traditionally , physiotherapy has been applied to human clients in a hospital , community , industrial or private setting . however , a variety of physiotherapy techniques have been applied to animal patients including techniques of mobilisation / manipulation in the management of back and neck problems , heat and cold therapy , hydrotherapy , ultrasound and low level laser therapy , and exercise . a variety of conditions are seen by animal physiotherapists including : back and neck problems , muscular disorders , wounds , sprains / strains , and post - fracture rehabilitation . there are published reports on the application of physiotherapy , with modifications , in animal patients . sharifi and sharma   reported earlier functional recovery in calves with tibial transfixation in reponse to exercise and massage . white and white   described the physiotherapy management of a purebred canadian holstein female calf , who suffered from complete lack of tone in the muscles of both hind limbs , following assisted delivery . the treatment involved a regime of massage ( stretching and passive movements lasting 20 minutes were applied to each leg and repeated every eight hours ) and aimed to overcome contracture of the extensor muscles of the hind limbs . the calf wore an adjustable splint and , after 10 days , the calf was able to stand . at 19 months taylor   described the treatment of trunk fibrositis in four elephants using short - wave diathermy ; after a month of diathermy , the animals were able to feed themselves . several authors reported the benefits of therapeutic ultrasound in the treatment of musculoskeletal problems in horses , dogs and cats . the application of alternative therapy , including acupuncture has been described . however , despite encouraging findings , some of the studies were limited by small sample sizes , lack of standardisation of treatments , subjective measures of outcome and the lack of control groups . mcnamara and mackintosh   surveyed veterinary surgeons in the uk and found that only 37% were aware of the existence of animal physiotherapists . previous work in an irish setting explored perceptions of animal physiotherapy among irish undergraduate veterinary students . the aim of this study was to investigate veterinary surgeons ' perceptions , knowledge and use of animal physiotherapy in the republic of ireland . a questionnaire was distributed to a random sample of 200 members on the veterinary register of ireland , in october 2003 , to ascertain their awareness and knowledge of animal physiotherapy . the total number of veterinary surgeons on the veterinary register of ireland was 2,282 in 2003 . the research instrument was developed following consultation with veterinary surgeons , and a review of relevant literature , to ensure face and content validity . the questionnaire had three sections comprising of open - ended and closed - ended questions . the first section provided a demographic profile of the respondents , practice details and experience of referring animals to an animal physiotherapist . for the statistical analyses we assigned the respondents to two groups : veterinarians who qualified in the 1970s or earlier ; and those who graduated in the 1980s or later . the second section explored the veterinary surgeons ' awareness of the role of physiotherapy in the treatment of various physiotherapeutic techniques . the third section contained 11 statements , which examined veterinary surgeons ' perceptions and attitudes towards animal physiotherapy . the respondents were asked to grade their responses using a likert scale ranging from ' strongly agree ' to ' strongly disagree ' . each questionnaire was accompanied by a cover letter , which explained the purpose of the study including details of how to return the completed questionnaire . the study was approved by the research ethics committee of the royal college of surgeons in ireland . in addition , the veterinary council of ireland gave permission to use the veterinary register of ireland . the data were analysed using descriptive and inferential statistics using an spss package . where appropriate , chi - squared analysis , pooled t test and a mann whitney - u test were used to analyse data further . of the 200 questionnaires distributed , 97 ( 49% ) were returned : 30 by veterinary surgeons in mixed practices ; 21 by veterinarians in large animal practices , 18 from equine practices , 17 by those in small animal practices and 11 from education research and other areas of practice . the respondents had graduated from a variety of veterinary colleges ; 