Canine
A1 Preliminary findings from a clinical test of a therapeutic garment for hip dysplasia
Lisa Bedenbaugh
K9Align, Irvine, CA, USA
Correspondence: Lisa Bedenbaugh (lhinerman2@aol.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A1
Background: Hip dysplasia is a very common orthopedic disorder in dogs, and a costly one for owners. Currently, only a few treatment strategies are available for treatment of hip dysplasia: medications, rehabilitation therapy, surgery and rigid braces/orthotics. We have developed a therapeutic garment which works to reduce effects of hip dysplasia by stimulating the proprioceptive system in a strategic way to engage the gluteal, epaxial and abdominal muscles as the dog moves, with the goal of enhancing the dynamic stability of the hip joint, thereby reducing the pain and inflammation associated with hip dysplasia.
Materials and methods: We conducted a preliminary clinical test of the garment on 5 dogs with varying degrees of hip dysplasia and asked the owners to have their dogs wear the garment daily for a minimum of 1 h, for a 3-week period. Owners filled out a Canine Brief Pain Index (CBPI), a validated pain scale, prior to the garment being fitted and again at the end of each week. Certified rehabilitation therapists (veterinarians or physical therapists, CCRP/T) collected objective data (hip extension ROM, thigh circumference), filled out a functional score, and videoed the dogs walking with and without the garment on at the initiation and completion of the clinical trial.
Results: Results from this study were favorable. All dogs demonstrated gains in hip extension ROM, thigh girth gains in 3/5 dogs, decreased lameness score in 4/5 dogs, improvement in walking distance in 3/5 dogs, better ability to climb stairs in 3/5 dogs and improvement in the CBPI noted by 4/5 owners. All dogs were accepting of the garment, and no declines in functional ability were noted by the owners during use.
Conclusion: Based on this limited sample trial, it appears that this garment could provide a novel approach to the treatment for hip dysplasia. A longer-term study with a larger test population is needed.
A2 Development of a Basic Functional Neurorehabilitation Scale (BFNRS) for evaluation and monitoring of dogs with thoracolumbar injury
Rita Cruz1,2, Inês Viegas3, António Ferreira4, Artur Varejão5, Ângela Martins1,2,3
1Hospital Veterinário da Arrábida (HVA), Azeitão, Portugal; 2Centro de Reabilitação Animal da Arrábida (CRAA), Azeitão, Portugal; 3Faculdade de Medicina Veterinária da Universidade Lusófona (ULHT), Lisboa, Portugal; 4Faculdade de Medicina Veterinária de Lisboa (FMV), Lisboa, Portugal; 5Universidade de Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
Correspondence: Ângela Martins (vetarrabida.lda@gmail.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A2
Background: Functional Neurorehabilitation (FNR) is an area of restorative neurology [1, 2, 3] which aims to achieve the functionality of neurologic patients classified according to the Modified Frankel Scale [4, 5, 6, 8, 11]. A study about the development of a Basic FNR Scale (BFNRS) for evaluation and monitoring of dogs with thoracolumbar injury (T3-L3) was performed to record the differences in patient’s recovery, direct the changes in the FNR protocols and achieve improved objectivity in the patient’s evaluation [7, 9, 10, 12, 13, 14].
Materials and methods: The BFNRS was applied to 34 dogs with imaging diagnosis of thoracolumbar lesion by computed tomography (CT) and magnetic resonance imaging (MRI), and classified with grade 0, 1 and 2 level of functionality according to the Modified Frankel Scale regardless breed, gender, age, body condition and etiology. At admission, the animals attempted to complete a FNR appointment, and were assessed regarding the mental state, gait, posture, postural reactions, peripheral spinal reflexes (PSR) and pain sensation. All the animals were evaluated by the BFNRS weekly while integrated in an intensive FNR program. The outcome was measured at the 4th and 8th week of the FNR program (Fig. 1). The BFNRS is a punctuation scale with 5 essential categories in the neurologic patient’s evaluation: sensorial evaluation, PSR evaluation, muscle tone evaluation, movement evaluation, and proprioception and coordination evaluation, which allows the animal’s categorization into: bad prognosis (BP), moderate prognosis (MP) and good prognosis (GP). The dogs classified with GP were integrated into a 6th category to readjust the FNR program and decrease residual neurologic deficits (Table 1). Statistical analysis was made from Microsoft Office Excel 2016 and IBM SPSS Statistics 22.0, evaluating the BFNRS score at the entrance and exit of HVA/CRAA with several variables such as gender, age, body condition, etiology and duration of FNR program.
Results: In the study, there was a significant relation between the BFNRS scores and the animal’s functionality (P < 0.01), significant relation between BFNRS scores and the FNR period (P < 0.01), and a positive correlation between the entrance’s score and the exit’s score, in addition to other interesting results.
Conclusion: The BFNRS allowed the evaluation of all the animals in a brief period (40 to 60 min), for fast perception of individual’s sensory and motor deficits, and the rapid change of the FNR’s protocols, which makes the BFNRS a possible operational tool for all FNR centers, according to the restorative neurology’s guidelines.
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Angeli CA, Edgerton VR, Gerasimenko YP, Harkema SJ. Altering spinal cord excitability enables voluntary movements after chronic complete pralysis in humans. Brain. 2014;137:1394–409.
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Dietz, V. Neuronal plasticity after a human spinal cord injury: positive and negative effects. Exp Neurol. 2012;235:110–5.
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Edgerton VR, Roy RR. Activity-dependent plasticity of spinal locomotion: implications for sensory processing. Exerc Sport Sci Rev. 2009;37:171–8.
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Courtine G, Gerasimenko Y, van den Brand R, Yew A, Musienko P, Zhong H, et al. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input. Nat Neurosci. 2009;12:1333–42.
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Duysens J, Crommert HW. Neural control of locomotion; the central pattern generator from cats to humans. Gait Posture. 1998;7:131–41.
