Blood flow restriction training does not negatively alter the mechanical strength or histomorphology of uninjured equine superficial digital flexor tendons

BACKGROUND

Low load exercise training with blood flow restriction (BFR) has become increasingly used by human physical therapists to prescribe controlled exercise following orthopaedic injury; its effects on the equine superficial digital flexor tendon (SDFT), however, are unknown.

OBJECTIVE

To investigate outcomes of pressure specific BFR walking exercise on uninjured equine SDFT biomechanics and histomorphology.

STUDY DESIGN

Controlled in vivo experiment.

METHODS

Four forelimbs of four horses were exposed to 40 BFR-walk sessions (10-min interval walking) on a treadmill over a 56-day study period with their contralateral forelimbs serving as untreated controls. Similarly, four forelimbs of four control horses were exposed to 40 sham cuff walk sessions. On study Day 56, all horses (n = 8) were humanely euthanised and forelimb SDFTs underwent non-destructive biomechanical testing and corresponding histomorphological analysis. Significance in biomechanical parameters between treatment groups was analysed using a mixed-effects ANOVA with Tukey's post-hoc tests.

RESULTS

Statistically significant differences in SDFT stiffness for both first (p = 0.02) and last cycles (p = 0.03) were appreciated within the BFR treated group only, with BFR exposed forelimbs being significantly stiffer than the contralateral unexposed forelimbs. When normalised to cross-sectional area, no significant differences were appreciated among treatment groups in elastic modulus for the first (p = 0.5) or last cycles (p = 0.4). No histological differences were appreciated among treatment groups according to Bonar, Movin, or musculotendinous junction evaluation criteria.

MAIN LIMITATIONS

Short-term comparisons were performed in a small sample population without correlation to performance outcome measures. Optimal occlusion percentages and walk protocols remain unknown.

CONCLUSIONS

This study demonstrated no negative impact of BFR on mechanical strength of the equine SDFT; however, evidence suggests that BFR results in increased tendon stiffness based on biomechanical testing and subsequent calculations. No consistent detrimental histomorphological changes were seen.

A Carnitine-Containing Product Improves Aspects of Post-Exercise Recovery in Adult Horses

Strenuous exercise can cause tissue damage, leading to an extended recovery period. To counteract delayed post-exercise recovery, a commercial product containing L-carnitine (AID) was tested in adult horses performing consecutive exercise tests to exhaustion. Fit Thoroughbreds were administered an oral bolus of placebo (CON) or AID prior to performing an exercise test to exhaustion (D1). The heart rate (HR) and fetlock kinematics were captured throughout the exercise test. Blood was collected before, 10 min and 1, 4 and 6 h relative to exercise for the quantification of cytokine (IL1β, IL8, IL10, TNFa) gene expression and lactate concentration. Horses performed a second exercise test 48 h later (D2), with all biochemical and physiological measures repeated. The results demonstrate that the horses receiving AID retained a greater (p < 0.05) amount of flexion in the front fetlock on D2 than the horses given CON. The horses presented a reduced (p < 0.05) rate of HR decline on D2 compared to that on D1. The expression of IL1β, IL8 and IL10 increased at 1 h post-exercise on D1 and returned to baseline by 6 h; the cytokine expression pattern was not duplicated on D2. These results provide evidence of disrupted cytokine expression, HR recovery and joint mobility in response to consecutive bouts of exhaustive exercise. Importantly, AID may accelerate recovery through an undetermined mechanism.

Use of acoustic myography to evaluate forelimb muscle function in retriever dogs carrying different mouth weights

OBJECTIVES

To evaluate the effect of mouth weight on gait and relative function of forelimb muscles in retriever hunting dogs as a possible explanation for biceps tendinopathy.

METHODS

Ten sound retriever dogs underwent acoustic myography, measuring efficiency (E-score), spatial summation (S-score), and temporal summation (T-score) during walk and trot on a pressure-sensitive walkway while carrying a 0 lb (0 kg), 1 lb (0.45 kg), and 3.2 lb (1.45 kg) mouth weight. Gait data included total pressure index (TPI), step length, and stance time. Statistics included a mixed effects model significant at p < 0.05.

