The Finnish Canine Stifle Index: responsiveness to change and intertester reliability

The Effect of Therapeutic Exercise on Body Weight Distribution, Balance, and Stifle Function in Dogs following Stifle Injury

Stifle injury is common in the companion dog population, affecting weight bearing, neuromuscular control, and balance. Therapeutic exercises after stifle injury seem to be effective, but high-quality research evaluating the effects is lacking. This randomized controlled trial evaluated the effects of a 12-week progressive therapeutic home exercise protocol on three-legged standing, targeting balance and postural- and neuromuscular control and disability in dogs with stifle injury. Thirty-three dogs with stifle injury were randomly allocated to intervention (n = 18) and control groups (n = 15), both receiving a standard rehabilitation protocol. Additionally, the intervention group received a progressive therapeutic exercise protocol. The outcome measures were static body weight distribution between hindlimbs, balance control, the canine brief pain inventory, and the Finnish canine stifle index. Both groups improved after the intervention period, but the group using the progressive therapeutic exercise protocol improved to a greater extent regarding static body weight distribution between the hindlimbs (I: median = 2.5%, IQR = 1.0-4.5; C: median = 5.5%, IQR = 3.0-8.8), pain-related functional disability (I: median = 0.0, IQR = 0.0-0.2; C: median = 0.9, IQR = 0.1-1.8), and stifle function (I: median = 25.0, IQR = 9.4-40.6; C: median = 75.0, IQR = 31.3-87.5), with intermediate to strong effects. These clinically relevant results indicate that this home exercise program can improve hindlimb function and restore neuromuscular control.

Non-invasive methods to assess muscle function in dogs: A scoping review

Skeletal muscle function can be affected by multiple disorders in dogs of which cranial cruciate ligament rupture or disease (CCLD) is one of the most common. Despite the significance of this condition only sparse research exists regarding assessment of muscle function in dogs. This scoping review aimed to identify the non-invasive methods for canine muscle function assessments that have been reported in the literature in the past 10 years. A systematic literature search was conducted 1st March 2022 across six databases. After screening, 139 studies were considered eligible for inclusion. Among the included studies, 18 different muscle function assessment categories were identified, and the most frequently reported disease state was CCLD. We included an attempt to elucidate the clinical applicability of the 18 reported methods, as experts were asked to subjectively assess the methods for their clinical relevance as well as their practical applicability in dogs with CCLD.

Development and testing of a stifle function score in dogs

Objective

The purpose of this study was to develop and test a quantitative stifle function score (SFS) in dogs with unilateral cranial cruciate ligament disease by combining clinical measures and functional tests. The objective of this study was to compare the proposed SFS to a symmetry index (SI) calculated from objective ground reaction forces (GRFs). We hypothesized that the SFS would have a strong correlation with SI.

Methods

Dogs with surgically and nonsurgically treated unilateral cranial cruciate ligament rupture and dogs with no known musculoskeletal problems were included in the study. Each dog was scored using the SFS and trotted across a force platform to obtain GRFs and calculate the SI, based on vertical GRFs. Fourteen items were included in the SFS: limb use at a walk, limb use at a trot, lameness at a walk, lameness at a trot, stair climbing, sit-to-stand, dancing, pain response, stifle effusion, thigh circumference/muscle atrophy, stifle extension, stifle flexion, and cranial drawer/tibial thrust, with each item scored based on previously determined criteria. A perfect SFS would receive a score of 100.

Results

Twenty-seven dogs were included in the study: twenty-one with unilateral cranial cruciate ligament disease and six control dogs. The mean SFS was 71.5 out of 100. To further characterize the association between SFS and SI the degree of gait asymmetry using SI was classified as <5%, 5.1–10%, 10.1–20%, 20.1–25%, and >25% difference between the pelvic limbs for all dogs. The mean SFS for each of the five categories were 97.8, 85.2, 65.4, 63, and 56.4, respectively. Correlation of SI and SFS was −0.863 (p < 0.0001). All of the individuals evaluated tests in the score were significantly correlated with SI except for pain response and stifle flexion. The SFS is in strong agreement with the SI, as confirmed by Bland–Altman analysis.

Conclusion

The SFS had a significant correlation and agreement with the SI calculated from GRFs. This SFS may be a useful, simple, and inexpensive tool to use in a clinical environment to monitor progression during the rehabilitation and recovery process following unilateral cranial cruciate ligament rupture.