Front Matter

220 Canine Sports Medicine and Rehabilitation

the effort required, and unlike swimming, the
UWTM gives the handler rapid control over the
situation, allowing the patient to rest as needed.
The UWTM is advantageous over the land
treadmill in that increasing water levels
will  reduce weight bearing on painful limbs.
The amount of reduction in weight bearing
has  been documented for mesomorphic dogs
(Levine et al., 2010).

UWTM variables

Temperature

All dogs working on a UWTM at temperatures
ranging from 30 to 34.4 °C (86–94 °F) had gradual
increases in heart and respiratory rates, rectal
temperature, and perceived exertional score, but
there were no differences between dogs working
at different temperatures (Utter et  al., 2002;
Dunning et al., 2003). Therefore, any temperature
between 86 and 94 °F is considered safe for work-
ing with canine patients. The authors prefer
using warmer temperatures in  the winter and
cooler temperatures in the summer, as it is more
comfortable for the patients and the therapists.

Water depth

Carpal height water causes increased flexion

of all joints without the resistance of water

(Figure 9.11). This height is also used for those

patients who prefer to float (lifting their legs to

avoid working). Elbow height water is used

for patients who are athletes, as there is

minimal buoyancy advantage at this height.

Just above‐shoulder (or greater trochanter)

height water provides for maximal buoyancy

without altering the gait pattern. Water levels

higher than this lead to a stilted gait, as the

patient will take short strides with extended

limbs to keep the nose above water

(Figure 9.12) (Levine et al., 2014).

Table 9.2 Comparison between swimming and
underwater treadmills

Swimming in

therapeutic pool

Underwater treadmill

Totally NWB

Maximum AROM

of joints

Nonambulatory patients

with paraparesis/paralysis

Improved core and trunk

strength

Cardiopulmonary

conditioning

Endurance for cross

training

Fun for swimming

patients

Facilitates PROM/all

body work

60% NWB

Improved AROM

compared to land

Proprioceptive gait

training

Improved balance

while walking

Cautious fracture

loading

Builds lean muscle

in limbs

Helps non‐swimmers

get started

Speeds gait retraining

AROM, active range of motion; NWB, non‐weight
bearing; PROM, passive range of motion.

Figure 9.11 Water at carpal height enhances carpal

flexion but diminishes resistance as most of the motion is

done outside of the water.

Figure 9.12 When the water is too high, above the

shoulder joint, the gait is stilted and range of motion and

flexion are greatly reduced. With the water at the level

halfway between the elbow and the shoulder, a good

workout with significantly decreased joint load, can be

achieved.