Rehabilitation: Proprioception, Incoordination, and Paresis.

Physiotherapeutic exercises aimed at stimulating motor control, flexibility, and stability are regularly employed in human physical therapy programs. Specifically, the use of such exercises has been shown to reduce both pain and reinjury. Pursuant to the equine patient, several core strengthening exercises and their role in activating deep epaxial musculature to subsequently improve postural motor control and alter thoracolumbar kinematics have been investigated. Both baited and passive exercises offer opportunities to facilitate stretching during dynamic phases and strengthening during static phases of exercise. Blanket recommendations regarding prescription of exercises is not advised, individual patient prescription should be considered in context of handler safety, specific rehabilitation goals, and patient ability to effectively complete the exercise.

Therapeutic Exercises for Equine Sacroiliac Joint Pain and Dysfunction.

This article provides the equine practitioner with a review of sacroiliac joint pain and dysfunction and outlines the importance of providing a specific prescription for a safe and effective therapeutic exercise program. The continuum of clinical dysfunction associated with the sacroiliac region is presented with prescribed interventions. The intent is to encourage the practitioner to perform a thorough assessment of the sacroiliac joint and the adjacent soft tissues and to use sound clinical reasoning to formulate a therapeutic exercise plan.

Rehabilitation Strategies for the Neurologic Horse.

Rehabilitation of the neurologic horse represents a unique challenge for the equine practitioner. Improving postural stability and balance control through improving the strength of the spinal stabilizer muscle multifidus remains one of the most promising rehabilitative targets. This muscle can be targeted through the use of physiotherapeutic exercises, various forms of perturbation, and even whole-body vibration. Neuroanatomic localization and diagnosis specificity enable the practitioner to determine suitability for such rehabilitative tasks, and with the advent of evolving strategies and commercially available equipment, the bandwidth for professionally guided programs is continuously being developed and is expected to improve traditional outcomes.

PhysiCan - a device for automatic CPM exercises implementation over canines: Design and analysis.

Continuous Passive Motion (CPM) devices have been used to assist physicians conducting human rehabilitation; however, similar machines specific for canine rehabilitation have not been found in the reviewed literature. This research performed a physical analysis of the hind limb of dogs to design a device for implementing automated CPM exercises. The device proved to comply with the guidelines to perform CPM exercises, allowing a proper setting of parameters to generate rehabilitation routines customized for different rehabilitation requirements. Also, an electromyography acquisition module was incorporated into the system, with surface electrodes to visualize and provide feedback to the user for muscle activation. Limitations were encountered with a range of motion of 80° and an error of approximately 2% for angular position accuracy.

Guidelines to Home Exercises and Lifestyle Modifications for Common Small Animal Orthopedic Conditions.

Patients with osteoarthritis and other orthopedic conditions may benefit from a home exercise program, as well as lifestyle modifications based on their condition. Home exercises can be performed to improve a pet's range of motion, weight-bearing, strength, and overall mobility. A home exercise program should be designed to improve the patient's impairments, and progression of exercises should occur depending on the patient's response and ability to master each exercise. Modifications to the pet's home environment should be considered so the pet can maneuver around the house and perform its daily tasks.

Influence of an Exercise Program, Muscle Strength, Proprioception, and Arm Length on Veterinary Students' Bovine Pregnancy Diagnosis Accuracy.

