Front Matter

Chapter 5 Introduction to Canine Rehabilitation 117

and precautions) and the patient’s prior level
of function. Rehabilitation goals are SMART:

● Specific
● Measurable and meaningful
● Acceptable and action‐oriented
● Reasonable and relevant
● Timely.

As an example: within 4 weeks, the patient
will demonstrate improved tarsal, stifle, and
hip joint mobility and quadriceps and gluteal
muscle strength to be able to transfer from sit to
stand on a nonskid surface independently 90%
of the time when called by the client.

Establishing the rehabilitation
plan of care

The rehabilitation plan of care (POC) is ini­
tially set at the time of the evaluation; how­
ever, it is a fluid plan and can be altered or
revised on subsequent visits (following re‐
evaluation by the physical therapist or veteri­
narian) based on careful observation and
monitoring of the patient’s response to treat­
ment and the client’s needs. The plan of care
should include treatment strategies and inter­
ventions as well as the proposed treatment fre­
quency and duration.
The rehabilitation treatment strategy is the
general plan of action whereby impairments or
functional limitations are improved, resolved,
reversed, or ameliorated. For example, if
impairments include reduced hip and stifle
extension joint mobility, reduced tarsal flexion
joint mobility, reduced gluteal strength, and
reduced quadriceps strength, and functional
limitations include the inability to rise from
sitting to standing without assistance, then the
treatment strategy will focus on improving
joint mobility, increasing strength, and improv­
ing sit‐to‐stand abilities.
Plans for eventual treatment progression
might be introduced, and specific activity or
mobility precautions and contraindications
might be outlined in the initial plan of care. The
therapist should ensure that the plan of care is
appropriate for the patient and client and
focused on the established impairments and
functional limitations, considerate of the previ­

ously stated rehabilitation goals. The plan of

care should include suggestions with regards

to potential referrals, to adjunctive profession­

als including CAVM providers, orthotists, or

prosthetists, as well as recommendations on

assistive devices, equipment, or home modifi­

cations that might be appropriate during or fol­

lowing the rehabilitation episode of care.

Client involvement and compliance

The therapist should make every effort to

involve the client throughout the rehabilitation

process. Through this involvement, the client is

empowered and invested in the patient’s recov­

ery, increasing the likelihood that the rehabilita­

tion process will be more successful. Clients

should be encouraged to assist in setting func­

tional goals and the plan of care, to give posi­

tive feedback to the patient during rehabilitation

treatments, and to be compliant with the home

exercise program and prescribed activity and

movement restrictions. The therapist can take

advantage of the time during visits to educate

the client with regards to the etiology of the

patient’s disorder and potential outcome,

encouraging better understanding by the

client and, again, increasing the likelihood of

compliance. To avoid confusion and conflict, in

the case of multiple clients and involved, active

family members, one person should act as

the primary client and/or spokesperson. This

person is able to be most consistent and com­

pliant with regards to ensuring attendance

at  follow‐up visits, performance of the home

exercise program, and compliance with activity

and movement restrictions, if warranted. This

person will also be the primary communicator

for the family, thus eliminating the potential

confusion of multiple iterations of instructions

and reports.

Rehabilitation interventions and tactics

When collaborating with a rehabilitation team

with wide‐ranging experience and skill, the

plan of care might include more specific

instruction with regards to manipulation or pro­

gression of variables of specific interventions.