The role of physiotherapy in canine orthopaedic rehabilitation, where place for orthoses
Orthopaedic diseases in dogs – a field of action for the surgeon and physiotherapist
Orthopaedic conditions are common in both dogs and cats, and rehabilitation for them is particularly necessary for:
– acute accidents such as fractures, dislocations and ligament ruptures or dislocations,
– chronic diseases such as osteoarthritis.
It is important to be aware that a specific diagnosis is necessary for proper rehabilitation.
The most common orthopaedic problems occurring in dogs are:
hip and elbow dysplasia,
ruptured cruciate ligament,
dislocation of the patella,
Achilles tendon injury,
wrist strain injuries,
intervertebral disc disease,
The use of orthoses and sensible physiotherapy help patients struggling with these types of conditions to recover.
Physiotherapy in orthopaedic rehabilitation in dogs
The main aim of physiotherapy treatments is undoubtedly to improve the wellbeing and quality of life of the patient by minimising pain, discomfort and stress.
Physical therapy and rehabilitation following orthopaedic surgery in companion animals is becoming increasingly popular, with more and more advances being made in this field every year. It is important to realise that surgery alone may not restore the animal’s original fitness, for a number of reasons ranging from concurrent soft tissue injury to osteoarthritis. Physiotherapy treatments after surgery help to restore strength, coordination and balance. Different techniques are useful at different stages to achieve optimal tissue healing and recovery of function. It has been shown that during the first 72 hours, rehabilitation should focus on reducing inflammation and pain, maintaining joint nutrition, restoring range of motion and stimulating vascularisation. Cryotherapy, massage and therapeutic exercises are therefore recommended. After the initial recovery period, its goals also include restoring strength, balance and normal gait patterns, as well as regaining original function. During this time, therapy can focus on therapeutic exercises and gradually increasing the animal’s activity. Research shows that therapeutic methods such as aquatherapy, electrical stimulation, laser therapy, therapeutic ultrasound and shockwave therapy significantly aid the healing process and reduce recovery time.
The role of orthoses in the treatment of orthopaedic conditions
Bracing is used externally to support or protect an injured body part, also to control, guide, protect, restrict movement or immobilise a limb, joint or body segment. They are seeing increasing use in the motor rehabilitation of companion animals. They work by applying forces at specific points on the body while preventing tissue damage.
In veterinary medicine, orthoses can be used to restrict movement in a particular direction, such as limiting the conduction of the hip after dislocation. They will also prove useful in supporting movement, such as a wrist orthosis for radial nerve damage. They also have a protective function – a tarsal orthosis after a fracture or dislocation – and a repair function when regional tissues (e.g. ligaments, joint capsule, periarticular tendons) are not strong enough to provide the needed support during the healing phase.
In some justified cases, an orthosis is chosen instead of surgical correction. However, the owner must be informed of the advantages and disadvantages of each solution.
Canine orthopaedic rehabilitation, and orthoses
A better understanding of movement and biomechanics in four-legged dogs has led to the development of more sophisticated orthoses with advanced design, created from materials that can be custom-made for each patient to meet their specific needs.
The effectiveness of the orthosis depends on the way it is designed, with the aim of restoring function without causing tissue trauma. It is essential that owners are properly trained in their use.
Orthoses have been successfully used in dogs with sciatic neuropathy, gastrocnemius muscle tendon strain, hind limb pad wounds, carpal ligament instability and other pathologies of both fore and hind limbs. Dog orthoses have also been developed to stabilise the ankle joint after rupture of the cranial cruciate ligament. In some cases, the orthosis can provide support to the limb or joint during treatment or rehabilitation, and its use is discontinued once sufficient biomechanical improvement has been achieved.
However, it is worth being aware that complete recovery of function in an ankle joint with cruciate ligament damage will not be possible with the use of an orthosis alone; therefore, rehabilitation is necessary.
Physiotherapy an essential part of orthosis use
The aim of physiotherapy in the rehabilitation of dogs with orthopaedic conditions is to help integrate the orthosis into the lifestyle of both owner and patient. A well-designed rehabilitation plan can accelerate recovery while preventing permanent disability and future injury.
Orthoses play a significant role in the overall wellbeing of the animal. They give support to a weak or non-functioning body part and can aid rehabilitation by increasing the animal’s mobility. The duration of immobilisation should be kept to a minimum, especially in situations of potential loss of joint movement. The choice of rehabilitation methods and techniques must be based on common sense, knowledge of rehabilitation techniques and clinical experience.
Most patients adapt quickly to the orthoses used and an appropriate behavioural approach can facilitate this. Rehabilitation focuses on learning to move with the orthosis in place and includes transitions (sitting down, lying down and standing up), navigating stairs and coping with different types of surfaces. Orthopaedic injuries lead to compensation of abnormal movements and associated muscle tension and weakness. Gait correction focuses on addressing these problems.
Remember that the initial training sessions should last a few minutes and be conducted in such a way that the patient has as positive an experience as possible. The role of physiotherapy in orthopaedic rehabilitation cannot be underestimated and, if approached correctly, has the potential to produce great results. The use of orthoses in the orthopaedic rehabilitation process allows patients to recover much more quickly, minimising the negative effects of their injuries.
“Practical Physiotherapy for Small Animal Practice” David Prydie, Isobel Hewitt
“Rehabilitation and physical therapy for selected orthopedic conditions in veterinary patients”
Andrea L Henderson , Christian Latimer , Darryl L Millis
“Orthoses and Exoprostheses for Companion Animals”
Denis J. Marcellin-Little DEDV a, Marti G. Drum DVM, PhD b, David Levine PT, PhD, DPT, CCRP, Cert. DN c, Susan S. McDonald EdD, OTR/L
“BSAVA Manual of Canine and Feline Rehabilitation, Supportive and Palliative Care”