Reporting outcome measures in veterinary physiotherapy with particular reference to the treatment of canine and equine joint cases in the UK.

BACKGROUND: Outcome measures are extensively used within human physiotherapy, but a widely accepted issue in veterinary physiotherapy is that outcome measures lack sufficient evaluation and standardisation in terms of how they are implemented. This cross-sectional study aimed to provide clarity on (1) the current selection of outcome measures in canine and equine physiotherapy and (2) investigate external influences on outcome measure selection, including comparative literature availability, professional memberships and background. METHODS: A structured scoping literature review consolidated current understanding and limitations. This informed a survey of qualified veterinary physiotherapists (n = 40). The statistical analysis comprised descriptive statistics. RESULTS: Key observations included (1) a lack of difference in outcome measure application between veterinary physiotherapists with and without a human physiotherapy background, (2) enhanced outcome measure utilisation by registry body members and (3) an overall skew towards subjective, rather than objective, outcome measure use. LIMITATIONS: The study was limited by the absence of a defined veterinary physiotherapist population and subsequent convenience sample size. CONCLUSION: The apparent skew towards subjective outcome measures highlights objective outcome measure underutilisation and the need for a more extensive evidence base. In conclusion, there is a need to develop comprehensive professional development resources promoting the use of repeatable outcome measures such as goniometers and the Liverpool osteoarthritis scoring.

Intravenous loss of over-the-wire catheter guidewires in 13 horses.

BACKGROUND: Over-the-wire (OTW) catheter placement is performed frequently in horses. Intravascular loss of a guidewire has been anecdotally reported, but there is limited information regarding the treatment and outcome of horses that have experienced this complication of OTW catheter placement. OBJECTIVES: Describe the clinical and diagnostic features, treatment, and outcome of horses experiencing IV guidewire loss at the time of OTW catheter placement. ANIMALS: Thirteen horses. METHODS: Multicenter retrospective study to identify horses with IV guidewire loss. Horses of all ages were considered for inclusion. Horses were excluded from the study if complete medical records of signalment, indication, and outcome were not available. Intravenous guidewire loss was defined as the guidewire being lost IV at the time of OTW catheter placement. RESULTS: No horses in this study experienced adverse clinical signs associated with the loss of a guidewire. Eight horses had the guidewire removed and the guidewire was left in situ in 5 horses. None of the horses with the guidewire in situ had experienced long-term effects. CONCLUSIONS AND CLINICAL IMPORTANCE: Intravenous guidewire loss seems to have a good long-term prognosis even in horses in which removal of the guidewire was not possible. Thus, in horses where guidewire removal is not feasible, guidewires that remain in situ may have limited to no adverse effects.

Horses, dogs and a camel it's all in a day's work for one veterinary physiotherapist.

Millie Byrne decided a quiet life wasn't for her and completed a master's degree in veterinary physiotherapy - and before she'd even finished she had taken the plunge and started her own business.

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.

Physical Rehabilitation for Small Animals.

Physical rehabilitation incorporates several elements, including but not limited to therapeutic exercises, manual therapy, and physical modalities. Understanding of the effects, indications, contraindications, and precautions is essential for proper use, while understanding of the diagnosis, assessment of the stage of tissue healing and repair, and accurate clinical assessment of the functional limitations are essential when establishing a physical rehabilitation plan.

Canine Comprehensive Mobility Assessment.

A comprehensive mobility assessment goes beyond the orthopedic or neurologic examination for the localization of pathology. This assessment involves attention to the dog's posture and stance, a hands-on examination with special attention to soft tissue structures, and the performance of functional assessments. A comprehensive mobility assessment can guide advanced diagnostic testing as well as providing a foundation in the formulation of a successful treatment plan.

