The emphasis in strength training is primarily on resistance. In a debilitated patient, strength training starts slowly, such
as moving from down to a sit, and a sit to a stand. Gravity is the only resistance needed here. External resistance can be
added as the patient progresses.
Many different types of weights can be used in veterinary rehabilitation. If the focus is on strengthening a single limb
or set of muscles, leg weights can be used. Adding core strengthening can help prevent thoracolumbar and lumbosacral injuries,
especially in canine athletes and chondrodystrophic breeds.
Many canine rehabilitation patients struggle with awareness of body position, or proprioception. Therapeutic exercise can
address this problem in a number of ways. In debilitated patients, proprioception training can be as simple as assisted standing,
progressing to standing with the addition of gentle perturbations by the therapist. When the patient is able to resist these
movements without losing balance, more challenges can be added such as rocker boards, wobble boards and other unstable surfaces.
A rocker board is a platform with a rounded rail on the underside that rocks from side to side when a dog stands on it. The
patient must work to resist this movement to maintain balance. Once the dog has mastered the rocker board, it can progress
to a wobble board — a platform with a hemisphere on the underside that can rock in any direction. The size of this hemisphere
can be increased to increase the challenge.
More active proprioception exercises include walking through a pile of PVC rails or over cavaletti rails set at irregular
heights and distances. Walking the dog on an air mattress also can improve proprioception. The more inflated the air mattress,
the easier it is for the patient. As the dog gains skill on this surface, gentle perturbations can be added, either to the
patient or to the mattress surface. Balance blocks are another proprioception tool. The dog can be placed on these blocks
and asked to stand. The blocks can then be slid apart, forward or backward, requiring the dog to reestablish its balance.
Design of the therapeutic exercise program
A canine rehabilitation therapist evaluates the patient and identifies the structures involved and the stage of recovery of
the tissue. From this evaluation, goals are set and a therapeutic exercise program is designed to meet them. The patient is
evaluated at each visit to measure progress made and to make adjustments to correct for any deficits. The rehabilitation therapist
must be able to recognize when the patient is ready to progress from early exercises to those that are more challenging. The
goal, once again, is to improve functioning and quality of life for the patient.
Many therapeutic exercise options can be used in canine rehabilitation — exercises that increase joint mobility, flexibility,
strength and endurance. Treadmills, pools, cones, poles, boards, weights — even cookies — can help dogs achieve health and
fitness goals. Ultimately, however, the skills and training of the therapist are what bring the benefits of therapeutic exercise
to canine patients.
Dr. Van Dyke is the founder and CEO of the Canine Rehabilitation Institute in Wellington, Fla., with locations in Fort Collins,
Colo., and Annapolis Junction, Md.