Effectiveness of Neuromuscular Electrical Stimulation and Dynamic Mobilization Exercises on Equine Multifidus Muscle Cross-Sectional Area.

Equine back pain can potentially initiate an unstable intervertebral situation that results in atrophy and dysfunction of the epaxial muscles even after back pain has resolved. Several physiotherapy approaches are advocated to promote the strengthening of the multifidus muscle. This study aimed to asses and compare the effect of dynamic mobilization exercises (DME) and neuromuscular electrical stimulation (NMES) in 8 adult horses (4 individuals by group) to increase the cross-sectional area (CSA) of this muscle after a 7-weeks period treatment. The epaxial muscles of NMES group were electrical stimulated during 10 minutes per session, 4 days a week for 7 weeks, yielding a total of 28 sessions per individual. Horses included in DME group were trained to move the chin to a specific position (three different cervical flexions, one cervical extension and three different lateral bending exercises) to the left and right sides, repeated 5 times per session, completing 28 sessions. Ultrasonographic images of the left and right multifidus muscle were acquired at 3 different spinal locations (T12, T16 and L2) at the initial and the end of the experiment. Significant increases (P < .050) in its CSA were obtained at all levels considered (except at T16), consistent with a 18.65% and 13.41% increase after NMES and DME, respectively. These results suggest that a 7-week period of DME or NMES treatments are useful to increase the CSA of the multifidus muscle in horses, and hence, these two therapies could be combined during a back-rehabilitation program to improve the spine stabilization in horses.

A Preliminary Study on the Use of HD-sEMG for the Functional Imaging of Equine Superficial Muscle Activation during Dynamic Mobilization Exercises.

Superficial skeletal muscle activation is associated with an electric activity. Bidimensional High-Density Surface Electromyography (HD-sEMG) is a non-invasive technique that uses a grid of equally spaced electrodes applied on the skin surface to detect and portray superficial skeletal muscle activation. The goal of the study was to evaluate the feasibility of HD-sEMG to detect electrical activation of skeletal muscle and its application during rehabilitation exercises in horses. To fulfil this aim, activation of the superficial descending pectoral and external abdominal oblique core muscles were measured using HD-sEMG technology during dynamic mobilization exercises to induce lateral bending and flexion/extension tasks of the trunk. Masseter muscle was instrumented during mastication as a control condition. A 64 surface EMG channel wireless system was used with a single 64 electrode grid or a pair of 32 electrode grids. HD-sEMG provided unique information on the muscular activation onset, duration, and offset, along each motor task, and permitting inferences about the motor control strategy actuated by the central nervous system. Signals were further processed to obtain firing frequencies of few motor-neurons. Estimation of electromyographic amplitude and spectral parameters allowed detecting the onset of muscular fatigue during the motor tasks performed. HD-sEMG allows the assessment of muscular activation in horses performing specific motor tasks, supporting its future application in clinical and research settings.

Thermal and behavioral response of horses submitted to functional exercises and acupuncture / Resposta térmica e comportamental de equinos submetidos a exercícios funcionais e acupuntura

The present research evaluated muscle activation degrees and relaxation of patrolling horses submitted to dynamic mobilization exercises, associated or not with acupuncture. Twelve mixed breed gelding, aged 10 ± 2.0 years, were distributed in three treatments. Treatment with a single session of dynamic mobilization exercises (longitudinal cervical flexion of head between hooves, between carpus and to up to chest); treatment with a single acupuncture session during 20 minutes, and treatment with a single session of dynamic mobilization exercises with acupuncture. Thermographic images were analyzed before and after applying treatments to the cervical, thoracic, dorsal, abdominal and pelvic regions. Animal behavior was assessed through five minutes filming, before and ten minutes after the end of each treatment application, in an uninterrupted way. Increase in animals body temperature at the end of the single session of functional exercises (P < 0.0001) at all animal regions were reported, being cervical and thoracic areas with highest final temperature values. There was no temperature variation for other treatments (P > 0.05). All treatments stimulated higher expression frequency (P < 0.05) of relaxation behaviors. A single dynamic mobilization exercises session is enough to promote intense muscular response in entire horse body; and with acupuncture, individually or associated, promoted muscle and mental relaxation, interfering positively in animal welfare.

