224 Canine Sports Medicine and Rehabilitation
Assistive techniques
Patterning
Patients with neurological disease who have
difficulty walking or who need to relearn the
pattern of walking can be assisted by the use of
patterning as described in Chapter 8. This is
best done with the patient standing in water to
provide buoyancy and balance. The therapist
moves the feet through the proper motion of a
step in the natural sequence of steps for the
walk, repeating this pattern 10 times before
turning on the treadmill.
Tail work
For patients who are not yet using their pelvic
limbs optimally, the authors have found that
tail work is quite beneficial. It is believed that
stimulating the nerves of the tail causes stimu-
lation of central pattern generators in the spine
(see Chapter 17). The therapist uses a thumb to
apply firm pressure to the top of the tail in a
circular pattern, starting approximately one‐
third of the way down the tail looking for a spot
that will initiate or improve motion of the pel-
vic limbs. If there is no response, the thumb
moves distally and the process is repeated until
a response is achieved (Figure 9.17). The tail can
also be stroked with a hand circling the entire
tail, and stroking from top to bottom. If this is
not successful, the direction of stroking can be
reversed, possibly increasing stimulation to the
piloerector muscles. Finally, scratching the
sides of the tail generates movement in some
patients. The therapist should avoid scratching
the ventral surface of the tail as this can stimu-
late defecation.FacilitationThe authors’ application of stimulatory tech-
niques to encourage motor function is based
upon the concepts of facilitation, which is the
enhancement or reinforcement of a reflex or
other nerve activity by the arrival of other excit-
atory impulses at the reflex center. The follow-
ing techniques are used, with the patient in the
UWTM, at the terminal stance phase of the
stride to initiate a proper stepping action in that
leg. The therapist stimulates the foot from the
lateral side to the area between the central pad
and toe pads, stimulating until foot lift occurs
(Figure 9.18). The calcanean tendon can be
quickly rolled between the thumb and fingers
to initiate withdrawal and foot lift at the termi-
nal contact phase of the stride. Stroking the cra-
nial tibial muscle belly from ventral to dorsal at
terminal stance initiates tarsal flexion and foot
lift. For patients that tend to adduct the pelvic
limbs, the therapist can tap the superficial glu-
teal muscles at terminal stance to encourage
abduction. Some patients respond well to the
same stimulus on subsequent days, others
require that the therapist change the stimulus.
Some patients struggle with trunk strength and
tend to move with the spine curved to one side.
Here, the therapist can stimulate the trunk: on
the convex side, stimulating the paraspinal and
abdominal muscles encourages them to fire.
This can be done at any time in the gait cycle.Figure 9.17 Tail work is applied to the proximal tail,
moving distally until the desired effect is achieved.
Figure 9.18 The therapist can stimulate the foot from
the lateral side to the area between the central pad and
toe pads, stimulating until foot lift occurs.