# Improving Mobility: A Case Report on the Rehabilitation of a Gait Anomaly in an Asian Elephant at a Thai Elephant Conservation Center

## TL;DR

A 31-year-old Asian elephant with a chronic left forelimb injury was successfully rehabilitated using a multidisciplinary approach, improving its gait and mobility.

## Contribution

This case report presents a novel multidisciplinary rehabilitation protocol for treating musculoskeletal injuries in large mammals like elephants.

## Key findings

- Limb symmetry improved after ten weeks of rehabilitation, with some fibrotic abnormalities disappearing.
- Biomechanical gait analysis showed significant asymmetry reduction and structural improvements.
- Persistent elbow function discrepancies suggest the need for further targeted rehabilitation.

## Abstract

This case study details the successful rehabilitation of a 31-year-old male Asian elephant (Elephas maximus) with a chronic injury to its left forelimb. The elephant exhibited circumduction gait, moving its left shoulder in a semicircular arc to clear the ground. Diagnostic evaluations revealed chronic inflammation of the medial collateral ligament in the elbow, and gait analysis of the lame limb demonstrated major asymmetries compared to the contralateral limbs. Multidisciplinary professionals developed a comprehensive rehabilitation protocol incorporating peripheral magnetic stimulation and strengthening exercises with therapeutic walking. After ten weeks, limb symmetry improved, and some fibrotic abnormalities disappeared. This case highlights how a multidisciplinary approach can facilitate restoration of normal walking patterns in elephants, offering suggestions and strategies for treating complex musculoskeletal ailments in large mammals.

This case report details the successful rehabilitation of a 31-year-old male Asian elephant (Elephas maximus) presenting with an abnormal left forelimb gait following chronic traumatic injury. The elephant exhibited a distinctive circumduction gait with a semicircular arc movement, characterized by limited flexion at the elbow and carpus, along with compensatory proximal shrugging during the swing phase. Diagnostic evaluations revealed joint space narrowing and ligament fibrosis, while biomechanical gait analysis using inertial measurement units highlighted significant asymmetries between affected and unaffected limbs. An interprofessional team developed a comprehensive rehabilitation protocol that integrated peripheral magnetic stimulation, task-specific therapeutic walking with adjustable obstacles, and progressive strengthening exercises. At the eight-week follow-up, improvements were observed in cross-correlation coefficients of limb movement and imaging assessments, indicating enhanced symmetry and structural improvements with reduced fibrosis. However, persistent discrepancies in elbow functions suggest that further targeted rehabilitation may be warranted. This report underscores the potential of a coordinated interprofessional approach to restore functional gait patterns in elephants and offers valuable insights for future rehabilitative strategies in managing complex musculoskeletal injuries in large mammals.