I’m sure many of us have heard of marker or clicker training, and using it can be very successful, especially when we have a patient that is food motivated and plans to be on your service for a long time. Yet, many times this takes a little more time than we want to spend when working with the average patient recovering from injury or surgery. Lure reward training works much faster.  This type of training is very successful, positive and can produce many movements that can be therapeutic in nature with regard to canine physical rehabilitation.

The idea of luring a dog into a position is nothing new; imagine how most people teach their dogs how to sit. They bring a food treat from the dog’s nose and move it up, telling the dog to look up, shifting weight to the rear, facilitating the movement to sit. This is the basic idea of lure reward training, no words are needed. Basic sit to stand exercises can be performed like this in clinic and more complex exercises can be achieved when we study the way dogs get up and down and apply our advanced knowledge of biomechanics and training. We can manipulate the way the patient uses their bodies even more when we use lure reward training and re-teach them to use their weak and injured parts, overcoming the compensations they may have acquired. Using a positive reinforcement technique may also help the canine patient understand better what you need them to do and this may stick with them long after the session has ended.

http://youtu.be/SgI8pbTQL6M

This video shows just how much this dog uses his forelimbs to compensate for the lack of strength he has in his rear due hip dysplasia and a resent FHO. It also illustrates how much we can control many of these compensations and how we can correct them through lure reward training.

I have found that with all training, the timing of the reward improves everything; this is why clickers work so well. But a well delivered food reward can work just as well when you work in close proximity to the patient, like many of us do. We can also increase and decrease the reward to further communicate how well the patient is doing an exercise, or try and make them get further with a task by giving more or less food. We can also change the type of food, sense some foods may hold greater value to dogs and others may just seem ok or not even be interesting. I’ve even fasted patients before therapy to get more attention and work out of a session.

This next video is a good example of how you can change a simple exercise like “sit to stand” and make it harder, and more challenging for the patient; still using lure reward training.

http://youtu.be/1Sq4P0MCVZg

Squat exercises at my clinic are done on a fairly regular basis and seem to benefit many hind limb pathologies in conjunction with other exercises.

Exercise in the canine is only limited to the imagination of the therapist and the mental and physical abilities of the patient. Working with props and using targeted functional exercises with techniques like lure reward training allows the patient to choose to work rather than be forced to. This generally means most patients are running over their owners to get into your door and love to please. Strengthening exercises, like underwater treadmill work, will always have a place in treatment plans due to the ease of use, and patient compliance, but underwater treadmill exercise does not always target everything needed to accomplish the goals of the modern patient seen in the veterinary practice.
Contribution by:
Robert J Porter III
Certified Canine Rehabilitation Practitioner
www.lavrc.com

This is most commonly caused by a positional fault, which
can easily be determined and fixed using a mobilization with movement
technique. Your patients depend on you to know about this technique and be able
to successfully administer it.

Our courses teach you all the handling skills necessary to
successfully assess and treat this problem.

Contribution by:
Brian Mulligan FNZSP (Hon), Diploma M.T.
www.bmulligan.com

You need to examine the cervical spine in such cases. And
for patients experiencing arm pain above the wrist,consider Cx 5 as suspect.
This can easily be confirmed using a spinal mobilization with arm movement. A
repositioning of cervical 4 on cervical 5 can often eliminate all symptoms.

Do you know the techniques for succesfully assessing and
treating this condition?

Contribution by:
Brian Mulligan FNZSP (Hon), Diploma M.T.
www.bmulligan.com

Mobilization with Movement (MWM) are important tools for
both assessing and, when indicated, treating knee pain and stiffness. We have
many training videos available that demonstrate how to perform the different
MWM assessment and treatment techniques.

When a patient’s condition is correctly assessed and the
indicated MWM treatment(s) properly applied, the patient feels NO PAIN from the
treatment and improvement in function should be instantly noted.

In some cases such as runners knee, corrective tapings can
be very effective when used in conjunction with MWM.

Contribution by:
Brian Mulligan FNZSP (Hon), Diploma M.T.
www.bmulligan.com

Clinical studies demonstrate that patients with cervicogenic
dizziness, in some cases of multi-year duration, can be treated effectively
with 4 to 6 sessions of sustained natural apophyseal glides (SNAGS).

One double-blind study conducted at an Australian university
compared SNAGS against a placebo method. The SNAG treatments used the movement
or position causing the dizziness.

Measured outcomes included Dizziness Handicap Inventory
(DHI), dizziness severity (VAS), frequency of dizziness, neck pain/headache
severity (VAS), cervical range of motion and sway index.

Based on pre- and post-treatment and 6 and 12 week follow
ups, significant improvements in the SNAG groups were noted across all
measurements as compared to the placebo group.

Significantly, follow ups have shown that the benefits of
the treatment, significant reductions of pain and dizziness were significant,
immediat and sustained: patients have remained symptom free for years after the
SNAG treatments were completed.