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Gerasimenko Y, Gorodnichav R, Machueva E, Pivovarova E, Semyenov D, Savochin A, et al. Novel and direct access to the human locomotor spinal circuitry. J Neurosci. 2010;30:3700–8.
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Gerasimenko Y, Gorodnichev R, Puhov A, Moshonkina T, Savochin A, Selionov V, et al. Initiation and modulation of locomotor circuitry output with multi-site transcutaneous electrical stimulation of the spinal cord in non-injured humans. J Neurophysiol. 2014;113:834–42.
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Grasso R, Ivanenko YP, Zago M, Molinari M, Scivoletto G, Castellano V, et al. Distributed plasticity of locomotor pattern generators in spinal cord injured patients. Brain. 2004;127:1019–34.
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Hubli M, Dietz V. The physiological basis of neurorehabilitation—locomotor training after spinal cord injury. J Neuroeng and Rehabil. 2013;10:1–8.
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Krueger E, Magri LM, Botelho AS, Bach FS, Rebellato CL, Fracaro L, et al. Low-intensity electrical stimulation and stem cells in a dog with acute spinal cord injury. In: Proceedings of the Thirteeth International Association of Science and Technology for Development (IASTED) International Conference on Biomedical Engineering 2017; Innsbruck.
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Lavrov I, Musienko PE, Selionov VA, Zdunowski S, Roy RR, Edgerton VR, et al. Activation of spinal locomotor circuits in the decerebrated cat by spinal epidural and/or intraspinal electrical stimulation. Brain Res. 2014;1600:84–92.
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Lewis MJ, Howard JF, Olby NJ. The relationship between trans-lesional conduction, motor neuron pool excitability and motor function in dogs with incomplete recovery from severe spinal cord injury. J Neurotrauma. 2017;34:2994–3002.
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Musienko P, Brand RV, Marzendorfer O, Roy RR, Gerasimenko Y, Edgerton VR, et al. Controlling specific locomotor behaviors through multidimensional monoaminergic modulation of spinal circuitries. J Neurosci. 2011;31:9264–78.
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Olby NJ, Smith DT, Humphrey J, Spinapolice K, Parke N, Mehta PM, et al. Pharmacokinetics of 4-aminopyridine derivatives in dogs. J Vet Pharmacol Therap. 2009;32:485–91.
A3 Recovery of walking after an IVDD without DPP with adipose derived mesenchymal stem cells
Yolanda Elbertse, Peter Hundepool
Rehab and Pain Centre for Animals, Rotterdam, Netherlands
Correspondence: Yolanda Elbertse (sterkliniek@live.nl)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A3
Background: A 2-year old female English Staffordshire Terrier had surgery for intervertebral disc disease (IVDD) at L1–L2, leaving her with no deep pain perception (DPP).
Materials and methods: The dog received 1 year of underwater treadmill (UTM) at a PT before being transferred to our center for more extensive rehab (Table 1). After improving her muscle stamina (Table 2) we started ground walking. Initially, the feet had to be placed forward by hand. She voluntarily protracted her foot 26 weeks later, with tactile hamstring cuing.
The rehab treatment improved her Olby score from 1 to a 3 [1]. The dog moved her hind legs during sleep and swimming. Table 2 shows her accomplishments. However, 6 additional months of extensive rehab did not improve her scoring beyond Olby 3. This was considered too poor of a performance outcome, thus adipose derived stem cell treatment was suggested.
Under general anesthesia fat was harvested at the falciformic ligament and the inguinal region. It was processed with the in-house-kit of Medivet. One ml was added to Nano whiskers and injected in the epidural space. The remainder (2 mL) was given intravenously.
Results: Three weeks post-injection, the dog showed neurological improvements (Table 3).
After one treatment the dog could walk for 45 min, though she continued to cross the hind legs or walk ‘ataxic-like’. During daily walks wheelchair usage was continued to prevent falls, though she walked on all four feet. At home she did not voluntarily utilize all four feet and continued dragging herself forward. After 10 months a second stem cell treatment was suggested. This time the stem cells were given intrathecally and through IV. Following this treatment, she began to walk around the house instead of dragging herself. Outdoors she made less gait deviations.
Conclusion: This study has a solid historical control. It is clear that the final results involving improved gait and hind limb muscle recruitment of the dog were achieved following the addition of stem cells treatment to the rehabilitation intervention. Further research is needed to determine if an intrathecal stem cell injection yields varied results from an epidural injection and to determine the best interval between treatments.
Reference
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1.
Olby NJ, Lim JH, Babb K, Bach K, Domaracki C, Williams K, et al. Gait scoring in dogs with thoracolumbar spinal cord injuries when walking on a treadmill. BMC Vet Res. 2014;10:58.
A4 Comparison of a commercially available consumer mobile movement analysis application with a 3-D kinematic gait analysis system
Jose L Guevara, Emily A Liles, Joseph P Weigel, Darryl L Millis
Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
Correspondence: Darryl L Millis (boneplate@aol.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A4
Background: Kinematic gait evaluation is increasingly used to assess the effects of exercises on joint motion and the efficacy of treatments for musculoskeletal conditions [1, 2]. Recently, several low-cost consumer applications (apps) have become available. The apps measure motion in 2-D, but aim to improve decision making using an economical, available, and easy to use kinematic gait analysis tool. However, the accuracy of these apps has not been evaluated in dogs. The purpose of this study was to compare a consumer movement analysis app to a 3-D kinematic gait analysis system (KGAS). We hypothesized that the two gait analysis systems not be significantly different in the sagittal plane in trotting dogs.