Utilização da fisioterapia na reabilitação de bezerro com poliartrite e paresia neuromuscular: relato de caso / Use of physiotherapy in the rehabilitation of calves with polyarthritis and neuromuscular paresis: case report / Uso de la fisioterapia en la rehabilitación de un ternero con poliartritis y parisia neuromuscular: reporte de caso

A reabilitação animal na medicina veterinária é um campo recente, porém crescente a cada dia. Neste sentido, a fisioterapia veterinária atua trazendo inúmeros benefícios, como melhoria dos movimentos, redução da dor, edema e outras. Interfere ainda no tempo de recuperação, redução de custos para o proprietário, podendo ser hoje utilizada como um tratamento na recuperação pós-cirúrgica. Desta forma, objetivou-se relatar o uso da fisioterapia em uma bezerra com poliartrite e paresia neuromuscular. O animal apresentou um aumento de volume nas articulações cárpicas e társicas após histórico de onfalite, permanecendo em decúbito esternal por vários dias. O proprietário resolveu aplicar ferro dextrano na região glútea do animal, o que causou uma lesão de nervo isquiático. Foram instituídos protocolos medicamentosos e fisioterápicos, que culminaram no estímulo da marcha, propriocepção, além de hipertrofia muscular. Porém, em virtude de complicações resultantes de onfalite, o animal veio a óbito.(AU)

Animal rehabilitation in veterinary medicine is a recent field, but growing every day. In this sense, veterinary physiotherapy works bringing numerous benefits, such as improved movements, reduced pain, edema and others. Reducing the recovery time, reducing costs for the owner, and today it can be used as a treatment in post-surgical recovery. In this sense, the objective was to report the use of physiotherapy in a heifer with polyarthritis and neuromuscular paresis. The animal showed an increase in volume in the carpal and tarsal joints after a history of omphalitis, remaining in sternal decubitus for several days. The owner decided to apply iron dextran to the animal's gluteal region, which caused an injury to the sciatic nerve. Medicinal and physical therapy protocols were instituted, which culminated in the stimulation of gait, proprioception, in addition to muscle hypertrophy. However, due to complications resulting from omphalitis, the animal died.(AU)

La rehabilitación animal en medicina veterinaria es un campo reciente, pero en crecimiento cada día. En este sentido, la fisioterapia veterinaria actúa aportando numerosos beneficios, como mejora de los movimientos, reducción del dolor, edemas y otros. Disminución del tiempo de recuperación, reducción de costos para el propietario, pudiendo ser utilizado hoy en día como tratamiento en la recuperación posquirúrgica. En ese sentido, el objetivo fue reportar el uso de fisioterapia en una vaquilla con poliartritis y paresia neuromuscular. El animal presentó un aumento de volumen en las articulaciones del carpo y del tarso tras un antecedente de onfalitis, permaneciendo en decúbito esternal durante varios días. El propietario decidió aplicar hierro dextrano en la región glútea del animal, lo que provocó una lesión en el nervio ciático. Se instauraron protocolos farmacológicos y de fisioterapia, que culminaron con estimulación de la marcha, propiocepción, además de hipertrofia muscular. Sin embargo, debido a complicaciones derivadas de la onfalitis, el animal falleció.(AU)

Effects of BEMER® physical vascular therapy in horses under training. A randomized, controlled double blind study.

Horses preparation for competition may cause psychological and physical stress. Physical vascular therapy BEMER® is reported to increase vasomotion and microcirculation, supporting body healing. This study aimed at assessing whether BEMER® physical vascular therapy in horses influences recovery rate of hematological and biochemical blood parameters within 1 h after moderate exercise and reduces stress measured by physiological and behavioral indicators. This prospective, randomized, double blinded, placebo-controlled crossover study included twelve warmblood horses (3 mares, 8 geldings, 1 stallion). Additionally to their daily work, horses were subjected to 15 min of exercise on a longe. Horses were randomly divided in two groups: A (n = 6), B (n = 6). Group A underwent first to BEMER® blanket for two weeks, then to Placebo blanket for two weeks. Group B did the opposite. Blood samples, thermographic infrared images, Heart Rate Variability and behavior were analyzed. ANOVA was used to investigate any treatment effect. After two weeks of treatment, although not statistically significant, hematocrit (%) measured immediately post exercise was lower in horses undergoing BEMER® treatment (48.30% ± 3.21) than both No blanket (51.15% ± 3.57) and Placebo blanket (49.58% ± 5.77). While wearing BEMER® blanket and after treatment, horses had a lower LF/HF ratio compared to other groups, although this difference was not statistically significant. These results possibly suggest an effect of BEMER® therapy on vagal activity and relaxation. Substantial progress in recovery after exercise was not confirmed, leading to the need for further investigation on the overall effect of BEMER® therapy.

