Fundamental principles of rehabilitation and musculoskeletal tissue healing

Abstract

ObjectiveTo review fundamental principles of tissue healing and physical rehabilitation as they apply to dogs recovering from cranial cruciate ligament (CCL) surgery.Study designInvited Review.Sample populationNone.MethodsA multidisciplinary group of specialists in small animal surgery, rehabilitation/sports medicine, and human physical and occupational therapy reviewed the currently available evidence for rehabilitation post‐CCL surgery. Because current evidence is limited, this group proposes guidelines for rehabilitation after CCL surgery based on the fundamental principles of tissue healing and physical therapy.ResultsThis Review proposes four fundamental principles of small animal physical rehabilitation based on the foundations of tissue healing and patient‐centric and goal‐oriented therapy. Postoperative rehabilitation programs should be designed such that patient progress is based on individual assessment according to the degree of tissue healing, strength, and achievement of functional goals. Therapists must fully understand phases of tissue healing, reassess the patient frequently, and use clinical reasoning skills to progress treatment appropriately for the individual patient.ConclusionUntil more robust evidence is available to guide treatment protocols, fundamental principles of rehabilitation should ideally be adhered to when providing rehabilitation, including after CCL surgery.Clinical significanceWhile this Review specifically addresses post‐CCL surgery rehabilitation, these fundamental principles should be applied broadly to animals enrolled in rehabilitation programs.

Observational Study on Lameness Recovery in 10 Dogs Affected by Iliopsoas Injury and Submitted to a Physiotherapeutic Approach

“…Marcellin-Little and collaborators [34] reported that in sports dogs, muscle recovery takes more than 6 weeks. A recent publication has also investigated the time required for muscle healing on the basis of injury grading; the authors reported grade 2 lesions had a very wide range from 3 weeks to 3-6 months [35].…”

Efficacy of Phytopharmaceuticals From the Amazonian Plant Libidibia ferrea for Wound Healing in Dogs

“…In the histological evaluation, we observed treated wounds with both Carbopol and murumuru butter Jucá-based formulations to have a better epithelization process. Wounds treated with the herbal formulation had connective tissue with a large number of active fibroblasts, better organized collagen fibers, and few blood vessels, in contrast to the control group, where a moderate amount of fibroblasts, disorganized collagen fibers, and newformed vessels were observed, demonstrating the need for additional time to complete the epithelization process (26). Previous reports also demonstrated that the healing process was facilitated by phytotherapeutics with this plant (7,25).…”

“…Those results support our choice for the methodological approach used to repeat all treatments in each animal. Dermal healing varies according to immune and nutritional status but genetic factors can also be associated (26). Furthermore, our study standardized the health and nutrition of all animals, and we used dogs from different genetic backgrounds.…”

Surface Electromyography of the Longissimus and Gluteus Medius Muscles in Greyhounds Walking and Trotting on Ground Flat, Up, and Downhill

“…When combined, the comparison of gait and incline was analyzed in the present report, and walking uphill did not show significant differences, with trotting flat and trotting downhill, in mean and maximum sEMG activities. In canine rehabilitation, choosing between one of these exercises would depend on the stage of rehabilitation and patient's conditions [1].…”

“…In the past decade, knowledge of canine physical therapy has experienced growing advances, being today very helpful and established professional services complementing the multidisciplinary veterinary team. Canine rehabilitation requires multimodal treatments applied to each patient on the basis of its specific needs [1]. To be efficient, physical therapists and veterinary surgeons need a thorough and scientifically-based understanding of the kinematics and muscle function in the therapeutic exercises prescribed.…”