Evaluation of intersegmental vertebral motion during performance of dynamic mobilization exercises in cervical lateral bending in horses

Primary phenotypic features associated with caudal neck pathology in warmblood horses

BACKGROUND

Detailed descriptions of clinical signs associated with radiological findings of the caudal cervical vertebral column are not available.

OBJECTIVES/HYPOTHESES

Describe the clinical features associated with neck pain or stiffness, neck-related thoracic limb lameness, proprioceptive ataxia consistent with a cervicothoracic spinal cord or nerve lesion, and their frequency of occurrence compared with control horses.

ANIMALS

A total of 223 Warmblood horses.

METHODS

Case-control study. Controls and cases were recruited prospectively. All horses underwent predetermined lameness and neurologic examinations. The frequency of occurrence of each clinical feature was compared between cases and controls and relative risk (RR) were calculated.

RESULTS

Ninety-six cases and 127 controls were included. Forty-seven (49%) of the cases were classified as neurologic, 31 (32.3%) had thoracic limb lameness, and 18 (18.7%) had neck stiffness or pain or both. Focal caudal cervical muscle atrophy (46, 47.9%), hypoesthesia (38, 39.6%), patchy sweating (16, 16.7%), hyperesthesia (11, 11.5%), and pain upon firm pressure applied over the caudal cervical articular process joints and transverse processes (58, 60.4%) were only observed in cases (P < .001). Sideways flexion of the neck was restricted in a higher proportion of cases (47/96, 49%) compared with controls (40/127, 31.8%; P = .009, RR 1.5). Hopping-type thoracic limb lameness was only observed in cases, (30, 31.6%). Deterioration in lameness after diagnostic anesthesia occurred in 13/31 (41.9%) cases.

CONCLUSIONS AND CLINICAL IMPORTANCE

Systematic clinical evaluation using the methods described should enable clinical differentiation between horses with caudal cervical lesions and horses with other causes of gait abnormalities.

Influence of surgical intervention at the level of the dorsal spinous processes on the biomechanics of the equine thoracolumbar spine

BACKGROUND

Surgical treatment options for horses with overriding dorsal spinous processes include interspinous ligament desmotomy and partial spinous process ostectomy. The impact of spinal surgery on the three-dimensional biomechanics of the equine thoracolumbar spine and the epaxial musculature is unclear.

OBJECTIVES

To investigate the influence of interspinous ligament desmotomy and cranial wedge ostectomy on the biomechanics of the equine thoracolumbar spine and the paraspinal Musculi multifidi.

STUDY DESIGN

Ex-vivo experiments.

METHODS

Twelve equine thoracolumbar spine specimens were mounted in a custom-made mechanical test rig. Based on computed tomographic imaging, distances between dorsal spinous processes and the spinal range of motion (lateral bending, axial rotation, flexion, extension) were compared before and after desmotomy and cranial wedge ostectomy performed at two or five surgical sites. Anatomical dissection was subsequently conducted to document surgical trauma to the Musculi multifidi following desmotomy.

RESULTS

The distance between spinous processes in neutral position did not increase significantly after desmotomy (median preoperative = 7.2 mm, interquartile range [IQR] = 3.6 mm; median postoperative = 7.4 mm, IQR = 3.7 mm; p = 0.09), but increased significantly after ostectomy (median preoperative = 8.8 mm, IQR = 4.2 mm; median postoperative = 13 mm, IQR = 6.1 mm; p < 0.001). Both surgical procedures significantly increased the rotational spinal range of motion (p = 0.001), particularly at the level T14/T15 (median preoperative = 6.4°, IQR = 3.2°; median postoperative = 8.2°, IQR = 3.5°; increase = 28.1%; p = 0.02). Musculi multifidi injury was evident at all desmotomy sites.

MAIN LIMITATIONS

Ex-vivo study with limited sample size.

CONCLUSIONS

Neither interspinous ligament desmotomy nor cranial wedge ostectomy resulted in an increased range of motion during flexion, extension or lateral bending but both procedures influenced the rotational component of the equine thoracolumbar spinal mobility.