Bovine pregnancy diagnosis (PD) by transrectal palpation (TRP) is an important skill for veterinary graduates. Factors influencing students' PD accuracy were investigated to optimize bovine PD by TRP training without increasing live animal exposure. The objective was to determine whether arm length and strength, proprioception, and exposure to a 6-week exercise training program were significantly associated with students' PD accuracy. Veterinary students (n = 128) who had previously received formal theoretical and practical training in bovine TRP and PD (live cows and TRP simulators) were assessed for PD accuracy on live cows. Prior to assessment, arm muscle strength measurement, an exercise program, and additional TRP sessions on Breed'n Betsy® simulators and live cows were offered to the students. Seventy-eight students volunteered to participate in the arm length measurement, muscle strength, and proprioception testing. Of these, 35 randomly allocated students completed a 6-week exercise program, after which muscle strength was reassessed. Each student performed PDs on six cows of which the pregnancy status, ranging from 6 weeks to 9 months pregnant or not pregnant, was predetermined by an experienced veterinarian. PD accuracy was measured as sensitivity and specificity, being defined as the proportion of pregnant or nonpregnant cows, respectively, correctly identified by the student. It is concluded that hand grip strength and participation in an exercise program are significant predictors of veterinary students' PD accuracy. Implementation of an exercise program aimed at improving grip strength in the veterinary curriculum is a novel approach to improve bovine TRP and PD training.

Relationship Between Postural Stability and Paraspinal Muscle Adaptation in Lame Horses Undergoing Rehabilitation.

Postural stability maintains balance, protects the spinal column, and allows accurate responses to destabilizing forces. The musculus multifidus (m. multifidus) is the major postural muscle located adjacent to the vertebrae along the length of the spinal column. Increased cross-sectional area (CSA) of the m. multifidus has been demonstrated in horses after a rehabilitation strengthening exercise program; however, correlation with functional postural stability has not been shown. The objective of the present study is to evaluate the relationship of the thoracolumbar m. multifidus CSA and measures of postural sway performance in lame horses undergoing rehabilitation exercises in clinical cases. Seven client-owned horses admitted to the equine rehabilitation service were included in the study. M. multifidus CSA was measured via ultrasonography at the start of a rehabilitation program (initial evaluation) and after 12 weeks of rehabilitation exercises (final evaluation). Postural sway data were also measured at initial and final evaluation. A significant increase in m. multifidus CSA was seen from initial to final evaluation. A moderate to strong correlation was present between m. multifidus CSA and postural sway variables. These results suggest that there is an association between postural stability and m. multifidus hypertrophy in lame horses undergoing individualized rehabilitation programs. However, more research is needed to provide a definitive answer on the nature of this relationship. Ideally, specific performance tests would better define and examine the relationship in which to guide clinicians in rehabilitation protocol development.

Rehabilitation of companion animals following orthopaedic surgery.

Physical therapy and rehabilitation following orthopaedic surgery in companion animals have become more common and new advancements in this field have been made in recent years. Surgery alone may not return the animal to its previous physical activity or work-related tasks, whether due to concurrent soft tissue trauma, arthrogenic muscle inhibition or osteoarthritis. Rehabilitation therapies following surgery can restore function as well as strength, coordination and balance. Many simple techniques such as cryotherapy and passive range of motion exercises have been shown to improve outcomes following musculoskeletal procedures and may help restore function as well as reduce pain and facilitate healing. Some techniques are more useful during different stages in order to achieve optimum tissue healing and recovery of function. During the first 72 hours, rehabilitation should focus on reduction of inflammation and pain, maintaining joint nutrition and range of motion, and stimulating vascularisation and healing; and may include cryotherapy, passive range of motion exercises, massage and therapeutic exercises. Following the initial recovery period, the goals of rehabilitation also include restoring strength, balance and normal gait patterns, as well as recovery of function. During this period the focus of therapy may shift toward therapeutic exercises, aquatic therapy and increasing activity in the animal. Therapeutic modalities such as neuromuscular electrical stimulation, photobiomodulation (laser therapy), therapeutic ultrasound and extracorporeal shock wave therapy have been reported to reduce pain and inflammation, enhance healing and reduce recovery time in the early and late stages following orthopaedic surgery.

The Effect of Core Abdominal Muscle Rehabilitation Exercises on Return to Training and Performance in Horses After Colic Surgery.

