1
|
Alves JC, Santos A, Lavrador C, Carreira LM. Minimal Clinically Important Differences for a Weight Distribution Platform in Dogs with Osteoarthritis. Animals (Basel) 2023; 14:128. [PMID: 38200859 PMCID: PMC10778445 DOI: 10.3390/ani14010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
In this retrospective study to determine the optimal method of evaluating static weight-bearing distribution to assess response to treatment in dogs with osteoarthritis using a weight distribution platform, data from the Clinica Veterinária de Cães (Portuguese Republican National Guard) clinical records were extracted. At baseline and at 15 days post-treatment, follow-up data from 80 dogs treated for bilateral hip osteoarthritis were categorized based on an anchor question. Estimates of minimal clinically important differences were calculated with distribution-based and anchor-based methods for deviation from normal weight-bearing and a symmetry index (SI). For deviation, the anchor-based methods provided a range from -0.3 to -3.1, and the distribution-based methods from 0.16 to 0.29. For SI, the anchor-based methods provided a range from -10.0 to -23.9, and the distribution-based methods from 1.31 to 2.88. Receiver operator characteristic curves provided areas under the curve >0.7, indicating an acceptable cut-off point. We presented estimates of -1 for deviation and -10 for SI in dogs with OA. These estimates can be used for research and patient monitoring. Future studies should include OA from other joints and animals from a broader clinical context.
Collapse
Affiliation(s)
- J. C. Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
- Centro de Ciência Animal e Veterinária, Lusófona University, 1749-024 Lisbon, Portugal
- MED—Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - Ana Santos
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal
| | - Catarina Lavrador
- MED—Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554 Évora, Portugal
| | - L. Miguel Carreira
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), 1300-477 Lisbon, Portugal
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon, (FMV/ULisboa), 1649-004 Lisbon, Portugal
- Anjos of Assis Veterinary Medicine Centre (CMVAA), 2830-077 Barreiro, Portugal
| |
Collapse
|
2
|
Brantberg I, Grooten WJA, Essner A. The Effect of Therapeutic Exercise on Body Weight Distribution, Balance, and Stifle Function in Dogs following Stifle Injury. Animals (Basel) 2023; 14:92. [PMID: 38200827 PMCID: PMC10778569 DOI: 10.3390/ani14010092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Ida Brantberg
- School of Veterinary Science, The University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, Wirral, UK
- Djursjukhuset Malmö, IVC Evidensia, Cypressvägen 11, SE-213 63 Malmö, Sweden
| | - Wilhelmus J. A. Grooten
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83 Huddinge, Sweden;
- Women’s Health and Allied Health Professionals’ Theme, Department of Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna N1:00, SE-171 76 Stockholm, Sweden
| | - Ann Essner
- Djurkliniken Gefle, IVC Evidensia, Norra Gatan 1, SE-803 21 Gävle, Sweden;
- Department of Women’s and Children’s Health, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| |
Collapse
|
3
|
Aldrich LA, Upchurch DA, Roush JK. Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery. Vet Surg 2023. [PMID: 37114870 DOI: 10.1111/vsu.13967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/12/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To compare the analgesic effect of surgical wound infiltration with liposomal bupivacaine (LB) to saline placebo in dogs after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN Blinded, randomized, placebo-controlled clinical prospective study. ANIMALS Fifteen client-owned dogs receiving LB and 17 dogs receiving an equivalent volume of saline placebo, all with confirmed unilateral cranial cruciate ligament insufficiency. METHODS Preoperatively and up to 48 h after surgery, Glasgow Composite Measure Short Form (CMPS-SF) pain scores were assigned and using a weight distribution platform, static bodyweight distribution (%BWdist ) to the operated limb was measured. Postoperatively, dogs also received carprofen 2.2 mg/kg subcutaneously every 12 h. Rescue analgesia was provided. Treatment success was defined as not requiring rescue analgesia over the 48-h postoperative period. RESULTS There was no difference between treatment success, postoperative opioid consumption, CMPS-SF pain scores, or %BWdist in dogs that received surgical wound infiltration with LB compared with those receiving saline placebo, following TPLO. There was no linear correlation between CMPS-SF pain scores and %BWdist . CONCLUSION For the population of dogs that underwent TPLO and received postoperative carprofen at our institution, LB did not provide an analgesic effect discernable by success/failure analysis, CMPS-SF pain scores, or %BWdist measurement using a weight distribution platform, compared with saline placebo. CLINICAL SIGNIFICANCE LB may not provide detectable analgesia during the first 48 h for dogs recovering from TPLO and receiving only postoperative carprofen.
