Front Matter

Chapter 15 Evaluation and Rehabilitation Options for Orthopedic Disorders of the Pelvic Limb 391

Gait analysis

The difference between a lameness exam and
gait analysis should be noted. The physical
therapist evaluates gait with an eye for
functional impairments and compensatory
movement. The patient is observed in each
gait (as appropriate for their current condi-
tion), as well as on stairs, inclines, declines,
and while moving in circles in both direc-
tions. The patient is viewed from the front,
the back, and each side. Stance and swing
phases of gait are observed for appropriate
ROM at each joint, proper muscle firing, and
for compensatory movement. For example, if
a patient is limited in stifle extension on the
right pelvic limb, the ipsilateral swing phase
of gait will be decreased. The examiner may
note compensatory excessive lumbar side
bending to the right in the patient’s attempt
to lengthen the swing phase. Further evalua-
tion is necessary to determine whether the
stifle extension is limited by swelling, muscle,
joint, or nerve.

Strength

Strength testing in humans is performed by

asking the patient to hold a limb in a specific

position against manual resistance. Strength

is graded according to the amount of resist-

ance tolerated. Grading is documented on a

0  to 5 scale, representing none, trace, poor,

fair, and good or normal. Attempts to design

strength testing for the canine patient have

been made. One such design uses position

and gravity in place of human manual resist-

ance. Grading is categorized as poor, fair or

good according to the ability to maintain

good posture in the test position. Strength

testing is important as the results are used to

direct the therapeutic exercise treatment pro-

gram. For example, if a pelvic limb is graded

fair, exercises are chosen that are appropriate

for this strength grade. As strength improves,

the exercises are changed accordingly.

Canine strength is tested by placing the

patient in specific test positions of varying

difficulty. Grading the test depends on the

patient’s ability to maintain a static, symmetri-

cal posture for at least 10 seconds. The therapist

makes note of compensatory movement related

to weakness or pain. For more on strength

testing in the canine patient, see Chapter  13.

Information regarding specific muscle function

is obtained by palpating individual muscles for

intensity of contraction while the test is being

performed. Strength tests are performed bilat-

erally for comparison. For accurate, reproduci-

ble testing it is essential that the patient’s head

be positioned appropriately. In the case of

pelvic limb testing, treats are offered such that

the head is elevated and retracted in order to

shift the weight to the pelvic limbs. Strength

grades are defined and documented as poor

(inability to maintain the standard test posi-

tion), fair (ability to maintain the standard test

position), and good (ability to maintain the

advanced test position).

Testing is initiated on a flat surface, using a

three-leg stance position. If the dog is unable

to maintain the test position for 10 seconds

(compensation is noted), a poor grade is docu-

mented and the test session is ended. If this

test position is well maintained without com-

pensation for 10 seconds, a fair grade is docu-

mented and a more advanced position can be

Figure 15.2 Abnormal sitting posture. Dog is sitting
with left stifle extended and left pelvic limb abducted.