We conducted a retrospective cohort study to test the hypothesis that performing 4 weeks of core abdominal rehabilitation exercises (CARE) postoperatively would be safe and associated with faster return to training and improved performance after colic surgery. Performance horses that recovered from colic surgery performed by the same surgeon and survived ≥ 1 year from 2008 to 2017 were included. Data were obtained from a review of medical records. Information about the horses' rehabilitation and performance was obtained from owners/trainers. Data from horses that completed a 4-week CARE program after surgery were compared with control horses that did not do the exercises after colic surgery. Data were analyzed using univariate and multiple regression, P < .05. Eleven CARE horses and 51 controls between the ages of 3 and 18 years were included in the data analysis. All CARE horses completed the rehabilitation program with no reported complications, returned to work faster after surgery, P = .002, and to training faster, P = .0002. After colic surgery, 81% of CARE horses improved their performance level compared with 7.8% of controls, P < .001. Core abdominal rehabilitation exercises were safely performed by horses after colic surgery with no reported complications and may have facilitated faster convalescence and improved performance.

Influence of dietary restriction and low-intensity exercise on weight loss and insulin sensitivity in obese equids.

BACKGROUND: The importance of including exercise with dietary modification for the management of obese equids is not clearly understood. OBJECTIVES: To evaluate the effect of a practical low-intensity exercise regimen, in addition to dietary restriction, on indices of insulin sensitivity (SI) and plasma adipokine concentrations in obese equids. ANIMALS: Twenty-four obese (body condition score [BCS] ≥ 7/9) horses and ponies. METHODS: Over a 12-week period, animals received either dietary restriction only (DIET) or dietary restriction plus low-intensity exercise (DIET+EX). All animals were provided with a restricted ration of grass hay at 1.25% body weight (BW) on a dry matter basis, providing 82.5% estimated digestible energy requirements. The DIET+EX group undertook low-intensity exercise 5 days per week on an automated horse walker. Before and after weight loss, total body fat mass (TBFM) was determined, indices of SI were calculated using minimal model analysis of a frequently sampled IV glucose tolerance test, and adipokines plus inflammatory biomarkers were measured using validated assays. RESULTS: Decreases in BCS, BW, and TBFM were similar between groups (all P > .05). After weight loss, animals in both groups had decreased basal insulin and leptin concentrations, and increased adiponectin concentrations (all P < .001). Furthermore, animals in the DIET+EX group had significantly improved SI and decreased serum amyloid A concentrations relative to animals in the DIET group (both P = .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Regular low-intensity exercise provided additional health benefits compared with dietary restriction alone in this population of obese equids.

Biomechanical and histologic evaluation of the effects of underwater treadmill exercise on horses with experimentally induced osteoarthritis of the middle carpal joint.

OBJECTIVE To evaluate the effects of exercise in an underwater treadmill (UWT) on forelimb biomechanics and articular histologic outcomes in horses with experimentally induced osteoarthritis of the middle carpal joint. ANIMALS 16 horses. PROCEDURES An osteochondral fragment was induced arthroscopically (day 0) in 1 middle carpal joint of each horse. Beginning on day 15, horses were assigned to exercise in a UWT or in the UWT without water (simulating controlled hand walking) at the same speed, frequency, and duration. Thoracic and pelvic limb ground reaction forces, thoracic limb kinematics, and electromyographic results for select thoracic limb muscles acting on the carpi were collected on days -7 (baseline), 14, 42, and 70. Weekly evaluations included clinical assessments of lameness, response to carpal joint flexion, and goniometric measurements of thoracic limb articulations. At study conclusion, articular cartilage and synovial membrane from the middle carpal joints was histologically examined. RESULTS Exercise in a UWT significantly reduced synovial membrane inflammation and resulted in significant clinical improvements with regard to symmetric thoracic limb loading, uniform activation patterns of select thoracic limb muscles, and return to baseline values for carpal joint flexion, compared with results for horses with simulated hand walking. CONCLUSIONS AND CLINICAL RELEVANCE Overall improvements in thoracic limb function, joint range of motion, and synovial membrane integrity indicated that exercise in a UWT was a potentially viable therapeutic option for the management of carpal joint osteoarthritis in horses.

