Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis

SIMPLE SUMMARY: Osteoarthritis (OA) is a chronic progressive disease, which frequently requires lifelong therapy in dogs. In addition to pain management with drugs, exercise modification and physical therapy are important measures to alleviate pain and to improve patient mobility and quality of life in osteoarthritic dogs. The main goals of physiotherapy for osteoarthritic dogs are pain reduction, improvement of muscle strength and preservation of joint function. For this purpose, the patient’s life style and environment are optimally adapted to facilitate daily life in osteoarthritic dogs. Owners learn to optimize daily exercise and to perform simple home exercises. Additionally, physiotherapists regularly adapt the PT-program according to patient progress and complement the home program with “PT-expert” exercises and physiotherapeutic modalities (for example: shock wave or laser therapy) to further improve the patient’s overall quality of life and function. The authors propose a simple systematic PT approach for canine OA, prioritizing measures according to simplicity, cost effectiveness and practicality in the form of a “PT pyramid”. The levels of the pyramid are in ascending order: environmental modification, exercise plan, OA-specific home exercises, and treatment by a veterinary physical therapist. Additionally, efficacy of physiotherapeutic measures is reviewed for canine osteoarthritis. ABSTRACT: Osteoarthritis (OA) is a common and debilitating condition in domestic dogs. Alongside pharmaceutical interventions and weight loss, exercise and physiotherapy (PT) are important measures in maintaining patient mobility and quality of life. Physiotherapy for OA aims to reduce pain, optimize muscular function and maintain joint function. Physiotherapeutic plans typically include PT exercises combined with therapeutic modalities, lifestyle and environmental modifications to improve the patient’s overall quality of life and function. Information on therapeutic clinical efficacy of physiotherapeutic measures for canine OA is still very limited. Thus, physiotherapeutic strategies are still primarily based on evidence extrapolated from human protocols tailored to people with OA. The authors propose a simple systematic PT approach for canine OA, prioritizing measures according to simplicity, cost effectiveness and practicality. This guide (the “Physiotherapy Pyramid”) aims to provide a clear stratified approach to simplify decision making and planning for owners, veterinarians and veterinary physiotherapists, leading to more straightforward design and implementation of treatment plans. Measures are implemented starting at the base of the pyramid, subsequently progressing to the top, allowing effective and practical interventions to be prioritized. The levels of the pyramid are in ascending order: environmental modification, exercise plan, OA-specific home exercises and treatment by a veterinary physiotherapist.