Adaptation and acceptability testing of the Expector® vibration vest in horses / Adaptação e teste de aceitabilidade do colete de vibração Expector® em equinos

The project is based on a test of a thoracic vibration vest prototype, adapted to equines by the Expector® vest's company, on healthy animals. Ten (10) equines were used in the project, male or female, adults, healthy, belonging to FMVZ-USP or private owners. Each animal went through two phases: A and B. Phase A consisted of the placement of the vest without turning on the vibrators, evaluating the animal's acceptability, facility, adaptation to the animal's body, and discomfort due to the vest's use. Phase B included the placement of the vest and turning on the vibrators, evaluating the animal's acceptability, reaction to the vibrators, and, if present, to which velocity/type of vibration, and the presence of adverse effects. Both phases were done three times on separate days. The behavioral parameters: "placement facility" and "adaptation to the animal's body" were observed. In phase B, the response to the vibration was classified from 0 to 5. The answer was evaluated on low and high intensities for the four vibration types. The heart rate (HR) and respiratory rate (RR) were also evaluated at the beginning and end of each repetition. The animals' HR was kept on normal, except for one animal on one day of the test. Concerning the RR, most animals presented moments of tachypnea. On the experiment's first day, 100% of grade Great to "facility of placement" and "adaptation to the animal's body" was obtained, but on days 2 and 3 this value dropped to 90% due to alterations in one animal's responses. Regarding vibration's responses, 77.3% were evaluated as no discomfort (grade 0), 17.1% little discomfort (grade 1), 3.3% medium discomfort (grade 2), 0.4% great discomfort (grade 3), 0.21% extreme discomfort (grade 4), and 1.6% non-acceptance of the vest (grade 5). Some possible changes on the prototype were also verified to be suggested to the manufacturer, such as the change of the buckle and the use of wireless control. Vest use appears promising for equine respiratory physiotherapy, considering the acceptability was good, and its efficiency on the expectoration of diseased animals must be tested.

O projeto consistiu no teste de um protótipo de colete de vibração torácica, adaptado aos equinos pela empresa do colete Expector®, em animais saudáveis. Foram utilizados 10 equinos, machos ou fêmeas, adultos, saudáveis, pertencentes à FMVZ-USP e a proprietários particulares. Cada animal passou por duas fases: A e B. A Fase A consistiu na colocação do colete sem ligar os vibradores, avaliando-se a aceitabilidade do animal; facilidade; adaptação ao corpo do animal e incômodo do mesmo à sua presença. Já a Fase B contava com a colocação do colete e funcionamento dos vibradores, avaliando-se a aceitabilidade do animal; reação aos vibradores e, se presente, a qual velocidade/tipo de vibração; presença de reações ou efeitos adversos. As duas fases foram realizadas em triplicata em dias separados. Foram observados os parâmetros comportamentais "facilidade de colocação" e "adaptação ao corpo do animal". Na fase B, a resposta à vibração foi classificada de 0 a 5. A resposta foi avaliada nas intensidades baixa e alta para os quatro diferentes tipos de vibração. Foram avaliadas também as frequências cardíaca (FC) e respiratória (FR) no início e final de cada repetição. A FC dos animais se manteve dentro do intervalo de normalidade, com exceção de um animal em um dia de avaliação. Em relação à FR, a maioria apresentou momentos de taquipneia. No primeiro dia de experimento obteve-se 100% de avaliação Ótima para "facilidade de colocação" e "adaptação ao corpo do animal", mas nos dias 2 e 3 esse valor caiu para 90% devido à alteração na resposta de um animal. Em relação à resposta à vibração, 77,3% das respostas foram avaliadas como nenhum incômodo (nota 0), 17,1% pouco incômodo (nota 1), 3,3% médio incômodo (nota 2), 0,4% muito incômodo (nota 3), 0,21% incômodo extremo (nota 4) e 1,6% não aceitação do colete (nota 5). Foram também verificadas algumas possíveis mudanças no protótipo a serem sugeridas ao fabricante, como mudança do tipo de fivela e uso de controle sem fio. A utilização do colete parece ser muito promissora para a fisioterapia respiratória em equinos, visto que a aceitabilidade foi muito boa, devendo-se agora realizar a avaliação de sua eficácia na expectoração de animais enfermos.(AU)

Effectiveness of chest physiotherapy using passive slow expiratory techniques in dogs with airway fluid accumulation: A randomized controlled trial.

