Hi Group A,
Welcome to Equine SEL sign off blog, 556AVN - Biomechanical assessment and exercise prescription.
In your group, using your allocated scenario, discuss a remedial exercise program appropriate to your case and stage of repair, which would improve locomotion and proprioception. You need to include groundwork and ridden work, explain the concept of "core stability" and how this is achieved. Give the pros and cons of the use of lunging, long reining, and the use of training aids, in relation to your case. You all have from now until the end of the week (16.12.22 - 5 pm) to contribute to this blog. You must contribute to this blog to get your SEL signed off. Ensure that your entries are based on evidence and that you are reactive to one another to allow a good discussion of the topic. I will be keeping an eye on the blog, but if you have any issues, you should email me. Please ensure that you register your name with your comments so that I know who has written what.
You have been
referred a 13 year old dressage horse who has shown loss of performance. The
owner identified low grade lameness on certain dressage movements whilst
schooling at home.
A full lameness
work-up highlighted the horse was 1/10 lame positive hock flexion test and
positive result on nerve block of the tarso-metatarsal joint.
X-rays confirmed arthritic changes of the tarso-metatarsal joint.
The horse was
treated with intra-articular hyaluronic acid (HA) and intra-articular corticosteroid
injections.
Post treatment
the veterinary surgeon recommended box rest for 3 days and then to be turned
out and gentle ridden exercise (road) for 4 days. Hacking could be commenced in
week 2.
The horse could
have physiotherapy treatment to ensure no muscular tightness before return
to full work.
At the end of the
second week the Veterinary Surgeon recommend that REP, in conjunction with the
hacking, be incorporated with the aim to encourage engagement of hindquarter
and increase activity of affected hock.
Pros and Cons of lunging:
ReplyDeletePros-
- The horse can be observed working without the added weight of a rider and without rider "interference". The horses' way of going may be more natural and less impeded depending on rider ability. (As the ability of the rider is not specified during the case study, it is always something to consider).
- Horse will have to work without the added aids of the rider; can show ataxia, proprioception and balance issues which may have not been picked up on previously (although unlikely in this case).
- Lunging can be used where the horse is particularly "fresh" after box rest or a period of not working as frequently to prevent injury to the owner/rider.
- Can improve strength within the back muscles if the horse is not ready for the weight of tack and rider due to muscular tightness or any other complications that may potentially occur.
- If training aids are not used, lameness may be able to be spotted easier on a horse while it is being lunged (the "head bob" produced from forelimb lameness can sometimes be disguised by a "good" rider) - As mentioned by Rosa during our theory sessions. (If there is any lasting lameness after the injections).
Cons-
- Some horses are quite lively to lunge and may injure themselves.
- If the exercise given is prescribed in a certain gait (walk, trot etc...), the handler will not have complete control and may struggle to keep the horse moving at a particular pace, especially if the horse has been on box rest or out of "normal levels" of work for an extended period of time.
- Inexperienced or misinformed handlers may risk doing more damage to the horse via the use of incorrectly fitted or misused training aids/tack, incorrect attachment of the lunge line, rough handling of the horse or dropping of any of the equipment during a groundwork session. Loose horses with lunge lines still attached to them can seriously injure themselves and others.
- Some training aids that can be used while lunging may damage the horse more than help (lunging rollers can cause pressure on the back similar to that of ridden work (R. Mackechnie-Guire et al, 2017)).
Anyone feel free to add to my comment :) I may change or add more to this comment. List of references available upon request
The core plays a vital role in stabilising the horse's pelvis, spine and back. Poor core strength results in the struggling of movement and balance, thus not allowing the horse to reach peak performance.
ReplyDeleteRegarding horse core strength and stability, five exercises will be beneficial to ensure the stability of the core strength. These will not necessarily be completed at the same time in the REP but may all be used at different times.
Number one is sternum lifts. Sternum lifts encourage flexion through the back, which requires and works the core muscles. Doing this for 15 to 20 seconds at a time is most beneficial. This should be done twice, once a day, five times a week (two consecutive days followed by a break day, then another two days followed by a break day).
Number two is baited stretches. There are three movements that are rounding of the neck (flexion), hollowing the neck (extension) and side to side (lateral bending). The stretches should be held for 10 to 15 seconds for five repetitions a day. These stretches can be done 5 times a week with 2 rest days.
