Underwater treadmill therapy in veterinary practice: Benefits and considerations - Veterinary Medicine
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Underwater treadmill therapy in veterinary practice: Benefits and considerations
This therapy can help patients return to full function after injury more quickly, improve muscle strength and joint range of motion, and even lose weight. So is it right for your practice?


Treadmill speed

Increasing the treadmill speed increases a patient's exertion through turbulence and resistance. Slow speeds (0.1 to 0.6 mph) are used in dogs that have neurologic problems since the viscosity of the water gives patients more reaction time and patients are more likely to step correctly instead of dragging their feet. Moderate speeds (1 to 2 mph) are used for most postsurgical and arthritic patients initially and to warm up and cool down athletes. Fast speeds (2.2 to 5 mph) are used for athletes and stronger patients that are more advanced in their rehabilitation.

Limb length and, thus, stride length are used to determine a starting speed. In our experience, a medium-sized dog just starting out on an underwater treadmill does best with initial speeds of 1 to 1.5 mph, which results in a comfortable, brisk walk.

Walking direction

Although used less frequently than forward walking, backward walking strengthens the biceps femoris, semitendinosus, semimembranosus, and superficial, middle, and deep gluteal muscles, which are often the muscles that weaken markedly in older patients, patients with metabolic or musculoskeletal disease, and patients with degenerative myelopathy. These muscles are also important for jumping, so backward walking is also an excellent exercise for athletes. The duration of backward walking is markedly shorter than that of walking forward since backward walking is more difficult. We usually start with 30 to 45 seconds and rarely go longer than five or six minutes, even with our athletic patients.

Water turbulence

1. A patient walking on an underwater treadmill with jets for added resistance under the guidance of Sierra Nash, treatment assistant.
Another option available with some underwater treadmill units is increased turbulence through the use of jets (Figure 1). Turbulence increases the exertion level, thus working the cardiovascular system and muscles more intensely than without the jets. At our practice, jets are used with any patient that can walk for 20 minutes on the underwater treadmill without becoming fatigued. Athletes, patients with degenerative joint disease, geriatric patients that have become weak from inactivity, and patients with hip dysplasia are a few examples of when jets can be added to the protocol. Jets should not be used with patients that have an unstable stifle or that have recently had cruciate surgery since the jets can increase the shear force applied to the tibia.

Water temperature

Cold water and warm water have different physiologic effects. Cold water (below 85 F [29.4 C]) tends to reduce the heart rate, which can be beneficial when exercising for conditioning. Warm water (86 to 94 F [30 to 34.4 C]) has negligible effects on cardiorespiratory parameters and exertion but increases circulation and flexibility, thereby reducing discomfort.7


The length and number of repetitions depends on the patient's athletic ability and the therapist's goal. If a patient has incurred an injury that has healed but it still refuses to apply weight to a limb, we will put the patient on the underwater treadmill with the intention of tiring the other three limbs to encourage the patient to use the fourth. This may be five to 10 minutes. This technique often eliminates the abnormal behavior within two to four sessions. On the other hand, debilitated patients may start out with three repetitions of 45 seconds with two-minute rests in between. The average patient starts off with three repetitions of one or two minutes and works up to 20 minutes. When this protocol is no longer a challenge, other variables are changed.


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