Water treadmill exercise reduces equine limb segmental accelerations and increases shock attenuation

Effect of speed and water depth on limb and back kinematics in Thoroughbred horses walking on a water treadmill

Water treadmill (WT) exercise may induce limb and back kinematics that meet specific training and rehabilitation goals. The study aimed to investigate the effects of walk speed, at different water depths (WDs), on limb and back kinematics of six Thoroughbreds exercising on a WT. Horses walked at 2.8/4.3/5.5/6.0 km/h (i.e. 0.8/1.2/1.5/1.7 m/s) at dry, metacarpophalangeal and carpal WD. Videography captured limb movement in the sagittal plane. Motion-capture measured thoracolumbosacral flexion-extension (FE), and lateral bend (LB) ranges of movement (ROM) using skin surface markers on the sixth, tenth, thirteenth, eighteenth thoracic, third and fifth lumbar, and third sacral spinous processes. Inertial-motion-sensors measured poll, withers and pelvic displacements. Following preliminary univariable analyses, multivariable mixed-effects linear-regression analyses were used to examine the relationship between speed, WD and each outcome variable (P < 0.05). Peak metacarpophalangeal, carpal and tarsal joint flexion increased with speed (P ≤ 0.002) and depth combined (P 0.001) while peak metatarsophalangeal flexion increased with WD only (P 0.001). Thoracolumbar FE-ROM between T10 and L3 and hindlimb retraction was increased by speed and WD combined (P 0.001). Hindlimb protraction was increased by speed (P 0.001) while hindlimb retraction was increased by speed and WD combined (P 0.001). Dorsoventral poll displacement was increased by speed (P 0.001) and carpal WD (P = 0.013), craniocaudal poll displacement was increased by speed and WD combined (P 0.001). Pelvic (tubera coxae and sacrum) dorsoventral displacements increased with speed and WD combined (P 0.001). Understanding the effects of speed and WD on limb, back and pelvic kinematics will improve decision making relating to dry and WT exercise within training.

Kinematic Analysis During Straight Line Free Swimming in Horses: Part 2 - Hindlimbs

Background

Swimming is used for rehabilitation and conditioning purposes in equine sports medicine. We described the swimming kinematics of the equine forelimbs in Part 1. The aim of Part 2 is to assess stifle, tarsus, and hind fetlock joints kinematics in swimming horses. The objectives were 1- to calculate and compare joint angles during swimming against passive mobilizations (PM), 2- to determine joints angular velocities during a swimming stride cycle.

Methods

Eleven elite endurance horses were used to swim in a 100-meter straight pool. Underwater (swimming) and overground PM videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metatarsal epicondyle, lateral aspect of the talus, lateral femoral epicondyle, and great trochanter of the femur. As a reference, maximal fetlock, tarsus, and stifle flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities, and range of motion (ROM) were statistically compared.

Results

The tarsus ROM was similar during PM and swimming. The stifle and fetlock ROM were greater during PM, although the stifle flexion was greater during swimming. The stifle and tarsus had the greatest hindlimb angular velocity during the swimming cycle. Greater angular velocities were observed during the retraction phase for all the hindlimb joints.

Conclusion

A short retraction phase with great angular velocity for the joints of interest characterized the swimming pattern observed. Swimming may be beneficial in horses when an increased ROM of the tarsus and stifle or a reduced fetlock extension is indicated for rehabilitation purposes.

Kinematic Analysis During Straight Line Free Swimming in Horses: Part 1 - Forelimbs

Background: Swimming is used for rehabilitation and conditioning purposes in equine sports medicine despite the lack of understanding of equine swimming kinematics. The aim of this study was to assess forelimb joints kinematics (elbow, carpus, and fetlock) in swimming horses. The specific objectives were 1- to calculate and compare joint angles in swimming vs. passive mobilizations (PM), 2- to determine joint angular velocities during a swimming stride cycle. Methods: Eleven elite endurance horses swam in a 100-m straight pool. Underwater (swimming) and overground (PM) videos were recorded from the horses' left side. Joint markers were applied on the lateral hoof wall, lateral metacarpal epicondyle, ulnar carpal bone, lateral humeral epicondyle, and the greater tubercle of humerus, from which elbow, carpus and fetlock angles, and angular velocities were obtained. As a reference, maximal fetlock, carpus, and elbow flexion/extension angles were determined during PM overground. Differences between angle extrema, angular velocities and range of motion (ROM) were compared. Results: Carpus and fetlock ROM were significantly smaller (p < 0.001) during swimming when compared with PM, while there was no difference in elbow ROM between both situations. The carpus had the greatest ROM of all joints during swimming. Absolute angular velocities values of all joints during swimming were greater during retraction than protraction (p < 0.001). When compared to other joints during protraction, the carpus joint reached the highest angular velocity. Conclusion: Swimming, as a rehabilitation exercise, has the potential to benefit horses where great elbow ROM with a moderate carpus and fetlock extension are wanted.

