Introduction to Animal Physiotherapy: Difference between revisions

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== Introduction ==
== Introduction ==
Physiotherapy is defined as the therapeutic use of physical agents / means (i.e. massage or exercises) to treat disease / injury. This has been shown to be an extremely useful adjunct to medicine, both human and veterinary.<ref>McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.</ref> The primary purpose of physiotherapy is to restore mobility / function and quality of life to patients.
Physiotherapy is defined as the therapeutic use of physical agents / means (i.e. massage or exercises) to treat disease / injury.<ref name=":3" /> This has been shown to be an extremely useful adjunct to medicine, both human and veterinary.<ref>McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.</ref> The primary purpose of physiotherapy is to restore mobility / function and quality of life to patients.


This is often done by stimulating the healing process to restore injured tissues, to improve the balance / strength of the injured tissues and to stabilise the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. Animal physiotherapy is an emerging field<ref name=":0">McGowan CM. Introduction. In: McGowan CM, Goff L editors. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals. Wiley-Blackwell, 2016. p.1-2</ref> and while it can be used to help any type of animal, the vast majority of cases seen in small animal practice are dogs.<ref>Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.</ref>[[File:PA dog walking.jpg|thumb|422x422px]]
This is often done by stimulating the healing process to restore injured tissues, to improve the balance / strength of the injured tissues and to stabilise the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. Animal physiotherapy is an emerging field<ref name=":0">McGowan CM. Introduction. In: McGowan CM, Goff L editors. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals. Wiley-Blackwell, 2016. p.1-2</ref> and while it can be used to help any type of animal, the vast majority of cases seen in small animal practice are dogs.<ref>Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.</ref>[[File:PA dog walking.jpg|thumb|422x422px]]


== History ==
== History ==
The first record of animal physiotherapy being practised comes from 1939 when Lord Mountbatten asked the Royal physiotherapist, Sir Charles Strong, to treat his horses.<ref name=":1">Van Der Walt, A. Introduction to Animal Physiotherapy Course. Physioplus, 2021.</ref> Work in the field evolved from this point on. The first official animal physiotherapy association, the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), was formed in the United Kingdom in 1985<ref>Veenman P. Animal physiotherapy. Journal of Bodywork and Movement Therapies. 2006; 10(4): 317-27.</ref> and, in 2011, animal physiotherapy was recognised as an official subgroup of the World Confederation of Physical Therapy (WCPT).<ref name=":1" />
The first record of animal physiotherapy being practised comes from 1939 when Lord Mountbatten asked the Royal physiotherapist, Sir Charles Strong, to treat his horses.<ref>Calatayud M. A royal history of animal physiotherapy. Available from: http://history.physio/a-brief-history-of-animal-physiotherapy/ (accessed 2 January 2021)</ref> Work in the field evolved from this point on. The first official animal physiotherapy association, the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), was formed in the United Kingdom in 1985<ref>Veenman P. Animal physiotherapy. Journal of Bodywork and Movement Therapies. 2006; 10(4): 317-27.</ref> and, in 2011, animal physiotherapy was recognised as an official subgroup of the World Confederation of Physical Therapy (WCPT).<ref name=":1">Van Der Walt, A. Introduction to Animal Physiotherapy Course. Physioplus, 2021.</ref>


== Transferring knowledge of human physiotherapy to other species ==
== Transferring knowledge of human physiotherapy to other species ==
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* post-anaesthetic recovery
* post-anaesthetic recovery
* ventilated animals
* ventilated animals
Physiotherapy aims at managing secretions, preventing pressure sores, preventing atelectasis, reducing the work of breathing and optimising the ventilation / perfusion ratio to ensure high oxygen saturation levels.<ref>Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.</ref>
Physiotherapy aims at managing secretions, preventing pressure sores, preventing atelectasis, reducing the work of breathing and optimising the ventilation / perfusion ratio to ensure high oxygen saturation levels.<ref name=":3">Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.</ref>


These aims are achieved through positioning (for pressure relief, postural drainage or to influence ventilation / perfusion ratio within the lungs), manual techniques such as percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and to aid secretion removal.
These aims are achieved through positioning (for pressure relief, postural drainage or to influence ventilation / perfusion ratio within the lungs), manual techniques such as percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and to aid secretion removal.

