Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament

Monk, Michelle; Preston, Christopher; McGowan, Catherine

doi:10.2460/ajvr.67.3.529

Cited by 145 publications

(128 citation statements)

References 18 publications

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“…For example, Johnson et al found a significant difference in TC between CCL-deficient dogs treated with electrical muscle stimulation and a control group at weeks 9 and 13 post-operatively (30.8±2.3cm vs. 27.2±2.3cm and 30.6±2.3cm vs 27.4±2.2cm, respectively), but hair coat length was not controlled between groups (Johnson et al, 1997). Monk et al demonstrated an increase in TC of 2.75±0.96cm in a surgically corrected limb followed by physical therapy and a decrease in TC of 0.5±0.28cm in surgically corrected limbs without physical therapy, however hair coat length was not described in this paper (Monk et al, 2006). Measurements evaluating surgical outcome, or response to treatment, should be performed prior to hair clipping, and only after the hair coat has fully returned.…”

Section: Discussionmentioning

confidence: 68%

Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs

Bascuñán

Kieves

Goh

et al. 2016

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Objective: To evaluate inter-and intra-observer variability, influence of hair clipping and laser guidance on canine thigh circumference (TC) measurements amongst observers.Background: It was our goal to further study the reliability of canine TC measurements as currently performed. For this purpose we designed a cadaveric model that allows for controlled inflation of the thigh resembling increase of muscle mass. We also investigated the impact of novel technologies (laser guidance) and hair clipping on TC measurements in this model.

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Section: Discussionmentioning

confidence: 68%

Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs

Bascuñán

Kieves

Goh

et al. 2016

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“…Numerous surgical treatment methods exist, and post-operative rehabilitation by animal physiotherapists is part of a successful outcome [4]. Osteoarthrosis (OA) is known to follow CCLd, regardless of the chosen surgical treatment method [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…Osteoarthrosis (OA) is known to follow CCLd, regardless of the chosen surgical treatment method [1,5]. Several reports of the effectiveness of physiotherapeutic intervention for dogs with stifle problems already exist [3,4,6]. However, the evaluation of success of physiotherapeutic treatment is subjective, since validated outcome assessment methods are lacking in veterinary medicine.…”

Section: Introductionmentioning

confidence: 99%

Ranking of physiotherapeutic evaluation methods as outcome measures of stifle functionality in dogs

Hyytiäinen

Mölsä

Junnila³

et al. 2013

Acta Vet Scand

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BackgroundVarious physiotherapeutic evaluation methods are used to assess the functionality of dogs with stifle problems. Neither validity nor sensitivity of these methods has been investigated. This study aimed to determine the most valid and sensitive physiotherapeutic evaluation methods for assessing functional capacity in hind limbs of dogs with stifle problems and to serve as a basis for developing an indexed test for these dogs. A group of 43 dogs with unilateral surgically treated cranial cruciate ligament deficiency and osteoarthritic findings was used to test different physiotherapeutic evaluation methods. Twenty-one healthy dogs served as the control group and were used to determine normal variation in static weight bearing and range of motion.The protocol consisted of 14 different evaluation methods: visual evaluation of lameness, visual evaluation of diagonal movement, visual evaluation of functional active range of motion and difference in thrust of hind limbs via functional tests (sit-to-move and lie-to-move), movement in stairs, evaluation of hind limb muscle atrophy, manual evaluation of hind limb static weight bearing, quantitative measurement of static weight bearing of hind limbs with bathroom scales, and passive range of motion of hind limb stifle (flexion and extension) and tarsal (flexion and extension) joints using a universal goniometer. The results were compared with those from an orthopaedic examination, force plate analysis, radiographic evaluation, and a conclusive assessment. Congruity of the methods was assessed with a combination of three statistical approaches (Fisher’s exact test and two differently calculated proportions of agreeing observations), and the components were ranked from best to worst. Sensitivities of all of the physiotherapeutic evaluation methods against each standard were calculated.ResultsEvaluation of asymmetry in a sitting and lying position, assessment of muscle atrophy, manual and measured static weight bearing, and measurement of stifle passive range of motion were the most valid and sensitive physiotherapeutic evaluation methods.ConclusionsRanking of the various physiotherapeutic evaluation methods was accomplished. Several of these methods can be considered valid and sensitive when examining the functionality of dogs with stifle problems.