One of our current success stories is Zeke, who came to us with a neurological referral and a tearful owner. Zeke was a ten year old male Irish Setter with a confirmed diagnosis of Degenerative Myelopathy, bilateral canine hip dysplasia and stifle disease.  We began our initial treatment with the Companion Therapy Laser. Our goals were to increase blood flow to the spinal musculature, decrease the pain and inflammation of the hips and stifles, promote cell proliferation and improve neovasculization. Towards these ends, his thoracic and lumber spine was lased thoroughly as were his hips and stifles. The laser treatment took approximately ten minutes with the Companion Therapy Laser and the immediate results were astounding. Zeke was able to walk more confidently and comfortably, his force plate analysis revealed an increase of ten percent of his weight on the bilateral hind limbs, and a decrease in the forelimbs. Zeke’s owner was thrilled and so are we! He now comes in twice a week for his treatments which consist of lasing treatments from the Companion Therapy Laser, joint mobilizations, balance and proprioceptive exercises, and the underwater treadmill. Functionally, he has improved so that at home so he can go on fifteen minute walks with his owner and walk across slippery surfaces. He is not currently on any pharmaceutical interventions. Recent literature on degenerative myelopathy indicates a six to eighteen month improvement in function and quality of life with laser treatment.

Hera is another of our success stories. A fifteen year old Pit Bull with osteoarthritis, Hera underwent a downward spiral that included a temporary intestinal disorder with secondary dehydration and a fall down a flight of stairs. When she first came to us, she was non-weight bearing in the front left limb, ataxic in the hindlimbs, only able to walk for approximately fifteen feet and stand for approximately ten seconds, and was unable to sleep through the night due to pain. Radiographs demonstrated osteoarthritis of the lumbosacralregion, and bruising of the left humerus. Secondary to her gastrointestinal disturbances, she was not placed on any medication and is still not on any medication.  We began using the Companion Therapy Laser with her, focusing on the lumbosacral region, lower cervical region, left shoulder and left elbow. Our goal was initial pain relief, inflammation reduction, cell proliferation and function restoration. After only two treatments, she was weight bearing on the left forelimb and walking up to one hundred feet. She even attempted to climb stairs! In addition, she began
sleeping through the night comfortably. She has become a regular at our clinic and is now walking for up to fifteen minutes, runs on occasion and has even attempted counter surfing!  She places about 70 percent of her weight on her forelimbs – equally!

The Companion Therapy Laser has been instrumental in success story after success story and is without a doubt the most utilized modality in our clinic!

Written by:
Debbie Gross Saunders, DPT, MSPT, OCS, CCRP
Wizard of Paws Physical Rehabilitation for Animals, LLC
www.wizardofpaws.net

Dysfunction of the C1-C2 segment is the primary cause of
cervicogenic headache and should be examined first. An accurate diagnosis can
be made using the flexion-rotation test (FRT). With the cervical spine fully
flexed, vertebral movement should be limited to the C1-C2. When this is the
case, normal range of motion is 44° to each side.

Various studies have shown that, for people suffering
cervicogenic headache, range of motion on the headache side is reduced on
average 17%. Reduced range of motion is not found in people suffering other
types of headaches.

Manual therapy, in particular, sustained natural apophyseal
glides (SNAGS), has been found to be effective in the treatment of cervicogenic
headache. Mulligan has shown that patients can also administer SNAGS treatments
to the C1-C2 themselves (self-SNAGS) using a strap to immobilize the C1 while
rotating to the left or right based on which side of the head the pain is
occurring.

Contribution by:
Brian Mulligan FNZSP (Hon), Diploma M.T.
www.bmulligan.com

The most common acute treatments are Rest, Ice, Compression,
Elevation (R.I.C.E.) and taping. Traditional immobilization taping techniques
are ineffective if not applied almost immediately. Both of these treatment
regimens are based on the (false) assumption that the ligaments are the focus
of the injury. Most ankle sprains result from the ankle rolling into an
inverted position when in a dorsiflexed position. The distal end of the fibula
then translates anteriorly on the tibia and talus, producing an inversion
sprain of the anterior talo-fibular ligament (ATFL).

Traditional taping methods are often ineffective for this
type of injury. They typically don’t provide adequate longitudinal
stabilisation and so may not prevent further injury. And frequently they don’t
reduce pain levels. In addition to not being effective, these methods can
actually cause problems; including restricted blood flow, decreased
proprioceptive feedback, and by restricting movement, interfere with the normal
gait and recovery process.

While the Mulligan concept does include taping as an initial
treatment, its application method increases stability, reduces pain, and
doesn’t restrict blood flow or restrict the normal gait. With the joint better
protected from re-injury, once the Mobilization with Movement (MWM) technique
therapy is initiated it has a better chance of success.

Contribution by:
Brian Mulligan
FNZSP (Hon), Diploma M.T.
www.bmulligan.com

The study found that both treatments were initially equally
effective.

At the 12-month follow up evaluation, all patients receiving
injections had experienced a return of their tennis elbow. In the group treated
with (MWM) however, none of the patients had experienced a recurrence.

The results of this study clearly show that (MWM) is the
option of choice. Do you know how to apply this proven Mobilization with
Movement treatment?

Contribution by:
Brian Mulligan FNZSP (Hon), Diploma M.T.
www.bmulligan.com