Materials and methods: Reflective spheres were attached to anatomic landmarks on ten dogs. Dogs were trotted in a test area while four infrared cameras and an infrared digital camcorder captured kinematic data. Five trials of each side of the dogs were obtained. Images from the infrared cameras were recorded in a KGAS program (Peak Motus, Centennial, CO, USA). Images from the infrared digital camcorder were uploaded to the app (Simi Move, Germany). Maximum flexion, extension, and total range of motion (ROM) were calculated for each trial of the shoulder, elbow, hip, and stifle using the KGAS and the app. Mean joint angles were calculated from the five trials. Total joint ROM was calculated for each trial by subtracting the flexion from the extension angle. Values obtained for the mobile app were compared to the KGAS by paired t test with P values < 0.05 considered significant.
Results: Mean joint angles obtained on the app were not significantly different (P > 0.702) from those generated by the KGAS (Figs. 1, 2). 97.5% of the angles measured on the mobile app deviated < 5% from KGAS values, with most of those deviating more than 5% measured during flexion. Although mean ROM calculated by the app exhibited greater deviation than expected, ROM values calculated on the app were not significantly different than actual values (p > 0.283).
Conclusion: The app performed well and may be an inexpensive method to obtain joint angles, with 97.5% of the measurements from the mobile app accurately identifying maximum joint angles within 5% of the KGAS values. Limitations of this study included artifact from images on the infrared digital camcorder and skin marker movement artifacts during ambulation. Additional studies are required to determine the best protocols and use of this technology in clinical settings.
References
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DeCamp CE. Kinetic and kinematic gait analysis and the assessment of lameness in the dog. Vet Clin North Am Small Anim Pract. 1997;27:825–40
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Gilette R. Gait analysis. In: Millis DL, Levine D, Taylor RA, editors. Canine rehabilitation and physical therapy. St. Louis (MO): WB Saunders; 2004. p. 201–10.
A5 Kinetic and temporospatial gait parameters in dogs: reproducibility of an instrumented pressure-sensitive canine treadmill
Kirsten Haeusler1, Doro Braun1, Nah-Chieh Liu2, Matthew James Allen2
1Zentrum für Tierphysiotherapie, Stuttgart, Germany; 2Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
Correspondence: Kirsten Haeusler (info@dr-haeusler.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A5
Background: Objective, reliable and validated gait analysis is rarely used routinely in clinical practice because it is time-consuming and rarely cost-effective. The purpose of this study was to assess the validity and reliability of a pressure sensor matrix equipped stationary treadmill (CanidGait®, Zebris) for measuring gait characteristics in dogs of various sizes and weights. We hypothesized that the system would provide reliable measures of gait parameters in dogs.
Materials and methods: 12 client-owned dogs were measured while walking on the CanidGait® system at a constant velocity of 3 km/h. Body weight of the dogs (kg), temporospatial (stride length, cadence) and kinetic data (pressure distribution) were recorded for all four limbs. Short-term (intra-session) reproducibility of the measurements was determined by comparing two measurements collected in the span of 2 h on the same day. Long-term (inter-session) reproducibility was determined by comparing baseline measurements on 1 day with a second set of measurements collected not less than 4 days later. Reproducibility between either the two measurements on the same day, or the two measurements on different days, were assessed using intraclass correlation coefficient (ICC) and ratios of difference. Statistical significance was determined at P < 0.05.
Results: The dogs evaluated in this study weighed between 12.7 kg and 31.2 kg. ICC values for intra-session and inter-session comparisons of pressure distribution ranged from 0.959 to 0.992 and 0.917 to 0.978 respectively. ICC values for step length and cadence were also excellent (> 0.76 in all cases). Results for swing and stance phase lengths were more variable (0.663 to 0.942). Overall ratios of differences were lower for comparisons from the same day, but in all cases ratios of differences were below 5%.
Conclusion: The CanidGait® system demonstrates excellent intra- and inter-session reproducibility. A ratio of difference of 5% or less indicates the validity of this system for objective gait analysis in dogs, both as a means of assessing lameness but also as an objective method of documenting the effectiveness of new surgical techniques and post-operative rehabilitation protocols.
A6 Lower back pain: positing a novel cause and treatment for canine urethral sphincter mechanism incompetency
David Lane1, Sarah Hill2
1Points East West Veterinary Services, Garibaldi Highlands, BC, Canada; 2Department of Military Psychology & Leadership, Royal Military College of Canada, Kingston, ON, Canada
Correspondence: Sarah Hill (dlane@pointseastwest.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A6
Background: Canine urethral sphincter mechanism incompetency (USMI) is the most common cause of urinary incontinence in dogs [1, 2]. Sex, age when neutered, bladder position, tail docking, breed, body weight, obesity, and urethral length are all risk factors, and the only recognized non-surgical treatment is ongoing medication [1–3]. To the authors’ knowledge, this paper is the first to posit that palpable lower back pain (LBP) is a potential cause or risk factor for USMI. If LBP is a cause of USMI, it follows that resolution of LBP should result in a reduction or resolution of USMI symptoms. We hypothesize that some dogs presenting with a history of urinary incontinence and concurrent symptoms of LBP, and whom receive treatment for LBP, will demonstrate a corresponding reduction in USMI symptoms.
Materials and methods: This retrospective study examined the outcomes of 19 dogs presenting with concurrent LBP and urinary incontinence that were treated for LBP exclusively (Group A). Further, as part of a larger research project, blinded outcomes were recorded on 5 dogs with a history of urinary incontinence and concurrent LBP, treated for LBP alone (Group B). Group A responses were divided into none, partial, or complete, based on the frequency or volume of urine leaked following treatment. The frequency and volume of incontinence episodes were compared pre and post treatment for Group B.
Results: Four Group A dogs (21.1%) showed no improvement in USMI symptoms. Seven (36.8%) showed partial improvement. Of the dogs demonstrating complete resolution, 0% relapsed within 6 months, 2 (10.5%) relapsed between 6 and 12 months, 2 (10.5%) relapsed after 12 months, and 2 (10.5%) permanently responded. Two dogs (10.5%) had mixed results, with one relapsing after 5 months then permanently resolving, and 1 relapsing within both the short and medium-term time frames (< 6 months, and 6–12 months). Eighty percent of Group B dogs showed a reduction in frequency of incontinence, and in voided urine volume.
