Pilot Study on Feasibility of Sensory-Enhanced Rehabilitation in Canine Spinal Cord Injury

Abstract

Physical rehabilitation is frequently recommended in dogs recovering from acute thoracolumbar intervertebral disc extrusion (TL-IVDE), but protocols vary widely. The objective of this study was to evaluate the feasibility of incorporating sensory-integrated neurorehabilitation strategies into a post-operative rehabilitation protocol in dogs with TL-IVDE. Non-ambulatory dogs with acute TL-IVDE managed surgically were prospectively recruited to this unblinded cross-over feasibility study. Eligible dogs were randomized to start with tactile-enhanced (artificial grass) or auditory-enhanced (floor piano) basic rehabilitation exercises performed twice daily for the first 4 weeks before switching to the opposite surface for the subsequent 4 weeks. Neurologic examination, open field gait scoring, girth measurements and an owner-completed feasibility questionnaire were performed at baseline and 2, 4, 6, and 8 weeks post-operatively. Twenty-four dogs were enrolled, 12 randomized to each order of exercises. Gait scores did not differ between the two groups at baseline, 4 or 8 week visits. All modified exercises could be performed and compliance was high. Adverse events potentially attributable to the study surface were mild, self-limiting and occurred in 2/24 dogs. The most common surface-related limitations were that the piano was slippery and that both surfaces were too short. The artificial grass was preferred by owners and dogs compared to the floor piano surface, but this was influenced by which surface was utilized first. Auditory and tactile modifications were feasible and safe to incorporate into a standardized rehabilitation protocol. This pilot study could prompt larger efficacy studies investigating the benefit of sensory-integrated rehabilitation in dogs with TL-IVDE.

Approach to Small Animal Neurorehabilitation by Locomotor Training: An Update

“…In addition, early intensive LT should be associated with multimodal modalities [ 18 , 19 , 20 , 63 , 85 , 88 , 123 ] in all neurological dogs and cats with or without pain perception after surgery or with conservative management, maintaining the stability of the SC. This early and intensive multimodal training can be applied across a diverse range of neural diseases, promoting research for years to come.…”

“…If the patient has monoplegia/monoparesis, paraplegia/paraparesis, or tetraplegia/tetraparesis, the adaptation to the treadmill surface is necessary to obtain voluntary or automatic movement. For that, the surrounding environment must be calm and quiet with classical music [ 19 , 20 , 62 , 63 , 88 ], but also with enough energy to promote motivation to start the step cycle, autonomously or with assisted exercises, such as the established bicycle movements, that may require perineal or tail stimulation [ 18 , 64 , 89 ].…”

Early Locomotor Training in Tetraplegic Post-Surgical Dogs with Cervical Intervertebral Disc Disease

“…This clinical study proposed new research tools that lead us to understand and justify the rupture of the cage rest or reduced exercise activity paradigm in these populations of dogs, suggesting early and intensive training [ 28 , 29 , 32 , 58 , 68 , 69 , 70 , 71 ], now applied in cervical C1–C5 compressive myelopathies. In contrast to the usual physical rehabilitation that is recommended with cryotherapy, passive range of motion, massage, assisted standing and walking [ 29 , 72 , 73 , 74 , 75 , 76 ]. Although in acute ataxic dogs, cage rest could be essential to reduce pain and inflammation secondary to affected nerve roots and meninges [ 77 , 78 ].…”

“…The propriospinal fibers also should be stimulated by multisynaptic pathways, re-establishing the connections between descending motor tracts, the central pattern generators, intrinsic circuitry and interneurons located on the pelvic and thoracic intumescences [ 81 , 82 , 83 , 84 ]. All those exercises were performed in an integrated sensory environment (e.g., listening to music), promoting somatosensory stimulation, as mentioned by Lewis and collaborators (2022) [ 72 ].…”

Intensive neurorehabilitation and allogeneic stem cells transplantation in canine degenerative myelopathy

“…The locomotor training implemented was based on fast step-cycle repetitions, always applied in a quiet environment, and ideally with musical stimulation ( 66 , 67 ). Due to the presentation of clonic reflexes, bicycle movements were only necessary to modulate the rhythm of the step cycle, rarely requiring tail and perineal stimulation.…”