The basics of therapeutic exercise dictate the exercise should always be safe for both the practitioner and the patient, present challenges, work on the goals set forth in the rehabilitation plan, and be reasonable for both the dog and the practitioner. Exercises should be challenging yet accomplishable for the dog, and always be safe. The goal should be progression and not regression. An overzealous therapeutic exercise program may set the dogs’ progress back significantly and has the potential to cause significant problems to the surgical or repair site. Neurological improvement may also be altered significantly with improper activity. Safety and caution should always be exhibited.
Therapeutic exercise should be exciting and fun for both the dog and the practitioner. Boredom and stagnation may easily set in with a therapeutic program. Although some dogs do better with a routine, changes and further challenges should be incorporated in to the program.
There are a variety of therapeutic exercise tools that may be utilized. The choices will depend upon the size of the clinic, financial constraints of the clinic, clientele, and own personal preferences. Many exercises may be performed with little to no equipment, and the equipment may also be designed with creativity. Cavaletti rails may be designed from just about anything with a step and a rail. Uneven surfaces may be crafted with creativity. Of course, aquatic therapy such as pools and underwater treadmills are some of the most costly items. They are very beneficial in the rehabilitation setting and have many applications. Land treadmills also have many applications in the rehabilitation setting.
Land treadmills are very appropriate for canine rehabilitation and may be used in most cases. Harnesses and lifts may be necessary for large and immobile patients. The treadmills should be large enough to accommodate the length of the dog, and features such as an incline and decline are very beneficial. The professional models of land canine treadmills meet many of the needs of the rehabilitation patient as well as the conditioning patient. The slow, passive movement of the treadmill is beneficial in increasing weight bearing as well as increasing range of motion. Harnesses are helpful with dogs beginning to walk after trauma or a neurological insult. The land treadmills are also very beneficial for conditioning and weight loss programs.
Underwater treadmills are very appropriate and offer a variety of benefits in addition to the treadmill action. The properties of water are extremely beneficial to the patient and serve a variety of purposes. The higher the level of water, the less stress placed on the joints. This makes the underwater treadmill a suitable tool for many dogs, inclusive of those with multiple joint involvements. Dogs recovering from a cranial cruciate surgery are usually able to place weight on their affected limb with a water height above the stifle and not affect the integrity of the repair. Neurological dogs or dogs that have suffered multiple orthopedic problems are often able to stand in water due to the properties of water. Fitness and weight loss programs are also a large component of underwater treadmill work.
Pools, swim tanks, and other water bodies offer forms of aquatic therapy. Aquatic therapy is beneficial for a wide range of patients. The appeal of aquatic therapy should be balanced with the benefits and risks. The dogs must be able to enter the water safely, possess the ability to swim, and possess the cardiac and pulmonary function to perform. Aquatic therapy takes advantages of the many properties of water and allows the dogs to increase their activity level.
Manual exercises are very beneficial to the rehabilitation patient and do not require any equipment. The exercises may be initiated with the dog in a down, sitting or standing position. Manual pressure should be given to challenge the dogs’ posture. The goal is for the dog to shift their weight and not to lose their balance. These exercises should be performed to the dogs’ endurance. Down dogs and dogs recovering from neurological surgery will understandably fatigue quickly and will require frequent rests. The exercise may be performed for a few seconds at varying repetitions depending upon the dogs’ endurance. Athletic dogs or more active dogs should be able to handle more activity and may be able to handle a few minutes of activity, at several repetitions. Alterations in head position will challenge the dogs’ balance as well. Utilizing low calorie treats or a toy to encourage the dog to move their head from side to side will promote weight shifting and weight bearing. When the dog lifts their head upward, there is a natural tendency to place more weight on to the rear legs. A simple exercise asking the dog to lift their head up to reach for a treat in a standing position will increase the weight bearing on the hindlimbs. This is a very beneficial exercise for dogs with hindlimb problems such as canine hip dysplasia or cruciate disease and can easily be performed by the owner.
While the dog is standing, varying limbs may be lifted approximately one half inch to two inches off the ground depending upon the height and stability of the dog. The dog should be able to maintain a level topline while shifting their weight. The leg may be held up for as long as the dog is able to maintain the level topline and this may be a second up to a minute. Each limb may be lifted separately and this may be performed for a number of sets and repetitions. To further challenge the activity, the contralateral limbs may be lifted simultaneously as well as the ipsilateral limbs. Lifting the ipsilateral limbs is often more difficult than the contralateral limbs and care should be taken.