Conclusion: Group A results indicate that treating LBP may reduce or eliminate the symptoms of USMI in 78.9% of dogs. Group B dogs also showed an average drop in both the frequency and volume of urine leaked in the short term following treatment. This suggests that LBP is a risk factor or potential cause of USMI. Further prospective, blinded, randomized, and controlled research is required to substantiate this observation.
This paper complies with the NIH guidelines for Humane Care and Use of Animals.
References
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Reichler I, Hubler M. Urinary incontinence in the bitch: an update. Reprod Domest Anim. 1987;49:75–80.
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Chew DJ, DiBartola SP, Schenck PA. Disorders of micturition and urinary incontinence. In: Chew DJ, DiBartola SP, Schenck PA, editors. Canine and feline nephrology and urology. 2nd ed. Saint Louis (MO): W.B. Saunders; 2011. p. 409–33
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Power SC, Eggleton KE, Aaron AJ, Holt PE, Cripps PJ. Urethral sphincter mechanism incompetence in the male dog: importance of bladder neck position, proximal urethral length and castration. J Small Anim Pract. 1998;39:69–72.
A7 Thermographic evaluation of the duration of cryotherapy effect in dogs undergoing tibial plateau leveling osteotomy (TPLO) surgery
Jack A. Lee1, Betsy Phillips1, Marti G. Drum1, Henry S. Adair, III2, Darryl L. Millis1
1Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA; 2Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
Correspondence: Darryl L. Millis (Boneplate@aol.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A7
Background: Cryotherapy is commonly applied to patients after tibial plateau leveling osteotomy (TPLO). Although studies have assessed duration of effect of cryotherapy in the canine stifle, few studies have examined this in the clinically relevant context of a post-operative stifle using noninvasive techniques [1–3]. Thermal imaging is a non-invasive method to measure superficial skin temperature and has been used in both human and veterinary medicine for a variety of indications, including to assess duration of cooling after cryotherapy. However, duration of cooling has not been assessed by thermography in the inflammatory setting of a post-operative canine stifle. The purpose of this study was to evaluate the use of thermal imaging to determine changes in surface temperature following TPLO, cryotherapy, and during the rewarming period. We hypothesized that thermal imaging would be useful to assess changes in limb surface temperature, and that the pattern of cooling and rewarming would be similar to invasive methods of measurement.
Materials and methods: Eighteen client-owned dogs undergoing TPLO surgery were enrolled after obtaining consent. The day after surgery, dogs were placed in a draft-free room with constant temperature and bandages were removed from limbs. Thermographic images were made of the lateral, cranial, and medial aspects of both stifles using a Med2000 thermal imaging camera. Thermal images were taken of the limb after bandage removal until temperature equilibrated 60 min after bandage removal. Cryotherapy was then applied for 20 min using bags of crushed ice. Thermographic images of the sites were obtained 15, 30, 45, 60, 90, 120, 150, 180, 210, and 240 min after cryotherapy. A one-way repeated measures analysis of variance (ANOVA) was used to evaluate the treatment effect across time at each site. Fisher’s least significant difference mean separation was used as post hoc test. The significance level was set at P < 0.05.
Results: Surface temperatures of all sites of the stifle were significantly lower after cryotherapy (P < 0.001, Fig. 1). Rewarming began within 15 min after cryotherapy, and by 45 min, temperature returned to equilibrium temperatures for all views of the stifle.
Conclusion: This rewarming pattern was similar to previous thermister derived rewarming data [1], although rewarming occurred sooner in these post-operative patients. These results suggest that more frequent application of cryotherapy may be indicated post-operatively. However, additional studies are needed to evaluate the relationship between surface temperatures measured with thermal imaging and temperatures of deeper tissues.
References
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1.
Vannetta M, Millis D, Levine D, Adair S, Schwartz P, Hicks D, et al. The effects of cryotherapy on in vivo skin and muscle temperature, and intramuscular blood flow. J Orthop Sports Phys Ther. 2006;36:A47.
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2.
Rexing J, Dunning D, Siegel A, Knap K, Werbe B. Effects of cold compression, bandaging, and microcurrent electrical therapy after cranial cruciate ligament repair in dogs. Vet Surg. 2010;39:54–8.
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Drygas K, McClure S, Goring R, Pozzi A, Robertson SA, Wang C. Effect of cold compression therapy on postoperative pain, swelling, range of motion, and lameness after tibial plateau leveling osteotomy in dogs. J Am Vet Med Assoc. 2011;238:1284–91.
A8 Evaluation of forces produced by therapeutic elastic resistance bands of various lengths and colors: a biomechanical study
Daniel McCarthy1, Ellis Wright2, Pierre-Yves Mulon3, Darryl Millis1
1CARES Center, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA; 2Biomedical and Diagnostic Sciences, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA; 3Large Animal Clinical Sciences, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
Correspondence: Daniel McCarthy (dmccart6@utk.edu)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A8
Background: Elastic resistance bands (ERB) have been used in human and veterinary rehabilitation to increase muscle strength. ERB are used in human physical therapy to improve muscle strength and achieve earlier return to function after surgery [1, 2], in elderly adults [3], osteoarthritis [4], and stroke injury [5]. Limited data have been published using ERB for veterinary conditions, but they are commonly used for neurologic and orthopedic disease. Studies in veterinary rehabilitation regarding forces generated using different lengths of bands, different stiffnesses, and by stretching to different lengths are lacking. Previous studies have published data for both 100 and 200% elongation values; however, these values may not be applicable in dogs, especially considering the stride length of dogs [6]. The aims of this study were to determine the forces produced with different stiffnesses of colored ERB at 1.25, 1.5 and 1.75 times the original length, and to determine the effects of using two different lengths of ERB (10 cm and 40 cm). We hypothesized that the ERB would behave in linear fashion and that shorter ERB, stiffer ERB, and greater elongation values would generate higher forces.