Collapse
Affiliation(s)
- Lauren A Aldrich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - David A Upchurch
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - James K Roush
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| |
Collapse
|
4
|
DiGiovanni LC, Roush JK, Berke K. Preoperative and postoperative stance analysis in dogs with patellar luxation confirms lameness improvement after surgery. Am J Vet Res 2023; 84:ajvr.22.10.0186. [PMID: 36662604 DOI: 10.2460/ajvr.22.10.0186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To document and compare preoperative and postoperative stance analysis measurements in animals with naturally occurring patellar luxation. ANIMALS 131 client-owned dogs surgically treated for naturally occurring unilateral or bilateral patella luxation between March 30, 2015, and February 12, 2020. PROCEDURES Weight bearing as a percent body weight on each limb was recorded with the use of a platform device for analyzing stance (PetSafe Stance Analyzer; LiteCure LLC, Companion Animal Health) preoperatively and postoperatively for all dogs. Signalment, limb affected, lameness grade, luxation direction, luxation grade, and surgical procedure were collected from patient records and assessed for the effects of these variables on weight bearing preoperatively or at the first or second postoperative recheck examination. RESULTS There were 61 males and 70 females, with a mean age and body weight of 4.62 years and 13.01 kg, included in the study. As age increased, body weight decreased in these dogs (P = .025). There was a statistically significant improvement in lameness after surgery (P = .008) at the second postoperative recheck examination. Lameness significantly decreased as postoperative time increased (P < .001, r = 0.503). As age increased, lameness at the initial visit decreased compared to younger dogs but not significantly (P = .062). There was no significant effect of preoperative luxation grade, luxation direction, surgical procedure, or sex when comparing initial lameness or lameness at recheck examination. CLINICAL RELEVANCE Surgical correction of patella luxation improves lameness as measured by postoperative stance analysis. Preoperative luxation grade or direction, surgical procedure performed, and sex of the animal did not significantly affect outcome in this group of dogs.
Collapse
Affiliation(s)
- Lisa C. DiGiovanni
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - James K. Roush
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - Kara Berke
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| |
Collapse
|
5
|
Lappalainen AK, Pulkkinen HSM, Mölsä S, Junnila J, Hyytiäinen HK, Laitinen-Vapaavuori O. Breed-typical front limb angular deformity is associated with clinical findings in three chondrodysplastic dog breeds. Front Vet Sci 2023; 9:1099903. [PMID: 36733429 PMCID: PMC9887302 DOI: 10.3389/fvets.2022.1099903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Angular front limb deformity (ALD) refers to an excessively curved limb conformation, which is seen in some chondrodysplastic dog breeds. Common characteristics of ALD include carpal valgus (VALG), front limb rotation (ROT), elbow incongruity, and lateral radial head subluxation. These may cause lameness and discomfort in affected dogs. The clinical impact and breed-specific characteristics of front limb conformation in chondrodysplastic breeds are unknown. This prospective and cross-sectional study aimed to investigate differences in front limb conformation between three chondrodysplastic breeds. We further evaluate whether front limb conformation is associated with clinical findings and limb function. We propose novel methods to classify findings in the interosseous space and to quantify lateral radial head subluxation. Data from a total of 224 front limbs from 112 dogs of three chondrodysplastic dog breeds (30 Standard Dachshunds, 29 Skye terriers, and 53 Glen of Imaal terriers) were included in the study. Front limb VALG and ROT were measured with a goniometer. From the radiographs, the elbow joint was graded for incongruity (INC), and the humeroradial angle (HRA) was measured to assess lateral radial subluxation. The association of front limb conformation with clinical signs and limb function was investigated using orthopedic examination, goniometric and kinetic measurements, and radiography. The breeds differed significantly in their front limb conformation. The Dachshund had the least ROT and the least radial head subluxation. The Skye terrier had the most VALG, the most radial head subluxation, and the largest prevalence of moderate and severe INC. The Glen of Imaal terrier had the most ROT. In addition, INC, ROT, VALG, and HRA were found to be independent of each other and were associated with several measurable clinical abnormalities and limb function such as pain, lameness, limited range of motion, and elbow joint osteoarthritis. This implies that VALG, ROT, and HRA could be used in addition to INC grading when choosing musculoskeletal characteristics of dogs suitable for breeding.
Collapse
Affiliation(s)
- Anu K. Lappalainen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland,*Correspondence: Anu K. Lappalainen ✉
| | - Hanna S. M. Pulkkinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Sari Mölsä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | | | - Heli K. Hyytiäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Outi Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
6
|
Abstract
Objective kinetic and kinematic data can be used as an objective measure of treatment intervention over time but can also be used to evaluate progress of clinical patients. Force plate and pressure sensitive walkway systems both offer the clinician the ability to obtain useful kinetic data, whereas additional equipment is required to obtain kinematic data. Which system is preferred depends on what specific data the researcher or clinician hopes to acquire; both are accurate and consistent, and each offers pros and cons compared with the other that must be considered.
