Front Matter

Chapter 8 Therapeutic Exercise 187

patient (Davies, 2017). These can also be used as
a form of communication with the patient dur­
ing exercises.

Patient motivation

Most dogs are very treat‐motivated, but the
rehabilitation therapist should have especially
high‐value treats such as cheese or peanut but­
ter available to motivate the patient to work. As
with human patients, canine patients can
become tired of certain motivators (Goldberg,
2016). Timing of delivery of the treat is critical.
This should be done immediately upon the
patient demonstrating the correct behavior.
Initially, each correct behavior is rewarded.
Gradually, treats can be given less often and
randomly as the patient masters the new skill.
Small individual treats are used during the
training phase. For some exercises, where con­
stant attention is desired, a frozen peanut but­
ter mug can be employed. Peanut butter is
smeared around the insides of a container such
as a mug, which is an appropriate size for the
patient’s muzzle. The container lined with
peanut butter is stored in the freezer. When the
dog is working, the container is held so that the
patient can lick the inside, working continu­
ously for the reward during an exercise such as
standing on a physioball. A variety of sizes of
peanut butter containers can be kept in the
freezer so that they are readily available for the
next patient (Figure 8.13).

Therapist body mechanics

The rehabilitation therapist should maintain
correct body posture to protect against work‐
related injuries (Milhem et  al., 2016). It is also
important to demonstrate correct body mechan­
ics as an example for the client correcting their
posture as needed when they practice the exer­
cises with their pet. Proper body mechanics
include keeping the elbows close to the body,
avoiding full flexion or extension of any joint
including the spine, and might include using
tools to prevent excessive spinal flexion/exten­
sion or side bending. Personal body posture
may go unnoticed as the client focuses on the
challenge of the exercise, so it is important for

the rehabilitation therapist to point out any

dangerous or inappropriate posture through­

out the exercise.

Creating a treatment calendar

A treatment calendar should be created that

provides the client with very specific details

regarding which exercises to do each day of the

week. Clients have time constraints that should

be discussed and accommodated. For individu­

als with a tight work schedule, assignments are

limited to the key exercises that will keep the

patient progressing appropriately. For the client

with a lot of available time, boundaries should

be set to prevent potential overtraining. Some

clients are weekend warriors, wanting to accom­

plish all treatments in two consecutive days. For

these individuals, splitting the workout into

body zones will prevent excessive soreness in

any muscle group.

Figure 8.13 Peanut butter slathered on the inside of a

mug and frozen makes a long‐lasting treat for dogs that

need to have their head moved into a specific position or

just to distract a dog while it stays in a certain position.

Source: Photo by Whitney Rupp.