RESULTS

Forelimb TPI increased with increasing weight. There was no significant change in individual muscle parameters in response to weight. Significance was found in between-muscle comparisons. For walk, T-score was significantly lower in triceps vs. brachiocephalicus with 1 lb, not with 3.2 lb., S-score was significantly lower in the biceps at 0, 1 lb, and triceps at 0 lb. when compared to brachiocephalicus, E-score was significantly lower in deltoideus vs. brachiocephalicus at trot with l and 3.2 lb. There was an overall significant effect of muscle on T-score at trot, but no individual muscle comparison was significant.

CONCLUSION

Forelimb load increases with mouth weight. Deltoideus had a longer contraction time in response to increasing weight at trot when compared to brachiocephalicus. The biceps muscle did not show increased work in response to increasing weight.

CLINICAL RELEVANCE

The underlying etiology of biceps tendinopathies in retriever dogs remains uncertain but is not due to increasing weight.

Cyclic tensile tests of Shetland pony superficial digital flexor tendons (SDFTs) with an optimized cryo-clamp combined with biplanar high-speed fluoroscopy

Background

Long-term cyclic tensile testing with equine palmar/plantar tendons have not yet been performed due to problems in fixing equine tendons securely and loading them cyclically. It is well established that the biomechanical response of tendons varies during cyclic loading over time. The aim of this study was to develop a clamping device that enables repetitive cyclic tensile testing of equine superficial digital flexor tendon for at least 60 loading cycles and for 5 min.

Results

A novel cryo-clamp was developed and built. Healthy and collagenase-treated pony SDFTs were mounted in the custom-made cryo-clamp for the proximal tendon end and a special clamping device for the short pastern bone (os coronale). Simultaneously with tensile testing, we used a biplanar high-speed fluoroscopy system (FluoKin) to track tendon movement. The FluoKin system was additionally validated in precision measurements. During the cyclic tensile tests of the SDFTs, the average maximal force measured was 325 N and 953 N for a length variation of 2 and 4 % respectively. The resulting stress averaged 16 MPa and 48 MPa respectively, while the modulus of elasticity was 828 MPa and 1212 MPa respectively. Length variation of the metacarpal region was, on average, 4.87 % higher after incubation with collagenase. The precision of the FluoKin tracking was 0.0377 mm, defined as the standard deviation of pairwise intermarker distances embedded in rigid bodies. The systems accuracy was 0.0287 mm, which is the difference between the machined and mean measured distance.

Conclusion

In this study, a good performing clamping technique for equine tendons under repetitive cyclic loading conditions is described. The presented cryo-clamps were tested up to 50 min duration and up to the machine maximal capacity of 10 kN. With the possibility of repetitive loading a stabilization of the time-force-curve and changes of hysteresis and creep became obvious after a dozen cycles, which underlines the necessity of repetitive cyclical testing. Furthermore, biplanar high-speed fluoroscopy seems an appropriate and highly precise measurement tool for analysis of tendon behaviour under repetitive load in equine SDFTs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-021-02914-w.

Biplanar High-Speed Fluoroscopy of Pony Superficial Digital Flexor Tendon (SDFT)-An In Vivo Pilot Study

The superficial digital flexor tendon (SDFT) is the most frequently injured structure of the musculoskeletal system in sport horses and a common cause for early retirement. This project's aim was to visualize and measure the strain of the sound, injured, and healing SDFTs in a pony during walk and trot. For this purpose, biplanar high-speed fluoroscopic kinematography (FluoKin), as a high precision X-ray movement analysis tool, was used for the first time in vivo with equine tendons. The strain in the metacarpal region of the sound SDFT was 2.86% during walk and 6.78% during trot. When injured, the strain increased to 3.38% during walk and decreased to 5.96% during trot. The baseline strain in the mid-metacarpal region was 3.13% during walk and 6.06% during trot and, when injured, decreased to 2.98% and increased to 7.61%, respectively. Following tendon injury, the mid-metacarpal region contributed less to the overall strain during walk but showed increased contribution during trot. Using this marker-based FluoKin technique, direct, high-precision, and long-term strain measurements in the same individual are possible. We conclude that FluoKin is a powerful tool for gaining deeper insight into equine tendon biomechanics.