BACKGROUND: Prolonged slow expiration (PSE) and assisted cough (AC) are airway clearance techniques feasible and well tolerated in dogs. OBJECTIVES: To evaluate the effectiveness of PSE and AC as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation. ANIMALS: Thirty-one client-owned dogs hospitalized in an intensive care unit from October 2014 to May 2018. METHODS: Prospective randomized controlled trial. Dogs presented with or developing acute dyspnea during hospitalization associated with airway fluid accumulation were assigned to CP group (medical treatment and CP, 15 dogs) or control group (medical treatment alone, 16 dogs). The arterial partial pressure of oxygen (PaO2 ) to fraction of inspired oxygen (FiO2 ) ratio (P/F ratio; PaO2 /FiO2 × 100) was calculated daily for the 1st 48 hours of hospitalization and using the last arterial blood gas performed before discharge or death. The ratio of days of hospitalization with oxygen/total number of hospitalization days (ratio of oxygen-free-days [O2 Free]) was calculated. RESULTS: During the 1st 48 hours, the P/F ratio increased significantly in the CP group compared to the control group (+ 35.1 mm Hg/day; 95% confidence interval [CI] = 0.4-57.5; P = .03). The (median; 1st quartile to 3rd quartile) difference between the P/F ratio at discharge and inclusion was significantly higher in the CP group (178 mm Hg; 123-241) than in the control group (54 mm Hg; -19 - 109; P = .001). Mean O2 Free increased by 46.4% in the CP group compared with control group (95% CI = 16-59; P = .001). Mortality was 13% (2/15) in the CP group and 44% (7/16) in the control group (P = .07). CONCLUSIONS AND CLINICAL IMPORTANCE: Prolonged slow expiration and AC improved P/F ratio within 48 hours and decreased need for oxygenation in dyspneic dogs with acute airway fluid accumulation.

Rehabilitation of the Canine Forelimb.

The goal of rehabilitation is to restore function and mobility and reduce pain associated with chronic disease. In human medicine, physical therapy is standard of care for acute and chronic injuries and an integral component of postoperative recovery. Although there is a dearth of evidence-based veterinary medical studies in rehabilitation therapy and modalities for forelimb injuries in dogs, some extrapolation from human medicine can be made and applied. When developing a rehabilitation and therapeutic plan, the biomechanics of the affected limb and timeline of tissue healing of the target tissue and/or joint are important to consider.

Convergence-Retraction Nystagmus in a Dog With Presumptive Ischemic Encephalopathy Following Acute Cervicothoracic Myelopathy.

A 6.5-year-old male neutered Trailhound was admitted for hyperacute, nonprogressive, left-sided hemiparesis. Physical and neurologic examination revealed nonpainful, left-sided poorly ambulatory hemiparesis, decreased left-sided postural reactions and thoracic limbs hyporeflexia. Neuroanatomic localisation was consistent with a left-sided C6-T2 myelopathy. Haematology and biochemistry revealed nonspecific abnormalities. Magnetic resonance imaging of the neck revealed a focal intramedullary lesion at the level of C6-C7 vertebrae compatible with acute hydrated noncompressive nucleus pulposus extrusion or ischemic myelopathy. During the second day of hospitalization, the dog developed convergence-retraction nystagmus, up-gaze palsy and eyelid retraction (Collier's sign) compatible with dorsal midbrain syndrome. Magnetic resonance imaging of the brain revealed a focal lesion compatible with dorsal midbrain ischemic infarct. Further clinicopathologic testing, thoracic and abdominal imaging were unremarkable. Ischemic encephalopathy of unknown etiology was additionally diagnosed. Physiotherapy was performed therapeutically. At 1-year follow-up the dog was normal. This is an unusual report of a dog with myelopathy followed by ischemic encephalopathy with manifestation of convergence-retraction nystagmus in the absence of vestibular signs. This saccadic intrusion is a characteristic clinical manifestation of a dorsal midbrain syndrome localization. The importance of a complete differential diagnoses list formation in a dog with ischemic encephalopathy which leads to a thorough diagnostic investigation plan is highlighted. Moreover, this report contributes to the enrichment of the clinical reasoning veterinary literature on convergence-retraction nystagmus. To the authors' knowledge, this is the second case report (fourth dog) to describe convergence-retraction nystagmus in dogs as a manifestation of dorsal midbrain syndrome.