Revision as of 21:44, 2 January 2021

Original Editor - Alan Jit Ho Mak Top Contributors - Alan Jit Ho Mak, Jess Bell, Tarina van der Stockt, Lucinda hampton, Kim Jackson, Ewa Jaraczewska, Rucha Gadgil and Aminat Abolade  

Top Contributors - Alan Jit Ho Mak, Jess Bell, Tarina van der Stockt, Lucinda hampton, Kim Jackson, Ewa Jaraczewska, Rucha Gadgil and Aminat Abolade  

Introduction[edit | edit source]

Physiotherapy is defined as the therapeutic use of physical agents / means (i.e. massage or exercises) to treat disease / injury.[1] This has been shown to be an extremely useful adjunct to medicine, both human and veterinary.[2] The primary purpose of physiotherapy is to restore mobility / function and quality of life to patients.

This is often done by stimulating the healing process to restore injured tissues, to improve the balance / strength of the injured tissues and to stabilise the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. Animal physiotherapy is an emerging field[3] and while it can be used to help any type of animal, the vast majority of cases seen in small animal practice are dogs.[4]

PA dog walking.jpg

History[edit | edit source]

The first record of animal physiotherapy being practised comes from 1939 when Lord Mountbatten asked the Royal physiotherapist, Sir Charles Strong, to treat his horses.[5] Work in the field evolved from this point on. The first official animal physiotherapy association, the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), was formed in the United Kingdom in 1985[6] and, in 2011, animal physiotherapy was recognised as an official subgroup of the World Confederation of Physical Therapy (WCPT).[7]

Transferring knowledge of human physiotherapy to other species[edit | edit source]

In order for physiotherapists to be able to successfully transfer their assessment and treatment skills to animals, there must be sufficient similarities in structure, function and physiology across species.[7] There is a growing evidence base to support the notion that these similarities exist. For example:

  • It has been found that the disease progression of osteochondrosis is similar in humans, horses and pigs. There are similar:[8]
    • Clinical presentations
    • Changes on MRI and x-ray
    • Histological appearances of the end-stage lesion
    • Locations affected
  • Spontaneous canine cancers have a similar pathophysiology and clinical presentation to the equivalent human cancers[9]

Moreover, some knowledge relevant to human physiotherapy has come from animal research. Horses are considered to be appropriate models for research on osteoarthritis of the knee.[7] Dogs are the animal model of choice for total hip joint replacements.[10]

The Role and Scope of Animal Physiotherapists[edit | edit source]

Animal physiotherapy is continuing to grow and develop as a profession. Animal physiotherapists work alongside a multidisciplinary team, just as they do in conventional physiotherapy. However, in most countries, animal physiotherapists do not have first-line practitioner status. They generally work on referral from a veterinarian.[3] Thus, there is a legal obligation to communicate with the veterinarian who is in charge of managing the animal patient.

There also needs to be a positive relationship with the animal’s carers. In the case of horses, this may be a large group, including the horse’s owner, rider, trainer, riding instructor, grooms and stableyard manager. There tends to be fewer carers involved in small animal care, but it is still important that each carer’s role in looking after the pet is understood.[7]

  • NB: There are different legal frameworks for animal physiotherapy across the world. If you are interested in this area of practice, it is essential to understand the legal requirements to practise this sort of physiotherapy in your country[7]

Physiotherapy can be beneficial for animals with a wide range of conditions. It is often indicated post-operatively to correct complications that can occur as a result of surgery. The demand for post-operative animal physiotherapy has kept pace with the growing number of surgical options for small animal patients.[3]

Like conventional physiotherapy, animal physiotherapy is divided into a wide variety of specialities. In veterinary medicine, the divisions are:[11]

  • Musculoskeletal
  • Respiratory
  • Orthopaedics
  • Neurological
  • Sports medicine
  • Elderly care / geriatrics

Musculoskeletal[edit | edit source]

Most people consider this as 'traditional physiotherapy'. The conditions seen can be split into soft-tissue injuries, such as sprains / strains or ruptures of ligaments, tendons or muscles; bursitis and bone or joint disease, such as osteochondritis dissecans. The injuries may be a result of either a traumatic event or overuse, where the owner cannot recall the specific onset of symptoms.[12]

Respiratory[edit | edit source]

This encompasses the acute care of animals in a hospital, specifically for:

  • post-anaesthetic recovery
  • ventilated animals

Physiotherapy aims at managing secretions, preventing pressure sores, preventing atelectasis, reducing the work of breathing and optimising the ventilation / perfusion ratio to ensure high oxygen saturation levels.[1]

These aims are achieved through positioning (for pressure relief, postural drainage or to influence ventilation / perfusion ratio within the lungs), manual techniques such as percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and to aid secretion removal.

