Underwater Treadmill or Swimming?

In Uncategorized by Denico Brand

As mentioned in the preceding two newsletters hydrotherapy has enormous benefits for health and wellness in our canine (and feline) patients. There seems to be a notion that the underwater treadmill can cure all manner of injuries, gait abnormalities and weaknesses and that the swimming pool has almost taken a back seat in physical rehabilitation. There is also an idea that hydrotherapy must be fun. I agree that a therapy session should be as stress free as possible but the goal is still therapy. The reality is that a treatment modality is only as good as the therapist. The therapist must have sufficient training and clinical reasoning skills to be able to choose an appropriate modality and apply it to reach the therapeutic goals set for the patient. 

After performing a physiotherapeutic examination on a patient, and spending a great deal of time questioning about history, lifestyle, ability and resources a decision is made regarding a program. The following questions may help in making a choice between underwater treadmill (UWT) sessions or swimming.

Does the dog like water? Any previous exposure to swimming at home? Or regular bouts of play in the local pond, river or ocean? If yes, then the pool is in. If no, then the UWT can be used very successfully to introduce the patient to water in a VERY controlled environment. Depth of water, speed at which the dog can move is highly variable and adaptable to the patient. The introduction occurs in a tank, further adding to the control. If the patient has undergone surgery and healing is incomplete then uncontrolled kicking (as occurs with anxiety) is avoided. The surgical site is protected. If an UWT is not available, a skilled therapist can still use a pool for rehab. 

Does the dog or a specific limb require support? With neurological patients a goal may be to assist with re-establishing posture. If this is so, then the ability for the dog to stand supported is important. An UWT may be the correct choice. Or is therapy required for a front leg or hind leg? Swimming is primarily a forequarter exercise. UWT allows for targeting of the hind limbs.

Is there a joint issue? Can the injury or surgical site withstand any pressure? Buoyancy of water helps to reduce weight bearing and thus concussion on affected joints. A pool or UWT may be useful. In the case of bone fractures an UWT is preferable because some weight bearing is required to stimulate new bone formation. 

Is muscle strengthening required? Which muscles? The resistance of the water can assist with initial muscle activation but a patient will soon reach a plateau in the UWT. Progressive loading is required to move the patient to the next level of rehabilitation. An UWT will not be appropriate for this adjusted outcome. But, the patient may need core activation and stabilisation. Swimming is a wonderful modality for this. 

Is the dog old? Or a brachycephalic breed? The cardiovascular load of swimming may be too much for such an individual. Having said that, an older Golden Retriever may benefit from the buoyancy in terms of release of muscular tension. A Pug may benefit from swimming in a float coat. 

Does the problem require increased flexion of a joint or improved extension? Or both? Swimming increases joint range of motion, particularly in flexion. The UWT seems to favour increased extension. 

Does the dog have a compensatory or neurological pattern that needs to be changed? The UWT may further enhance the pattern that is present. Swimming is different to any gait or pattern and so this may be required to allow changes in movement, release of muscular tension, and strengthening in order to achieve the desired result. In fact, the UWT may exacerbate certain patterns if used inappropriately. 

As stated before, hydrotherapy is a hugely beneficial modality but it can create larger problems if used inappropriately. Please consult with a registered therapist. www.saapra.co.za