Objetivou-se avaliar o grau de ativação e relaxamento muscular de equinos de patrulhamento submetidos à exercícios de mobilização dinâmica associados ou não à acupuntura. Doze cavalos castrados, sem raça definida, com idade de 10 ± 2,0 anos, foram distribuídos em três tratamentos: tratamento com uma sessão única de exercícios de mobilização dinâmica (flexão cervical longitudinal da cabeça entre os cascos, entre os carpos e até o peito); tratamento com sessão única de acupuntura (20 minutos); e tratamento com sessão única composta por exercícios de mobilização dinâmica associados a acupuntura. Foram analisadas imagens termográficas antes e após a aplicação dos tratamentos das regiões cervical, torácica, dorsal, abdominal e pélvica. A avaliação comportamental foi obtida por meio de filmagens 5 minutos antes e 10 minutos após o término da aplicação dos tratamentos, de maneira ininterrupta. Houve aumento (P < 0,0001) na temperatura corporal dos animais ao final da sessão única de exercícios funcionais para todas as regiões estudadas, sendo a cervical e torácica aquelas com maior valor de temperatura final. Não houve variação da temperatura nos demais tratamentos (P > 0,05). Todos os tratamentos geraram maior frequência (P < 0,05) na expressão de comportamentos relacionados ao relaxamento. A realização de uma sessão única de exercícios de mobilização dinâmica é suficiente para promover uma intensa resposta muscular em todo o corpo do equino, e tanto os exercícios funcionais quanto a acupuntura, de maneira individual ou associada, foram capazes de promover relaxamento muscular e mental, interferindo de maneira positiva no bem-estar dos animais.

Multimodal therapy for treatment of equine back pain: a report of 15 cases.

Back pain and diseases of the spine are considered significant problems in equine sports and veterinary medicine. This article reports a multimodal approach to the treatment of equine back pain using ozonized platelet rich plasma (PRP), dynamic mobilization exercises, and therapeutic shoeing in 15 horses involved in the vaquejada discipline. Fifteen American Quarter Horses of both sexes engaged in vaquejada in the state of Rio Grande do Norte, Brazil, with a mean age of 8.61 ? 1.73 years were examined at a training center for lower performance diagnostics or back pain. A complete clinical examination was performed on all horses at rest to determine the general conformation and alterations in posture, symmetry, and curvature of the spine. The horses were examined while walking and trotting in straight lines and circles to determine the presence of lameness and/or gait asymmetry. Spinal abnormalities on clinical examination were classified on a scale of 0 to 5 based on the following parameters: degree of response to pain from back palpation, hypertonicity of the back muscles, stiffness of the thoracolumbar joint, and physical dysfunction. After physical examination, ultrasound was performed to identify the cause of the thoracolumbar pain. The therapeutic protocol consisted of the intralesional application of ozonized PRP combined with therapeutic ultrasound, dynamic mobilization exercises, and therapeutic shoeing. All treated animals returned to sports activities at a higher level of performance than at the beginning of the treatment. Six months after treatment, telephone contact was made with the owner or trainer to determine if the back pain had relapsed. None of the animals relapsed during this period, and they participated in vaquejada normally.

Lombalgia e doenças da coluna vertebral são considerados problemas significativos nos esportes equestres e na medicina veterinária. Este artigo tem como objetivo relatar uma abordagem multimodal no tratamento da lombalgia em equinos utilizando plasma rico em plaquetas ozonizado, exercícios de mobilização dinâmica e ferrageamento terapêutico em quinze equinos da disciplina vaquejada. Quinze equinos da raça Quarto de Milha, praticantes da modalidade vaquejada no estado do Rio Grande do Norte, Brasil, ambos os sexos, com idade média de 8,61 ? 1,73 anos, foram examinados em centro de treinamento para diagnóstico de baixo desempenho ou lombalgia. Exame clínico completo foi realizado em todos os equinos em repouso para determinar a conformação geral, alterações na postura, bem como simetria e curvatura da coluna vertebral. Os equinos foram examinados enquanto caminhavam e trotavam em linhas retas e círculos para determinar a presença de claudicação e/ou assimetrias de marcha. As anormalidades da coluna vertebral no exame clínico foram classificadas em uma escala de 0 a 5 com base nos parâmetros: grau de resposta da dor à palpação, hipertonia muscular, rigidez da articulação toracolombar e disfunção física. Após exame físico, foi realizada ultrassonografia para identificação da causa da dor toracolombar. O protocolo terapêutico consistiu na aplicação intralesional de PRP ozonizado associado ao uso de ultrassom terapêutico, exercícios de mobilização dinâmica e ferrageamento terapêutico. Todos os animais tratados voltaram às atividades esportivas com nível de desempenho superior ao demonstrado no início do tratamento. Seis meses após o tratamento, foi realizado contato telefônico com o proprietário ou treinador para saber se a lombalgia havia recidivado. Nenhum dos animais teve recidiva durante este período e estavam disputando provas de vaquejadas normalmente.