The implementation and initial evaluation of a physical therapy program for captive chimpanzees (Pan troglodytes).

Due to advances in captive nonhuman primate (NHP) medical care, the number of geriatric chimpanzees (≥35-years old) is growing. With old age comes a variety of physical conditions, including arthritis, stroke, and mobility impairments. Programs aimed at enhancing the welfare of geriatric chimpanzees are now quite common, but there are few published empirical evaluations of the efficacy of such programs. The current study aimed to create, implement, and evaluate the effects of participation in a physical therapy (PT) program on physical health, mobility, welfare, and behavior. Nine chimpanzees with mobility impairments participated in personalized PT routines (using positive reinforcement training) twice per week for 5 months. Additionally, nine control chimpanzees (non-mobility-impaired, matched with PT chimpanzees on age and gender) participated in body exam behavior sessions (also using positive reinforcement training) twice per week. All chimpanzees were rated on 14 health, well-being, and behavior items, as well as level of mobility throughout the PT program. Chimpanzees that participated in the PT program showed significant increases in ratings of physical health, well-being, and activity levels across phases of the program. Furthermore, compared to control chimpanzees, PT chimpanzees showed significant increases in ratings of ease of movement. Because raters were not blind to physical therapy treatment, our results represent an initial evaluation of the program that may suggest that participation in the PT program has physical, behavioral, and welfare benefits. Assessments of novel geriatric-focused care strategies and programs are essential to further enhance the welfare of the captive chimpanzee population, which is currently comprised of many geriatric animals, whose proportion of the captive population will only increase.

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.

Fundamental principles of rehabilitation and musculoskeletal tissue healing.

OBJECTIVE: To review fundamental principles of tissue healing and physical rehabilitation as they apply to dogs recovering from cranial cruciate ligament (CCL) surgery. STUDY DESIGN: Invited Review. SAMPLE POPULATION: None. METHODS: A multidisciplinary group of specialists in small animal surgery, rehabilitation/sports medicine, and human physical and occupational therapy reviewed the currently available evidence for rehabilitation post-CCL surgery. Because current evidence is limited, this group proposes guidelines for rehabilitation after CCL surgery based on the fundamental principles of tissue healing and physical therapy. RESULTS: This Review proposes four fundamental principles of small animal physical rehabilitation based on the foundations of tissue healing and patient-centric and goal-oriented therapy. Postoperative rehabilitation programs should be designed such that patient progress is based on individual assessment according to the degree of tissue healing, strength, and achievement of functional goals. Therapists must fully understand phases of tissue healing, reassess the patient frequently, and use clinical reasoning skills to progress treatment appropriately for the individual patient. CONCLUSION: Until more robust evidence is available to guide treatment protocols, fundamental principles of rehabilitation should ideally be adhered to when providing rehabilitation, including after CCL surgery. CLINICAL SIGNIFICANCE: While this Review specifically addresses post-CCL surgery rehabilitation, these fundamental principles should be applied broadly to animals enrolled in rehabilitation programs.

Recommendations for rehabilitation after surgical treatment of cranial cruciate ligament disease in dogs: A 2017 survey of veterinary practitioners.

