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Pointing light at musculoskeletal and neurological conditions: clinical applications 121

the efficacy of different drugs, supplements, and diets. is not going to make osteophytes disappear, other fac-
The phenomenon is more frequent among cat owners tors can improve partially or totally with LT, alone or
than dog owners. And unfortunately, when some- in combination with other therapies, depending on the
body experiences the placebo effect in his own body, case.
he is really feeling less pain, but when he experiences Goniometry measures change in the passive ROM
a placebo relating to the pet’s condition, the animal is of limb joints. It is one way of objectifying the evo-
not getting any relief. So keep examining the patient, do lution of these patients; it is non-invasive and avail-
not just rely on the owner’s assessment – although you able for everyone with a simple goniometer, and
could be experiencing the same effect, beware of your useful both when different clinicians follow the case
own potential placebo! A worsening of the condition or when we check the patient over time ourselves.
after treatment withdrawal (or when laser sessions are We can monitor the angle the joint achieves and
spaced further apart too soon) is also a good indicator the angle at which pain or discomfort appears. Such
of its effects. angles, depending on the joint and its physiological
movements, can refer to flexion/extension, abduction/
9.6.2 Goniometry adduction, or internal/external rotation, and comprise
both the neutral and the elastic zones, since both are
Range of motion (ROM) is the entire physiological within physiological limits. It is necessary to have
range through which a joint can move, measured from standardized bony landmarks with which to align the
a neutral or zero position. A decrease in ROM can be arms of the goniometer, then once your arms (fixed
due to multiple factors, including pain, joint capsule and mobile) are aligned, the fulcrum of the device is
and muscle fibrosis, tendon shortening, neurological placed (Fig. 9.8).
disorders, trigger points, and osteophytes. While LT Of course, in veterinary medicine we have to consider

Figure 9.8 Goniometry of the stifle in a canine patient.

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