KALÇA OSTEOARTRİTLİ KÖPEKLERDE FİZYOTERAPİ- AĞRI, KAS VE TOPALLIK ÜZERİNE ETKİLER: RANDOMİZE KONTROLLÜ BİR ÇALIŞMA

Öz

Amaç: Çalışmamızın amacı kalça osteoartriti (OA) olan köpeklerde fizyoterapi programının etkinliğini incelemekti. Yöntem: Kalça OA'sı olan 20 köpek dört haftalık çalışmaya dahil edildi. Köpekler rastgele olarak fizyoterapi grubu (PTG) ve kontrol grubu (CG) olarak iki gruba ayrıldı. PTG ve CG'deki köpeklerin kalça eklemine hyaluronik asit (HA) enjekte edildi. PTG'deki fizyoterapi programı masaj, elektrofiziksel modaliteler ve egzersizlerden oluşturuldu. Primer değerlendirmeler ağrı yoğunluğu, kas kütlesi ve topallama skorlarıydı. Ağrı değerlendirmesi Basit Ağrı Derecelendirme Skoru (0-4) ile yapıldı. Kas kütlesi uyluk çevresi ölçümleri kullanılarak, topallama ise özel bir skorlama sistemi (0-5) kullanılarak ölçüldü. Sonuçlar: Çalışmanın sonunda, PTG'de ağrı (p=0,006) ve topallık skorları (p=0,005, p=0,006) azalmış ve kas kütlesi artmıştı (p=0,012). Ayrıca, gruplar arası karşılaştırmalar, tüm değişikliklerin CG'ye kıyasla PTG'de istatistiksel olarak daha fazla iyileştiğini göstermiştir (p=0,042, p=0,010, p=0,028, p=0,015). Tartışma: Çalışmamızda kullanılan "HA + fizyoterapi" programının ağrıyı azaltmada ve kas kütlesini artırmada "tek başına HA"ya göre daha etkili olduğunu düşünüyoruz. Bu nedenle, fizyoterapi programlarının OA'lı köpeklerin tedavisinde faydalı ve güvenli olduğunu söyleyebiliriz. Fizyoterapi programları, özellikle hastalığın erken evrelerinden itibaren kas atrofisi ve topallık gelişimini önlemek için kullanılabilir.

Anahtar Kelimeler

• Ağrı
• Hayvanlarda Fizyoterapi
• Kas
• Köpek
• Osteoartrit

PHYSIOTHERAPY IN DOGS WITH HIP OSTEOARTHRITIS – EFFECTS ON PAIN, MUSCLE AND LAMENESS: A RANDOMISED CONTROLLED TRIAL

Abstract

Purpose: The aim of this study was to investigate the effectiveness of a physiotherapy programme in dogs with hip osteoarthritis (OA). Methods: 20 dogs with hip OA were included in the four-weeks study. The dogs were randomly divided into two groups as physiotherapy group (PTG) and control group (CG). Hyaluronic acid (HA) was injected into the hip joint of dogs in PTG and CG. The physiotherapy programme in PTG consisted of massage, electrophysical modalities and exercises. Primer assessments were pain intensity, muscle mass and lameness scores. Pain assessment was performed with Simple Pain Rating Score (0-4). Muscle mass was measured by thigh circumference measurement and lameness was measured by scoring system (0-5). Results: At the end of the study, pain intensity (p=0.006) and lameness scores (p=0.005, p=0.006) were decreased and muscle mass was increased in the PTG (p=0.012). In addition, between group comparisons showed that all changes were statistically improved in the PTG compared to the CG (p=0.042, p=0.010, p=0.028, p=0.015). Conclusion: We think that the "HA + physiotherapy" programme used in our study is more effective than "HA alone" in reducing pain and increasing muscle mass. Therefore, we can say that physiotherapy programmes are beneficial and safe in the treatment of dogs with OA. Physiotherapy programmes can be used to prevent the development of muscle atrophy and lameness, especially from the early stages of the disease.

Keywords

• Animal Physiotherapy
• Dog
• Muscle
• Osteoarthritis
• Pain

Kaynakça

1. Mille MA, McClement J, Lauer S. Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis. Vet. Sci. 2023; 10(1):2.
2. Meeson RL, Todhunter RJ, Blunn G, Nuki G, Pitsillides AA. Spontaneous dog osteoarthritis -a One Medicine vision. Nat Rev Rheumatol. 2019;15(5):273-287.
3. Clark N, Comerford E. An update on mobility assessment of dogs with musculoskeletal disease. J Small Anim Pract. 2023;10.1111/jsap.13650.
4. Moore SA. Managing Neuropathic Pain in Dogs. Front Vet Sci. 2016;3:12. Published 2016 Feb 22.
5. Mathews K, Kronen PW, Lascelles D, et al. Guidelines for recognition, assessment and treatment of pain: WSAVA Global Pain Council members and co-authors of this document:. J Small Anim Pract. 2014;55(6):E10-E68.
6. Hielm-Björkman AK, Kapatkin AS, Rita HJ. Reliability and validity of a visual analogue scale used by owners to measure chronic pain attributable to osteoarthritis in their dogs. Am J Vet Res. 2011;72(5):601-607.
7. Quinn MM, Keuler NS, Lu Y, Faria ML, Muir P, Markel MD. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg. 2007;36(4):360-367.
8. Loureiro A, Constantinou M, Diamond LE, Beck B, Barrett R. Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits. BMC Musculoskelet Disord. 2018;19(1):303.

