Animal Physiotherapy

Assessment, Treatment and Rehabilitation of Animals

Catherine McGowan, Lesley Goff, Catherine McGowan, Lesley Goff

• Editorial: Wiley-Blackwell
• Año: 2016
• ISBN:
  9781118852316
• Edición: 2
• Categoría: Medicine
• Categoría: Veterinary Medicine

A thoroughly updated edition of this essential reference guide for physiotherapists and physical therapists, looking to apply the proven benefits of physiotherapy to the treatment of companion and performanceanimals.

• Seven new chapters provide greatly expanded coverage of practical treatment and rehabilitation
• Includes reviews of different physiotherapy techniques, drawing on both human and animal literature
• Discusses approaches in small animal medicine as well as for elite equine athletes
• Provides applied evidence-based clinical reasoning model, with case examples
• Now in full colour with many more illustrations

CHAPTER 1
Introduction

Catherine M. McGowan

University of Liverpool, Liverpool, UK

The aim of this book is to provide physiotherapists and interested others with a broad base of information on animal physiotherapy; the assessment, treatment and rehabilitation of animals. Physiotherapy (called physical therapy in some countries) is an established, independent profession with an excellent reputation for evidence-based practice. In the medical field, physiotherapists form an essential part of musculoskeletal, neurological and cardiorespiratory care from paediatrics to geriatrics and sports medicine. Physiotherapy research has led human medical advancement in areas such as back and pelvic pain, whiplash and women's health. The positive perception of physiotherapy in the human sphere, together with an increased awareness of options and expertise available for animals, has resulted in a demand for physiotherapy for animals.

Animal physiotherapy is an emerging profession, representing physiotherapists qualified to treat humans, who are applying their skills on animals. Physiotherapists, when working with animal patients, work on referral from a veterinary surgeon rather than autonomous first contact practice as with human patients. This presents the ideal situation where veterinarians and physiotherapists continue to practise within, and be regulated by, their own profession but work together as a multidisciplinary team in the assessment, treatment and rehabilitation of animals. This situation is also essential in an emerging profession where the evidence base is necessarily largely drawn from the medical field, and as such, physiotherapists when working with animal patients must draw upon their knowledge and experience in people in order to appropriately translate that knowledge to animals.

This new area of expertise has been embraced by both physiotherapy professional bodies and registration boards, as well as educational institutions. Leading universities in the United Kingdom and Australia have led the way in providing postgraduate university-based training for physiotherapists to specialise in treating animals. Formalised, special interest groups (SIGs) of animal physiotherapy have been established by many physiotherapy professional groups around the world, represented by the official subgroup of the World Confederation for Physical Therapy (WCPT), the International Association of Physical Therapists in Animal Practice (IAPTAP; www.wcpt.org/iaptap).

In this text we have used the terminology animal physiotherapy to designate the professional assessment, treatment and rehabilitation of animals by physiotherapists (or physical therapists). In some countries, the terminology veterinary physiotherapy is also used, but we have continued with animal physiotherapy in accordance with the WCPT.

Physiotherapists provide a functional assessment to identify pain or loss of function caused by a physical injury, disorder or disability and they use techniques to reduce pain, improve movement and restore normal muscle control for better motor performance and function. Physiotherapists can provide equivalent levels of care and follow-up treatment for their animal patients, as they can for people. In small animal surgery, the demand for postoperative physiotherapy has paralleled the increase in surgical options for small animal patients. Elite equine athletes and their riders now access a team of professionals including the veterinarian–animal physiotherapist team. More and more people prefer to opt for treatments where they can see progressive results, professional teamwork and high levels of care and expertise.

The text begins with essential applied background information on animal behaviour, nutrition, biomechanics and exercise physiology. Following this are chapters focusing on the assessment of the musculoskeletal and neurological systems in animals from both a veterinary and physiotherapy perspective, including chapters on lameness and neurological conditions in the dog and horse and physiotherapy assessment. The next section reviews physiotherapy techniques, drawing from both the human and animal literature in their discussion. The final chapters apply this information to an evidence-based clinical reasoning model describing the physiotherapy approaches to treatment and rehabilitation of animals, giving case examples. The last chapter outlines outcome measures in animal physiotherapy, reminding us all that assessment and reassessment of physical dysfunction, with accurate measurement of the response to treatment, are fundamental principles of physiotherapy.

