Front Matter

108 Canine Sports Medicine and Rehabilitation

Range of motion (ROM) and goniometry

Objective measurement of active, passive, and
resisted motions allows for identification of
impairments that may relate to the patient’s func­
tional limitations and disability. These measure­
ments may provide a valuable baseline as well as
being an efficient method of re‐evaluation, dem­
onstrating progression in rehabilitation. Deficits
or asymmetry in range of motion (ROM) meas­
urements in combination with other examination
information (e.g., pain on palpation, reduced
joint accessory motion) might assist in identifica­
tion and localization of impairment.

Active ROM is motion performed indepen­

dently by the power of the individual’s mus­

cles without assistance. Active ROM can be

limited due to weakness, pain, swelling, joint

mobility limitations, or soft tissue extensibility

limitations. Passive ROM is motion performed

on the individual by an external force. The sub­

ject’s muscles are relaxed, and no contraction is

generated. This passive production of osteokin­

ematic motion may be limited due to an intra‐

articular lesion, pain, swelling, contracted joint

capsule, or soft tissue extensibility limitations.

True passive ROM is difficult to perform in the

Special tests: Grade I R medial patellar luxation.

Negative tibial thrust and cranial drawer tests. Muscle

atrophy of left gluteals, hamstrings, and quadriceps

with thigh circumference reduced by 1 cm on left.

With rear feet placed on scales, weight‐bears

2 pounds on left and 6 pounds on right.

Home environment: Patient lives in single‐story

home with tile, hardwood flooring, area rugs, and

runners. Two steps to enter home, and yard is fenced

with a pool. Two other dogs. Clients have a high bed

with two steps for ease of access by dogs. Patient has

not been allowed onto bed per surgeon’s orders.

History: Patient was previously very active, compet-

ing in agility trials approximately twice monthly

with two agility classes weekly and informal prac-

tice 2–3 times per week. Regularly walked 20–30

minutes 4–5 times per week, and swam in pool on

occasion.

Table 5.2 Summary for Case Study 5.2 using disablement model

Diagnosis Post-operative left grade 2 medial patellar luxation

Disability Unable to participate in activities (agility, walks) with clients or play with other dogs

Functional

limitation

Unable to rise from sit or down using pelvic limbs symmetrically; unable to climb stairs properly;

unable to use the left pelvic limb properly with ambulation or in standing

Impairment Pain, decreased strength, decreased weight bearing and improper use of the left pelvic limb with

gait and movements, compensatory techniques with movements

Goals (1) Clients will be compliant and demonstrate competency with home exercises/activities and

all precautions and contraindications in 2 weeks

(2) Patient will demonstrate symmetrical use of pelvic limbs to transfer from stand to sit/down

and down/sit to stand in 4 weeks

(3) Patient will have 0.5 cm increased left thigh muscle girth in 6 weeks

(4) Patient will stand with 2 pounds more weight bearing on the left pelvic limb in 6 weeks for

improved standing symmetry

(5) Patient will ambulate without lameness on left pelvic limb in 8 weeks

(6) Patient will ambulate up and down steps using the left pelvic limb properly in 8 weeks

Rehabilitation

plan, strategy,

and tactics

● Physical rehabilitation sessions weekly for 6 weeks and then every other week for 8 weeks,

then begin a return to agility training once cleared by surgeon

● Massage therapy to assist with tightness due to compensatory issues

● Strategy: Strengthening, weight shifting, neuromuscular facilitation/stimulation, pain

management, promote improved posture, body awareness/proprioception, and use of limb,

and decrease compensatory techniques

● Tactics: Therapeutic exercise with focus on progressive strengthening and weight‐bearing

program, neuromuscular facilitation techniques, manual therapy (massage, stretching, and

joint mobilizations to stifle for pain and to pelvis to correct dysfunction), laser therapy, neuro-

muscular electrical stimulation (NMES), postural/core/functional task retraining