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Digitized
by
the Internet
Archive
in
2010 with
funding
from
Lyrasis
IVIembers
and
Sloan
Foundation
http://www.archive.org/details/caninephysicalthOOdana
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DESCRIPTION
Upon graduation from
College
of the
Atlantic
I
intend
to
enter
veterinan,'
school
in
pursuit ofmy ambition
to
be
a
veterinarian.
While
at
COA
I
have focused my
academics
on
completing
perquisites for \-eterinar}'
school. Furthermore, I have done
coursework in
anatomy
and ph}'siology
and
completed my internship in Animal
Healthcare at Farm
Sanctuary.
I also
work
in a spay and
neuter clinic for dogs and cats
making
me
familiar
with
the
surgical setting. Therefore,
my
senior project on canine
physical therapy and rehabilitation
is a fitting culmination to
my undergraduate
education. This project
will
combine
coursework,
experience,
and
prior interest
with
a
unique hands-on
learning
opportunity
in an expanding
area
of
veterinar> medicine.
First,
I
will
research physical therap)' and rehabilitation
methods
for canines
including
thermotherapy, range
of
motion, massage,
aquatherapy,
and strength
training.
I
will
then im'estigate these
topics
more
closely in relation
to post-operative recovery
from
anterior
(cranial) cruciate ligament
(ACL) repair surger}'.
In
addition, I
will
explore
and
compare
the
two main surgical
options
for
correction
of the torn ligament: Extracapsular
surgery and Tibial Plateau Leveling Osteotomy (TPLO).
As
well
as
learn
about
the
anatomy
of the knee joint
and the role
of
the
ACL.
Next.
I will
obser\e
the Extracapsular
surgery
on my
canine
companion.
Cinnamon's,
hind
left
limb.
Following this. I
will, under guidance
of a
\'eterinarian,
develop and implement a post-operative rehabilitation regiment to include the various
areas of research. The physical therapy
exercises
are designed
to
promote healing and
to
re-teach
use
of
the
affected
limb.
I
will
log the process
in
both
\\Titten and
photographic
formats.
The
time commitment for the
actual
rehab procedures
is expected to range from
1
'/2
to
3+
hours
daily for
12
weeks.
In
addition to the
log,
I
will
compose
a
final
report
detailing my research
findings and the canine physical therap}' experience.
GOALS
M\-
educational goals
in this project are
two-fold:
first,
to
understand the
ligament
injur}',
consequences, and methods of
repair, and
secondly,
to
understand and be
able
to
apply physical
therap}
and
rehabilitation techniques
for
canines
following orthopedic
injur}-.
M}'
project
goals are the
following:
complete
a
canine rehabilitation
treatment
program, maintain a
log
-
both
photographic and \\Titten
-
of the treatment
program, and
author a fmal report
of m}'
research
findings, methods,
and
experience.
NEW
LEARNING
In order to conduct this project. I
will
need to
learn about canine
joint
structure
and function through
a canine
anatomy text.
I
\\ill need to
learn
about
corrective surgery
for
torn
ACLs
in
canines which I
will
do
using
Journal of
the
American
Veterinary
Medical .A.ssociation
articles.
I
will need
to
become competent
in rehabilitation and
ph}sical
therapy methods
and procedures
which
I
will accomplish
through
consultation
with
a
veterinarian
and the texts Animal Physiotherapy:
Assessment,
Treatment, and
Rehabilitation
of
Animals
and Canine
Rehabilitation and
Physical
Therapy.
I
will further
explore
massage techniques using
the text
Canine
Massage:
A Complete
Reference
Manual.
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FINAL
PRODUCT
The
tangible
output
of my
completed
project
will be
a
written and
photographic
log
of the
rehabilitation
process
I go
through
with
my
canine
companion
following
ACL
repair
surgery and a
final
report
detailing
my academic
research findings,
reasoning and
methods
behind the
chosen
physical
therapy program,
and the
experience
of carrying it
out.
DIRECTORS
My project
director
is Dr.
George
Carley, DVM,
a
licensed
veterinarian in
Tulsa,
Oklahoma.