Materials and methods: Five replicates of cut sections (10 cm and 40 cm) of different colored ERB (Theraband, Akron, OH) (tan, yellow, red, green, blue, and black, with colors arranged from least stiff most stiff) were placed in an Instron Biomechanical 5969 testing device. Bands were distracted at 3 m/min for 30 cycles at 1.25, 1.5 and 1.75 times the original length and maximal forces per cycle were recorded. Data were analyzed using ANOVA to evaluate different ERB. Mean forces were compared using Tukey’s test, and Pearson’s correlations were calculated in XLSTAT. Significance was set at P < 0.05.
Results: The mean forces produced at each elongation length are indicated in Table 1. There was a strong linear correlation of elongation length for each color of ERB (P < 0.05, Table 2). There were significantly lower values measured using the 40 cm versus the 10 cm band length for all colors (Table 3).
Conclusion: Stiffer bands (darker colors), and increased elongation values generated greater forces. Shorter length ERB produced greater forces compared to a longer length of similar color. Further studies and calculations are underway to further characterize ERB based on these preliminary data. In addition, formulas may be generated to provide practitioners with information relative to the forces being applied during therapeutic exercises using ERB.
References
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1.
Ditmyer MM, Topp R, Pifer M. Prehabilitation in preparation for orthopaedic surgery. Orthop Nurs. 2002;21:43–54.
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Christiansen DH, Falla D, Frost P, Frich LH, Svendsen SW. Physiotherapy after subacromial decompression surgery: development of a standardised exercise intervention. Physiotherapy. 2015;101:327–39.
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Chen KM, Li CH, Huang HT, Cheng YY. Feasible modalities and long-term effects of elastic band exercises in nursing home older adults in wheelchairs: a cluster randomized controlled trial. Int J Nurs Stud. 2016;55:4–14.
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Swank AM, Kachelman JB, Bibeau W, Quesada PM, Nyland J, Malkani A, et al. Prehabilitation before total knee arthroplasty increases strength and function in older adults with severe osteoarthritis. J Strength Cond Res. 2011;25:318–25.
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In T, Jin Y, Jung K, Cho HY. Treadmill training with Thera-Band improves motor function, gait and balance in stroke patients. NeuroRehabilitation. 2017;40:109–14.
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Hottinger HA, DeCamp CE, Olivier NB, Hauptman JG, Soutas-Little RW. Noninvasive kinematic analysis of the walk in healthy large-breed dogs. Am J Vet Res. 1996;57:381–8.
A9 Variables affecting class IV laser absorbance
Daniel McCarthy1, Darryl Millis1, Agricola Odoi2
1CARES Center, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA; 2Biomedical and Diagnostic Sciences, The University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
Correspondence: Daniel McCarthy (dmccart6@utk.edu)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A9
Background: Laser therapy is increasingly used in veterinary medicine. Laser therapy, or photobiomodulation, has positive effects on wound healing, joint conditions, and analgesia for chronic and acute pain in people [1–4], but the effects rely on photon delivery to the appropriate tissues. Chromophores are substances that exist in tissues and reduce laser penetration. The type and thickness of tissues may also alter the penetration of photons through tissues. To our knowledge, no studies have evaluated these variables noninvasively in live dogs. The purpose of this study was to objectively evaluate class IV laser penetration through various tissues in dogs. We hypothesized that an increasing melanin and erythema index, and unclipped hair, would decrease photon penetration. Further, we hypothesized that laser penetration would vary among different tissue types.
Materials and methods: Twenty healthy dogs weighing between 15 and 30 kg were included in the study. Laser penetration was evaluated at six sites, including the pinna, triceps muscle, inguinal skin, caudal vertebra and caudal vertebra intervertebral space, distal common calcaneal tendon, and proximal caudal thigh. Tissue thickness, colorimeter measurement including melanin and erythema index, and laser penetration were evaluated prior to and after clipping hair at each designated site. Penetration was measured using a wavelength photodetector placed in a jig positioned 180 degrees from a class IV laser (CTC-12, LiteCure, Newark, DE) aperture at 0.5, 1, 3, and 5 W power settings. Mean laser penetration values were compared using generalized linear mixed models in SAS. Statistical significance was set at P ≤ 0.05
Results: No adverse effects were observed. Laser penetration decreased significantly with unclipped hair (94.6%) versus clipped hair (98.6%) and greater melanin index (each unit increased absorbance 0.033%, P < 0.0001) in all tissues. Erythema index did not influence laser penetration (P = 0.273). Tissue type also affected mean laser penetration (Table 1).
Conclusion: Unclipped hair decreased laser penetration by approximately 4%. Tissue type and thickness also affected laser penetration, with no penetration through triceps muscle and caudal vertebra. Based on the findings reported here, patients should be clipped prior to therapeutic laser application to improve transmission to tissues, and differences in tissue structure should be taken into account prior to laser application. Future studies are necessary to measure photon penetration to target tissues and to determine the dose of laser for ideal photobiomodulation of cells in live dogs.
References
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Reddy GK, Stehno-Bittel L, Enwemeka CS. Laser photostimulation accelerates wound healing in diabetic rats. Wound Repair Regen. 2001;9:248–55.
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Stelian J, Gil I, Habot B, Rosenthal M, Abramovici I, Kutok N, et al. Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the knee treated with narrow-band light therapy. J Am Geriatr Soc. 1992;40:23–6.
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Djavid GE, Mortazavi SMJ, Basirnia A, Roodsari GS, Jamili P, Sheikhbahaee N, et al. Low level laser therapy in musculoskeletal pain syndromes: pain relief and disability reduction. Lasers Surg Med. 2003;152:43.
