Martins Ângela, Gouveia Débora, Cardoso Ana, Carvalho Carla, Coelho Tiago, Silva Cátia, Viegas Inês, Gamboa Óscar, Ferreira António
Faculty of Veterinary Medicine, Lusófona University, Campo Grande, 1300-477 Lisboa, Portugal.
Animal Rehabilitation Center, Arrábida Veterinary Hospital, Azeitão, 2925-583 Setúbal, Portugal.
Animals (Basel). 2021 Oct 22;11(11):3034. doi: 10.3390/ani11113034.
This retrospective controlled clinical study aimed to verify if intensive neurorehabilitation (INR) could improve ambulation faster than spontaneous recovery or conventional physiotherapy and provide a possible therapeutic approach in post-surgical paraplegic deep pain perception-positive (DPP) (with absent/decreased flexor reflex) and DPP-negative (DDP) dogs, with acute intervertebral disc extrusion. A large cohort of T10-L3 Spinal Cord Injury (SCI) dogs ( = 367) were divided into a study group (SG) ( = 262) and a control group (CG) ( = 105). The SG was based on prospective clinical cases, and the CG was created by retrospective medical records. All SG dogs performed an INR protocol by the hospitalization regime based on locomotor training, electrical stimulation, and, for DPP, a combination with pharmacological management. All were monitored throughout the process, and measuring the outcome for DPP was performed by OFS and, for the DPP, by the new Functional Neurorehabilitation Scale (FNRS-DPP). In the SG, DPP dogs had an ambulation rate of 99.4% ( = 167) and, in DPP, of 58.5% ( = 55). Moreover, in DPP, there was a strong statistically significant difference between groups regarding ambulation ( < 0.001). The same significant difference was verified in the DPP dogs ( = 0.007). Furthermore, a tendency toward a significant statistical difference ( = 0.058) regarding DPP recovery was demonstrated between groups. Of the 59 dogs that did not recover DPP, 22 dogs achieved spinal reflex locomotion (SRL), 37.2% within a maximum of 3 months. The progressive myelomalacia cases were 14.9% (14/94). Therefore, although it is difficult to assess the contribution of INR for recovery, the results suggested that ambulation success may be improved, mainly regarding time.
这项回顾性对照临床研究旨在验证强化神经康复(INR)是否比自然恢复或传统物理治疗能更快地改善步行能力,并为急性椎间盘突出导致的术后截瘫性深部疼痛感知阳性(DPP)(屈肌反射缺失/减弱)和DPP阴性(DDP)犬提供一种可能的治疗方法。一大群T10 - L3脊髓损伤(SCI)犬(n = 367)被分为研究组(SG)(n = 262)和对照组(CG)(n = 105)。SG基于前瞻性临床病例,CG通过回顾性医疗记录创建。所有SG犬根据住院方案进行INR治疗,包括运动训练、电刺激,对于DPP犬,还结合药物治疗。在整个过程中对所有犬进行监测,对于DPP犬,通过OFS测量结果,对于DDP犬,通过新的功能神经康复量表(FNRS - DPP)测量结果。在SG中,DPP犬的步行成功率为99.4%(n = 167),DDP犬为58.5%(n = 55)。此外,在DPP犬中,两组之间在步行方面存在统计学上的显著差异(P < 0.)。在DDP犬中也验证了相同的显著差异(P = 0.007)。此外,两组之间在DPP恢复方面存在显著统计学差异的趋势(P = 0.058)。在59只未恢复DPP的犬中,22只犬实现了脊髓反射性运动(SRL),其中37.2%在最多3个月内实现。进行性脊髓软化病例为14.9%(14/94)。因此,尽管很难评估INR对恢复的贡献,但结果表明步行成功率可能会提高,主要在时间方面。