A Preliminary Investigation into Ridden Water Submersion Training as an Adjunct to Current Condition Training Protocols in Performance Horses

Simple Summary

Superficial Digital Flexor Tendon (SDFT) injuries are the most common musculoskeletal injury reported in equestrian jumping disciplines. In an attempt to reduce incidences of injuries in elite event horses, Ridden Water Submersion Training (RWST) is a form of condition training that involves submerging the horse up to sternum height in water and trotting for set intervals. It is used by a small number of trainers to increase cardiovascular fitness whilst potentially minimising tendon temperature increase, which is typically reported during traditional condition training sessions. The results of this study suggest that RWST acted as a moderate sub-maximal intensity level of exercise in a group of elite international event horses whilst preventing the accompanying increase of distal limb temperature commonly associated with condition training on land. RWST could thus be a useful adjunct to current condition training protocols, particularly for horses that compete in disciplines that have high incidence rates of tendon injury. However, further research is required to provide a more comprehensive understanding of the workload imposed during RWST training.

Abstract

This observational study aimed to elucidate the effects of RWST on the cardiovascular and musculoskeletal systems of horses and concurrently determine whether RWST limits distal limb temperature increases previously reported during gallop training on land. A group of 15 clinically sound international event horses were recruited, and heart rate (HR), speed (km/h) and thermal images of the distal limb were analysed at set intervals during RWST training. Intervals of RWST produced a total mean HR_max value of 65.18 ± 3.76%, which is within the parameters for increased aerobic stamina. Mean HR increased significantly (p < 0.01) while mean distal limb temperature decreased significantly (p < 0.01) between warm-up and RWST, which contrasts with positive correlations previously reported during gallop training on land. These preliminary results suggest that RWST can be classed as a moderate submaximal intensity exercise in elite international event horses whilst restricting an increase in temperature of the distal limb that is commonly associated with tendon rupture. Horses competing at very elite levels of eventing only represent a small percentage of the total performance population; therefore, further research is needed to ascertain the physiological effects of RWST in non-elite performance horses, as well as horses competing across various equestrian disciplines.

Consensus for the General Use of Equine Water Treadmills for Healthy Horses

Simple Summary

Water treadmill exercise has become popular in recent years for the training and rehabilitation of equine athletes. Water treadmill exercise sessions can be tailored to the individual horse and the training/rehabilitation goals by altering the frequency, duration of exercise, water depth and belt speed. Recent work suggests that there are large variations in current modes of use between users, despite shared training or rehabilitation goals. In 2019, a group of researchers and experienced water treadmill users met in the UK to establish what was commonly considered to be best practice in the use of the modality. The result of these discussions was the production of ‘Water treadmill guidelines—a guide for users’, released in 2020 via various equestrian websites. The purpose of this article is to describe the development of these guidelines and propose them as a starting point for further collaboration between researchers and practitioners in the pursuit of ‘best practice’ in water treadmill exercise for horses.

Abstract

Water treadmill exercise has become popular in recent years for the training and rehabilitation of equine athletes. In 2019, an equine hydrotherapy working group was formed to establish what was commonly considered to be best practice in the use of the modality. This article describes the process by which general guidelines for the application of water treadmill exercise in training and rehabilitation programmes were produced by the working group. The guidelines describe the consensus reached to date on (1) the potential benefits of water treadmill exercise, (2) general good practice in water treadmill exercise, (3) introduction of horses to the exercise, (4) factors influencing selection of belt speed, water depth and duration of exercise, and (5) monitoring movement on the water treadmill. The long-term goal is to reach a consensus on the optimal use of the modality within a training or rehabilitation programme. Collaboration between clinicians, researchers and experienced users is needed to develop research programmes and further guidelines regarding the most appropriate application of the modality for specific veterinary conditions.