77 from university college dublin , nine from trinity college dublin and the remaining 11 from the royal veterinary college london , berlin , queensland , edinburgh and glasgow . only eight of the respondents had graduated since 2000 , 29 had qualified in the 1990s , 22 in the 1980s , 24 in the 1970s , 10 in the 1960s . only four had been qualified for over 50 years the majority ( n = 77 : 79% ) were aware of animal physiotherapists , while 35 ( 45% ) respondents were aware of the term ' chartered ' animal physiotherapist . of those who were aware of animal physiotherapy ( n = 77 ) , the sources of information ( more than one allowed ) were veterinary colleagues ( n = 21 : 27% ) , animal owners ( n = 20 : 26% ) , professional journals ( n = 18 : 23% ) and physiotherapists ( n = 13 : 17% ) . only four respondents ( 5% ) cited lectures at college , while eight ( 10% ) reported television and the internet as sources . only 20 ( 26% ) of the veterinary surgeons who were aware of animal physiotherapists had referred a case to an animal physiotherapist . of those 20 , 12 indicated that they referred to a chartered physiotherapist who was a member of the irish society of chartered physiotherapists , two referred to unregistered physiotherapists , while six were unsure whether or not the physiotherapist was registered . thirteen of the veterinary surgeons who had referred an animal were satisfied with the treatment , four were very satisfied , three were unimpressed but not negative ; none were dissatisfied . those working in equine practice were more aware of animal physiotherapy ( = 5.7 , df 1 , p = 0.017 ) and more likely to refer to an animal physiotherapist ( = 48.36 , df 1 , p = 0.0001 ) . there was no significant association between the year of qualification and level of awareness of animal physiotherapy ( = 0.3587 , df 1 , p = 0.5492 ) . when asked to nominate the most appropriate species to receive physiotherapy , 73 of the respondents opted for the horse , 69 for the dog , 24 for the cat and 13 for the cow competitive animals ( greyhounds , race horses , show jumpers ) were considered most likely to receive treatment ( 59 respondents ) . there appeared to be greatest awareness of physiotherapy related to back ( 68 respondents : 88% ) and neck ( 62:80% ) problems followed by ligament damage ( 61:79% ) , joint restriction ( 59 : 77% ) , tendon damage ( 58:75% ) and post - fracture rehabilitation ( 57:74% ) ( figure 1 ) . fewer veterinary surgeons were aware of physiotherapists ' involvement with respiratory conditions ( nine : 12% ) , haematoma ( 11 : 14% ) and skin problems ( three : 4% ) . the veterinary surgeons were asked to indicate their level of knowledge of a variety of therapeutic techniques ( table 1 ) . techniques such as massage , ice therapy and hydrotherapy were well known , while respondents had a reasonable knowledge of manipulation / mobilisation . electrotherapy treatments such as ultraviolet , shortwave diathermy and interferential were not known , while 62% had never heard of taping . veterinary surgeons ' awareness of use of physiotherapy for particular conditions ( n = 77 ) . self - assessment of knowledge of physiotherapeutic techniques by 77 veterinary respondents a knowledge score was generated by ranking the response from zero to four for each of the 19 techniques ( i.e. , 0 = never heard of , 4 = know a lot ; maximum score = 76 ) . a pooled t test was performed to compare the mean knowledge between the referring veterinarians ( n = 20 ; mean score 34.0 , sd 10.7 ) and non - referring veterinary surgeons ( n = 57 ; mean score 25.9 , sd 10.7 ) . a significant difference was found ( t = -2.806 , df 75 , p = 0.006 ) . a mann whitney u test also indicated that referring veterinary surgeons had the greater knowledge of physiotherapy techniques ( z = -2.54 , p = 0.011 ) . the responses of the subset of veterinary surgeons aware of animal physiotherapy ( 77 : 79% ) , were explored in relation to 11 statements which referred to professional issues pertaining to animal physiotherapy ( table 2 ) . analysis indicated that 64 respondents ( 83% ) believed that the appropriate career path was through qualification as a chartered physiotherapist , followed by post - graduate qualification as an animal physiotherapist , and 71 ( 92% ) agreed that a register of chartered animal physiotherapists should be set up in the republic of ireland . responses of veterinary surgeons ( n = 77 ) to 11 statements relating to animal physiotherapy apt = animal physiotherapist / physiotherapy vs = veterinary surgeons a majority ( 74 : 96% ) stated that