The Postural and Body Surface Temperature Response of Leisure Horses to Lunging with Selected Lunging Aids

Incorporating lunging into a horse's daily routine aims to enhance fitness, physical condition, and specific skills or exercises when using lunging aids (LAs). To assess the effectiveness of lunging, non-contact technologies like geometric morphometrics and infrared thermography can be employed. This study seeks to evaluate lunging efficiency based on the horse's posture and surface temperature when lunging with different head and neck positions. The study aims to determine if changes in a horse's posture correspond to increased metabolic activity, as indicated by body surface temperature. Thirteen horses included in the study were lunged with chambon (CH), rubber band (RB), and triangle side reins (TRs) as well as with a freely moving head (FMH). Images were taken in visible light and infrared. Principal Component Analysis (PCA) was used to analyze horse posture changes and a Pixel-Counting Protocol (PCP) was used to quantify surface temperature patterns. The horses' posture exhibited contrasting changes, reflected by a changing centroid shape (p < 0.0001) but not size (p > 0.05) when lunged with RB and TRs, but not CH. Different (p < 0.0001) surface temperature patterns were observed during lunging. FMH lunging resulted in lower temperatures over a larger surface, CH induced moderate temperatures on a smaller area, RB caused moderate to high temperatures across a broader surface, and TRs led to higher temperatures over a smaller region. The studied lunging cases returned different (p < 0.0001) surface temperature patterns. Lunging with FMH returned lower temperatures over a larger surface, CH moderate temperatures on a smaller area, RB moderate to high temperatures across a broader surface, and TRs higher temperatures over a smaller region. The proposed methods can be applied to evaluate the efficiency of lunging in horses.

The Effect of Capacitive-Resistive Electrical Therapy on Neck Pain and Dysfunction in Horses

Neck pain and stiffness are increasingly recognized in horses and often treated using multimodal pharmaceutical and rehabilitation approaches. In humans, deep tissue heating is reported to reduce neck pain and increase flexibility. The objective of this project was to determine the effects of capacitive-resistive electrical therapy on neck pain and stiffness in horses. A blinded, randomized, controlled clinical trial with 10 horses assigned to active and 10 horses assigned to sham treatment groups. Neck pain, stiffness, and muscle hypertonicity were assessed by manual palpation. Forelimb postural stability was evaluated using a portable media device with built-in inertial sensing components. All outcome parameters were recorded once weekly for four weeks. Using manufacturer recommendations, the treatment group received active capacitive-resistive electrical therapy to the lower cervical region (C4-C7), twice weekly for a total of six treatments, while the control group received a sham (inactive) treatment. Data was analyzed using a mixed model that was fit separately for each response variable. There were no significant differences noted over time or between groups for any outcome parameter evaluated. While neck pain and stiffness decreased by week three in both groups, the improvement was not significant. Limitations include the lack of a definitive pathoanatomic diagnosis of cervical pathology and in vivo temperature measurements. Capacitive-resistive electrical therapy was ineffective in reducing neck pain and dysfunction using the recommended treatment protocols. No short-term adverse effects were noted. Specific clinical applications and effective treatment parameters need further evaluation.

Rehabilitation Strategies for the Neurologic Horse

Rehabilitation of the neurologic horse represents a unique challenge for the equine practitioner. Improving postural stability and balance control through improving the strength of the spinal stabilizer muscle multifidus remains one of the most promising rehabilitative targets. This muscle can be targeted through the use of physiotherapeutic exercises, various forms of perturbation, and even whole-body vibration. Neuroanatomic localization and diagnosis specificity enable the practitioner to determine suitability for such rehabilitative tasks, and with the advent of evolving strategies and commercially available equipment, the bandwidth for professionally guided programs is continuously being developed and is expected to improve traditional outcomes.

Equine Rehabilitation: A Scoping Review of the Literature

Simple Summary

When a horse is diagnosed with a locomotor disorder, the veterinarian treats the specific injury to restore the horse to soundness. Even after the injury has healed, however, the horse may not be fully functional due to persistent limitations in movement or strength in specific areas of the body. As in people, rehabilitation seeks to optimize function and reduce any existing disability using a variety of methods including manual therapy, the use of physical and mechanical agents, and specialized exercise regimes. This study has reviewed the scientific literature with the goal of identifying which types of physical therapy have been described in horses over the past 20 years. The most frequently reported techniques were exercise, electrotherapy, and hydrotherapy but there are relatively few publications describing details of their use and outcomes in clinical cases. This study reviews the methodology and outcomes of rehabilitation in clinical cases. The results highlight the paucity of clinically-based reports on the practical applications of equine rehabilitation and physical therapy.