He is in
private
practice
and has
experience
performing
the
Extracapsular
surgery.
The
director will
answer
research
related
questions, oversee the
physical therapy
regimen, and
approve
the
final
report and
project log.
Meetings shall
occur
4-5
times
through
the course
of the
project
(every
2-3
weeks)
The
back-up
director,
listed
as
the
3'^''
advisor on the cover
sheet?,
will
be
available
for
questions
and
advice.
She
will
assess
and
provide
feedback on
report drafts
and
approve
the
final
report
and
project
log
should
the project
director become
unable
to
do
so.
CRITERIA FOR
EVALUATION
Did dana
norwood
meet
the
both the stated
learning and
project
goals?
Did she
conduct
and
document the
treatment
regimen?
Did
she
complete the
final report to
a
satisfactory
degree?
TIMETABLE
Week One
(June
15-
21)
Research
physical
therapy
&
rehabilitation,
massage
Week
Two (June
22-
28)
Continue
physical
therapy
&
rehabilitation
research
Research
Extracapsular
surgery and
TPLO
and
joint
anatomy
End
of week-
Observe surgery
Meet
with
director
and
discuss
rehabilitation
treatment
plan
Begin
treatment
plan
and
log
Week
Three
(June 29
-
July
5)
Continue
research, rehab
plan &
log
Week Four (July
6-
12)
Continue research, rehab
plan
&
log
Meet with
director
and
discuss
research
and
concerns
Week Five
(July
13-
19)
Continue research,
rehab plan &
log
Draft of
research findings
due to both
directors
Week
Six
(July
20-
26)
Continue
rehab
plan
&
log
Week
Seven
(July
27-
August
2)
Continue rehab
plan
&
log
Meet
with director
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Week
Eight (August
3-
9)
Continue...
Week
Nine
(August
10-
16)
Continue...
Week
Ten (August
17-23)
.
'
Continue...
Draft
of
experience
part
of
report
due
to
both
directors
Meet
with director
Week
Eleven (August
24-
30)
Continue...
Final
draft
of
report and
log
due
Final report and
log
to
library
upon
receipt
from Director.
BIBLIOGRAPHY
Goff, Lesley,
and
Narelle
Stubbs.
Animal
Physiotherapy:
Assessment,
Treatment,
and
Rehabilitation of Animals
. Ed.
Catherine
McGowan.
1st ed.
Wiley-Blackwell,
2007.
Hourdebaigt,
Jean-Pierre.
Canine
Massage
A Complete
Reference
Manual
.
Grand
Rapids:
Dogwise,
2003.
Marsolais.
Gregory S. et
al.
Effects
of postoperative
rehabilitation
on limb
function after
cruciate ligament
repair
in dogs.
Journal of the
American
Veterinary
Medical
Association 220
(2002):
1325-330.
Millis,
Darryl,
MS
DVM,
David
Levine, PhD
PT, and
Robert Taylor,
DVM
MS.
Canine
Rehabilitation
and
Physical
Therapy
. 1st
ed.
Saunders,
2004.
Monk,
Michelle
L.
et
al.
Effects
of
early
postoperative
physiotherapy
on
limb
function
after tibial
plateau
leveling osteotomy
in
dogs
with deficiency
of the cranial
cruciate
ligament.
American
Journal of
Veterinary
Research
67
(2006):
529-36.
Pacchiana, Philip,
DVM et al. Surgical and
postoperative
complications
associated
with
tibial
plateau
leveling
osteotomy
in dogs
with
cranial
cruciate
ligament.
Journal
of the
American
Veterinary Medical
Association
222
(2003):
184-93.
Zachos,
Terri
A,
DVM, et al.
Growth
factors and
their
potential
therapeutic
applications
for
healing
of musculoskeletal and other
connective
tissues.
American
Journal of
Veterinary Research 66 (2005):
727-38.
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My
dog,
Cinnamon, ruptured
her
cranial cruciate
ligament
(CCL) while
running
in a wooded area
of
a dog
park.