Water height modifies forelimb kinematics of horses during water treadmill exercise

Although equine water treadmills (WTs) are increasingly being used for the rehabilitation of equine athletes, the immediate- and short-term effects of this type of exercise on limb movement in the WT and overground are unknown. Therefore, the objective of this study was to evaluate the effects of WT exercise on equine forelimb kinematics on land and under various WT conditions before and after a prolonged period of WT conditioning. External markers were used to collect 2D kinematic data (joint extension, flexion, range of motion (ROM), elevation; stride mechanics) at 120 frames/s. Thirteen mixed breed, English performance horses were filmed under three test conditions: (1) horses walked on sand; (2) horses walked on a WT (water heights: dry, carpus, stifle); (3) horses walked on sand immediately following a WT session. Walking speeds during testing varied between horses, ranging from 1.3-1.5 m/s, but were held constant for each individual horse for all tests on both days. Testing occurred on days 1 and 10, with horses being trained on the WT for days 2 through 8 (28 min/day). Comparisons were made using linear mixed effects models. Carpal ROM and elbow ROM were greater when horses were walked in water, compared to without water (dry treadmill) and overground (P<0.0001 for all). This increased ROM was achieved primarily via an increase in joint flexion. With the addition of water, stride length increased and stride frequency decreased, accompanied by an increased percentage duration of swing phase. No effects of conditioning on gait mechanics were observed overground. Therefore, WT exercise may be meaningful for physical rehabilitation through increased joint flexion and ROM observed.

Comparing racing performance following arthroscopic surgery of metacarpophalangeal/metatarsophalangeal and carpal joints in Thoroughbred racehorses rehabilitated using conventional and underwater treadmill therapies

BACKGROUND

Rehabilitation of horses using underwater treadmill therapy has been shown to improve joint range of motion, joint mobility, stride length and proprioceptive parameters with experimental studies. However, studies investigating the prognosis and return to function following rehabilitation are lacking.

METHODS

A retrospective study of Thoroughbred racehorses treated with arthroscopic surgery for osteochondral fragments of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints or carpal joints undergoing conventional rehabilitation or underwater treadmill assisted rehabilitation at the same facility were included. The objective of the current study was to investigate if underwater treadmill assisted rehabilitation following arthroscopy in the Thoroughbred racehorse was positively associated with returning to racing, time to return to racing and postoperative racing performance including Beyer Speed Figures.

RESULTS

Surgery was performed on 165 horses on 174 surgical occasions; 70 (40.2 per cent) underwent underwater treadmill rehabilitation, with the remainder undergoing conventional rehabilitation. The time to return to racing was a median of 227 (IQR 185-281) days and 239 (IQR 205-303) days for underwater treadmill and conventional rehabilitation, respectively (P=0.16). Of the horses that raced presurgery, 83 per cent (58/70) of underwater treadmill rehabilitated horses and 61 per cent (63/104) of horses undergoing conventional rehabilitation returned to racing following surgery (P=0.02).

CONCLUSION

Underwater treadmill rehabilitation is superior in returning a Thoroughbred racehorse to racing following arthroscopic surgery of the carpus and/or MCP/MTP joints.

Combined Effects of Water Depth and Velocity on the Accelerometric Parameters Measured in Horses Exercised on a Water Treadmill

Horse trainers often claim that exercise on a water treadmill (WT) leads to a greater muscle power and development compared to terrestrial locomotion, because of the greater viscosity of water compared to air. This research assesses locomotor changes measured with accelerometers fixed in the pectoral region and in the sacrum midline in six horses subjected to exercise sessions of 40 min duration on a WT without water (DT), and with water at the depth of fetlock (FET) and carpus (CAR) with velocities of 6 km/h and at the depth of stifle (STF) at 5 km/h. Another five horses performed the same exercise sessions but always with a velocity of 5 km/h. Total power increased from DT to FET and CAR, without significant differences between CAR and STF depths when the velocity was the same. However, a significant decrease was found when the velocity was reduced. The greater total power with water was distributed mainly to the dorsoventral axis, with significant increases in dorsoventral displacement and dorsoventral power. Both parameters were significantly affected by velocity and water depth. In conclusion, total and dorsoventral powers increased with velocity and water depth, leading to reduction in longitudinal and mediolateral power, during exercise on a WT.