OBJECTIVE: To report current recommendations made by veterinarians for rehabilitation after surgical treatment of cranial cruciate ligament (CrCL) disease. STUDY DESIGN: Anonymized electronic survey. SAMPLE POPULATION: Veterinarians performing CrCL stabilization. METHODS: An electronic survey was created to collect information on general attitudes toward postoperative rehabilitation and recommendations regarding therapeutic modalities and bandaging. Quantitative data are reported by descriptive statistical analysis, percentage of responses, or mean (±SD). The recommendations for postoperative bandaging beyond 24 hours and for postoperative rehabilitation after extracapsular stabilization compared with after tibial osteotomy were tested by using Cochran-Mantel-Haenszel tests, with P < .05 considered statistically significant. RESULTS: The data analysis included 376 responses (13% response rate). Most (71%) respondents consistently recommended postoperative rehabilitation. Rehabilitation was more than twofold more likely to be recommended after extracapsular stabilization than after osteotomies (P = .0142). Most respondents did not recommend bandaging beyond 24 hours postoperatively (P = .00012). CONCLUSION: Most respondents recommended either formal or informal postoperative rehabilitation therapy. CLINICAL SIGNIFICANCE: If the survey respondents are representative of veterinarians performing CrCL surgery, the current attitude is supportive of postsurgical rehabilitation. Most respondents would welcome evidence-based guidelines for rehabilitation protocols.

Investigation into clients' perception of postoperative physiotherapy for dogs undergoing cranial cruciate ligament disease surgery.

AIM: To evaluate clients' understanding, perception and experience of postoperative physiotherapy after undergoing an osteotomy technique for cranial cruciate ligament disease (CCLD). METHOD: A retrospective questionnaire was sent to 202 owners of dogs that underwent CCLD surgery at the Queen Mother Hospital for Animals between 1 January 2015 and 31 December 2017, with 63 responses obtained. RESULTS: Significant differences were found in choice of physiotherapy between clients recommended or not by their vets (p<0.01), and between those offered additional information and those who were not (p<0.01). Of those who chose physiotherapy, 85% had a satisfactory experience. No difference was found in choice of physiotherapy between clients aware of its availability and those who were not (p=0.069). No association was found between cost of the service and clients' perception of cost-worthiness (p=0.169) or between cost-worthiness and recovery outcome (p=0.420). A correlation was found between clients' perception of cost-worthiness and satisfaction level (p=0.03). Clients' knowledge was related to the choice of physiotherapy (p=0.01), but not to other investigated factors. A significant relationship was found between clients' age and choice of physiotherapy (p=0.01), with younger clients choosing physiotherapy more often. CONCLUSION: Veterinarians recommending physiotherapy and providing accurate information affect clients' decision to choose, and perception of, physiotherapy, in addition to clients' own knowledge.

Physiotherapy protocol during initial postoperative period of arthroscopy in horses / Protocolo fisioterápico durante o período pós-operatório inicial de cirurgia artroscópica em equinos

This study evaluated the effects of a physiotherapy protocol applied in joints with osteochondritis dissecans submitted to arthroscopy. Twelve horses totaling twenty joints were used and divided into two uniform groups, according to articular lesion grade. Treated Group (TG) received the physiotherapy protocol (cryotherapy, passive rage motion and controlled exercise) that initiate just after anesthetic recovery and extended for five days. Control Group (CG) remained resting in stall during the same period. Physical examination and synovial fluid analysis were used to evaluate the treatment. The synovial fluid examination consisted of physical analysis (color, aspect, and viscosity), mucin clot evaluation, Serum Amyloid A, Prostaglandin E2 and urea concentration. Synovial samples were collected by arthrocentesis at the beginning of the surgical procedure (D1), 48 hours (D3) and 96 hours (D5) after surgery. Before arthroscopy and daily during the postoperative period joints were evaluated by physical exam: superficial temperature (°C), range of motion (degrees) and circumference (centimeters). The joint physical examination showed no significant difference between groups and neither along the days for the same group. The parameters of synovial fluid showed difference over the moments in each group but didn't have difference between groups. Color and aspect had the same patterns across moments, in CG fluid had significant change when compared D1 with D3 (color and aspect: p<0.001) and D5 (color: p<0.001; aspect: p<0.05) becoming mostly bloody and cloudy in D3 and D5. However in TG the difference was significant just between D1 and D3 (color and aspect: p<0.05), showing an improvement of synovial fluid in D5 (color and aspect: p<0.05). Viscosity and mucin clot evaluation showed significant change in CG between D1 and D3 (viscosity: p<0.01; mucin clot: p<0.05) and between D1 and D5 (viscosity: p<0.01;mucin clot: p<0.01). In TG no significant difference of viscosity and mucin clot was observed over the moments, showing an early improvement of synovial fluid quality. The Serum Amyloid A concentration showed an extremely significant increase in CG (p<0.001) when compared D1 (1217.13±664.47µg/mL) and D3 (42423.80±52309.31µg/mL). The comparison between D1 and D5 in CG, and across moments in TG, had no statistical difference. The PGE2 eicosanoid remained statistically unchanged all over the time. Urea showed significant increase in D3 when compared to D1 (p<0.001) in CG, and had no variation in TG. The physiotherapy protocol minimized the inflammatory mediators and provided minor alterations in synovial fluid after arthroscopy.(AU)