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Chow RT, Heller GZ, Barnsley L. The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study. Pain. 2006;124:201–10.
A10 Surface electromyography of the vastus lateralis, biceps femoris, and gluteus medius muscles in normal dogs during treadmill exercise with elastic resistance bands
Hannah McLean1, Darryl Millis1, David Levine2
1Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine Knoxville, TN, USA; 2Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN, USA
Correspondence: Hannah McLean (hthurma2@vols.utk.edu)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A10
Background: Therapeutic exercises are an essential part of the rehabilitation of musculoskeletal and neurologic conditions, as well as strengthening and conditioning of dogs. Elastic resistance bands (ERB) are used to provide resistance during therapeutic exercise, thereby increasing muscle strength [1]. In humans, muscle activity using surface electromyography (EMG) is used in healthy populations to determine the role and interactions of different muscles during specific tasks as well as in clinical studies to assess muscle dysfunction or maladaptions due to neurologic or musculoskeletal injury or pain. Several studies have evaluated canine muscle activity using needle EMG or surface EMG during walking and trotting on a treadmill at different angles of inclination or declination [2–4]. The objective of this study was to evaluate surface EMG muscle activity of the vastus lateralis (VL), biceps femoris (BF), and gluteus medius (GM) muscles during walking and trotting on a treadmill with progressively increasing elastic band resistance in clinically normal dogs. We hypothesized that surface EMG muscle activity would increase with increasing resistance.
Materials and methods: Surface EMG (Noraxon, Scottsdale, AZ) was performed during treadmill walking and trotting with 4 different stiffnesses of ERB (Theraband, Akron, OH– Yellow, Red, Green, Blue) secured above the hock. Dogs were acclimated to the treadmill prior to the study. The treadmill velocity was set to a comfortable walk (1.4–2.0 MPH) and trot (3.0–4.1 MPH). The ERB were held at 120–150% elongation based on tensiometer measurements [5]. Raw EMG data was rectified, smoothed and filtered prior to statistical analysis. The means of maximal and mean muscle potentials during 3 gait cycles were compared among the different ERB. Data were analyzed using a mixed model analysis. Significance was set at the P < 0.05 level.
Results: At the walk and trot, the maximum amplitude of the GM was significantly lower than BF and VL for all ERB (P < 0.05). During the walk, the maximum amplitude increased with progressively increasing resistance of the different ERBs (P < 0.05). At the trot, the GM again had a significantly lower amplitude at all resistances, and the maximum amplitude of the VL and BF increased with increasing resistance of the different ERBs (P < 0.05).
Conclusion: Increased muscle activity in the BF and VL can be achieved by use of ERB and muscle activity progressively increases with increasing band resistance at the walk and trot. Specific knowledge of muscle activation patterns during therapeutic exercises should allow practitioners to target specific muscles for strengthening.
References
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Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy: a summary of systematic reviews. Phys Ther. 2005;85:1208–23.
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Breitfuss, Franz M, Peham C, Bockstahler B. Surface electromyography of the vastus lateralis, biceps femoris, and gluteus medius muscle in sound dogs during walking and specific physiotherapeutic exercises. Vet Surg. 2015;5:588–95.
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Bockstahler BB, Gesky R, Mueller M, Thalhammer JG, Peham C, Podbregar I. Correlation of surface electromyography of the vastus lateralis muscle in dogs at a walk with joint kinematics and ground reaction forces. Vet Surg. 2009;38:754–61.
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Lauer SK, Hillman RB, Li L, Hosgood GL. Effects of treadmill inclination on electromyographic activity and hind limb kinematics in healthy hounds at a walk. Am J Vet Res. 2009;70:658–64.
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Uchida, MC, Nishida, MM, Sampaio, RAC, Moritani T, Arai, H. Thera-band® elastic band tension: reference values for physical activity. J Phys Ther Sci. 2016;28:1266–71.
A11 The use of radial pressure wave therapy to manage chronic musculoskeletal pain in dogs
Britt Mills
Mills Veterinary Services, Armstrong, BC, Canada
Correspondence: Britt Mills (millsdvm@gmail.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A11
Radial pressure wave therapy has been used in humans to treat chronic soft tissue injuries, especially tendinopathies. Postulated mechanisms of action include transmission of positive pressure energy through tissue, cavitation, alteration of ion channels, stimulation of nitric oxide pathways, stimulation of angiogenesis, reduction in inflammation, and tissue and nerve regeneration. It is useful in small animal veterinary medicine because it is very well tolerated in unsedated animals, and it provides a viable method to treat pain when non-steroidal anti-inflammatories cannot be used. The purpose of this study is to demonstrate the efficacy of radial pressure wave therapy in treating various chronic pain conditions in dogs. Over a period of 6 months, ten dogs were selected for case studies. They all had pain conditions that were obvious to the owner and had persisted for more than 1 month. The location of pain varied but included shoulder and stifle pain, generalized hindquarter pain, and spine and forelimb pain. All dogs received three treatments approximately 2 weeks apart and efforts were made to ensure there were no changes in medication or exercise during the treatments. The treatment intensity and duration was tailored to the size of the dog and the site treated. The treatments were evaluated by owner reports of changes in demonstrated pain and lameness, and also by veterinary evaluation. No dog required sedation and all dogs except two showed a clear improvement in pain.
Reference
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1.
Moya D, Ramon S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am. 2018;100:251–63.
A12 Effect of aquatic exercise on cardiovascular parameters of dogs
Darryl Millis, Rachel Dickson, Ellen Camp, Jose Guevara, Marti Drum
CARES Center, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
Correspondence: Darryl Millis (boneplate@aol.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A12
Background: A previous study found that heart rate (HR) and respiratory rate (RR) increased prior to fatigue with ground treadmill exercise [1]. Little information exists regarding aquatic exercise and the cardiovascular system in pet dogs compared to people [2, 3]. Because cardiovascular parameters in pet dogs may differ from those of elite athletes, we collected data from pet dogs. Our main objective was to measure cardiovascular, respiratory, and thermal parameters of dogs undergoing a graded fitness test in an underwater treadmill with three different water levels, and during swimming. We hypothesized that HR and RR would increase during exercise for each condition, and these parameters would peak prior to fatigue.
