Balance training for dogs

Introduction

Maintaining balance during normal movement and unexpected disruptions in movement is vital for an animal, and relies on what is known as postural stability (PS), which is governed by the visual, somatosensory, and vestibular systems in the central nervous system. These systems coordinate posture-stabilizing muscles, allowing a swift response to any balance disturbance. Balance exercises are an integral part of a rehabilitation program for neurological and orthopedic conditions in veterinary medicine, and aim to improve muscle function and promote postural stability. Additionally, a training program incorporating proprioceptive challenges is to be recommended proactively, both for sporting dogs to prevent injuries 1,2,3 and for older animals to maintain a good quality of life 4. This paper will briefly review the concept of postural stability before describing exercises that can help improve and maintain a dog’s balance.

Understanding postural stability and balance maintenance

The center of pressure (COP) is a fundamental concept in the study of movement and balance. It basically represents the body’s center of mass, which will vary within the base of support (the area beneath a body that includes every point of contact that the body makes with the supporting surface) as an animal moves. The COP will dictate the muscle movements necessary for an animal to maintain stability 5, whilst the area beneath the animal used to maintain its balance, the functional base of support 5,6, depends on an individual’s standing width. If the COP exceeds the functional base of support, a dog must take compensatory steps in order to prevent a fall 7.

In human medical research, a single-leg stance leads to what is known as increased COP excursion, whilst (not surprisingly) a wider-based stance results in better balance performance 8,9. In dogs, a three-legged standing test can be used to assess balance clinically 10, and a proposed balance score for small animals has been developed, including tasks such as sitting, different standing positions, turning, and stair climbing 11. Studies using blindfolding and a motorized balance platform have addressed the challenge of objectively assessing PS in animals 12, and posturographic measurements in dogs during different settings on a training device show increased COP parameters compared to standard standing measurements 13; very challenging settings using the platform resulted in dogs taking protective steps because their COP exceeded the functional base of support. While a dog will exhibit a wider COP excursion in the craniocaudal compared to the mediolateral direction during standard standing measurements, under challenging conditions on the platform it will sway equally in craniocaudal and mediolateral directions 13.

Postural control deficits

Increased postural instability, often seen in aging or musculoskeletal diseases, affects joint stability and muscle function 14, with changes in muscle spindles and neural pathways over time leading to reduced proprioceptive signals, impairing stability 15. Dogs with cranial cruciate ligament rupture (CCLR) perform poorly on balance tests and show postural stability deficits when compared to healthy controls 16,17, and similar deficits are evident in dogs with stifle osteoarthritis secondary to CCLR, elbow osteoarthritis, sarcopenia and aging 18,19; interestingly, elbow osteoarthritis has a greater impact on stability than stifle osteoarthritis 18. Understanding and addressing postural issues in dogs with musculoskeletal conditions and older animals is therefore crucial, as this can extend both a dog’s life expectancy and healthy lifespan 20.

Postural stability training programs

Training programs have shown promise in canine PS improvement, mirroring human medical research 20 – for example, one survey linked weekly balance and strength training to a reduced risk of CCLR in agility dogs 3, and a 12-week home exercise plan improved hindlimb weight distribution, balance, and stifle function in dogs with CCLR or medial patellar luxation compared to standard rehabilitation methods 21. Despite its assumed importance in preventing and treating musculoskeletal and neurological issues in veterinary medicine, PS training is often overlooked; a survey found only 42.7% of active working dog owners implement preventive measures, and only 2% use balance training 22.

The literature outlines various balance exercises, but it is crucial to tailor these to the specific needs of a patient. Discussed below are common exercise options, categorized by difficulty level (beginner, intermediate, and advanced). The “beginner” level is for dogs with orthopedic or neurological issues, “intermediate” is for well-trained dogs with these medical conditions or generally healthy animals, and “advanced” is for canine athletes, but exercise suitability also depends on the dog’s condition and disease stage 2.

Beginner training

The exercises described are suitable for dogs of different skill levels, including beginners and those with specific health conditions. They can be tailored to individual capabilities, with a focus on gradually increasing difficulty while ensuring the safety and well-being of the animal. Handlers can provide support as needed using a sling, offering either maximal (75-100% bodyweight) or partial (< 75% bodyweight) support 2.

Walking over or standing on surfaces with different textures

The somatosensory system is crucial for proprioceptive sensation. Particularly in patients experiencing neurological loss of somatosensory sensation, different surfaces play a pivotal role in reestablishing sensibility, so animals are encouraged to walk or stand on surfaces with a variety of textures.

Standing weight-shifting exercises

Weight shifting exercises are commonly used to improve proprioception and muscle tone, particularly in neurological or poorly muscled patients, but while these exercises generally improve postural stability and activate muscles, a well-muscled dog without neurological deficits may not benefit from such minor challenges. The handler should apply pressure near the hip (Figure 1) or shoulder joints alternately to challenge the PS, especially in the mediolateral direction 2. As dogs show greater instability in this plane, careful application of pressure during lateral challenges is necessary. Compensatory stepping indicates excessive pressure, and should prompt adjustments in load or assistance. Another technique involves encouraging weight shifts through head movements using treats, again with an emphasis of avoiding compensatory steps.

