Select Manual Assessment Techniques and Clinical Reasoning Skills Used in Canine Physical Rehabilitation Before Engaging in Manual Therapy Treatment.

Manual therapy is a cornerstone of physical therapy and canine physical rehabilitation. Although veterinary literature has tackled the topic of manual therapy treatments in animal patients, less attention has been paid to the assessment techniques and clinical reasoning skills that guide a practitioner toward determining if, when, and where manual therapies will be most effective. This article tackles the topics of clinical reasoning, the functional diagnosis, observational skills, and physical evaluation techniques that serve as prerequisites to the use of manual therapeutics.

Veterinary Spinal Manipulative Therapy or Animal Chiropractic in Veterinary Rehabilitation.

Veterinary rehabilitation is a multimodal diagnostic and treatment approach that is recommended and provided to patients daily. One therapeutic modality that may be beneficial (diagnostically and therapeutically) is veterinary spinal manipulative therapy or animal chiropractic (AC). AC is a receptor-based health-care modality being provided more frequently in veterinary practices. All clinicians should strive to understand the mode of action, indications, contraindications, how it affects the patient from the neuro-anatomical and biomechanical point of view, and most importantly, when not to provide the requested modality, as further diagnostics may be indicated.

Equine Manual Therapies in Sport Horse Practice.

Manual therapies involve the application of the hands to the body, with a diagnostic or therapeutic intent. Touch therapies, massage, joint mobilization, and manipulation are all critical components in the management of muscular, articular, and neurologic components of select injuries in performance horses. Musculoskeletal conditions that are chronic or recurring, not readily diagnosed, or are not responding to conventional veterinary care may be indicators that manual therapy evaluation and treatment is needed.

Effectiveness of combined acupuncture and manual therapy relative to no treatment for canine musculoskeletal pain.

Despite the rise in popularity of both acupuncture and manual therapy in veterinary medicine, and the increasing number of Canadian veterinarians practising these techniques, there is little research demonstrating their effectiveness. In this repeated measures, therapeutic trial, 47 client-owned dogs with naturally occurring lameness were assessed for clinical response to treatment. Owners were blinded to the treatment schedule and completed questionnaires to assess their dogs' comfort and mobility. Comparison between pre- and post-treatment results demonstrated that combined acupuncture and manual therapy provides immediate short-term improvement in comfort and mobility, as demonstrated by owner observed changes in play behavior (P = 0.015), walking (P < 0.001), trotting (P = 0.002), jumping (P < 0.001), descending stairs (P = 0.003), rising from a lying position (P < 0.001), and reduced stiffness after rest (P < 0.001) or following exercise (P < 0.001). Mood and attitude also improved, but did not attain statistical significance.

Efficacité de l'acupuncture et de la thérapie manuelle combinées par rapport à l'absence de traitement pour la douleur musculo-squelettique canine. Malgré la croissance de la popularité de l'acupuncture et de la thérapie manuelle en médecine vétérinaire et le nombre grandissant de vétérinaires canadiens qui pratiquent ces techniques, il existe peu de recherche démontrant leur efficacité. Dans cet essai thérapeutique à mesures répétées, 47 chiens appartenant à des clients atteints de boiterie naturelle ont été évalués pour leur réponse clinique au traitement. Les propriétaires n'ont pas été informés du calendrier de traitement et ils ont rempli des questionnaires afin d'évaluer le confort et la mobilité de leurs chiens. La comparaison entre les résultats avant et après le traitement ont démontré que l'acupuncture et la thérapie manuelle combinées offraient une amélioration immédiate à court terme pour le confort et la mobilité, comme le démontrent les observations faites par les propriétaires pour le comportement de jeu (P = 0,015), la marche (P < 0,001), le galop (P = 0,002), le saut (P < 0,001), la descente d'escaliers (P= 0,003), le lever d'une position couchée (P < 0,001) et une raideur réduite après le repos (P < 0,001) ou après de l'exercice (P < 0,001). L'humeur et l'attitude se sont aussi améliorées, mais sans atteindre une importance statistique.(Traduit par Isabelle Vallières).

Joint Mobilization and Manipulation for the Equine Athlete.

Joint mobilization and manipulation provide important diagnostic and therapeutic approaches for addressing musculoskeletal issues in veterinary medicine. Soft tissue and joint mobilization are used to assess the quality and quantity of joint range of motion and as a primary means of treating musculoskeletal disorders. Spinal manipulation was shown to be effective for reducing pain, improving flexibility, reducing muscle tone, and improving symmetry of spinal kinematics in horses. Because of potential misuse and safety issues, joint mobilization and manipulative therapies should be provided only by specially trained veterinarians or licensed human manual therapists.

Canine thoracic costovertebral and costotransverse joints: three case reports of dysfunction and manual therapy guidelines for assessment and treatment of these structures.

