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OBJECTIVE To assess intraobserver repeatability and interobserver and in vivo versus photographic agreement of a scoring system for the implant-skin interface (ISI) of external skeletal fixation (ESF). SAMPLE 42 photographs of ISIs from 18 dogs for interobserver agreement and intraobserver repeatability and 27 photographs of ISIs from 6 dogs for in vivo versus photograph agreement. PROCEDURES An ISI inflammation scoring system was developed. It included scales for 6 metrics (erythema, drainage amount, drainage type, swelling, hair loss or lack of hair regrowth, and granulation tissue). Photographs of the ISI of ESF were obtained by use of a standard protocol and evaluated to determine intraobserver repeatability and interobserver agreement (Cronbach α; 4 raters) of the ISI score. Agreement between in vivo and photographic ISI scores (2 raters) and correlation between median scores across metrics were evaluated. RESULTS 42 photographs met the inclusion criteria. Overall intraclass correlation coefficients ranged from 0.922 to 0.975. Interobserver overall Cronbach α ranged from 0.835 to 0.943. For in vivo versus photographic assessment, 27 ISIs in 6 dogs and their photographs were evaluated. The Cronbach α for both raters ranged from 0.614 to 0.938. Overall, the Cronbach α ranged from 0.725 to 0.932. Mean photographic scores were greater than mean in vivo scores for each metric. Pearson correlation coefficients ranged from 0.221 to 0.923. Erythema, swelling, and granulation were correlated with all other metrics. CONCLUSIONS AND CLINICAL RELEVANCE In this study, an ISI scoring system used in this study had high repeatability and agreement and may therefore be considered for use in clinical situations. Photographic scores were not equivalent to in vivo scores and should not be used interchangeably.

Cats have orthopedic problems, including osteoarthritis, fractures, and luxations that are positively impacted by physical rehabilitation. Most cats have an independent behavior that requires using a tactful approach to rehabilitation. Cats often do well with manual therapy and electrophysical modalities. Feline rehabilitation sessions may be shorter than canine rehabilitation sessions. Cats do best with therapeutic exercises when these exercises are linked to hunting, playing, or feeding., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Therapeutic exercises are the cornerstone of the rehabilitation programs of companion animals. Therapeutic exercises are used to improve active joint range of motion, to improve weight bearing and limb use, to build strength and muscle mass, and to increase conditioning (eg, endurance, speed). Each case is unique as chronicity, type of injury, patient signalment and temperament, owner compliance, and level of required functional recovery vary widely. Therapeutic exercises are also essential for partial return to work or performance and to learn to perform activities of daily living after injury or surgery., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A comprehensive physiotherapy plan for neurology patients manages pain, prevents secondary complications, and supports the health and function of musculoskeletal tissues during recovery. Neurologically impaired patients range in ability from complete immobility (tetraplegia/paraplegia), partial mobility (tetraparesis/paraparesis), mild ataxia, to pain only. Important considerations for the design of a physiotherapy program include access to the patient, level of staff support, and safety of staff, patient, and client during treatments. A thorough overview of the treatment plan and expected outcome should be discussed with the client at the onset of therapy and should be reviewed frequently, particularly as the patient's status changes., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Exoprostheses are devices that are secured to incomplete limbs to enable locomotion. By comparison, orthoses are devices externally applied to support or protect an injured body part. Orthoses also can be used to control, guide, protect, limit motion of, or immobilize an extremity, a joint, or a body segment. Exoprostheses and orthoses are a growing aspect of the physical rehabilitation of companion animals. They require precise design and fabrication. Patients and owners must be trained to use the devices. Exoprostheses and orthoses can have a profound beneficial impact on the mobility and the quality of life of companion animals., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Patients who have total joint arthroplasty have varying needs related to rehabilitation. In the short term, rehabilitation should be used in all dogs to identify high-risk patients and to minimize the likelihood of postoperative complications. Many patients undergoing total hip replacement recover uneventfully without needing long-term physiotherapy. All patients undergoing total knee replacement and total elbow replacement need rehabilitation to restore limb use and maximize their functional recovery. This article presents rehabilitation considerations for companion animals undergoing total hip replacement, total knee replacement, and total elbow replacement; postoperative complications and how to mitigate risks; and anticipated patient outcomes., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Deciding on which supportive device, orthotic, or prosthetic is best suited for a given patient is a complex process involving many different factors. The ability to manage biomechanical abnormalities successfully may be enhanced by an understanding of the properties of the various materials that comprise these devices, their effect on functional performance, and other associated patient factors. Veterinary health care providers are faced with the challenge of effectively addressing the physiologic and fiscal needs of the patient in a rapidly changing patient care environment.