Abstract

Injuries to the locomotor system are a common problem in athletic horses. Veterinarians address these injuries using appropriate medical, surgical, and pharmacological treatments. During or after recovery from the initial injury, horses may be treated for functional locomotor deficits using specific rehabilitation techniques aimed at restoring full athletic performance. This study reviews the literature to identify which rehabilitative techniques have been used most frequently in horses over the past 20 years, the protocols that were used, and the outcomes of the treatments in naturally occurring injuries and diseases. Publications were identified using keyword selection (Equine Athlete OR Equine OR Horse) AND (Rehabilitation OR Physiotherapy OR Physical Therapy). After removing duplicates and screening papers for suitability, 49 manuscripts were included in the study. The majority of publications that met the inclusion criteria were narrative reviews (49%) in which the authors cited the relatively small number of published evidence-based studies supplemented by personal experience. Observational/descriptive studies were also popular (35%). Randomized control trials accounted for only 10%. The most frequently reported rehabilitation techniques were exercise, electrotherapy, and hydrotherapy. The findings highlight the need for further information regarding type of intervention, parameterization, and outcomes of equine rehabilitation in clinical practice.

Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment

Simple Summary

Neck pain and dysfunction in the horse is becoming an increasingly important topic among riders, trainers and veterinarians. Some horses may present for a subtle performance decline, while others may show dramatic, dangerous behavior. It is important to recognize how to carefully evaluate the horse in an effort to understand the different types of pain that may be contributing to the different behaviors. The musculoskeletal and nervous systems may both play a role in the development of clinical signs. Recognizing that there are many diagnostic options as well as several treatments choices is important. This synopsis covers the disease processes that may contribute to the development of neck pain and dysfunction in the horse, as well as several possible diagnostic and treatment options.

Abstract

Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.

The Effect of a Physiotherapy Intervention on Thoracolumbar Posture in Horses

Dynamic mobilisation exercises (DME) are often used as part of a physiotherapy rehabilitation programme. Whilst immediate kinematic effects have been measured, the change in posture is anecdotally reported to have a longer duration. This study aimed to test the reliability of a simple objective measurement method, suitable for use in clinical practice, and to objectively measure equine thoracolumbar posture, before and after DME. A single investigator took triplicate measurements of the sagittal thoracolumbar shape using a flexicurve ruler (FCR) then triplicate measurements of the thoracolumbar shape using an adapted FCR (aFCR) in 37 horses. Subsequently, the thoracolumbar shape of 12 horses was measured using the aFCR before random allocation into two groups. Six horses acted as a control group and six horses underwent a series of DME, which included cervical flexion and lateral flexion baited stretches. Measurements were repeated prior to DME, at thirty minutes, one hour and at twenty-four hours after DME to assess thoracolumbar posture. The aFCR ruler had excellent intra-rater reliability compared to a standard FCR (aFCR: p = 0.146; intraclass correlation coefficient (ICC) 0.971; FCR: p = 0.0001; ICC 0.979). Significant increases in flexion occurred in the thoracolumbar region at 30 min (p = 0.027) and one hour (p = 0.046) after DME, but not at 24 h (p > 0.05) with no significant differences in the control group (p > 0.05) between baseline and subsequent times. The results suggest DME create a short-term postural change, determined by using an aFCR, which supports their use as part of a veterinary physiotherapy rehabilitation programme.

Objective measurement in equine physiotherapy

Objective measurement should be incorporated into all areas of physiotherapy including within the assessment and treatment of horses, as there is a need to evaluate the effectiveness of treatment intervention objectively. Whilst objective measures are available in a research laboratory setting it appears that in clinical practice mostly subjective methods of recording assessment and reassessment data are used. This article reviews the objective measures currently available to equine physiotherapists for use in clinical practice, beyond those available in a research laboratory setting. Within the literature there are studies reporting the reliability and validity of objective measures for the assessment of pain, gait, posture, range of motion, palpation and muscle size in horses. Whilst these validated objective measurement tools are available, they are not presently used consistently in clinical practice. In addition, the non-verbal nature of the equine patients precludes the use of self-reporting, meaning that there are no reported functional outcome scores possible similar to use with human patients. However, the combined use of pain responses, behavioural changes and objective measures collected during clinical assessment, both pre and post treatment, could be useful in practice. Equine physiotherapists should integrate more objective methods of recording data from assessments of horses.

