A Systematic Review of Musculoskeletal Mobilization and Manipulation Techniques Used in Veterinary Medicine

Abstract

Mobilization and manipulation techniques are often used in small animal and equine practice; however, questions remain concerning indications, dosing and efficacy. A bibliographic search was performed to identify peer-reviewed publications from 1980 to 2020 that evaluated the clinical effects of musculoskeletal mobilization and manipulation techniques in dogs, cats and horses. The search strategy identified 883 papers for review. Inclusion and exclusion criteria were applied. The clinical indications, dosages, outcome parameters, and reported efficacy within each publication were recorded and categorized for comparison with scientific quality assessed according to a standardized grading system. Fourteen articles were included in this systematic review of which 13 were equine and one was a canine study. Seven of these were cohort studies and seven were randomized controlled clinical trials. The canine study involved carpal immobilization-remobilization and all equine studies focused on the effects of passive mobilization (n = 5) or manipulation (n = 8) of the axial skeleton. Study quality was low (n = 4), moderate (n = 7), and high (n = 3) and included a wide array of outcome parameters with varying levels of efficacy and duration of therapeutic effects, which prevented further meta-analysis. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Optimal technique indications and dosages need to be determined to improve the standardization of these treatment options.

A Questionnaire Study on the Use of Complementary and Alternative Veterinary Medicine for Horses in Sweden

“…Several therapists and veterinarians stated that they believe that there is scientific evidence that their methods are effective in animals, however, many CAVM methods lack conclusive scientific support for clinical efficacy for specific indications [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. This emphasizes the importance of the initiation of well-designed research studies to ensure evidence-based information.…”

“…The umbrella term includes a wide range of methods, from those that could almost be considered as conventional medicine to those where animal studies are lacking or even suggested to have no effect in animals [ 2 , 3 , 4 , 5 ]. The literature reviews published generally state that there is insufficient scientific research to draw any firm conclusions regarding the clinical efficacy of treatments for specific indications for many of CAVM methods [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. The reasons often listed are, a limited number of studies, small sample sizes, lack of control groups, and other methodological limitations, as well as considerable heterogeneity in reported treatment effects [ 7 , 10 , 12 ].…”

A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Soft Tissue Mobilization

“…The present article is one of a series of systematic review articles in a Special Issue of Animals on complementary and alternative veterinary medicine (CAVM) therapies used in sport and companion animals. The other articles will cover manipulation/mobilization therapies [ 13 ], electrotherapies, therapeutic ultrasound, extracorporeal shock wave therapy, laser therapy, acupuncture, and “miscellaneous therapies” [ 14 ].…”

The Effect of Chiropractic Treatment on Limb Lameness and Concurrent Axial Skeleton Pain and Dysfunction in Horses

“…Chiropractic is commonly used in equine practice as an adjunctive treatment for managing chronic back pain and lameness [ 27 , 28 ]. A systematic review of spinal manipulation techniques suggests a high level of efficacy in reducing thoracolumbar pain, stiffness, and muscle hypertonicity in horses [ 29 ]. While chiropractic care has a strong body of evidence for treating equine back pain and dysfunction, there is limited evidence for its effect on the appendicular skeleton and associated limb lameness [ 30 ].…”