# Physiotherapy enhances gait stability in a forelimb-amputated dog undergoing postoperative radiotherapy: a case report

## TL;DR

Physiotherapy helped improve gait stability in a dog that had a forelimb amputation and was undergoing radiotherapy.

## Contribution

This case report provides objective evidence of physiotherapy's benefits for gait function in amputee dogs during radiotherapy.

## Key findings

- Physiotherapy reduced vertical head movement, indicating improved gait stability.
- Shoulder and elbow extension increased during the loading response phase, suggesting better weight-bearing efficiency.

## Abstract

Limb amputation is a standard surgical procedure in dogs for the management of limb tumors such as osteosarcoma, soft tissue sarcoma, and malignant peripheral nerve sheath tumors. While many dogs adapt functionally to limb loss, altered biomechanics, compensatory strain on remaining limbs, and impaired mobility can negatively impact their quality of life. Physiotherapy is recommended to facilitate post-amputation recovery; however, objective data on its effectiveness in dogs remain limited. Furthermore, when radiotherapy is required postoperatively, the necessary daily anaesthesia and cage rest can exacerbate functional decline due to restricted activity. The impact of physiotherapy on gait function in a forelimb-amputee dog undergoing concurrent radiotherapy is described in this report.

A 14-year-old neutered male Toy Manchester Terrier underwent left forelimb amputation following the diagnosis of a malignant peripheral nerve sheath tumor at the C6–T1 spinal level. One month postoperatively, the dog began a three-week course of radiotherapy that required daily anaesthesia and prolonged cage rest, raising concerns about mobility deterioration. To mitigate these effects, a structured physiotherapy program was implemented. The program consisted of daily 30-minute sessions focusing on range of motion exercises, balance and proprioception training, weave pole exercises, and cavaletti rail walking. Gait analysis was performed on the first and last days of the physiotherapy program (pre- and post-physiotherapy) using a two-dimensional kinematic system.

After three weeks of physiotherapy, a reduction in vertical head movement was observed (48.3 cm to 34.5 cm), indicating improved gait stability. Additionally, shoulder and elbow extension showed an increase during the loading response phase, which is crucial for weight-bearing and locomotor efficiency.

This case provides objective evidence supporting the potential benefits of physiotherapy in enhancing gait function and stability in dogs following a forelimb amputation, even when physical activity is restricted due to radiotherapy-related hospitalization. The findings suggest that integrating physiotherapy into post-amputation care may mitigate functional decline associated with prolonged cage rest and optimize recovery. Further studies are needed to investigate the long-term benefits of physiotherapy and effects of physiotherapy on compensatory musculoskeletal adaptations in amputee dogs.