The Pattern of Superficial Body Temperatures in Leisure Horses Lunged with Commonly Used Lunging Aids

Simple Summary

In the training of horses, special lunging aids may be used to regulate head and neck position during exercise without the intervention of a rider. The rubber band and triangle side reins and the chambon have an impact on thoracolumbar kinematics and the motion of the fore- and hindlimbs. Lunging aids are assumed to modulate the work of horses’ muscles, which results in altering the superficial thermographic patterns. Thermography is a non-invasive, contactless imaging technique based on detecting emitted infrared radiation representing the temperature of the body surface, influenced by muscle metabolism and blood circulation. Training sessions for 16 horses performed in the study included exercises at walk, freely active trot, and canter. Surface temperatures of 11 regions of interest were evaluated on all images, corresponding to areas influenced by neck fixation and engaging hindquarters. In conclusion, thermography was shown as a useful tool in lunging aids’ usefulness evaluation. Different types of lunging aids influence the mobility of horse neck and back and its choice for leisure horses lunging should be made individually. Lunging aids change the surface temperature of different body parts during the leisure horse work on the lunge.

Abstract

Background: The natural head and neck position (HNP) of horses differs from the position in horse riding when bit is used. The special lunging aids (LAs) are applied in order to modify HNP. Different types of LAs have the potential to affect the work of horse muscles and the superficial thermographic patterns (STPs). The effects of thre LAs on STPs of neck, chest, back, and hindquarters were investigated. Methods: Sixteen leisure horses were lunged with freely moving head (FMH), rubber band (RB), chambon (CH), and triangle side reins (TRs). The thermographic images (n = 896) were analyzed before/after lunging for mean temperatures (T_mean) and minimum–maximum difference (T_diff). Results: Superficial T_mean increased (p < 0.001) in cranial part of neck, back, thoracic area, and limbs after lunging regardless of LAs application or its type. In comparison to other LAs: With RB, T_mean was higher in regions of interest (ROIs) 2,7 and lower in ROIs 3–4 (p < 0.05); with CH, T_mean was higher in ROIs 2–4 and 7 (p < 0.01); and with TRs, T_mean was higher in ROIs 2–4,7,9–11 (p < 0.01). In ROIs 2–4 and 7, T_diff was lower with LAs than with FMH (p < 0.01) and in ROIs 9–10 with TRs. Conclusions: The choice of LAs should be dictated by the expected effect; however, all LAs increase the quality of the leisure horse lunging. LA use is more desirable than lunging with FMH.

CT measures of lumbosacral paraspinal muscle size are not correlated with CT measures of lumbosacral stability in military working Labrador Retrievers

Management of degenerative lumbosacral stenosis in military working dogs more frequently utilizes core conditioning exercise programs. Future research on the effectiveness of these programs may benefit from an improved understanding of relationships between paraspinal muscle size and lumbosacral stability. The aim of this retrospective, secondary analysis, cross-sectional study was to test the following hypotheses related to CT measures: (a) transverse paraspinal muscle area ratios differ between hip flexion and extension, (b) lumbosacral angle and lumbosacral range of motion differ by lumbosacral angle measurement technique, and (c) transverse paraspinal muscle area ratios are correlated with CT measures of lumbosacral stability (parasagittal and parasagittal oblique foraminal area changes) regardless of hip position and with lumbosacral range of motion within each hip position. Lumbosacral CT scans in hip flexion and extension were retrieved from a previous prospective study of military working Labrador Retrievers. A single observer performed triplicate measurements of transverse paraspinal muscle area ratios, parasagittal foraminal area, and parasagittal oblique foraminal area for each hip position and another observer independently performed triplicate measurements of lumbosacral angle and lumbosacral range of motion at L7-S1 using two published techniques. Thirty-nine dogs were analyzed and significant differences were identified between hip flexion and extension for all mean transverse paraspinal muscle area ratio values (P ≤ .05). Mean lumbosacral angles also significantly differed between the published techniques in both hip flexion and extension. When comparing mean lumbosacral range of motion values, one of the published techniques produced significantly smaller values. No significant correlation was found between transverse paraspinal muscle area ratios and parasagittal foraminal area changes, parasagittal oblique foraminal area changes, or lumbosacral range of motion. These results should be considered when designing studies using these CT measures in military working dogs.

