Vetnuus | Desember 2023 20 « BACK TO CONTENTS Electroacupuncture Kapatkin et al. (2006) Randomised, controlled crossover trial Control Electroacupuncture Sham 9 dogs 3 weeks Subjective: owner questionnaire(VAS) Objective: GRF No significant improvement with EAP II Chomsiriwat & Ma (2019) Randomised clinical trial Electroacupuncture Laser acupuncture 31 dogs 8 weeks Subjective: veterinary assessment CMI: CBPI Improved CBPI scores and hip joint ROM with both treatments. EAP led to significantly greater improvements in pain score and QOL assessment than LAP III Gold bead or wire implantation acupuncture HielmBjorkman et al. (2001) Randomised, double blinded, controlled clinical trial Sham acupuncture Gold wire implants at acupuncture points 38 dogs 6 months Subjective: veterinary and owner assessment Radiographs No statistically significant differences between treated and control groups II Jaeger et al. (2006) Randomised, double blinded, controlled, clinical trial Gold bead implantation at acupuncture points Placebo (sham) 78 dogs with hip OA 6 months Subjective: owner questionnaire, veterinary examination Significantly greater improvements in mobility and reduced pain signs in treated group II QLA Health-related quality of life scale for dogs with signs of pain secondary to cancer, HCPI Helsinki Chronic Pain Index, VAS Visual analogue scale, EAP Electro-acupuncture, HD Hip dysplasia, CMI Clinical metrology instrument, CBPI Canine brief pain index, LAP Laser acupuncture, GRF Ground reaction forces, AC Accelerometery, SOS Subjective orthopaedic scoring, CSOM Clientspecific outcome measures, OA Osteoarthritis Environmental modifications Making modifications to the home environment can improve the ability of OA dogs to carry out daily functions, which is likely to improve their everyday QOL. Environmental modifications can include the use of non-slip mats or rugs in the house where a slippery flooring (e.g. laminate flooring) exists, supportive bedding to improve comfort, slings to reduce pressure on limbs, raised food and water bowls to reduce the need for affected dogs to bend down, and ramps for vehicular access (Goldberg 2022). Implementation of these changes is a relatively simple, often cost-effective step that can help to involve owners in their dogs’ care and aid the ease at which dogs can exist within their homes. Despite this, having these discussions with owners may be overlooked by veterinary practitioners (Belshaw et al. 2020). Manual therapies Manual therapies include“hands-on”physiotherapy techniques, such as massage therapy and myofascial release, passive range of movement exercises and stretches (Crook et al. 2007, Hyytiäinen et al. 2013, Riley et al. 2021). Massage therapy for OA is common in the human field; however, the exact mechanism of action of massage as a pain-relieving treatment is unknown. Many potential mechanisms exist, including improved local perfusion (Monteiro Rodrigues et al. 2020), improved lymphatic drainage and increased blood lactate clearance (Bakar et al. 2015), reduced inflammation (Waters-Banker et al. 2014), reduced cortisol levels and lowered stress, anxiety and depression in humans (Field et al. 1996). There is some evidence that massage may improve short-term outcomes in patients with knee OA, although the quality of clinical trials is limited (Wu et al. 2022). In dogs with musculoskeletal pain, an uncontrolled study examining subjective outcomes after massage therapy sampled 527 dogs treated by over 60 practitioners by means of a survey of their current or retrospective cases (Riley et al. 2021). The vast majority (95.5%) of dogs were reported by the practitioners to have responded to treatment, with significant reductions in pain scores and improvements in QOL reported (Riley et al. 2021). Land-based therapeutic exercise Land-based therapeutic exercise regimes aim to improve muscle strength, improve balance and reduce stiffness in OA-affected patients (Bennell et al. 2008). In humans, therapeutic exercise in patients with OA is considered an important part of non-pharmaceutical treatment. A Cochrane systematic review of the literature found that exercise moderately reduced pain, increased QOL and improved physical function in human patients with knee OA (Fransen et al. 2015). In dogs, therapeutic exercise can play a key role in the multi-modal management of OA (Drum et al. 2015, Drum et al. 2021). Current evidence for non-pharmaceutical, non-surgical treatments of canine osteoarthritis <<< 19 Tabel 3 continued Type of acupuncture investigated Author Study type Groups Sample size Study length Outcome measures Conclusions Evidence level (Aragon & Budsberg 2005)
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