Orthopaedics[edit | edit source]

Physiotherapy following surgery is used to maximise the success of the surgery. By working with the surgeon, recovery can be optimised. Orthopaedic surgeons may have their own protocols for rehabilitation following surgery and knowledge of these protocols is needed by the owner and therapist before embarking on a rehabilitation programme. These protocols provide specific guidance about weight-bearing status and when specific exercises can be introduced.[13]

Neurological[edit | edit source]

Neurological physiotherapy refers to the rehabilitation of animals following a neurological injury, which can involve a single limb or the whole body. Neurological damage can be managed conservatively or surgically. It may completely resolve or can leave lasting damage.[13]

The amount of initial damage usually has a significant impact on the ultimate recovery. Long-term solutions to permanent damage sometimes have to be sought, such as using wheels, harnesses or splints, to support the animal's everyday activities.

Sports medicine[edit | edit source]

The preparation of an animal for athletic activity is extremely important and requires physical training, skill training and cardiovascular training. Modalities that reduce recovery time and encourage a return to full fitness are considered vital to protect what are considered “valuable assets”.[14]

Animal physiotherapists can help to guide owners on conditioning programmes that are both sports- and animal-specific. Different sports will place very different demands on animals. For instance, the endurance capability of a sled dog is very different to the speed of a racing greyhound. The rehabilitation of sports injuries is also extremely important as often these animals are not lame, but subtle changes in muscle tightness can affect their performance.

Elderly care / geriatrics[edit | edit source]

As pets (and owners) are living longer, there are increasing numbers of arthritic animals presenting for treatment. These animals often have other co-morbidities, such as diabetes, that can complicate the rehabilitation process.[15] A holistic management approach will help to ensure that these animals can stay comfortable and maintain their function for longer.

Developmental problems[edit | edit source]

A large number of young animals are seen with genetic / developmental problems, and they benefit greatly from physiotherapy to support their joints. Conditions such as hip and elbow dysplasia are often seen. Physiotherapy, including hydrotherapy,[16] can improve their quality of life and prevent further problems or surgeries such as total hip replacements.

Evidence to Support the Use of Physiotherapy in Animals[edit | edit source]

While there are not many well-designed studies to support the use of physiotherapy in animals, massage is one area that has been researched in more detail. It has been proposed that because of similarities in physiology and anatomy between humans and certain animals, massage may confer similar benefits in animals as it does in people. Several studies have explored this hypothesis and found that:[17]

  • Manual lymph drainage can reduce experimentally-induced lymphoedema in rats when compared to a control group[7]
  • Massaging the caudal thigh muscles of horses increases range of motion when compared to a sham treatment[18]
  • The use of relaxing massage may help to calm and relax racehorses and improve race performance[19]

Differences between humans and animals[edit | edit source]

Despite the similarities between humans and animals discussed above, there are also important differences (i.e. quadruped vs biped). It is important to understand the comparative anatomy and biomechanics of each species in order to determine the best treatment option.[7] 

Pathogenesis can be different even in shared pathologies or dysfunctions:

  • In humans, cruciate ligament ruptures are an acute injury more common in athletes, but in dogs they are the result of chronic disease processes.[20] Therefore, post-operative rehabilitation occurs in the context of chronic deconditioning[7]
  • In humans, there are dynamic fluctuations in intervertebral disc disease, but in dogs (particularly chondrodystrophic (i.e. short legged phenotype) dogs like dachshunds), the disc calcifies and if disc material extrudes, surgery is almost always recommended[7]

Human-Animal Dyad[edit | edit source]

The human-animal dyad refers to the relationship between a human caregiver and the animal. This can mimic a parent-child relationship. The dog–human attachment bond, for instance, is said to include all four features of attachment bonds that arise in human caregiver–infant relationships:[21]

  1. Proximity seeking
  2. Separation related distress
  3. Safe-haven effect
  4. Secure base effect

When assessing animal patients, it is important to remember that all of the information about an animal comes directly from the owner, even when using validated pain measures.[7] The carer's own personality traits and emotions can have a significant impact on the animal.[7] For instance, owners who tend to catastrophise and have higher pain-related anxiety are more likely to catastrophise about their animal’s pain levels or disability.[7] Pain neuroscience education for the owner, therefore, plays an important role in treatment of the animal.[7]

In the case of horses, research shows that there is a high degree of emotional contagion. Emotional contagion is defined as: “the phenomenon of an automatic adoption of an emotional state of another person”.[22] In animal physiotherapy, it refers specifically to the animal reflecting the emotional state of conspecifics (i.e. a member of the same species), or of other animals / individuals in their environment.[7] Horses have been found to demonstrate emotional contagion when observing human-horse interactions.[23]