Collapse
|
7
|
Izawa K, Fukunaga K, Hirota Y, Orito K. Displacement of center of mass in dogs in response to foot sensory stimulation. Vet Surg 2021; 50:1304-1315. [PMID: 34038003 DOI: 10.1111/vsu.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/09/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Evaluate center of mass (CoM) displacement values during four-limb and three-limb standing with limb suspension in dogs before and after applying sensory stimulation to a forelimb or hindlimb. STUDY DESIGN Experimental study. ANIMALS Six clinically normal beagles. METHODS A four force-plate apparatus was built to assess static weight distribution. Dogs stood on the device with one limb in contact with each force plate. We created a plastic device to induce sensory stimulation so that lameness could not be detected visually when stimulating the paw. Experimenters confirmed the degree of lameness by walking before and after measurement. Body-weight shifts were induced via suspension of each limb and transient sensory stimulation to the right forelimb or left hindlimb. CoMs of five postures were compared, with and without transient sensory stimulation. RESULTS The four-limb CoM was located cranial to the center of the X- and Y-axis coordinates (X: -0.82 ± 9.12, Y: 61.00 ± 5.82). During three-limb standing with suspension of either forelimb, CoM shifted backward toward the contralateral side compared to four-limb standing. During hindlimb suspension, CoM shifted to the contralateral side. With right forelimb sensory stimulation, there were large CoM changes for both four-limb and three-limb standing (X: -34.53 ± 9.09, Y: 52.21 ± 6.88). CoM changes were small with left hindlimb sensory stimulation (X: 6.47 ± 13.86, Y: 69.41 ± 5.55). CONCLUSION CoMs during four-limb and three-limb standing were influenced by sensory stimulation of a forelimb and, to a lesser extent, of a hindlimb. CLINICAL SIGNIFICANCE Static evaluation of CoM may aid clinicians in the diagnosis and recovery of forelimb lameness.
Collapse
Affiliation(s)
- Kousuke Izawa
- Laboratory of Physiology II, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan.,ONE for Animals, Yokohama, Kanagawa, Japan
| | - Koya Fukunaga
- Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
| | - Yuji Hirota
- Laboratory of Basic Education, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| | - Kensuke Orito
- Laboratory of Physiology II, School of Veterinary Medicine, Azabu University, Sagamihara, Kanagawa, Japan
| |
Collapse
|
8
|
Brønniche Møller Nielsen M, Pedersen T, Mouritzen A, Vitger AD, Nielsen LN, Poulsen HH, Miles JE. Kinetic gait analysis in healthy dogs and dogs with osteoarthritis: An evaluation of precision and overlap performance of a pressure-sensitive walkway and the use of symmetry indices. PLoS One 2020; 15:e0243819. [PMID: 33320889 PMCID: PMC7737891 DOI: 10.1371/journal.pone.0243819] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/26/2020] [Indexed: 11/18/2022] Open
Abstract
In veterinary practice, a thorough gait examination is essential in the clinical workup of any orthopedic patient, including the large population of dogs with chronic pain as a result of osteoarthritis. The traditional visual gait examination is, however, a subjective discipline, and systems for kinetic gait analysis may potentially offer an objective alternative for gait assessment by the measurement of ground reaction forces. In order to avoid unnecessary testing of patients, a thorough, stepwise evaluation of the diagnostic performance of each system is recommended before clinical use for diagnostic purposes. The aim of the study was to evaluate the Tekscan pressure-sensitive walkway system by assessing precision (agreement between repetitive measurements in individual dogs) and overlap performance (the ability to distinguish dogs with lameness due to osteoarthritis from clinically healthy dogs). Direction of travel over the walkway was investigated as a possible bias. Symmetry indices are commonly used to assess lameness by comparing ground reaction forces across different combinations of limbs in each dog. However, SIs can be calculated in several different ways and specific recommendations for optimal use of individual indices are currently lacking. Therefore the present study also compared indices in order to recommend a specific index preferable for future studies of canine osteoarthritis. Forty-one clinically healthy dogs and 21 dogs with osteoarthritis were included in the study. High precision was demonstrated. The direction of travel over the walkway was excluded as a possible bias. A significant overlap was observed when comparing ground reaction forces measured in dogs with osteoarthritis compared to clinically healthy dogs. In some affected dogs, symmetry indices comparing contralateral limbs differed from clinically healthy dogs, but in general, the overlap performance was insufficient and, consequently, general use of this method for diagnostic purposes in dogs with osteoarthritis cannot be recommended.
Collapse
Affiliation(s)
| | - Tenna Pedersen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Amalie Mouritzen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Anne Desiré Vitger
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lise Nikolic Nielsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Helle Harding Poulsen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - James Edward Miles
- Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark
| |
Collapse
|