more research needs to be published on the effect of animal physiotherapy and 69 ( 90% ) were interested in learning more about animal physiotherapy . while 70 ( 91% ) respondents indicated they would be willing to allow animal physiotherapists to choose their own treatments , under veterinary control , only 33 ( 43% ) believed that animal physiotherapists possess the ability to assess and evaluate musculoskeletal and neurological disorders . less than half ( 35 : 43% ) of the veterinary surgeons felt that animal physiotherapy was often used as a last resort and 53 respondents ( 63% ) believed the cost of animal physiotherapy did not deter animals owners from seeking treatment . mann - whitney u tests were used to explore the differences in opinions between referring and non - referring veterinary surgeons for each statement . there were no significant differences between the groups ( p > 0.05 ) . the opinions of the respondents were independent of whether or not they had referred to an animal physiotherapist . in the final comments generally , respondents felt that veterinary surgeons and the public should be given more information explaining the role of animal physiotherapy and its efficacy . many were concerned that there was a large number of unqualified ' quacks ' calling themselves animal physiotherapists treating animals . several respondents indicated that they were very interested in referring to an animal physiotherapist but unable to locate one . the majority ( n = 77 : 79% ) were aware of animal physiotherapists , while 35 ( 45% ) respondents were aware of the term ' chartered ' animal physiotherapist . of those who were aware of animal physiotherapy ( n = 77 ) , the sources of information ( more than one allowed ) were veterinary colleagues ( n = 21 : 27% ) , animal owners ( n = 20 : 26% ) , professional journals ( n = 18 : 23% ) and physiotherapists ( n = 13 : 17% ) . only four respondents ( 5% ) cited lectures at college , while eight ( 10% ) reported television and the internet as sources . only 20 ( 26% ) of the veterinary surgeons who were aware of animal physiotherapists had referred a case to an animal physiotherapist . of those 20 , 12 indicated that they referred to a chartered physiotherapist who was a member of the irish society of chartered physiotherapists , two referred to unregistered physiotherapists , while six were unsure whether or not the physiotherapist was registered . thirteen of the veterinary surgeons who had referred an animal were satisfied with the treatment , four were very satisfied , three were unimpressed but not negative ; none were dissatisfied . those working in equine practice were more aware of animal physiotherapy ( = 5.7 , df 1 , p = 0.017 ) and more likely to refer to an animal physiotherapist ( = 48.36 , df 1 , p = 0.0001 ) . there was no significant association between the year of qualification and level of awareness of animal physiotherapy ( = 0.3587 , df 1 , p = 0.5492 ) . when asked to nominate the most appropriate species to receive physiotherapy , 73 of the respondents opted for the horse , 69 for the dog , 24 for the cat and 13 for the cow ; only nine respondents chose goats and exotic animals . competitive animals ( greyhounds , race horses , show jumpers ) were considered most likely to receive treatment ( 59 respondents ) . there appeared to be greatest awareness of physiotherapy related to back ( 68 respondents : 88% ) and neck ( 62:80% ) problems followed by ligament damage ( 61:79% ) , joint restriction ( 59 : 77% ) , tendon damage ( 58:75% ) and post - fracture rehabilitation ( 57:74% ) ( figure 1 ) . fewer veterinary surgeons were aware of physiotherapists ' involvement with respiratory conditions ( nine : 12% ) , haematoma ( 11 : 14% ) and skin problems ( three : 4% ) . the veterinary surgeons were asked to indicate their level of knowledge of a variety of therapeutic techniques ( table 1 ) . techniques such as massage , ice therapy and hydrotherapy were well known , while respondents had a reasonable knowledge of manipulation / mobilisation . electrotherapy treatments such as ultraviolet , shortwave diathermy and interferential were not known , while 62% had never heard of taping . veterinary surgeons ' awareness of use of physiotherapy for particular conditions ( n = 77 ) . self - assessment of knowledge of physiotherapeutic techniques by 77 veterinary respondents a knowledge score was generated by ranking the response from zero to four for each of the 19 techniques ( i.e. , 0 = never heard of , 4 = know a lot ; maximum score = 76 ) . a pooled t test was performed to compare