9. Bieler T, Magnusson SP, Christensen HE, Kjaer M, Beyer N. Muscle power is an important measure to detect deficits in muscle function in hip osteoarthritis: a cross-sectional study. Disabil Rehabil. 2017;39(14):1414-1421.
10. Buckner SL, Jessee MB, Dankel SJ, Mattocks KT, Abe T, Loenneke JP. Resistance exercise and sports performance: The minority report. Med Hypotheses. 2018;113:1-5.
11. Gupta RC, Lall R, Srivastava A, Sinha A. Hyaluronic Acid: Molecular Mechanisms and Therapeutic Trajectory. Front Vet Sci. 2019;6:192. Published 2019 Jun 25.
12. Turhan AU, Açıl S, Gül O, Öner K, Okutan AE, Ayas MS. Treatment of knee osteochondritis dissecans with autologous tendon transplantation: Clinical and radiological results. World J Orthop. 2021;12(11):867-876.
13. Millis DL and Levine D, 2014. Assessing and Measuring Outcomes. In Canine Rehabilitation And Physical Therapy, 2nd Ed, Elsevier, pp:220-242.
14. Carapeba GO, Cavaleti P, Nicácio GM, Brinholi RB, Giuffrida R, Cassu RN. Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia. Evid Based Complement Alternat Med. 2016;2016:2076921.
15. Lee MI, Kim JH, Kwak HH, et al. A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis. J Orthop Surg Res. 2019;14(1):314.
16. Verrico CD, Wesson S, Konduri V, et al. A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain. Pain. 2020;161(9):2191-2202.
17. Taglietti M, Facci LM, Trelha CS, et al. Effectiveness of aquatic exercises compared to patient-education on health status in individuals with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2018;32(6):766-776.
18. Dycus DL, Levine D, Marcellin-Little DJ. Physical Rehabilitation for the Management of Canine Hip Dysplasia. Vet Clin North Am Small Anim Pract. 2017;47(4):823-850.
19. Lesnak JB, Sluka KA. Mechanism of exercise-induced analgesia: what we can learn from physically active animals. Pain Rep. 2020;5(5):e850.
20. Vaz MA, Baroni BM, Geremia JM, et al. Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013;31(4):511-516.
21. Melo Mde O, Pompeo KD, Brodt GA, Baroni BM, da Silva Junior DP, Vaz MA. Effects of neuromuscular electrical stimulation and low-level laser therapy on the muscle architecture and functional capacity in elderly patients with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2015;29(6):570-580.
22. Mölsä SH, Hyytiäinen HK, Hielm-Björkman AK, Laitinen-Vapaavuori OM. Long-term functional outcome after surgical repair of cranial cruciate ligament disease in dogs. BMC Vet Res. 2014;10:266.
23. Brown DC, Boston RC, Farrar JT. Comparison of force plate gait analysis and owner assessment of pain using the Canine Brief Pain Inventory in dogs with osteoarthritis. J Vet Intern Med. 2013;27(1):22-30.
24. Obeidat AM, Wood MJ, Adamczyk NS, et al. Piezo2 expressing nociceptors mediate mechanical sensitization in experimental osteoarthritis. Nat Commun. 2023;14(1):2479.
25. Drygas KA, McClure SR, Goring RL, Pozzi A, Robertson SA, Wang C. Effect of cold compression therapy on postoperative pain, swelling, range of motion, and lameness after tibial plateau leveling osteotomy in dogs. J Am Vet Med Assoc. 2011;238(10):1284-1291.
26. Pellegrino FJ, Risso A, Relling AE, Corrada Y. Physical response of dogs supplemented with fish oil during a treadmill training programme. J Anim Physiol Anim Nutr (Berl). 2019;103(2):653-660.
27. Kim AY, Elam LH, Lambrechts NE, Salman MD, Duerr FM. Appendicular skeletal muscle mass assessment in dogs: a scoping literature review. BMC Vet Res. 2022;18(1):280.
28. Millis D, Janas K. Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis. Vet Clin North Am Small Anim Pract. 2021;51(2):235-251.
29. Tomlinson J, Nelson M. Conditioning Dogs for an Active Lifestyle. Vet Clin North Am Small Anim Pract. 2022;52(4):1043-1058.
30. Monk ML, Preston CA, McGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. Am J Vet Res. 2006;67(3):529-536.
31. Fischer S, Nolte I, Schilling N. Adaptations in muscle activity to induced, short-term hindlimb lameness in trotting dogs. PLoS One. 2013;8(11):e80987.