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Table 1 Physiotherapeutic evaluation protocol

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

1. Visual evaluation of lameness The evaluation was performed outside, on a non-slip pavement surface, with the dog on a leash trotting 50 m in a straight line, and movements were observed twice from the front, back and on both sides of the dog.
  The handlers were instructed to move at a brisk walking speed, with the dog moving in a relaxed trot speed at either side of the handler; heel-command was not recommended. If any oblique movement was noted, the handler was asked to present the dog both on their right and left to rule out any effect of excess eye contact between the dog and the handler.
  Movements were also observed in circles, 2–3 m in diameter, leading the dog in both directions.
2. Visual evaluation of diagonal movement Possible oblique body position during movement in straight lines was noted: moving diagonally in three lines, hindquarters to the right or left.
3.-6. Visual evaluation of functional active range of motion (AROM) (3.-4.) and thrust of hind limbs (5.-6.) “Sit (3.) and sit-to-move (4.)” The dog was led over a 20-m distance and asked to sit and sit-to-move 3 times within equal distances. Any functional limitation or compensation of the sitting position, such as external rotation, abduction, limited flexion of the hind limbs, was noted. Observed weakness or asymmetry in thrust of hind limbs from the ground was noted.
 Lie down (5.) and lie-to-move (6.)” were done using a similar protocol.
7. Movement in stairs The stairs used for testing were 15 cm high, 30 cm deep, and 2 m wide indoor stairs with solid steps and un-slippery surface. The dog was led and the handler was instructed to perform a controlled climb up and down the stairs. This was done twice and observed from both above and below in turn.
8. Manual evaluation of hind limb muscle atrophy The dog stood in a symmetrical, square position, with the owner holding the dog straight. The symmetry of the width of the muscle bulk of both hind limbs was evaluated manually by palpating and comparing them simultaneously. This was done for both the cranial and caudal thigh muscle groups.
9. Manual evaluation of static weight bearing of hind limbs (meSWB) Static weight bearing of the hind limbs was evaluated manually by lifting each of the limbs in turn and evaluating possible differences in resistance; a weaker resistance was noted.
10. Quantitative measurement of static weight bearing of hind limbs (qmSWB) SWB was also measured with the hind limbs placed on two identical digital scales (Medica plus M-135, Truebell Vantaa, Finland). The scales had a measurement accuracy of 0.1 kg and a measurement range from 3 kg to 150 kg. The scales gave a stationary final score. The measurement protocol is described elsewhere [10]. Measurements were recorded in kilograms, with an accuracy of two decimals, and the mean values for each dog were calculated.
11.-14. Measurement of passive range of motion: PROM of stifle (11.-12.) and tarsal joints (13.-14.) The PROM of stifle and tarsal joints was measured from unsedated dogs using a small-sized, flexible 180° UG with a 5° scale. The dog was placed in lateral recumbency, where the handler maintained the position of the dog, and the examiner was situated caudally to the dog. Joints proximal to the one being measured were positioned so that the least amount of muscular restriction affected the joint measured.
  Measurement procedure followed standard joint measurement protocols, where the UG was placed lateral to the joint in question, and the axis of the UG was placed over the axis of the movement of the joint. The stationary arm of the UG lied parallel to the longitudinal axis of the bone proximal to the joint and pointed towards the greater trochanter of the femur when the PROM of the stifle joint was measured, and towards the extensor groove and the tibial tuberosity when the tarsal joint was measured.
  The movable arm of the UG lied parallel to the longitudinal axis of the bone distal to the joint segment and pointed towards the lateral malleolus of the fibula when the PROM of the stifle joint was measured, and towards the distal end of the fifth metatarsus when the tarsal joint was measured.
  Three measurements of each joint in maximal flexion and extension from both hind limbs were taken. All of the same-side measurements were taken alternately between the two joints before the dog’s side was changed. The PROM in extension and flexion was followed through until the last possible end of PROM was met at the furthest possible full fifth degree, limited by either active resistance of the dog, pain, or palpable end-feel. Possible deviant findings in end-feels and limiting factors were recorded.
  1. For each task, the handler of the dog, usually the owner, was given standardized instructions. The tests were always performed in the same environment. In case of disturbance (e.g. reaction to other dogs, misbehaviour), the handler was asked to repeat the tasks more often than mentioned in the protocol. Assistive aids, such as treats or toys, were used to motivate the dogs to perform tasks, if needed. An assistant recorded the results.