Parameters and functional analysis of the deep epaxial muscles in the thoracic, lumbar and sacral regions of the equine spine

The epaxial muscles produce intervertebral rotation in the transverse, vertical and axial axes. These muscles also counteract the movements induced by gravitational and inertial forces and movements produced by antagonistic muscles and the intrinsic muscles of the pelvic limb. Their fascicles are innervated by the dorsal branch of the spinal nerve, which corresponds to the metamere of its cranial insertion in the spinous process. The structure allows the function of the muscles to be predicted: those with long and parallel fibres have a shortening function, whereas the muscles with short and oblique fibres have an antigravity action. In the horse, the multifidus muscle of the thoracolumbar region extends in multiple segments of two to eight vertebral motion segments (VMS). Functionally, the multifidus muscle is considered a spine stabiliser, maintaining VMS neutrality during spine rotations. However, there is evidence of the structural and functional heterogeneity of the equine thoracolumbar multifidus muscle, depending on the VMS considered, related to the complex control of the required neuromuscular activity. Osteoarticular lesions of the spine have been directly related to asymmetries of the multifidus muscle. The lateral (LDSM) and medial (MDSM) dorsal sacrocaudal muscles may be included in the multifidus complex, the function of which is also unclear in the lumbosacral region. The functional parameters of maximum force (F_max ), maximum velocity of contraction (V_max ) and joint moment (M) of the multifidus muscles inserted in the 4th, 9th, 12th and 17th thoracic and 3rd and 4th lumbar vertebrae of six horses were studied postmortem (for example: 4MT4 indicates the multifidus muscle that crosses four metameres with cranial insertion in the T4 vertebra). Furthermore, the structural and functional characteristics of LDSM and MDSM were determined. Data were analysed by analysis of variance (anova) in a randomised complete block design (P ≤ 0.05). For some muscles, the ordering of V_max values was almost opposite to that of F_max values, generally indicating antigravity or dynamic functions, depending on the muscle and VMS. The muscles 3MT12, 3ML3 and 4ML4 exhibited high F_max and low V_max values, indicating a stabilising action. The very long 7MT4 and 8MT4 multifidus had low F_max and high V_max values, suggesting a shortening action. However, some functional characteristics of interest did not fall within these general observations, also indicating a dual action. In summary, the results of the analysis of various structural and functional parameters confirm the structural and functional heterogeneity of the equine thoracolumbar multifidus complex, depending on the VMS, regardless of the number of metameres crossing each fascicle. To clarify the functions of the equine multifidus muscle complex, this study aimed to assess its functional parameters in thoracolumbar VMSs with different movement characteristics and in the MDSM and LDSM muscles, hypothesising that the functional parameters vary significantly when the VMS is considered.

The Disappearing Lamellae: Implications of New Findings in the Family Equidae Suggest the Loss of Nuchal Ligament Lamellae on C6 and C7 Occurred After Domestication

Conflicting data predominantly describes the equine nuchal ligament lamellae (NLL) attachments as C2-C6 or C2-C7; however, preliminary evidence suggests C2-C5. This study aimed to identify morphological variations in the attachments of the NLL in four species of the family equidae and determine if the variations were species or breed linked. Cadaveric examination evaluated 98 equids; Equusasinus (n = 2), Equus ferus caballus (n = 93), Equus przewalskii (n = 2), and Equus quagga boehmi (n = 1). Twenty breeds of E. f. caballus were included according to breed type-modern horse (n = 81), ancient type (n = 10), primitive (n = 4). Of the 98 equids, observations were divided into three categories according to the NLL attachments: C2-C5, C2-C6, and C2-C7; in category C2-C7, E. f. caballus (n = 3/93), modern horse 0 of 81, ancient 1 of 8, primitive 2 of 4; in category C2-C6, modern horse 2 of 81; in category C2-C5, modern horse 79 of 81, ancient type 7 of 8, primitive 2 of 4. Equus asinus, E. przewalskii, and E. q. boehmi all expressed category C2-C7. In total, 88 of 98 expressed category C2-C5; 2 of 98 category C2-C6; and 8 of 98 category C2-C7. These findings suggest that category C2-C5 provides sufficient evidence to suggest a normal occurrence. The high incidence of an absent NLL on C6 and C7 may be considered a contributing factor in caudal cervical osteoarthritis. Furthermore, category C2-C7 still exists in an ancient and primitive breed closely related to the tarpan, implying the NLL may have been attached from C2 to C7 in prehistoric horse before domestication. This hypothesis is supported by the findings of E. asinus, E. przewalskii, and E. q. boehmi, displaying attachments from C2 to C7.