Owners and trainers exercise sporting dogs to increase their fitness and optimize their conditioning and performance. Training is designed to in-crease strength, endurance, and agility and is sport-specific. Sporting dogs are susceptible to specific musculoskeletal injuries. The rehabilitation of sporting dogs after these injuries follows specific principles during the acute, subacute, and reconditioning periods.

Setting up rehabilitation services presents several challenges to the veterinary practitioner. Members of the rehabilitation team need to have a solid knowledge base of acute and chronic orthopedic and neurologic disorders and a knowledge of rehabilitation principles and applications. The working environment has to be adapted to patients with limited mobility, specific equipment and supplies are to be used, and a fee structure should be implemented. This article reviews these logistic aspects of companion animal rehabilitation.

Physical therapy is a profession with an established scientific basis in human beings and companion animals. It has a large number of clinical applications in the restoration, maintenance, and promotion of optimal physical function. In providing physical therapy, the goal is to restore, maintain, and promote optimal function, optimal fitness, wellness, and quality of life as they relate to movement disorders and health. A major emphasis is to prevent or minimize the onset, clinical signs, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, and injuries.

Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

Objective--To assess the effect of computed tomography (CT) scan protocols (radiation amounts) and fabrication methods on biomodel accuracy and variability. Sample--Cadaveric femur of a Basset Hound. Procedures--Retroreconstructions (n = 158) were performed of 16 original scans and were visually inspected to select 17 scans to be used for biomodel fabrication. Biomodels of the 17 scans were made in triplicate by use of 3 freeform fabrication processes (stereolithography, fused deposition modeling, and 3-D printing) for 153 models. The biomodels and original bone were measured by use of a coordinate measurement machine. Results--Differences among fabrication methods accounted for 2% to 29% of the total observed variation in inaccuracy and differences among method-specific radiation configurations accounted for 4% to 44%. Biomodels underestimated bone length and width and femoral head diameter and overestimated cortical thickness. There was no evidence of a linear association between thresholding adjustments and biomodel accuracy. Higher measured radiation dose led to a decrease in absolute relative error for biomodel diameter and for 4 of 8 cortical thickness measurements. Conclusions and Clinical Relevance--The outside dimensions of biomodels have a clinically acceptable accuracy. The cortical thickness of biomodels may overestimate cortical thickness. Variability among biomodels was caused by model fabrication reproducibility and, to a lesser extent, by the radiation settings of the CT scan and differences among fabrication methods. [ABSTRACT FROM AUTHOR]

Objective--To design and manufacture free-form biodegradable polycaprolactone (PCL) bone plates and to compare mechanical properties of femoral constructs with a distal physeal fracture repaired by use of 5 stabilization methods. Sample Population--40 canine femoral replicas created by use of additive manufacturing and rapid tooling. Procedures--Surgery duration, mediolateral and craniocaudal bending stiffness, and torsional stiffness of femoral physeal fracture repair constructs made by use of 5 stabilization methods were assessed. The implants included 2 Kirschner wires inserted medially and 2 inserted laterally (4KW), a commercial stainless steel plate (CSP), a custom free-form titanium plate (CTP), thin (2-mm-thick) biodegradable PCL plates (TNP) placed medially and laterally, and thick (4-mm-thick) PCL plates (TKP) placed medially and laterally. Results--Surgical placement of 4KW was more rapid than placement of other implants. The mean caudal cantilever bending stiffness of CTP and CSP constructs was greater than that for TNP, TKP, and 4KW constructs, and the mean caudal cantilever bending stiffness of TNP and TKP constructs was greater than that for 4KW constructs. The mean lateral cantilever bending stiffness of TKP constructs was greater than that for 4KW constructs. Differences among construct types were not significant in yield strength, ultimate strength, yield torque, and ultimate torque. Conclusions and Clinical Relevance--The mechanical properties of fracture repair constructs made from free-form PCL biodegradable plates compared favorably with those of constructs made from Kirschner wires. The impact of PCL plates on musculoskeletal soft tissues, bone healing, and bone growth should be evaluated before clinical use. [ABSTRACT FROM AUTHOR]

Objective--To assess the impact of partial immersion in water on vertical ground reaction force (vGRF) and vGRF distribution in dogs. Animals--10 healthy adult dogs. Procedures--Weight placed on each limb of each dog was measured 3 times (1 scale/ limb). Dogs were then immersed in water to the level of the tarsal, stifle, and hip joints, and vGRFs were measured. Coefficients of variation for triplicate measurements were calculated. Mixed-effects ANOVAs were used to compare the vGRF for thoracic versus pelvic limbs and the vGRF at various immersion levels as well as the vGRF distributions among limbs at various immersion levels. Results--Mean ± SD vGRF before immersion was 249 ± 34 N. It was significantly decreased by 9% after immersion to the tarsal joints (227 ± 32 N), by 15% after immersion to the stifle joints (212 ± 21 N), and by 62% after immersion to the hip joints (96 ± 20 N).The vGRFs were significantly higher for the thoracic limbs than for the pelvic limbs before immersion and at all immersion levels. Dogs placed 64% of their weight on the thoracic limbs before immersion. That ratio did not differ significantly after immersion to the tarsus (64%) or stifle (63%) joints, but was significantly larger after immersion to the hip joints (71%). Conclusions and Clinical Relevance--vGRF decreased as the depth of immersion increased. The thoracic limb-to-pelvic limb vGRF ratio was unchanged in dogs after immersion to the tarsal or stifle joints, but it increased after immersion to the hip joints. [ABSTRACT FROM AUTHOR]

