Physical rehabilitation techniques go a long way toward helping animals regain use of limbs following surgery and speed the
process. While that may be the most obvious, it is not the sole benefit of such therapy.
Dr. Darryl L. Millis, professor of orthopedic surgery and director of surgical services in the Department of Small Animal
Clinical Sciences at the University of Tennessee in Knoxville, discusses other benefits of rehab therapy, latest trends in
the field and even explodes a myth in the following question-and-answer session with DVM Newsmagazine.
Millis' general clinical interest is in small-animal orthopedic surgery and physical rehabilitation. His research interests
include modulation of bone healing, osteoarthritis and post-operative physical therapy of orthopedic patients.
Millis earned his DVM degree from Cornell University and completed a small-animal internship and surgery residency at Michigan
State University. He is a Diplomate of the American College of Veterinary Surgeons.
Based on research he has conducted since 1985, Millis has published more than 120 peer-reviewed articles in numerous journals.
He is co-editor of the book, Canine Rehabilitation and Physical Therapy (2004).
Q. When dealing with physical rehabilitation in small-animal patients, what is the most significant challenge for general
A. The knowledge and (lack of) education. To date, physical rehabilitation is not something that's taught in veterinary schools
to a large extent. In larger veterinary schools and even some smaller programs, students may be exposed to lectures on rehabilitation.
But when you consider what is involved in obtaining a master's in physical rehabilitation, you realize that a lot isn't covered
in the schools.
I've had interest in animal rehabilitation since I was on faculty at Mississippi State back in 1991. I noticed that animals
treated with rehabilitation modalities used at that time recovered better than what I was used to. In the 1950s and 1960s,
if a football player tore his cruciate ligament, you may as well have considered his career nearly over. These days, it's
considered a treatment failure if the person doesn't get back to function after such an injury. The same is true in the animal
Q. You have research interests in modulation of bone healing, osteoarthritis and postoperative physical therapy of orthopedic
patients. Can you speak to some of the important trends in each of these areas?
A. Osteoarthritis is a huge area. The pharmaceutical companies have jumped on that big-time because of the number of dogs with
osteoarthritis. You can even find a significant volume of popular press information on human nonsteroidal therapies as well
as other COX-2 inhibitors. People have increasing concerns about long-term use of NSAIDs, which has opened up a new realm
of treatment for dogs, including physical therapy and extracorporeal shockwave therapy, for example.
The multimodal approach to therapy is new. The current work being done with stem-cell therapy is interesting. It's definitely
on the cusp of gaining popularity.
The challenge is to determine how to combine one therapy with other treatments to make the outcome more impressive. Part of
the problem is lack of funding and evidence-based research to evaluate all of the methods and products entering the market.
But that trend is starting to change.
Q. If you had one longstanding myth to bust about small-animal orthopedic surgery, what might it be?
A. A good one — and I still hear this today — is that I will hear practitioners say, "My patients do so well after surgery that
they don't need rehabilitation."
My question is, will they do as well, or as quickly as they would have, had rehabilitation been used as part of the treatment?
Q. Is the overlap between human and animal physical rehabilitation relevant?
A. Yes, it's very relevant. Obviously there are differences between human and animal therapy. One of the biggest is the realization
that animal therapy is probably more like pediatrics, where the baby can't verbalize what's happening. But much of the basic
scientific work for human rehabilitation was done on dogs. In turn, the model work done on animals has application for those
of us in veterinary medicine, along with contributing to clinical applications with humans.