Balance or rocker boards are beneficial for many types of rehabilitation patients from those beginning to ambulate after a neurological injury to those competing in an agility trial. Rocker and balance boards are used to enhance balance and proprioception through the use of an uneven surface. They may be used for orthopedic cases, in particular post cranial cruciate repair, to improve weight bearing, balance, proprioception, and neuromuscular facilitation. A variety of exercises may be performed to facilitate the goal. One or both forelimbs may be placed on the board to encourage weight bearing on the affected limb. Balance may be altered by rocking the board or encouraging the dog to shift his weight through head movements. One or both hindlimbs may also be placed on the board to encourage weight bearing on the affected limb. The board or the dog may be shifted to encourage weight bearing. This activity may be performed for orthopedic and neurological conditions of
both the forelimb and hindlimb. Levels of difficulty may be adjusted with the stability of the board, manual weight shifting of the dog, head position, and visual perception.
Uneven surfaces such as foam, bedding, sand, or carpet are a beneficial rehabilitation tool to assist with the enhancement of balance, proprioception and neuromuscular facilitation for a wide variety of rehabilitation patients. The dogs may be walked or lead over the uneven surface at varying speeds to enhance proprioception. Neurological cases will benefit from the challenge to their bodies and will assist in their neurological recovery. Orthopedic cases will benefit as well. Balance exercises may be performed while standing on the uneven surfaces in the form of weight shifting.
Balls, physiorolls, or eggs are beneficial for a variety of conditions. They may be utilized to assist with weight bearing. A smaller physioroll may be used to place the forelimbs on to encourage weight bearing and weight shifting on to the hindlimbs. This is beneficial in many cases inclusive of canine hip dysplasia, cruciate disease, general hindlimb weakness, and iliopsoas cases. The hindlimbs may be places on a smaller physioroll to encourage weight bearing on the forelimbs and this is beneficial in cases such as elbow dysplasia and shoulder instability. A large physioroll may be used to improve core strength. Core strength is a necessity in all dogs and may be used in a variety of circumstances. If neurologically stable, a post intervertebral disc disease dog should use the roll to assist with weight shifting and postural strength. The dog is usually in a sphinx position and weight shifting is performed by rocking the dog side to side. The roll is stabilized. This movement is also beneficial for the dog with shoulder and/or hip instability. Progressive exercises may be performed while the dog is in a sitting or standing position. Standing postures should be progressed to with caution and work on core strengthening, weight shifting, and balance and proprioception. Many dogs can benefit from these activities.
Cavaletti rails serve a variety of purposes including weight shifting, improvement of range of motion, improvement of stride length, and improvement of balance and proprioception. The rails may be set at varying distances and varying heights depending upon the goal of the exercise. Stride length goals will involve distancing the rails to increase the length of the dogs’ stride. Four to six rails may be set up and the dog is walked or trotted over the rails. For the advancement of stride length, the height of the rail should not come over the dogs’ hock. To increase range of motion, the height of the rails may be set above the hock. This is a useful exercise to increase hock, stifle and hip flexion and extension in the hindlimb and to increase carpal, elbow and shoulder flexion and extension in the forelimb. It may also be used to determine if there are ranges of motion limitations during gait that are not determined during a normal gait evaluation. The rails may be staggered in height and in diagonals to increase balance and proprioception. Dogs with neurological insults will have a difficult time initially negotiating the obstacles. Additional obstacles of varying heights and depths may be added to assist with the exercise.
Weaving or performing figure eights is a simple exercise that will also benefit a variety of dogs. The exercise may be set up with cones or something similar and will assist in the improvement of balance, proprioception, weight shifting, spinal range of motion, and forelimb and hindlimb rotation and abduction and adduction. The activity may be performed on a variety of surfaces such as carpet, grass, concrete and a matted floor to challenge the activity. Figure eights are a simple method to start with and may be advanced to a series of weaving with cones or other objects. Speeds may be varied to challenge the dog.
Leash walking, hiking and jogging are other methods of therapeutic exercise that are simply utilized. Controlled leash walking is a common activity after many orthopedic surgeries and is also used n the exercise of restricted dogs with soft tissue injuries. Advancements include controlled off leash activity, hiking and jogging. Varying the speeds of the gait pattern is a useful activity to challenge the dogs’ balance and proprioception.
Exercise duration will be determined by the individual dog, goals of treatment, and restrictions. Each dog should have an individualized program and the goal should be tailored to meet the individual goals. Whether the goal is to herd sheep for a living or to channel surf with their owners, the exercise program needs to be tailored to meet the demands of the goals. Therapeutic exercise comes in many shapes and forms. It is one of the enjoyable aspects of rehabilitation and brings the dog closer to meeting their final goals.
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Debbie began her physical therapy career with a Bachelor’s of Science degree in Physical Therapy from Boston University. It was during her physical therapy education that she began to think about combining her love of animals with the principles of physical therapy. She holds a Master of Science degree from Quinnipiac University in Orthopedic Physical Therapy with distinction. The same year she became a certified by the American Board of Physical Therapy Specialties in Orthopedics. Debbie then went on to earn her doctorate degree from the University of Tennessee in August of 2008.