I
wasn't
immediately aware
of
her injury,
but
she
was limping
the following day and for
a
few days
after. I
assumed
she
just
had
sore
muscles,
like
anyone
gets
from
overexertion,
and
the
symptoms
subsided
for
a while. She would sometimes
limp when
she
first
got up
from
lying
down,
but she
walked
normally
the majority
of
the time and had
no
problems
running. Eventually
her
symptoms became
more
pronounced. By
the
time
the
injury
was
diagnosed, she
already had secondary complications including
muscle atrophy
in the leg
and arthritis
in
the
joint.
Cinnamon
underwent
surgery
to
replace
the
ligament
and I conducted
her
subsequent physical
therapy
under
the guidance
of
Dr.
George
Carley,
DVM.
In order
to understand this
injury,
one
must
have
a
solid understanding
of
the
stifle joint and the
CCL. The stifle joint
is the
canine
equivalent of
the
human knee
joint.
Ligaments
serve
to both
guide
and restrict movement
throughout
the
body.
Articular
ligaments
link
two bones
together across a joint, while
others support
internal
structures
including
the uterus
bladder,
liver, and
diaphragm (Ethier and
Simmons
2007).
The stifle
joint
contains five articular ligaments.
The medial
collateral ligament
and
the
lateral
collateral ligaments
link the femur to the tibia
on
both
sides
of the
joint. They
prevent side-to-side
motion in
the stifle
joint. The
caudal
cruciate ligament
attaches
caudally to the tibia and cranially
to the femur. It
restricts
rearward
motion
of tibia in
relation to
the
femur. The
cranial cruciate ligament
attaches cranially
to the
tibia
and
caudally to the femur. It
restricts
forward
motion
of
the
tibia past the
normal articular
surface
of the
femur. Rupture ofthe
CCL is
usually
the
result
of
excessive internal
rotation
of the
stifle joint
(Millis
et al.
2004).
Norwood
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/
'
patella
lateral
collateral
ligament
cranial
\
cruciate
~
ligament
lateral
meniscus
fibula
femur
caudal
cruciate
ligament
-
medial
meniscus
medial
collateral
ligament
tibia
(Atlas of Veterinary
Clinical
Anatomy)
Ligaments
are extra-cellular
matrices
(ECM)
excreted
by fibroblasts
(ligament
cells). Two
thirds of
a
ligament's
wet
weight
is
water,
which
lubricates
and assists in
the
transport of
nutrients
within
the
ligament. Collagen
accounts
for about 80%
of
the
dry
weight
with
elastin and
proteoglycans composing
most of the
remainder
(Ethier and
Simmons
2007).
Therefore, collagen
has a profound effect on ligament
function.
Collagen
has
a
hierarchical
structure. The basic
unit
is tropocoUagen
-
a
three-chain
helical
structure stabilized
by hydrogen bonding.
TropocoUagen
molecules
cross-link
covalently
with staggered neighboring
molecules. Five
tropocollagens
form
a
microfibril;
microfibrils aggregate
to
form
subfibrils,
which
group to
form
fibrils.
Collagen fibers are
composed of these fibrils.
In
the middle ofa
ligament,
aggregafions
of
fibers
form fascicles
(Ethier and Simmons
2007).
The
Norwood
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collagen fibers in
ligaments are
nearly parallel,
not fully, giving them
a
wavy
appearance. Stress
applied to ligaments must first straighten
the
fibers into
a
fully-
parallel
state. Ligaments
also
contain
elastin. These
features make
ligaments
more
resilient than other connective
tissues
that
also have
a high-collagen
composition,
such as tendons.
Because ligaments are
predominantly collagen,
the biomechanical properties
of ligaments
are
based
largely on the properties of collagen. Structural properties of
collagen
can
be
illustrated
by
a
load-deformation
curve. Load is
the force
being
applied to the material, and
deformation
is the extent of
distortion
the material
exhibits. The following is
a
generic
load-deformation curve.
B
NON
ELASTIC
(PLASTIC)
REGION
'^
Q
m,
YIELD
/^D
t
FAILURE