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“…Therefore following immobilization to protect healing muscle, early remobilization is required to induce correct growth and orientation of regenerated myofibers. 204 The rehabilitation group had significantly larger thigh circumference than the home-exercise group 6 weeks after TPLO, with no difference between the affected and nonaffected limbs. One rule of thumb regarding humans states that a remobilization period of twice the duration of the immobilization period is necessary for a return of limb circumference to normal values.…”

Section: Response Of Muscle To Remobilizationmentioning

confidence: 80%

Responses of Musculoskeletal Tissues to Disuse and Remobilization

Millis¹

2014

Canine Rehabilitation and Physical Therapy

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P atients afflicted with neurologic, orthopedic, metabolic, and other diseases frequently have reduced weight bearing and use of limbs. In addition, some conditions may be treated with splints, casts, or other coaptation devices, resulting in decreased limb use. The tissues most affected by disuse and immobilization are cartilage, joint capsule, muscle, ligament, tendon, and bone. Knowledge of how these tissues respond to disuse and immobilization, the types of deleterious tissue changes, and the time frame over which these changes occur, are important in understanding the need for physical rehabilitation. For example, stress deprivation of joints results in proliferation of connective tissue within the joint space, adhesions between synovial folds, adherence of connective tissue to cartilage surfaces, atrophy of cartilage, reduced proteoglycan (PG) content, ulceration at points of cartilage to cartilage contact, disorganization of cellular and fibrillar ligament alignment, reduced collagen mass, increased ligament compliance, weakened ligament insertion sites, reduced load-to-failure and energy-absorbing capacity of the bone-ligament-bone complex, and osteoporosis of the involved extremity. 1 Rehabilitation of patients with acute or chronic neurologic or orthopedic conditions involves the application of controlled challenges to tissues to improve strength, condition, and function. It is important to understand how to safely remobilize tissues after injury and a period of immobilization. Rehabilitation must sufficiently challenge tissues to enhance and positively influence their recovery and healing. However, if tissues are overchallenged, they may be damaged, ultimately delaying recovery or cause additional injury. There must be a balance between the simultaneous demands for protection against undue stress to facilitate healing, and the need for stress to attenuate atrophy of musculoskeletal tissues. 2 A review of these concepts forms the basis for a rational approach to developing rehabilitation programs. CartilageDisorders of articular cartilage and joints are some of the most common and debilitating diseases encountered in veterinary practice. Understanding the normal structure and function of articular cartilage is a prerequisite to understanding the pathologic processes. The mechanical properties of articular cartilage arise from the complex structure and interactions of its biochemical constituents. The viscoelastic properties of cartilage, primarily resulting from fluid flow through the solid matrix, explain deformational responses observed during loading. For example, cartilage that is loaded rapidly is stiffer than the same cartilage that is loaded slowly. Degenerative processes include the breakdown of normal constituents of cartilage, especially the collagen network and PGs, which affects the mechanics of fluid flow through cartilage. Factors contributing to such breakdown include direct trauma, obesity, immobilization, and excessive repetitive loading of the cartilage. Training activities, without tr...

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Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament

Abstract: After TPLO in CCL-deficient dogs, early physiotherapy intervention should be considered as part of the postoperative management to prevent muscle atrophy, build muscle mass and strength, and increase stifle joint flexion and extension ROMs.

Cited by 145 publications

References 18 publications

Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs

Evaluation of Factors Influencing Thigh Circumference Measurement in Dogs

Ranking of physiotherapeutic evaluation methods as outcome measures of stifle functionality in dogs

Responses of Musculoskeletal Tissues to Disuse and Remobilization

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