Front Matter

Chapter 8 Therapeutic Exercise 205

is walked over the tread three times from back
to front. Each time the patient completes this
action he is given lots of praise and a treat as
positive reinforcement. On the third pass, the
patient is asked to sit or lie down on the belt,
then get off for the reward. On the fourth pass,
with the patient standing, the tread is started,
getting it to the appropriate walk speed for this
patient within 1–2 seconds. If this is done too
slowly, it is confusing for the patient. Done too
quickly, the patient will panic and crouch onto
the tread, risking falling off the back of the belt.
The handler must have a cookie available at all
times to encourage the patient to rise if he is
starting to crouch.
Goal: The patient should move in a proper
walk, amble, or trot, not a pace (see Chapters 2
and 10 for more details). If the patient paces at
what should be a trot speed, the handler should
tug gently to the side on the collar, causing a
brief moment of imbalance, which will gener­
ally create a transition to the trot.

Belt speed

Patients with neurological disease are generally
started using a slow belt speed of 0.1–0.5 miles
per hour (0.16–0.8 kilometers per hour)—just
fast enough to encourage a walk. If a treadmill
is not available, the therapist can lean over the
patient while walking forward and move the

feet in a proper pattern (Figure 8.27). For neuro­

logically intact patients, the speed should allow

for a comfortable walk with no pauses in foot­

falls. As the speed increases, the patient will go

through an amble (fast walk) to the trot. The

appropriate trotting speed is a function of the

patient’s body type. A Dachshund may trot

well at 1.2 to 1.5 miles per hour (1.9–2.4 kilom­

eters per hour) while a Golden Retriever will

trot at closer to 4 to 5 miles per hour (6.4–8 kilo­

meters per hour). Border Collies are often not

comfortable at a walk and may trot at slower

than expected speeds.

Endurance exercise

Endurance exercise on a treadmill should not

begin before the patient has reached skeletal

maturity. Additionally, warm‐up and cool‐

down periods of 2–5 minutes each should be

incorporated into any endurance work on the

treadmill. Exercises start within comfortable

parameters for the patient. For an athlete,

the  dog can be walked at a fast speed at the

highest incline, usually 11° on most canine

treadmills.

The exercise period might start with three sets

of 3‐ to 5‐minute sessions, progressing to two

sets of 10 to 15 minutes, then to one set of 20

to  30 minutes. When the patient can work at

this  pace and incline for 20 to 30 minutes, the

Figure 8.27 Hand position is important when assisting a patient to ambulate on the treadmill. The therapist must assist
without impeding motion and stimulate the motions that the patient has the hardest time performing. Source: Photo by
Whitney Rupp.