the mean knowledge between the referring veterinarians ( n = 20 ; mean score 34.0 , sd 10.7 ) and non - referring veterinary surgeons ( n = 57 ; mean score 25.9 , sd 10.7 ) . a significant difference was found ( t = -2.806 , df 75 , p = 0.006 ) . a mann whitney u test also indicated that referring veterinary surgeons had the greater knowledge of physiotherapy techniques ( z = -2.54 , p = 0.011 ) . the responses of the subset of veterinary surgeons aware of animal physiotherapy ( 77 : 79% ) , were explored in relation to 11 statements which referred to professional issues pertaining to animal physiotherapy ( table 2 ) . analysis indicated that 64 respondents ( 83% ) believed that the appropriate career path was through qualification as a chartered physiotherapist , followed by post - graduate qualification as an animal physiotherapist , and 71 ( 92% ) agreed that a register of chartered animal physiotherapists should be set up in the republic of ireland . responses of veterinary surgeons ( n = 77 ) to 11 statements relating to animal physiotherapy apt = animal physiotherapist / physiotherapy vs = veterinary surgeons a majority ( 74 : 96% ) stated that more research needs to be published on the effect of animal physiotherapy and 69 ( 90% ) were interested in learning more about animal physiotherapy . while 70 ( 91% ) respondents indicated they would be willing to allow animal physiotherapists to choose their own treatments , under veterinary control , only 33 ( 43% ) believed that animal physiotherapists possess the ability to assess and evaluate musculoskeletal and neurological disorders . less than half ( 35 : 43% ) of the veterinary surgeons felt that animal physiotherapy was often used as a last resort and 53 respondents ( 63% ) believed the cost of animal physiotherapy did not deter animals owners from seeking treatment . mann - whitney u tests were used to explore the differences in opinions between referring and non - referring veterinary surgeons for each statement . there were no significant differences between the groups ( p > 0.05 ) . the opinions of the respondents were independent of whether or not they had referred to an animal physiotherapist . in the final comments generally , respondents felt that veterinary surgeons and the public should be given more information explaining the role of animal physiotherapy and its efficacy . many were concerned that there was a large number of unqualified ' quacks ' calling themselves animal physiotherapists treating animals . several respondents indicated that they were very interested in referring to an animal physiotherapist but unable to locate one . mcnamara and mackintosh   reported that only 37% of uk veterinary surgeons were aware of the existence of animal physiotherapists . however , six years later , shipley   reported that 98% of veterinary practitioners in england and wales were aware of them . previous irish work among fourth and fifth year undergraduate veterinary students at university college dublin reported a level of awareness of 85% . veterinary colleagues , animal owners , professional journals and physiotherapists were the main sources of information about animal physiotherapy . many of these , such as back and neck injury or soft tissue and joint problems , are conditions for which physiotherapy has been publicised in human clients and it may be that their knowledge of human physiotherapy was extrapolated to the area of animal physiotherapy . wounds and skin problems were considered least likely to benefit from physiotherapy , although knowles and mackintosh   found that animal physiotherapists frequently treated wounds and skin problems . the results highlighted the need for more information on the less familiar conditions that may benefit from physiotherapy . consistent with the findings of knowles and mackintosh , respondents were aware of physiotherapy techniques such as massage , hydrotherapy , ice therapy , manipulation / mobilisation and ultrasound . there has been much published literature relating to these techniques and their application in animals . the positive opinions of veterinary surgeons towards many aspects of animal physiotherapy were independent of whether or not they had ever referred to an animal physiotherapist . perhaps this understanding of the role of the animal physiotherapist was involved in their decision to refer , or they may have learned more about physiotherapy through the referral process . the majority of respondents agreed that the appropriate career path for an animal physiotherapist was through qualification as a chartered physiotherapist . postgraduate courses and masters degrees in animal physiotherapy are available in the university of london and the university of queensland . several respondents indicated that they had not referred as they did not know an animal physiotherapist in the area or they did not know how to find one . greater communication and dissemination of information is essential if veterinary surgeons are to be informed of the role and availability of the animal physiotherapist . in this study , 71 ( 92% ) respondents called for the setting up of a register of animal physiotherapists , as exists in the uk . clearly , animal physiotherapists also need to promote their own practices with veterinary colleagues in the locality . currently , in ireland and the uk , the law decrees that an animal physiotherapist may only treat an animal if it has been referred by a veterinary surgeon . the association of physiotherapists in animal therapy   is a clinical interest group of the chartered society of physiotherapy and was founded in 1985 following concerns raised by uk veterinary surgeons regarding the number of unqualified animal physiotherapists , and has 178 members . category b members are not necessarily physiotherapists and must be supervised by a category a member or a veterinary surgeon . the majority of respondents ( n = 74 : 96% ) called for more research on the effect of animal physiotherapy . if animal physiotherapy is to develop , ongoing research is essential to increase the evidence base for efficacy of treatment . the publication of research in veterinary and physiotherapy journals could enhance awareness of animal physiotherapy and create a forum for discussion benefiting veterinary medicine and animal physiotherapy . many respondents ( 55% ) felt that cost did not deter owners from seeking treatment . the reduction in recovery time and return to full fitness is vital to protect a valuable asset . this economic aspect has not been examined in any depth in previous surveys of veterinary surgeons . interestingly , a majority of the veterinary surgeons ( n = 73 ; 93% ) supported the concept of veterinary surgeons and animal physiotherapists working out of the same practice . veterinary surgeons and animal physiotherapists could explore the economic and practical aspects of this arrangement in the future . close liaison between veterinary surgeons and physiotherapists may avoid unnecessary referrals and promote referrals where the costs of animal physiotherapy are clearly justified . the response rate was somewhat low with only 49% of questionnaires returned and the possibility of a non - response bias exists . stratification of the sample for geographical region and type of veterinary practice did not occur and , therefore , it is not entirely evident how representative the 97 respondents are of those currently practising veterinary surgery in ireland . the majority of irish veterinary surgeons recognised that the animal physiotherapist can have a role in modern veterinary medicine . however , for animal physiotherapy to be widely used , veterinary surgeons need to have knowledge of , and access to , chartered animal physiotherapists . it is vital that animal physiotherapists demonstrate the effectiveness of treatments among veterinary colleagues if this specialist area of physiotherapy is to progress . we wish to thank all of the veterinary surgeons who participated in the study and the veterinary council of ireland for allowing us to use the veterinary register .
the aim of this study was to investigate veterinary surgeons ' perceptions , knowledge and use of animal physiotherapy in the republic of ireland . 
 a questionnaire was developed and sent to 200 veterinary surgeons , of which 97 were returned . 
 results indicated that 77 ( 79% ) of respondents were aware of animal physiotherapists . 
 common sources of information included veterinary colleagues , owners and professional journals , with physiotherapists themselves and undergraduate training being less commonly cited . 
 awareness of animal physiotherapy was greatest amongst those working in equine practice ( 2 = 5.7 , df 1 , p = 0.017 ) ; they were more knowledgeable about its techniques ( t = 2.806 , df 75 , p = 0.006 ) and more likely to refer ( 2 = 48.36 , df 1 , p = 0.0001 ) . 
 seventy - four respondents ( 96% ) thought that more research was necessary to increase the evidence base for animal physiotherapy . 
 if this branch of physiotherapy is to develop , there needs to be increased interaction and co - operation between veterinary surgeons and chartered animal physiotherapists .