- Lateral bending is where the horse stretches around the body towards the girth
- Flexion is accomplished by the bowing stretch, where the horse is encouraged to stretch down to the level of the carpus
- Extension is achieved by holding the bait to encourage the horse to stretch its neck in an upward direction
(UTCVM, 2016)
Number three is tail pulls. Lateral tail pulls activate the core musculature as well as caudally directed pulling. This should be done in 10 to 30-second increments and should be done once daily for 5 days a week (Egger et al., 2014).
Number four is raised walk poles in hand. Raised cavalletti poles done at both a walk and working trot stimulate contraction of the abdominal muscles and thus strengthens them. First, this must be done with alternating raised poles and can then be moved onto a set of linear raised poles. This can be done for five minutes three times a week. As the horse becomes more comfortable, the time can increase to 15 minutes (Paulekas and Haussler, 2009).
Number five is downhill incline work. Walking downhill encourages farther reach under the body, which in turn strengthens the abdominal musculature. Backing up the hill is also useful. Hill work should be done three times a week and can be done both in hand and ridden, but should begin in hand (Paulekas and Haussler, 2009).
I agree with Stephens exercise plan, with the additional of 2-3 rest days for the horse alongside periodic reassessment through weight shifting and dynamic analysis of carriage.
ReplyDeleteAn additional con identified within lunging is the other use of the lateral aspect of muscle engagement due to the circular movement pattern. It can therefore be said that lunging should be used alongside other forms of exercising to ensure essential muscle groups are targeted. When lunging it is important to work on both reigns to prevent over use of a single lateral aspect and reduce the risk of asymmetries.
Within this comment ill be exploring some of the baseline anatomy of core stability and talking about the potential within training aids
Core stability is the ability to maintain muscular control during abdominal contractions. Abdominal contractions result in an increase of the hydrostatic pressure within the abdominal cavity, placing resistance onto the vertebrae. Improving the strength, endurance and proprioception within the abdominals and epaxial muscles will work to increase core stability (Davies, 2013). Within an equine model the bow and string theory is utilised to depict the dorsal and ventral chains of muscle engagement that enables balance and structure within the vertebrae. this has an increased level of importance when introducing a rider due to the additional weight and reduced equilibrium (Weeren and Haussler, 2010).
Training aids are complementary pieces of equipment placed upon or around the horse to alter locomotory patterns and carriage. The type, placement and use of these tools can have varying effects and produce different actions. When using this equipment it is therefore necessary to have an intended goal and good knowledge of the equipment's application and function. additional factors such as gait and terrain can also influence the way in which these tools work so researching the optimum factors for the specific tool and aim is vital while also considering patient history (Calzone et al., 2022)
A study conducted by Stenfeldt et al (2020) explored the use of an Equiband™ on dorsoventral back kinematics. Equibands act as an elastic resistance band that can improve stability, posture and proprioception. This study included privately owned horses who were determined not lame by their owners, this introduces the probability of misinformation and bias through wrongful diagnosis. The horses were listed as being in regular work but no mention of discipline was provided which could alter the pre-existing muscular development and baseline stability. Kinematic markers and 20 high speed motion cameras were used to determine locomotory patterns. This is a gold standard method of recording kinematics as the use of cameras reduces the risk of human error and therefore improving the data's validity. data was formed by manually calculating the mean motion differences for segments L5, L3, T15 and T12. It was determined that there was an increase in ROM in L5, while T12 and the lumbar region displayed increased stability and T15 displayed increased extension. These changes can enhance abdominal muscle use and therefore be used as a means of strengthening core engagement. It is also worth noting how the use of a girth was found to have similar effects of the equiband on T12 and T15. This could have a positive application during ridden work and provides an indication of reason for future research into optimum girth design.
A key point that has not yet been mentioned would be the progress in which the horses rehabilitation should follow. As this is a grade 1 lameness, the horse has a high functioning capability however it is important to not rush intensity. Activities should be initiated at the base level to not only ensure the animals capability but to also introduce the concept and technique if not previously performed. Due to the horses low lameness grade these exercise prescriptions can quickly be increased (including within the same session) to meet the current performance level of the horse.