Enhancement of brain plasticity and recovery of locomotive function after lumbar spinal cord stimulation in combination with gait training with partial weight support in rats with cerebral ischemia.

Lumbar spinal cord stimulation (LSCS) is reportedly effective for the recovery of locomotive intraspinal neural network, motor cortex and basal ganglia in animals with complete spinal cord injury and parkinsonism. We evaluated the effect of LSCS in combination with gait training on the recovery of locomotive function and brain plasticity using a rat model of brain ischemia. Adult male Sprague Dawley rats with ischemia were randomly assigned into one of four groups: sham treatment (group 1), LSCS only (group 2), LSCS with gait training and 50% (group 3) and 80% (group 4) of body weight support. Evaluations before randomization and 4weeks after intervention included motor scoring index, real-time PCR and Western blot. Motor scoring index was significantly improved after the intervention in groups 2 and 3. The ratio of phospho-protein kinase C (PKC) to PKC measured in the infarcted area tended to be higher in groups 3 and 4. Protein expression of mGluR2 and mRNA expression of mGluR1 measured in the contralateral cortex were lower in groups 3 and 4. The ratio of phospho-Akt to Akt and mRNA expression of vascular endothelial growth factor measured in the ischemic border zone were higher in group 2. The mRNA expression of MAP1b measured in the infarcted area was significantly higher in group 2. The findings suggest that LSCS and gait training with an adequate amount of body weight support may promote brain plasticity and facilitate the functional recovery.

Effects of a structured exercise programme in sedentary dogs with chronic diarrhoea.

The aim of this investigation was to evaluate the effects of a structured exercise programme in sedentary dogs with chronic diarrhoea. Twenty-two dogs were enrolled in the study. All dogs received oral prednisolone (1 mg/kg/day for 14 days, followed by a tapering dosage) for 10 weeks. After four weeks of prednisolone treatment, dogs were assigned to either the exercise or control group (n=11 each). Owners of dogs in the exercise group were instructed to guide their dogs in structured exercise training (low-intensity to moderate-intensity aerobic and resistance exercise three to five days per week). After 10 weeks of prednisolone treatment with concomitant 6 weeks of complementary exercise, the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) score had decreased significantly in the exercise group (from 8.8±1.5 at the start of the exercise programme to 2.4±1.5; P<0.001); no such change was observed in the control group (from 9.2±0.9 to 9.2±1.1). CIBDAI scores differed significantly between the groups at the end of the 10-week study period (P<0.001). The exercise programme affected all six CIBDAI parameters significantly; bodyweight (P<0.001, adjusted r2=0.722) was most affected. A structured exercise programme may have positive effects on clinical symptoms in sedentary dogs with chronic diarrhoea.

Extracorporeal shockwave therapy and therapeutic exercise for supraspinatus and biceps tendinopathies in 29 dogs.

Supraspinatus tendinopathy (ST) and biceps tendinopathy (BT) are common causes of forelimb lameness in large-breed dogs and have historically been treated with conservative management or surgery. Extracorporeal shockwave therapy (ESWT) and therapeutic exercise (TE) are thought to be treatment options for these conditions. The objectives of this study were to report the clinical presentations of dogs treated with ESWT for shoulder tendinopathies, to determine the association between shoulder lesion severity identified on ultrasonography or MRI and outcome, and to compare the outcomes of dogs treated with ESWT with and without TE. Medical records of 29 dogs diagnosed with shoulder tendinopathies and treated with ESWT were reviewed, and 24 dogs were diagnosed with either unilateral BT or BT and ST. None were found to have unilateral ST. Five dogs were diagnosed with bilateral disease. Eighty-five per cent of dogs had good or excellent outcomes determined by owner assessment 11-220 weeks after therapy. Outcomes were found to be better as tendon lesion severity increased (P=0.0497), regardless if ESWT was performed with or without TE (P=0.92). ESWT should be considered a safe primary therapeutic option for canine shoulder tendinopathies. Larger controlled prospective studies are needed to adequately assess these findings.

