinal hyperesthesia group) (n = 74) and the NSHG (non-spinal hyperesthesia group) (n = 40), evaluated in each time point for two weeks according to a neurorehabilitation checklist by three observers for inter-agreement relation. LT was safely applied with 62.3% of the OFS ≥ 11 within 15 days and of these, 32.4% achieved a OFS ≥ 13. There were no new cases of hyperesthesia in the NSHG and from the SHG all recovered. Comparing groups, a significant difference was observed in their ability to achieve ambulatory status (p < 0.001), between the presence of hyperesthesia and days until ambulation (p < 0.006) and in each time point (p < 0.001; R2 = 0.809). Early LT may be a safe treatment to be applied in the first 3 days on these dogs and spinal hyperesthesia should be important to the rehabilitation team. This study should be continued.

Approach to Small Animal Neurorehabilitation by Locomotor Training: An Update

“…In SCI human patients, this exercise can be performed through manual assistance by therapists or, mostly in cases of severe deficits and cardiorespiratory restrains, continued by robotic exoskeleton assistance or robotic assisted treadmill training (e.g., Lokomat ® ) [ 60 , 61 ]. On the other hand, in the veterinary field, spinalized animals presented good results when performing treadmill training [ 18 , 19 , 20 , 62 , 63 ], also in comparison with walking on different floors [ 64 ]. The alternative to robotic assistance in small animals that require body weight support has been the use of continuous wheelchair training, or in heavier dogs through a passive standing device above the treadmill [ 62 ].…”

“…On the other hand, in the veterinary field, spinalized animals presented good results when performing treadmill training [ 18 , 19 , 20 , 62 , 63 ], also in comparison with walking on different floors [ 64 ]. The alternative to robotic assistance in small animals that require body weight support has been the use of continuous wheelchair training, or in heavier dogs through a passive standing device above the treadmill [ 62 ].…”

“…In translation for small animals, there are few reports of rehabilitation sessions manly with underwater treadmill locomotor training [ 85 , 86 ]. Recently some studies have been published describing locomotor exercises on land and underwater treadmill, in acute and chronic intervertebral disc disease (IVDD) dogs [ 19 , 20 ], SCI contusion cats, cervical IVDD dogs and in acute non-compressive nucleus pulposus extrusion (ANNPE) dogs [ 62 , 63 ].…”

“…If the patient has monoplegia/monoparesis, paraplegia/paraparesis, or tetraplegia/tetraparesis, the adaptation to the treadmill surface is necessary to obtain voluntary or automatic movement. For that, the surrounding environment must be calm and quiet with classical music [ 19 , 20 , 62 , 63 , 88 ], but also with enough energy to promote motivation to start the step cycle, autonomously or with assisted exercises, such as the established bicycle movements, that may require perineal or tail stimulation [ 18 , 64 , 89 ].…”