Even at a beginner level, dogs can benefit from incorporating training equipment into their fitness plan. Both bi- and multidirectional balance boards are utilized in canine rehabilitation (Figures 2 and 3), although the latter may induce more uncontrollable movements, intensifying the challenge and potentially causing distress 2, and so for beginners a craniocaudal bidirectional board is recommended. It is advisable to perform exercises with assistance, especially in the mediolateral direction, to ensure safety. While wobble cushions (Figure 4) might be too challenging for some dogs initially, they offer a cost-effective alternative to expensive equipment and are easier to handle, particularly compared to multidirectional balance boards. For a more controlled training environment, motorized training platforms can be employed (Figure 5) 13.

Dynamic canine balance training

Commands such as giving a paw, sitting and lying down are effective during balance training, tailored to the patient’s abilities. The three-legged stance is a key test for assessing the postural system 10; typically, the limb diagonally opposite to the affected one should be lifted first, then the ipsilateral limb raised, followed by the contralateral one 2. For simpler exercises like sit-to-stand, modifications may be needed for orthopedically or neurologically impaired animals; this can include using a sling or by providing support for the pelvis. Such modifications can help older dogs to regain muscle strength and independence in daily activities.

Intermediate training

The above-mentioned exercises are suitable for the intermediate difficulty level with slight adjustment, but again the dog’s orthopedic and neurological health must be stable enough to handle these demands.

Standing weight shifting exercises

Standing weight shifting exercises involve using both bi- and multidirectional wobble boards to challenge the animal’s balance. The wobble board is moved in various directions during the session, but there should be continuous support to prevent falls. Initially, exercises should be brief with only a few repetitions.

Dynamic balance training

In addition to introducing further challenges to the previous methods, the following exercises are recommended. Many exercises like weight shifting, sit-to-stand, and down-to-stand can be done on unstable surfaces like wobble cushions to increase the challenge; note that a softer pillow increases the difficulty. Wheelbarrowing (Figure 6) involves lifting the hindlimbs, which promotes increased use of the forelimbs and challenges posture, coordination, and strength. Dancing (Figure 7) elevates the front limbs to target the hindlimbs, and whilst it can be performed moving both forwards and backwards, forward dancing is generally more challenging and suitable for patients with advanced fitness levels 2. Walking over obstacles is another common physiotherapy exercise for dogs; cavaletti rails (Figure 8) will challenge PS. In healthy dogs, hindlimb COP movement slows during obstacle crossing, promoting controlled limb movement, proprioception and balance, but this exercise does not significantly change limb support in healthy dogs 23. Initially, the poles should be placed on the ground for a gentle introduction, with poles set apart by at least the dog’s length; the height can be increased gradually by 1-2 cm per session, but should not exceed the level of the dog’s carpal joint. Slalom walking (Figure 9) involves navigating a course marked by poles or cones; this engages various muscle groups, promoting strength and flexibility, and enhances agility, coordination, and proprioception.

Advanced training

Combined exercises

The intermediate exercises mentioned above can be made more challenging by incorporating unstable surfaces. Combining various surfaces with wobble cushions and cavaletti poles, or placing wobble cushions on balance boards adds an additional challenge for PS (Figure 10). As previously mentioned, dancing can benefit dogs with intermediate to advanced fitness levels. Forward dancing is suitable for even advanced patients. Similarly, backward walking poses a challenge for dogs, and (backed by human rehabilitation research 23) shows positive effects on PS, and should be considered an excellent exercise for advanced patients. It enhances limb loading on the hindlimbs, proprioception, and limb coordination, although dogs should not be asked to take more than 2-3 steps backwards initially.

Crouching movements

Limbo exercise (Figure 11) involves training dogs to navigate under a horizontal bar, and can be used as an introduction to crouched movement, which not only promotes physical flexibility but also enhances the dog’s body awareness and coordination. The bar should initially be set slightly lower than the height of the dog, and during this exercise all limbs should be used symmetrically; lateral pushing or slipping should be avoided. Tunnels are another option, and have the advantage that the animal must crawl for a longer period.

Peanut balls

Incorporating an elongated “peanut ball” (Figure 12) into balance training introduces an additional element of challenge and engagement. The ball provides an unstable surface, requiring the dog to engage various muscle groups to maintain balance, and can be used for standing, sit-to-stand, and down-to-stand exercises, adding another dimension to dynamic canine balance training. As always, the emphasis should always be on creating a positive and safe experience, promoting gradual progression to advanced exercises to ensure the well-being of the dog throughout the training process 2.

Conclusion

Balance exercises are a crucial part of veterinary medicine, aiding in the rehabilitation of neurological and orthopedic conditions by enhancing muscle function and postural stability. Proprioceptive training is also recommended both for sporting dogs in order to prevent injuries and for older animals to maintain a good quality of life. Understanding postural stability mechanisms and the deficits associated with aging and musculoskeletal disorders, and implementing tailored training programs, are essential steps in improving canine balance and overall well-being. By incorporating various exercises at different difficulty levels and gradually progressing towards advanced challenges, veterinarians and pet owners can ensure a positive and safe training experience, ultimately benefiting the dog‘s health and longevity.