ABSTRACT
Physical rehabilitation is frequently recommended in dogs recovering from acute thoracolumbar intervertebral disc extrusion (TL-IVDE), but protocols vary widely. The objective of this study was to evaluate the feasibility of incorporating sensory-integrated neurorehabilitation strategies into a post-operative rehabilitation protocol in dogs with TL-IVDE. Non-ambulatory dogs with acute TL-IVDE managed surgically were prospectively recruited to this unblinded cross-over feasibility study. Eligible dogs were randomized to start with tactile-enhanced (artificial grass) or auditory-enhanced (floor piano) basic rehabilitation exercises performed twice daily for the first 4 weeks before switching to the opposite surface for the subsequent 4 weeks. Neurologic examination, open field gait scoring, girth measurements and an owner-completed feasibility questionnaire were performed at baseline and 2, 4, 6, and 8 weeks post-operatively. Twenty-four dogs were enrolled, 12 randomized to each order of exercises. Gait scores did not differ between the two groups at baseline, 4 or 8 week visits. All modified exercises could be performed and compliance was high. Adverse events potentially attributable to the study surface were mild, self-limiting and occurred in 2/24 dogs. The most common surface-related limitations were that the piano was slippery and that both surfaces were too short. The artificial grass was preferred by owners and dogs compared to the floor piano surface, but this was influenced by which surface was utilized first. Auditory and tactile modifications were feasible and safe to incorporate into a standardized rehabilitation protocol. This pilot study could prompt larger efficacy studies investigating the benefit of sensory-integrated rehabilitation in dogs with TL-IVDE.
ABSTRACT
Dogs with thoracolumbar intervertebral disc extrusion (TL-IVDE) can exhibit variable neurologic deficits after decompressive surgery. The objectives of this study were to quantify changes in static weight distribution (SWD) and limb and body circumference over time in dogs recovering from surgery for TL-IVDE. Dogs with acute TL-IVDE were prospectively evaluated at baseline (48-72 h post-operatively), 2, 4, 8, and 12 weeks post-operatively. Commercially-available digital scales were used to measure weight distributed to the pelvic limbs (PL%) and asymmetry between left and right pelvic limbs (LRA), each expressed as a percentage of total body weight. Trunk and thigh circumference measurements were performed using a spring-loaded tape measurement device. Measurements were performed in triplicate, compared to neurologically normal small breed control dogs and analyzed for changes over time. P <0.05 was significant. Twenty-one dogs were enrolled; 18 regained ambulation and 3 did not by study completion. PL% increased from 27.6% at baseline to 30.7% at 12 weeks but remained lower than in control dogs (37%) at all time points (p < 0.0001), even excluding dogs still non-ambulatory at 12 weeks (p < 0.025). LRA was similar to the control dogs, and did not have an association with surgical side. Caudal trunk girth decreased over time to 95% of baseline (p = 0.0002), but this was no longer significant after accounting for reductions in body weight (p = 0.30). Forward shifting of body weight persisted in dogs with TL-IVDE 12 weeks after surgery even among ambulatory dogs. SWD and circumference measurements could provide additional objective measures to monitor recovery.
ABSTRACT
BACKGROUND: Objective outcome measures capable of tracking different aspects of functional recovery in dogs with acute intervertebral disc herniation are needed to optimize physical rehabilitation protocols. Normal, pre-injury distribution of body weight in this population is unknown. The aims of this study were to quantify static weight distribution (SWD) using digital scales and to establish the feasibility of different scale methods in neurologically normal, mature, chondrodystrophic small breed dogs predisposed to intervertebral disc herniation. RESULTS: Twenty-five healthy, mature dogs were enrolled with a mean age of 4.6 years (SD 2.7) and a mean total body weight of 11.5 kg (SD 3.6). SWD for the thoracic and pelvic limbs and between individual limbs was acquired in triplicate and expressed as a percentage of total body weight using commercially available digital scales in four combinations: two bathroom, two kitchen (with thoracic and pelvic limbs combined), four bathroom and four kitchen (with limbs measured individually). SWD was also obtained using a pressure sensing walkway for comparison to scale data. Feasibility for each method was determined and coefficients of variation were used to calculate inter-trial variability. Mean SWD values were compared between methods using an ANOVA. The two bathroom scales method had the highest feasibility and lowest inter-trial variability and resulted in mean thoracic and pelvic limb SWD of 63 % (SD 3 %) and 37 % (SD 3 %), respectively. Thoracic limb mean SWD was higher for the PSW compared to any of the scale methods (p < 0.0001). CONCLUSIONS: SWD in a population of healthy chondrodystrophic dogs was simple to obtain using inexpensive and readily available digital scales. This study generated SWD data for subsequent comparison to dogs recovering from acute intervertebral disc herniation.
