Front Matter

Chapter 13 Evaluation and Rehabilitation Options for Orthopedic Disorders of the Canine Thoracic Limb 337

partial weight bearing of the right thoracic
limb. These postural findings could lead a ther-
apist to further examine the cervical spine and
right thoracic limb in detail. See Chapter 15 for
an evaluation of the pelvic limbs.

Function

The purpose of the functional assessment is to
critically analyze functional transitions that
may indicate primary or secondary physical
limitations. Functional assessment should, at a
minimum, include lateral recumbence‐to‐sit,
sternal‐to‐sit, sit‐to‐stand (Figure 13.3), and
stand‐to‐sit. Additionally, it may include move-
ment on curbs, ramps, stairs, and into and out
of the client’s primary vehicle. Movement
abnormalities during each of these functional
activities can provide important information
regarding injury location. For example, refusal
to assume and maintain a sternal recumbent
position may indicate decreased glenohumeral
joint flexion, hypermobility of the gleno-
humeral joint, or hypomobility of the elbow
joint. Further evaluation is indicated, including
muscle and bone palpation, passive range of
motion, muscle flexibility, fascial mobility,
clearing the spine, joint play and special tests of
passive range of motion (osteokinematics), flex-
ibility, joint play (arthrokinematics), and palpa-
tion and special tests of the thoracic limbs.

Clinical findings will lead to a problem list

that will then lead to an assessment and

treatment plan. For example, if thoracic limb

lameness increases when a dog is walking

downstairs, the therapist would further evalu-

ate the shoulder joint. During the course of the

evaluation the therapist may find decreased

shoulder joint flexion, decreased cranial glide

joint play of the glenohumeral joint, and pain

on palpation of the biceps tendon—leading the

therapist to hypothesize that biceps brachii is

the primary tissue type injured. In best practice,

these clinical findings would then lead to fur-

ther diagnostics prior to development of a treat-

ment plan.

Strength

Skeletal muscle provides strength to maintain

posture and move joints while absorbing exter-

nal forces and distributing loads (Hill, 1950).

The purpose of strength testing is to determine

baseline force‐producing capacity of a particu-

lar skeletal muscle group and to analyze, in the

problem list, if more strength is required to

meet the client’s goals for the patient. Prior to

strength testing, quality of muscle bulk must be

observed to determine whether atrophy is pre-

sent. If atrophy is noted, limb circumference is

measured with a Gulick tape measure taking

particular note of the area measured to allow for

(A) (B)

Figure 13.3 Functional assessment of the thoracic limb requires observation of the primary functional activities needed
for daily living. Here a dog is attempting to stand by first (A) swinging the head in preparation for standing, and (B)
struggling to extend the pelvic limbs and elevate the pelvis. As this geriatric patient with a medical diagnosis of hip
osteoarthritis moves from sit to stand, the cranial placement of the feet and the extended position of the elbows indicate
likely caudal shoulder muscle concentric contraction pulling the body to stand. This posturing decreases the need to
actively flex the shoulder and elbow joints indicating possible arthrokinematic issues that need to be assessed in the
evaluation. (Images derived from video.)