Influence of ladder climbing exercise on bone of rats induced to osteoporosis and immobilization / Influencia del ejercicio en escalera sobre el hueso de ratas inducidas a la osteoporosis e inmovilización

Introduction: The oophorectomy surgery produces menopause, which in turn predisposes to many problems such as osteoporosis, with consequent deterioration of microarchitecture and decreasing mass bone, predisposing to the risk of fractures, which are often treated with immobilization, which negatively affects the muscle, cartilage and bone tissues. Despite the rich literature on exercise as a way of remobilization, both in humans and in animals, there is a gap with respect to some types of exercise, such as that performed with climb ladders. The aim of this study was to analyze the effects of ladder climbing exercise on rats bone histomorphometry induced osteoporosis and subjected to immobilization. Methods: 36 female Wistar rats were separated into six groups: G1, G2 and G3 subjected to pseudo-oophorectomy; and G4, G5 and G6 to oophorectomy. After 60 days rest, G2, G3, G5 and G6 had immobilized the right hind limb for 15 days, followed by remobilization for the same period, being free in the box to G2 and G5, and ladder climbing exercise to G3 and G6. At the end of the experiment, the rats were euthanized, their tibias removed bilaterally and submitted to histological routine. Results: There was a significant decrease in cortical bone (area and thickness) and osteocytes numbers, and increased medullary canal, in immobilized limbs of ovariectomized rats. However, the exercise of climbing a ladder was able to reverse these losses due to oophorectomy associated with immobilization. There was also a significant decrease in the area and trabecular thickness in members subjected to immobilization, being reversed with the free remobilization and in ladder. Conclusions: the ladder climbing exercise was effective in the recovery process of bone tissue damaged by immobilization on osteoporosis model by ovariectomy in rats

Introducción: La cirugía ooforectomía produce menopausia, que a su vez predispone a muchos problemas tales como la osteoporosis, con el consiguiente deterioro de la microarquitectura ósea, lo que aumenta el riesgo de fracturas, que a menudo son tratadas con la inmovilización, que afecta negativamente el tejido muscular, cartilaginoso y óseo. A pesar de la abundante literatura sobre el ejercicio físico como medio de recuperación, tanto en humanos como en animales, existe una brecha con respecto a algunos tipos de ejercicios, como los realizados con escaleras de ascenso. El objetivo de este estudio fue analizar los efectos del ejercicio de subir una escalera sobre el hueso de ratas con osteoporosis inducida y sometidos a inmovilización. Métodos: Se dividieron 36 ratas Wistar en seis grupos: G1, G2 y G3 sometidos a pseudo-ooforectomía; y G4, G5 y G6 a ooforectomía. Después de 60 días de descanso, G2, G3, G5 y G6 habían inmovilizado la extremidad posterior derecha durante 15 días, seguido de removilización durante el mismo tiempo, realizando ejercicio libre en la jaula los grupos G2 y G5, o ejercicio subir escaleras para los grupos G3 y G6. Al final del experimento, las ratas fueron sacrificadas, sus tibias fueron retiradas bilateralmente y sometidas a un análisis histológico. Resultados: Se observó una disminución significativa en el hueso cortical (área y espesor) y del número de osteocitos, y el aumento del canal medular, en las extremidades inmovilizadas de ratas ovariectomizadas. Sin embargo, el ejercicio de subir una escalera fue capaz de revertir estas pérdidas debidas a ooforectomía asociada con la inmovilización. También hubo una disminución significativa en el espesor de la área trabecular de los miembros sometidos a inmovilización, siendo revertido con la removilización libre y en escalera. Conclusiones: El ejercicio de subida en una escalera fue eficaz en el proceso de recuperación del hueso dañado por inmovilización en el modelo de osteoporosis por la ovariectomía en ratas

Controlled Exercise in Equine Rehabilitation.