Este estudo avaliou os efeitos de um protocolo fisioterápico, aplicado em articulações com osteocondrite dissecante, submetidas à artroscopia. Foram utilizados 12 cavalos, totalizando 20 articulações, divididas em dois grupos homogêneos de acordo com a graduação da lesão articular. O grupo tratado (GT) recebeu o protocolo fisioterápico (crioterapia, movimentação passiva e exercício controlado) que se iniciou imediatamente após a recuperação anestésica e se estendeu por cinco dias. O grupo controle (GC) permaneceu em repouso na baia, pelo mesmo período. Exame físico da articulação e análise do líquido sinovial foram utilizados para avaliar o tratamento. O exame do líquido sinovial consistiu em análise física (cor, aspecto e viscosidade), avaliação do coágulo de mucina e concentrações de amiloide sérica A, prostaglandina E2 e ureia. Amostras de líquido sinovial foram colhidas por artrocentese no início do procedimento cirúrgico (D1) e após 48 (D3) e 96 horas (D5) do procedimento cirúrgico. Antes da artroscopia e diariamente no período pós-operatório, as articulações foram avaliadas por exame físico: temperatura superficial (°C), ângulo de flexão (graus), circunferência (centímetros). A avaliação física das articulações não apresentou diferença significativa entre os grupos nem ao longo dos dias em cada grupo. Nas análises do líquido sinovial, observou-se uma variação diferente entre os momentos em cada grupo porém sem diferença significativa entre os grupos. A cor e o aspecto tiveram resultados semelhantes ao longo do tempo, no GC houve uma alteração significativa quando comparados D1 e D3 (cor e aspecto: p<0,001) e D1 e D5 (cor: p<0,001; aspecto: p<0,05) tornando-se sanguinolento e turvo na maioria das amostras em D3 e D5. Já no GT, houve diferença significativa apenas entre D1 e D3 (cor e aspecto: p<0,05), demonstrando melhora no líquido sinovial em D5 (cor e aspecto: p<0,05). A viscosidade e o coágulo de mucina apresentou alteração significativa no GC entre D1 e D3 (viscosidade: p<0,01; coágulo de mucina: p<0,05) e entre D1 e D5 (viscosidade e coágulo de mucina: P<0,01). No grupo tratado não foram observadas alterações significativas em viscosidade e coágulo de mucina, ao longo dos momentos, demonstrando uma melhora precoce na qualidade do líquido sinovial. A amiloide sérica A apresentou um aumento extremamente significante no GC (p<0,001) quando comparados D1 (1217,13±664,47µg/dL) e D3 (42423,80±52309,31µg/dL). Quando comparados D1 e D5 no GC e ao longo do tempo no GT não foram observadas diferenças significativas. A concentração de PGE2 permaneceu sem alterações. As mensurações de ureia apresentaram aumento significativo em D3 quando comparado a D1 (p<0,001) no GC e não apresentou variação no GT. O protocolo fisioterápico minimizou os mediadores inflamatórios e proporcionou menor alteração do líquido sinovial após artroscopia.(AU)