Methods and methods: Fifteen adult dogs, weighing 20–40 kg and of various fitness levels were evaluated. Dogs were acclimated to an underwater treadmill (UWTM) and a swimming pool (SP) prior to data collection. Resting HR; systolic (SBP), diastolic (DBP) and mean blood pressure (MBP); rectal temperature; and RR were obtained. Dogs underwent a graded exercise test in the UWTM at 3 water levels performed in random order, (1) carpus (C), (2) midantebrachium (MA), (3) elbow (E), until mild fatigue. Dogs walked 2 km/h for 5 min, followed by a 1 min rest period to obtain data. Dogs were walked for additional 5 min intervals at increasing velocity (0.5 km/h for each period) until mild fatigue, with 1 min rest periods between sessions. Because velocity could not be controlled during swimming, data were collected every minute, with a 1 min rest period to collect data. Data were analyzed using ANOVA to evaluate changes over time and among groups.
Results: Dogs exercised for a mean of 56.3, 58.3, 53.3, and 6.2 min for C, MA, E, and SP, respectively. In general, SP HR was greatest, and C HR was lowest (Fig. 1). HR increased steadily throughout exercise with minimal indication of fatigue. Similarly, RR gradually increased throughout exercise in all groups, with the greatest RR within 15 min of fatigue in UWTM groups and within 3 min in the SP group (Fig. 2). There were no significant changes in SBP, DBP, MBP, or temperature to indicate fatigue (P > 0.05).
Conclusion: Mild increases in HR and moderate increases in RR may be useful to design conditioning protocols to induce mild training stress. Possible recommendations from this graduated exercise test suggest an increase in 10 heartbeats per min, or a RR of 100 may precede exercise fatigue.
References
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1.
Camp E, Dickson R, Guevara J, Drum M, Millis D. Cardiovascular parameters of exercising pet dogs. Acta Vet Scand. 2016;58:A44.
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2.
Whitley JD, Schoene LL. Comparison of heart rate responses: water walking versus treadmill walking. Phys Ther. 1987;67:1501–4.
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Johnson BL, Stromme SB, Adamczyk JW, Tennoe KO. Comparison of oxygen uptake and heart rate during exercises on land and in water. Phys Ther. 1977;57:273–8.
A13 The effect of a dynamic warm-up protocol on performance in agility dogs
Romany Pinto, Emily Horan, Kira Penney, Sarah Parker, Cindy Shmon
Western College of Veterinary Medicine, Saskatoon, Saskatchewan, Canada
Correspondence: Romany Pinto (romany.pinto@usask.ca)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A13
Background: Dynamic warm-up can improve performance and prevent injuries in human athletes [1]. To our knowledge, no studies have investigated the effects of warm-up in dogs, despite significant injury rates in sports such as agility [2, 3, 4, 5]. We wished to assess the effects of a dynamic warm-up on performance in agility dogs.
Materials and methods: We recruited 22 agility dogs of varying age and breed. Owners performed their dog’s normal pre-agility preparation prior to completing an agility course. Electronic timing equipment provided times to 0.01 s. All runs were videotaped. Owners were randomly divided into a control group (CG) and a warm-up group (WG). The WG received instruction on the dynamic warm-up. The protocol was based on those used in several human studies. It included cardiovascular activity, dynamic stretches, passive stretches, proprioceptive activities and agility activities. Four weeks later, the CG handlers did their normal pre-agility routine. The WG did the dynamic warm-up protocol. The dogs ran the same course as on Day 1. The blinded principal investigator analyzed each video and determined the number of times off task (TOT) for each dog. This included any time a dog paused, went off course, or restarted the weave poles. Day 1 times were subtracted from Day 2 times to give an outcome of change in time for each dog. Day 1 TOT was subtracted from Day 2 TOT to give an outcome of change in TOT for each dog. The differences between groups were compared using the Wilcoxon Rank sum test.
Results: Twenty-one dogs completed the study protocol. Dogs in the CG were a median of 2.48 s slower on Day 2, while WG dogs were a median of 3.18 s faster (Table 1, Fig. 1). The difference between groups was significant (P = 0.035). The CG dogs had a median of no difference in TOT between Day 2 and Day 1. The WG dogs had a median of 1 fewer TOT on Day 2 (Fig. 2). The difference between groups was nearing significance (P = 0.067). Seven of the 8 faster dogs (88%) in the WG had fewer TOT on Day 2.
Conclusion: The dynamic warm-up protocol significantly reduced agility run times. This may be due in part to improved focus and fewer TOT. Further research is needed to investigate the protocol’s effect on dogs’ running speed as well as any effects on injury rates.
Acknowledgements: The authors acknowledge Jason Good, Christina Tollett, Alexandra Wentzell, Christine Wilson and the Saskatchewan agility clubs for their assistance with this study.
References
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1.
Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol. 2011;111:2633–51.
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2.
Cullen KL, Dickey JP, Bent LR, Thomason JJ, Moëns NM. Survey-based analysis of risk factors for injury among dogs participating in agility training and competition events. J Am Vet Med Assoc. 2013;243:1019–24.
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3.
Cullen KL, Dickey JP, Bent LR, Thomason JJ, Moëns NM. Internet-based survey of the nature and perceived causes of injury to dogs participating in agility training and competition events. J Am Vet Med Assoc. 2013;243:1010–8.
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4.
Kerr ZY, Fields S, Comstock RD. Epidemiology of injury among handlers and dogs competing in the sport of agility. J Phys Act Health. 2014;11:1032–40.
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5.
