Effect of therapeutic exercise on body weight distribution, balance, and stifle function in dogs following stifle injury

summary of:
Effect of therapeutic exercise on body weight distribution, balance, and stifle function in dogs following stifle injury
vet examine dog in clinic with client
Brantberg, I., Grooten, W.J.A. and Essner, A.
Published in:
December 2023
Type of access:

Open access

In our edition of: Feb 2024
In our categories of: small animals

our summary:

Brantberg, I.,  Grooten, W.J.A. and Essner, A. (2024) Effect of therapeutic exercise on body weight distribution, balance, and stifle function in dogs following stifle injury. Animals,14 (1), no. 92. https://doi.org/10.3390/ani14010092

The aim of this randomised controlled study was to evaluate the effect of an add-on progressive therapeutic exercise protocol on balance control and function in dogs following stifle injury compared to a standard rehabilitation programme alone.

Thirty-three client-owned dogs diagnosed with stifle injury and referred to a veterinary physiotherapist at an animal hospital in Sweden were enrolled in the study. The dogs were randomly allocated into two groups: intervention (n=18) and control (n=15). On the first visit to the veterinary physiotherapist baseline data was measured, demographic data included weight, body condition score and muscle condition score, and outcome data included static body weight distribution between hindlimbs, balance control as well as assessment with the canine brief pain inventory (CBPI), and the Finnish canine stifle index (FCSI). The study protocols were then followed for 12 weeks at the end of which the measurements for outcome data were repeated.

Both groups followed a standardised rehabilitation protocol, which was based on hydrotherapy, joint mobility, soft tissue treatment and a home regime with activity restrictions and leash walking. Dogs in the intervention group additionally followed a home-based progressive therapeutic exercise protocol, based on two exercises with progressive levels of difficulty, to be performed twice a day for approximately 5-10 minutes per session. The progressive therapeutic exercise protocol was developed to address the six systems of balance control: biomechanical constraints, anticipatory postural adjustments, postural responses, sensory orientation, stability limits, and stability in gaits.

Twenty-six dogs completed the 12 weeks of the rehabilitation programme: 14 dogs in the intervention group and 12 in the control group. For all outcome measures there were no significant differences between the groups at baseline. After the 12 week period there was a significant improvement in the intervention group in static body weight distribution between the hindlimbs, pain-related functional disability and stifle function compared to the control group. The median CBPI pain interference score was significantly lower in the intervention group and the median score of the FCSI was in favour of the intervention group. There was no significant difference for balance control between the two groups.

Limitations of the study include the small study population, the short time frame of 12 weeks, the use of an unvalidated method of measurement, the owners and veterinary physiotherapist were not blinded to the groups, and that the same veterinary physiotherapist conducted all the rehabilitation sessions, assessments and data collection.

Take Home

This study provides some evidence for the value of adding short simple daily home exercises to a standard rehabilitation programme for dogs with stifle injury as they can improve outcomes. Future research should include more thorough testing of balance control in dogs with stifle injuries.

The following may also be of interest:

Canine Cruciate Registry [RCVS Knowledge] [online] Available from: https://knowledge.rcvs.org.uk/quality-improvement/canine-cruciate-registry/ [Accessed 16 February 2024]

Merickel, J. and Gordon-Evans, W. (2021) Do dogs with non-surgically managed cranial cruciate ligament disease have better outcomes with rehabilitation? Veterinary Evidence, 6 (2). https://doi.org/10.18849/ve.v6i2.361

Beaulieu, A. F. and Pozzi, A. (2016) Does physical therapy after a TPLO lead to improvement of the 1-Year post-operative peak vertical force? Veterinary Evidence, 1 (3). https://doi.org/10.18849/ve.v1i3.31

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