Controlled exercise is a fundamental and critical component of any rehabilitation program for the equine athlete. The ideal controlled exercise program is designed to complement the normal tissue reparative process after injury. As a general rule, the program starts with complete rest followed by stall rest and short periods of walking. Over time, the intensity of the controlled exercise is gradually and systemically increased until complete healing has occurred. A well-designed, injury-directed, controlled exercise program enhances the healing process.

Cardiac effect of short-term experimental weight gain and loss in dogs.

During 12 weeks, 18 normal dogs were fed a high-caloric diet intended to induce obesity (weight-gain phase). For the next 12 weeks (weight-loss phase), all dogs were fed a diet calculated to provide maintenance needs. During this second phase, dogs were randomly assigned to three groups differing only in their exercise regimen: group 1 dogs were not exercised, group 2 dogs were exercised three times each week on a treadmill, group 3 dogs were similarly exercised and outfitted with a vest holding additional weights. Echocardiographic data were obtained at baseline and following both the weight-gain and weight-loss phases. The weight-gain phase of the study was associated with an increase in bodyweight (31.4 per cent), decrease in body density (3.9 per cent) and an increase in left ventricular (LV) myocardial cross-sectional area in all groups. Cardiac hypertrophy was variably reversible during the weight-loss phase, with complete recovery for group 1, partial recovery for group 2 and no recovery in group 3. Regardless of group, weight loss was associated with a significant increase in LV diameter, a reduction of heart rate and an increase in heart rate-corrected isovolumetric relaxation time.

Corrective shoeing in horses: analysis of the adaptation period to the new condition imposed / Ferrageamento corretivo em equinos: análise do período de adaptação à nova condição imposta

Corrective shoeing is a method commonly used to alter the locomotion pattern in animals or as therapy for various disorders of the locomotive system of horses. However, to date, there have been no scientific studies discussing the period during which animals adapt to this type of intervention. The goal of this study was to evaluate the horseshoe adaptation period with the toe or heel elevated by six degrees at 0, 48, and 96 hours after each type of shoeing. For this analysis, the horses were recorded while walking on a treadmill. Stride length and gait qualitative analyzes were performed using Dvideow software. The level of significance adopted was 5%. In the present study, there was no significant difference between the evaluation times; elevating the toe or heel by six degrees do not generates discomfort during locomotion, therefore, horses are able to return to a regular exercise or training routine immediately after shoeing.

O ferrageamento corretivo é um método comumente ma Dvideow. O nível de significância adotado foi de 5%. No utilizado para alterar o padrão do andamento dos animais, presente estudo, não houve diferença significativa entre os assim como na terapêutica de diversas afecções do siste-dias avaliados, a elevação em seis graus da pinça ou talões ma locomotor dos equinos. No entanto, não existem, até não gerou desconforto durante a passada, portanto, os ani o momento, estudos científicos que revelem o período de mais podem retornar às atividades regulares de exercício e adaptação do andamento dos animais a este tipo de in-treinamento imediatamente após o ferrageamento. tervenção.O objetivo deste estudo foi avaliar o período de adaptação à ferraduras com elevação em seis graus da pinça ou talões em equinos caminhando em esteira rolante. O período de adaptação à ferradura foi avaliado nos tempos 0, 48 e 96 horas após cada tipo de ferrageamento proposto. Os animais foram gravados caminhando em esteira rolante. O comprimento da passada e a análise qualitativa do andamento foram realizados com o auxílio do programa Dvideow. O nível de significância adotado foi de 5%. No presente estudo, não houve diferença significativa entre os dias avaliados, a elevação em seis graus da pinça ou talões não gerou desconforto durante a passada, portanto, os animais podem retornar às atividades regulares de exercício e treinamento imediatamente após o ferrageamento.