This textbook is not a handbook of physiotherapy but rather a text aiming to cover the scientific and clinical principles behind animal physiotherapy. For animal physiotherapists, it will be a valuable reference text in their profession. For veterinarians and others who work with animals, it will be a valuable insight into the profession of physiotherapy and what it can achieve.

CHAPTER 2
Applied animal behaviour: assessment, pain and aggression¹

Daniel Mills¹ and Fiona Williams²

¹University of Lincoln, Lincoln, UK

²Dogs at Donyatt Canine Hydrotherapy, Ilminster, Somerset, UK

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Summary

It is important for the animal physiotherapist to understand animal behaviour both in terms of the assessment of signs of pain and the safe and appropriate delivery of physiotherapeutic interventions. Here we discuss the importance of considering both genetic and environmental factors when assessing animal behaviour in general as well as factors influencing the identification and assessment of pain more specifically. The mechanisms underlying pain and pain management are also considered with reference to their relationship with behaviour. Finally, we discuss aggression in terms of potential triggers and its management whilst administering treatments.

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2.1 Introduction

Understanding animal behaviour is important for animal physiotherapists to ensure safe handling of animals that may be in pain and therefore aggressive, and to facilitate a more complete and accurate assessment of the animal's pain. Often, we only know that an animal is in need of physiotherapeutic intervention because of its behaviour. The behaviour may be overt, such as a non-weight-bearing lameness, or more subtle, such as a decline in activity or in the vigour of the activity. In either case, the challenge may be to distinguish pain from a pain-free loss of physical function or mobility.

In horses, pain may manifest as training problems or poor performance. If we wish to address the cause of this behaviour (rather than simply contain the problem), then we need to be aware of the full range of potential factors that interact with and influence behaviour. This involves at least some appreciation of many diverse branches of zoology as well as various branches of psychology, veterinary medicine, animal management and nutrition. This might seem a bit daunting, and is why it is often most effective to work as part of a multidisciplinary team, with everyone respecting each other's expertise.

Since there are two elements to the expression of pain, that is, a sensory-discriminative component (i.e. processing of the nature of the aversive stimulus and its bodily location) and an affective-motivational component of pain (i.e. the emotional and behavioural response to pain or its anticipation) (Craig 2006), it is important to recognise their differing behavioural expression. The former will largely relate to local changes such as lameness and local sensitivity to interference, whereas the latter will be expressed in more general behavioural changes such as increased aggressivity and avoidance.

Therefore, the animal physiotherapist should be aware that some animals might need behavioural therapy in order to treat the affective-motivational aspects of pain before the sensory-discriminative component of pain can be effectively addressed. Although animal physiotherapists are not expected to be behaviour specialists and should not be tempted to practise beyond their own knowledge base and skill, a solid grounding and appreciation of the subject are essential to avoid putting themselves and others at risk of harm and to avoid threatening the well-being of their animals. Animal physiotherapists who have moved into the field from the human discipline may have a substantial awareness of the psychological effects of chronic pain, but it is important to understand the biological and cognitive differences that exist between humans and non-human animals and not assume that what applies to one species necessarily applies to another. Anthropomorphism (ascribing human characteristics to animals) may lead to superficial and/or inaccurate assessments with consequently inappropriate treatment. It is therefore important to always be thorough and assess all of the available information objectively in the light of the biology of the species being considered.

In this chapter, we begin with an initial guide to the principles that underpin the assessment of animal behaviour. Behaviour, like physiology, is a mechanism and expression of an animal's attempt to adapt to or cope with its environment. To survive and be successful within an evolutionary context, animals must be as efficient as possible, since those able to adapt most appropriately will outcompete those less efficient. Accordingly, the behaviour of a given individual should be viewed as an attempt by the animal to behave most appropriately in the current circumstances given previous experience.

There are three major considerations to the evaluation of an animal's behaviour: the nature of the individual concerned; its previous experience; and its current circumstance. Consideration of all three is fundamental to a complete understanding of why an animal is behaving in a particular way. After discussing these three considerations, we move on to discuss the concepts of pain, pain assessment, pain management and aggression within a context that is relevant to the animal physiotherapist.

2.1.1 Assessment of animal behaviour

As previously mentioned, there are three major principles that should be included in one's thought process when trying to evaluate an animal's behaviour.

1. The nature of the individual is influenced genetically at many levels.
2. Previous experience has both general and specific effects on behaviour.
3. The current circumstance of the individual refers to both its general motivational state and the internal and external factors which cause this state to dominate the animal's behaviour.

Genetic influence

Genetic effects lay the foundation ...