Levy M, Hall C, Trentacosta N, Percival M. A preliminary retrospective survey of injuries occurring in dogs participating in canine agility. Vet Comp Orthop Traumatol. 2009;22:321–4.
A14 Euthanasia diversion by use of extracorporeal shockwave therapy to improve mobility and decrease pain in a Treeing Walker hunting dog
Tamara Sue Shearer
Western Carolina Animal Pain Clinic, Sylva, NC, USA
Correspondence: Tamara Sue Shearer (tshearer5@frontier.com)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A14
Background: Extracorporeal shockwave therapy should be considered as part of the multimodal therapy to support palliative and hospice care patients to help restore function and mitigate pain. Patients may present for euthanasia, hospice, or palliative care when symptoms of a chronic condition interfere with activities of daily living, a decision is made not to pursue curative treatment, or when a patient has progressive consequences of a trauma which is associated with health complications [1].
Materials and methods: A retired 9-year old, 32 kg, neutered male Treeing Walking Coonhound presented to the Western Carolina Animal Pain Clinic for euthanasia because of a bilateral forelimb lameness associated with osteoarthritis of the humeroradial and humeroulnar joint which had exacerbated 2 weeks prior to the visit. Prior to the visit, his therapy included carprofen, gabapentin, amantadine, injectable glycosaminoglycan, oral supplements, laser therapy, acupuncture, therapeutic exercise and joint mobilizations [2, 3, 4, 5]. New modifications of existing dosages had failed to mitigate the pain.
Results: Upon presentation, the dog had a lameness score of 3/5 and pain score of 8/10. Quality of life scale was 275/500 [6]. Under light sedation (0.3 mg dexmedetomidine, IM), the patient received 3 treatments of 750 shocks with an energy level of 0.25 mJ/mm2 using the Storz Duolith® Vet divided between the medial and lateral areas of the elbows every 2 weeks for 3 treatments. At the end of the series of treatments the lameness score improved to 1/5, quality of life to 450/500 and the pain scale decreased to 2/10.
Conclusion: Based on this case study, extracorporeal shockwave therapy should be offered as another treatment option over euthanasia for clients that have a desire to palliate a painful lameness.
References
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1.
Shearer T. Pet hospice and palliative care protocols. Vet Clin North Amer Small Anim Pract. 2011;41:507–18.
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2.
Shearer T, August K. Physical medicine, rehabilitation, complementary and integrative medicine treatment modalities. In: Shanan A, Pierce J, Shearer T, editors. Hospice and palliative care for companion animals. Hoboken NJ: Wiley Blackwell; 2018; https://doi.org/10.1002/9781119036722.ch19
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3.
Millis D, Levine D. Exercises for proprioception and balance. In: Millis D, Levine D, editors. Canine rehabilitation and physical therapy. 2nd ed. Philadelphia: Elsevier; 2014. p. 484–94
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4.
Durant A, Millis D. Applications of extracorporeal shockwave in small animal rehabilitation. In: Millis D, Levine D, editors. Canine rehabilitation and physical therapy. 2nd ed. Philadelphia: Elsevier; 2014. p. 381–9.
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5.
Hanks J, Levine D, Bockstahler B. Physical agent modalities in physical therapy and rehabilitation of small animals. Vet Clin North Am Small Anim Pract. 2015;45:33–7.
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6.
Xie H. 3 steps of palliative care and end-of-life care. In: Traditional Chinese Veterinary Medicine (TCVM) Palliative Care and End-of-Life Care Lecture series 2018.
A15 Heart rate testing in agility dogs
Gillian Tabor1, Hannah Carmicheal1, Nicky Grant2
1Animal Welfare Research and Knowledge Exchange Arena, University Centre Hartpury, Gloucester, UK; 2Win Clinic, Willowbrook Garden Centre, Wellington, UK
Correspondence: Gillian Tabor (Gillian.tabor@hartpury.ac.uk)
Acta Veterinaria Scandinavica 2019, 61(Suppl 1):A15
Background: Heart rate (HR) has been used as a proxy measure for exercise intensity in human and horse training but its use is less reported in dog training. Agility dog trainers could use peak and mean heartrate of dogs undergoing agility trials to report episodes of physiological stress and fitness. Currently there are no studies published evaluating technique or outcome for HR testing of agility dogs over an agility run consisting of a timed course of obstacles. The aim of this study was to use a simple manual method of heartrate monitoring, pre-and post-agility trial, to test the hypothesis that heartrates would be higher after completion of the course.
Materials and methods: HR of 39 UK Kennel club rated grade 7 dogs (mean age 5.7 ± 1.7 years, 11 males, 18 females, variable breeds) were collected immediately preceding (PreHR) and after (PostHR) competing over an agility course. The course consisted of 168 m with 20 obstacles (13 jumps, 3 tunnels, set of 12 weaves, dogwalk, A-frame, see-saw) and was part of a 1-day camp for agility performance. Manual palpation was used to locate the femoral artery in the medial thigh region and dogs’ pulses were counted for 30 s. The number of beats per minute (BPM) was derived by multiplying by this number by two, to obtain a HR.
Results: Data from 22 dogs were excluded due to unreliability of HR collection as a result of the behaviour of the dog. HR of 17 dogs were successful collected at the two measurement points (PreHR mean 95.5 ± 19.7 BPM; PostHR mean 97.6 ± 14.4 BPM). The was no significant differences between PreHR and PostHR (t16 = 0.388 P = 0.703).
Conclusion: The behavioural excitement and rapid movement of the dogs in the competition environment limited the ability to collect HR data in this group of dogs. Of those that were collected there was a large spread of HR BPM with no mean difference between PreHR and PostHR. Physiological arousal due to excitement in this scenario appeared to be the limiting factor in the reliability of using the HR to measure exercise intensity. Therefore to record training load data an alternative method would need to be tested, such as continuous monitoring and data capture during the agility trial using technology to log HR.