Structural and functional characteristics of the thoracolumbar multifidus muscle in horses

The multifidus muscle fascicles of horses attach to vertebral spinous processes after crossing between one to six metameres. The fascicles within one or two metameres are difficult to distinguish in horses. A vertebral motion segment is anatomically formed by two adjacent vertebrae and the interposed soft tissue structures, and excessive mobility of a vertebral motion segment frequently causes osteoarthropathies in sport horses. The importance of the equine multifidus muscle as a vertebral motion segment stabilizer has been demonstrated; however, there is scant documentation of the structure and function of this muscle. By studying six sport horses postmortem, the normalized muscle fibre lengths of the the multifidus muscle attached to the thoracic (T)4, T9, T12, T17 and lumbar (L)3 vertebral motion segments were determined and the relative areas occupied by fibre types I, IIA and IIX were measured in the same muscles after immunohistochemical typying. The values for the normalized muscle fibre lengths and the relative areas were analysed as completely randomized blocks using an anova (P ≤ 0.05). The vertebral motion segments of the T4 vertebra include multifidus bundles extending between two and eight metameres; the vertebral motion segments of the T9, T12, T17 and L3 vertebrae contain fascicles extending between two and four metameres The muscle fibres with high normalized lengths that insert into the T4 (three and eight metameres) vertebral motion segment tend to have smaller physiological cross-sectional areas, indicating their diminished capacity to generate isometric force. In contrast, the significantly decreased normalized muscle fibre lengths and the increased physiological cross-sectional areas of the fascicles of three metameres with insertions on T9, T17, T12, L3 and the fascicles of four metameres with insertions on L3 increase their capacities to generate isometric muscle force and neutralize excessive movements of the vertebral segments with great mobility. There were no significant differences in the values of relative areas occupied by fibre types I, IIA and IIX. In considering the relative areas occupied by the fibre types in the multifidus muscle fascicles attached to each vertebral motion segment examined, the relative area occupied by the type I fibres was found to be significantly higher in the T4 vertebral motion segment than in the other segments. It can be concluded that the equine multifidus muscle in horses is an immunohistochemically homogeneous muscle with various architectural designs that have functional significance according to the vertebral motion segments considered. The results obtained in this study can serve as a basis for future research aimed at understanding the posture and dynamics of the equine spine.

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.

The equine neck and its function during movement and locomotion

During both locomotion and body movements at stance, the head and neck of the horse are a major craniocaudal and lateral balancing mechanism employing input from the visual, vestibular and proprioceptive systems. The function of the equine neck has recently become the focus of several research groups; this is probably also feeding on an increase of interest in the equine neck in equestrian sports, with a controversial discussion of specific neck positions such as maximum head and neck flexion. The aim of this review is to offer an overview of new findings on the structures and functions of the equine neck, illustrating their interplay. The movement of the neck is based on intervertebral motion, but it is also an integral part of locomotion; this is illustrated by the different neck conformations in the breeds of horses used for various types of work. The considerable effect of the neck movement and posture onto the whole trunk and even the limbs is transmitted via bony, ligamentous and muscular structures. Also, the fact that the neck position can easily be influenced by the rider and/or by the employment of training aids makes it an important avenue for training of new movements of the neck as well as the whole horse. Additionally, the neck position also affects the cervical spinal cord as well as the roots of the spinal nerves; besides the commonly encountered long-term neurological effects of cervical vertebral disorders, short-term changes of neural and muscular function have also been identified in the maximum flexion of the cranial neck and head position. During locomotion, the neck stores elastic energy within the passive tissues such as ligaments, joint capsules and fasciae. For adequate stabilisation, additional muscle activity is necessary; this is learned and requires constant muscle training as it is essential to prevent excessive wear and tear on the vertebral joints and also repetitive or single trauma to the spinal nerves and the spinal cord. The capability for this stabilisation decreases with age in the majority of horses due to changes in muscle tissue, muscle coordination and consequently muscle strength.

Equine back pain reviewed from a motor control perspective

Back pain is recognized as a common and often recurrent problem in people and horses. Although there are many inciting causes of back pain, these often lead to a common pathway involving changes in neuromotor control and neurogenic atrophy of m. multifidi. The multi-layered and multi-directional fibres of this muscle stabilize the intervertebral joints in the face of bending and torsional moments. Inactivation and atrophy result in spinal instability and micromotion of the joints that predispose to further injury and degenerative changes, thus setting the scene for recurrent episodes of back pain. This review explores similarities between human and equine back pain, especially with regard to pathophysiology and prevention.