Canine Geriatric Rehabilitation: Considerations and Strategies for Assessment, Functional Scoring, and Follow Up.

Christopher Frye,Margret Lenfest,Brittany Jean Carr,Allison Miller

doi:10.3389/fvets.2022.842458

Christopher Frye, Margret Lenfest + Show 2 more

Open Access

https://doi.org/10.3389/fvets.2022.842458

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Abstract

Geriatric animals account for half of the pet population in the United States with their numbers increasing annually. Furthermore, a significant percentage of veterinary patients with movement limitations could be grossly categorized as geriatric and living within the end stage of their predicted lifespans. Because mobility is correlated to quality of life and time to death in aging dogs, a major goal in optimizing canine geriatric health is to improve functional movement. Within the geriatric population, identifying disabilities that affect daily living and quality of life may be used by the rehabilitation practitioner to provide stronger prognoses, treatment goals, and outcome measures. Examples of such means are described within this review. In human medicine, the concept of “optimal aging”, or “healthy aging”, has emerged in which inevitable detrimental age-related changes can be minimized or avoided at various levels of physical, mental, emotional, and social health. Both environment and genetics may influence aging. Identifying and improving environmental variables we can control remain a key component in optimizing aging. Furthermore, diagnosing and treating age related comorbidities common to older populations allows for improved quality of life and is often directly or indirectly affecting mobility. Obesity, sarcopenia, and a sedentary lifestyle are a trifecta of age-related morbidity common to both people and dogs. Healthy lifestyle choices including good nutrition and targeted exercise play key roles in reducing this morbidity and improving aging. Disablement models act as essential tools for creating more effective physiotherapy plans in an effort to counter dysfunction and disability. Within these models, functional testing represents a standard and validated means of scoring human geriatric function as well as monitoring response to therapy. Because of the great need in dogs, this review aims to provide a reasonable and testable standardized framework for canine functional scoring. We believe a complete assessment of canine geriatric patients should comprise of identifying environmental variables contributing to health status; diagnosing comorbidities related to disease and aging; and characterizing disability with standardized methods. Only through this process can we construct a comprehensive, reasonable, and targeted rehabilitation plan with appropriate follow up aimed at healthy aging.

Highlights

The typical geriatric patient presents to a veterinary rehabilitation service in one of three ways: noted decline in mobility at home; post-surgery physiotherapy; or a decline in mobility noted by another veterinarian
Within this context we have reviewed the pertinent canine and human literature; highlighted several methods to examine canine geriatric task dependent movement; and proposed a reasonable, testable framework for developing a standardized canine geriatric functional score
The study concluded that the perceived exertion scale (PES) exhibited consistent and repeatable use when monitoring healthy dogs exercising on a land treadmill at mild to moderate intensity, but that further validation would be required for patients suffering from orthopedic or neurologic disease [80]

Summary

INTRODUCTION

The typical geriatric patient presents to a veterinary rehabilitation service in one of three ways: noted decline in mobility at home; post-surgery physiotherapy; or a decline in mobility noted by another veterinarian. Three common age-related morbidities described in both human and canine medicine deserve a more in-depth discussion as they influence each other and are commonly present and respond directly to rehabilitation and exercise therapy: sarcopenia, obesity, and sedentary life style. Regardless, combatting obesity with appropriate nutritional and exercise intervention can improve movement function, decrease discomfort, and help retain lean muscle mass in aging dogs [27]. Functional limitations are a product of impairment, which can be a decrease in strength, endurance, mobility, balance, proprioception, flexibility, and/or range of motion Within this context we have reviewed the pertinent canine and human literature; highlighted several methods to examine canine geriatric task dependent movement (within the hospital setting); and proposed a reasonable, testable framework for developing a standardized canine geriatric functional score.

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Objective

CONCLUSIONS