Based on the clinical observation that dogs with a steep tibial plateau slope had variable tibial morphology, we hypothesized that these dogs could be further characterized using measurements developed by examining computer generated models of specific proximal tibial malformations. A 3D tibial model was created from a normal canine tibia. The model was manipulated to reproduce two specific proximal tibial anomalies representing deformities originating from the tibial plateau or the proximal tibial shaft. Data from these models were used to create specific measurements that would characterize the shape of these anomalies. These measurements included the diaphyseal tibial axis (DTA)/proximal tibial axis (PTA) angle, which defined the orientation of the proximal portion of the shaft in relation to the tibial mid-shaft. These measurements were then made on radiographs of dogs with and without cranial cruciate ligament (CCL) rupture. Models with tibial plateau and proximal shaft deformities had a steep tibial plateau slope (TPS). Models with proximal shaft deformity had a markedly increased DTA/PTA angle. The model with a 10° proximal shaft deformity had a DTA/PTA angle of 11.23°. Six dogs (9.0%) had a DTA/PTA angle larger than 11.23° (range, 11.4–13.9°). Dogs in this group had ruptured CCL and a steep TPS. Dogs with CCL rupture had higher TPS (mean, 31.8±4.1°) and DTA/PTA angle (mean, 6.0±3.3°) than dogs without CCL rupture (means, 23.6±3.4° and 4.1±2.2°, respectively). Dogs with proximal shaft deformity represented a distinct group, which could not be identified using the magnitude of the TPS alone. Characterizing more precisely the shape of the proximal portion of the tibia in dogs contributes to our understanding of the pathogenesis of steep TPS and may facilitate the optimization of the surgical management of dogs with CCL rupture. [ABSTRACT FROM AUTHOR]

Objective--To assess the intra- and interobserver repeatability of 2-dimensional (2-D) kinematic analysis of walk and sit-to-stand motions in dogs. Animals--10 healthy adult Labrador Retrievers. Procedures--10 dogs were filmed during walk and sit-to-stand motions. Five trials were recorded for each dog, 3 of which were digitized. Two observers manually marked 15 landmarks on each frame during the motions of interest for these 3 trials Each observer repeated the procedure approximately 1 week later. The 2-D joint angles were calculated. Intra- and interobserver coefficients of multiple correlations (CMCs) were calculated for each joint angle-time history. Results--Intraobserver repeatability, assessed as the mean CMCs of 12 joint angle measurements made for 10 dogs by 2 observers, was good or excellent in 23 of 24 (96%) mean CMCs of the joints measured. Interobserver variation, assessed by comparing CMCs of measurements made by 2 observers on 10 dogs on 2 days, was good or excellent in 161 of 240 (67%) CMCs of joints measured. Conclusions and Clinical Relevance--Intraobserver repeatability of 2-D kinematic measurements made on digitized videotapes was excellent. Interobserver repeatability of these measurements was acceptable. [ABSTRACT FROM AUTHOR]

Objective--To determine the electrical impulse duration thresholds (chronaxy) for maximal motor contraction of various muscles without stimulation of pain fibers in dogs. Animals--10 healthy adult Beagles. Procedures--The dogs were used to assess the minimal intensity (rheobase) required to elicit motor contraction of 11 muscles (5 in the forelimb [supraspinatus, infraspinatus, deltoideus, lateral head of the triceps brachii, and extensor carpi radialis], 5 in the hind limb [gluteus medius, biceps femoris, semitendinosus, vastus lateralis, and tibialis cranialis], and the erector spinae). The rheobase was used to determine the chronaxy for each of the 11 muscles in the 10 dogs; chronaxy values were compared with those reported for the corresponding muscles in humans. Results--Compared with values in humans, chronaxy values for stimulation of Aα motor fibers in the biceps femoris and semitendinosus muscles and muscles of the more distal portions of limbs were lower in dogs. For the other muscles evaluated, chronaxy values did not differ between dogs and humans. Conclusions and Clinical Relevance--Application of the dog-specific chronaxy values when performing electrical stimulation for strengthening muscles or providing pain relief is likely to minimize the pain perceived during treatment in dogs. [ABSTRACT FROM AUTHOR]