The costovertebral and costotransverse joints receive little attention in research. However, pain associated with rib articulation dysfunction is reported to occur in human patients. The anatomic structures of the canine rib joints and thoracic spine are similar to those of humans. As such, it is proposed that extrapolation from human physical therapy practice could be used for the assessment and treatment of the canine patient with presumed rib joint pain. This article presents 3 case studies that demonstrate signs of rib dysfunction and successful treatment using primarily physical therapy manual techniques. General assessment and select treatment techniques are described.

Proposed treatment for geriatric vestibular disease in dogs.

Sudden-onset vestibular dysfunction in the canine is a commonly seen condition in veterinary practice, with some veterinarians reporting several cases each month. However, traditional veterinary medicine has little to offer these patients other than symptomatic relief for the severe nausea that accompanies the vertigo and supportive advice for the owners. Owners of affected dogs are informed that these symptoms usually resolve within a few days. As physical therapists, we often see cases of benign paroxysmal positional vertigo in our human practice clinics, and effective protocols for diagnosis and treatment of the condition have been developed for this condition. A modified testing and repositioning postural maneuver used successfully on 12 canine patients in our canine rehabilitation clinic (The Canine Fitness Centre, Calgary, Alberta, Canada) is hereby described.

Manual therapy in veterinary rehabilitation.

As it matures, the field of animal rehabilitation is welcoming utilization of interventions that have proven efficacy in the specialty of physical therapy for human patients. More recently, manual therapy techniques have become more accepted. Range-of-motion and stretching techniques; mobilization or manipulation of soft tissues, peripheral joints, and the spine; neuromuscular facilitation techniques; techniques unique to osteopathy; chest physical therapy; manual lymphatic drainage techniques; and neural mobilization techniques are now commonly incorporated in clinical practice, and these interventions are more commonly cited in the veterinary literature. The following is a brief review of these manual therapy approaches including the goals, effects, indications, precautions, and contraindications.

The role of manual therapies in equine pain management.

Manual therapy includes a diverse array of techniques, such as touch therapies, massage, physical therapy, osteopathy, and chiropractic, that were originally developed for use in humans and have been gradually applied to horses. All forms of manual therapy have variable reported levels of effectiveness for treating musculoskeletal issues in humans, but mostly only anecdotal evidence exists in horses. This article explores the scientific literature for evidence of efficacy, safety, and common mechanisms of action of the different forms of manual therapies for potential use in managing acute or chronic pain syndromes in horses. Currently, there is limited evidence supporting the effectiveness of spinal mobilization and manipulation in reducing pain and muscle hypertonicity. Further research is needed to assess the efficacy of specific manual therapy techniques and their contribution to multimodal protocols for managing specific somatic pain conditions in horses.

Distal luxation of the patella in a horse.

A 19-year-old Thoroughbred gelding presented with sudden onset, non-weight bearing lameness in the right hindlimb. Radiography confirmed distal luxation of the patella, which was replaced into its normal anatomical location under general anaesthesia. There were no pathological sequelae noted on follow-up examination 9 months after the initial injury. To our knowledge, this is a rare manifestation of patellar luxation, only reported once previously in the equine literature.

Effects of vertebral mobilization and manipulation on kinematics of the thoracolumbar region.

OBJECTIVE: To measure passive spinal movements induced during dorsoventral mobilization and evaluate effects of induced pain and spinal manipulative therapy (SMT) on passive vertebral mobility in standing horses. ANIMALS: 10 healthy adult horses. PROCEDURES: Baseline vertical displacements, applied force, stiffness, and frequency of the oscillations were measured during dorsoventral spinal mobilization at 5 thoracolumbar intervertebral sites. As a model for back pain, fixation pins were temporarily implanted into the dorsal spinous processes of adjacent vertebrae at 2 of the intervertebral sites. Vertebral variables were recorded again after pin placement and treadmill locomotion. In a randomized crossover study, horses were allocated to control and treatment interventions, separated by a 7-day washout period. The SMT consisted of high-velocity, low-amplitude thrusts applied to the 3 non-pin-placement sites. Control horses received no treatment. RESULTS: The amplitudes of vertical displacement increased from cranial to caudal in the thoracolumbar portion of the vertebral column. Pin implantation caused no immediate changes at adjacent intervertebral sites, but treadmill exercise caused reductions in most variables. The SMT induced a 15% increase in displacement and a 20% increase in applied force, compared with control measurements. CONCLUSIONS AND CLINICAL RELEVANCE: The passive vertical mobility of the trunk varied from cranial to caudal. At most sites, SMT increased the amplitudes of dorsoventral displacement and applied force, indicative of increased vertebral flexibility and increased tolerance to pressure in the thoracolumbar portion of the vertebral column.