Understanding these relationships, as well as having an awareness of animal behaviour enables the physiotherapist to approach and handle animal patients in a safe and effective way.[7]

Summary[edit | edit source]

  • Animal physiotherapy is a growing area of practice
  • While research is limited at present, there is evidence of sufficient interspecies similarities to support the use of human techniques on animals
  • Physiotherapy can be beneficial to all animals, but the choice of treatment can be limited by the presence of co-morbidities
  • The behaviour of an animal, the level of understanding of the owner and their emotions can influence the outcome of physiotherapy interventions

References[edit | edit source]

  1. ↑ 1.0 1.1 Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.
  2. ↑ McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.
  3. ↑ 3.0 3.1 3.2 McGowan CM. Introduction. In: McGowan CM, Goff L editors. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals. Wiley-Blackwell, 2016. p.1-2
  4. ↑ Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.
  5. ↑ Calatayud M. A royal history of animal physiotherapy. Available from: http://history.physio/a-brief-history-of-animal-physiotherapy/ (accessed 2 January 2021)
  6. ↑ Veenman P. Animal physiotherapy. Journal of Bodywork and Movement Therapies. 2006; 10(4): 317-27.
  7. ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 7.12 7.13 7.14 Van Der Walt, A. Introduction to Animal Physiotherapy Course. Physioplus, 2021.
  8. ↑ McCoy AM, Toth F, Dolvik NI, Ekman S, Ellermann J, Olstad K et al. Articular osteochondrosis: a comparison of naturally-occurring human and animal disease. Osteoarthritis Cartilage. 2013; 21(11): 1638-47.
  9. ↑ Schiffman JD, Breen M. Comparative oncology: what dogs and other species can teach us about humans with cancer. Philos Trans R Soc Lond B Biol Sci. 2015; 370(1673): 20140231.
  10. ↑ Skurla CP, Pluhar GE, Frankel DJ, Egger EL, James SP. Assessing the dog as a model for human total hip replacement. Analysis of 38 canine cemented femoral components retrieved at post-mortem. J Bone Joint Surg Br. 2005; 87(1): 120-7
  11. ↑ Price H. Introduction to veterinary physiotherapy. Companion Animal. 2014; 19(3): 130-3.
  12. ↑ Goff L, Crook T. Physiotherapy assessment for animals. Animal physiotherapy, assessment, treatment and rehabilitation of animals. UK: Blackwell Publishing. 2007 Jan 1:136-63.
  13. ↑ 13.0 13.1 Colveiro AC, Rauber JS, Ripplinger A, Wrzesinski M, Schwab ML, Pigatto A, Ferrarin DA, Mazzanti A. Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy. Acta Scientiae Veterinariae. 2020 Oct 13;48.
  14. ↑ Doyle A, Horgan NF. Perceptions of animal physiotherapy amongst Irish veterinary surgeons. Ir Vet J. 2006; 59(2): 85-89.
  15. ↑ Cottriall S. The geriatric canine and physiotherapy. Companion Animal. 2014; 19: 296-300.
  16. ↑ Preston T, Wills AP. A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia. The Veterinary Journal. 2018; 234: 105-10.
  17. ↑ Corti L. Massage therapy for dogs and cats. Top Companion Anim Med. 2014; 29(2): 54-7.
  18. ↑ Hill C, Crook T. The relationship between massage to the equine caudal hindlimb muscles and hindlimb protraction. Equine Vet J Suppl. 2010; (38): 683-7.
  19. ↑ Kowalik S, Janczarek I, Kędzierski W, Stachurska A, Wilk I. The effect of relaxing massage on heart rate and heart rate variability in purebred Arabian racehorses. Anim Sci J. 2017; 88(4): 669-77.
  20. ↑ Griffon DJ. A review of the pathogenesis of canine cranial cruciate ligament disease as a basis for future preventive strategies. Vet Surg. 2010; 39(4): 399-409.
  21. ↑ Payne E, Bennett PC, McGreevy PD. Current perspectives on attachment and bonding in the dog-human dyad. Psychol Res Behav Manag. 2015; 8: 71-9.
  22. ↑ Singer T, Tusche A. Understanding others: brain mechanisms of theory of mind and empathy. In: Glimcher PW, Fehr E editors. Neuroeconomics: Decision making and the brain. London: Elsevier, 2014. p.513-32
  23. ↑ Trösch M, Pellon S, Cuzol F, Parias C, Nowak R, Calandreau L et al. Horses feel emotions when they watch positive and negative horse-human interactions in a video and transpose what they saw to real life. Anim Cogn. 2020; 23(4): 643-53.
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