Gymnastic Training of Hippotherapy Horses Benefits Gait Quality When Ridden by Riders with Different Body Weights.

The objective was to evaluate the effects of gymnastic training on stride characteristics of walk and trot in therapy horses carrying riders of different weights. Eighteen horses used for therapeutic riding 5 days/week were randomly divided into 2 groups. Nine horses performed gymnastic (GYM) exercises after therapeutic riding on 4 days/week for 3 months, 9 horses did no additional exercises (SED). On days 0 and 90, an inertial sensor mounted to the girth on the ventral midline was used to evaluate stride characteristics when horses were ridden at walk (1.3 m/second) and trot (3.0 m/second) by able-bodied riders representing rider: horse body weight ratios (BWRs) 15%, 20%, and 25%. On day 0, the measured variables did not differ significantly between sedentary (SED) and GYM groups, but on day 90, the following statistically significant results were found: GYM-trained horses had higher regularity for all BWRs at walk and 15% and 20% BWRs at trot. Higher stride symmetry was found in GYM-trained horses carrying 25% BWRs at walk and all rider weights at trot. Dorsoventral displacement was higher in GYM-trained horses when carrying 20% and 25% BWRs at walk and 25% BWRs at trot. Dorsoventral power was lower in SED-trained versus GYM-trained horses carrying 15% BWR at walk and 20% BWR at trot. A more regular and symmetrical stride with a larger range of dorsoventral trunk motion is likely to provide a better therapeutic riding experience.

Efficacy of early controlled motion of the ankle compared with no motion after non-operative treatment of an acute Achilles tendon rupture: study protocol for a randomized controlled trial.

BACKGROUND: Early controlled ankle motion is widely used in the non-operative treatment of acute Achilles tendon rupture, though its safety and efficacy have never been investigated in a randomized setup. The objectives of this study are to investigate if early controlled motion of the ankle affects functional and patient-reported outcomes. METHODS/DESIGN: The study is performed as a blinded, randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups. Patients aged from 18 to 70 years are eligible for inclusion. The intervention group performs early controlled motion of the ankle in weeks 3-8 after rupture. The control group is immobilized. In total, 130 patients will be included from one big orthopedic center over a period of 2½ years. The primary outcome is the patient-reported Achilles tendon Total Rupture Score evaluated at 12 months post-injury. Secondary outcome measures are the heel-rise work test, Achilles tendon elongation, and the rate of re-rupture. The primary analysis will be conducted as intention-to-treat analyses. DISCUSSION: This trial is the first to investigate the safety and efficacy of early controlled motion in the treatment of acute Achilles tendon rupture in a randomized setup. The study uses the patient-reported outcome measure, the Achilles tendon Total Rupture Score, as the primary endpoint, as it is believed to be the best surrogate measure for the tendon's actual capability to function in everyday life. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02015364 . Registered on 13 December 2013.

Core Training and Rehabilitation in Horses.

The central body axis or core is a key component in controlling body posture and providing a stable platform for limb movements and generation of locomotor forces. Persistent dysfunction of the deep stabilizing muscles seems to be common in horses indicating a need for core training exercises to restore normal function. Core training should be performed throughout the horse's athletic career to maintain a healthy back and used therapeutically when back pain is identified. This article reviews the structure and function of the equine thoracolumbar spine with special reference to function, dysfunction, conditioning, and rehabilitation of the core musculature.