Equine Antebrachial Compartment Syndrome Secondary to Flexor Muscle Myopathy With Subsequent Muscle Atrophy And Tendonitis: A Case Report

This case report describes a 16-year-old jumping stallion that had a marked swelling over the left antebrachial area along with substantial lameness after a fall. The horse was weight bearing but lame (4/5; AAEP scale) at the walk with marked enlargement in the caudal aspect of the antebrachial region. After a static musculoskeletal examination, radiography and ultrasonography the horse was diagnosed with flexor muscle myopathy and presumptive extremity compartment syndrome. Following medical treatment, the horse improved clinically over several days. Six-months post injury the horse showed flexor muscle atrophy but was sound at the walk and trot. The horse was presented again 3 months later with an enlargement of the palmar left metacarpus that was diagnosed as a superficial digital flexor tendonitis. This report describes the episodes from the onset of extremity compartment syndrome until the superficial digital flexor tendonitis, discusses anatomical features of the region, physiopathology of compartment syndrome and the possible biomechanics behind the flexor muscle atrophy and the tendonitis.

A Horse of a Different Color?: Tensile Strength and Elasticity of Sloth Flexor Tendons

Tendons must be able to withstand the tensile forces generated by muscles to provide support while avoiding failure. The properties of tendons in mammal limbs must therefore be appropriate to accommodate a range of locomotor habits and posture. Tendon collagen composition provides resistance to loading that contributes to tissue strength which could, however, be modified to not exclusively confer large strength and stiffness for elastic energy storage/recovery. For example, sloths are nearly obligate suspenders and cannot run, and due to their combined low metabolic rate, body temperature, and rate of digestion, they have an extreme need to conserve energy. It is possible that sloths have a tendon "suspensory apparatus" functionally analogous to that in upright ungulates, thus allowing for largely passive support of their body weight below-branch, while concurrently minimizing muscle contractile energy expenditure. The digital flexor tendons from the fore- and hindlimbs of two-toed (Choloepus hoffmanni) and three-toed (Bradypus variegatus) sloths were loaded in tension until failure to test this hypothesis. Overall, tensile strength and elastic (Young's) modulus of sloth tendons were low, and these material properties were remarkably similar to those of equine suspensory "ligaments." The results also help explain previous findings in sloths showing relatively low levels of muscle activation in the digital flexors during postural suspension and suspensory walking.

Effects of Racing Surface and Turn Radius on Fatal Limb Fractures in Thoroughbred Racehorses

North American Thoroughbred racing is conducted on three types of surfaces—dirt, turf, and synthetic. The tracks are oval, and races are run counterclockwise. The loading on right and left limbs is expected to differ as a function of turn radius, banking, surface, and gait asymmetry. Hind limbs and forelimbs also have different functions related to propulsion and turning, respectively. This study uses the Equine Injury Database for race starts from 1 January 2009 through 31 December 2014, to compare injury rates across participating North American racetracks. The data are limited to catastrophic injuries in which horses died or were euthanized due to a fracture within 72 h of the start of the race. Overall injury rates were lower on turf and synthetic surfaces and the pattern of limb injuries in left vs. right and fore vs. hind limbs were different. Regardless of surface, forelimbs were more likely to fracture. Dirt surfaces showed higher rates of forelimb injuries compared to other surfaces, hind limbs were more likely to experience a fatal fracture on turf than on dirt. The left fore and right hind limbs were more likely to experience a fatal fracture but only on dirt surfaces.

Keep calm and hang on: EMG activation in the forelimb musculature of three-toed sloths (Bradypus variegatus)

Sloths exhibit below branch locomotion whereby their limbs are loaded in tension to support the body weight. Suspensory behaviors require both strength and fatigue resistance from the limb flexors; however, skeletal muscle mass of sloths is reduced compared with other arboreal mammals. Although suspensory locomotion demands that muscles are active to counteract the pull of gravity, it is possible that sloths minimize muscle activation and/or selectively recruit slow motor units to maintain support, thus indicating neuromuscular specializations to conserve energy. Electromyography (EMG) was evaluated in a sample of three-toed sloths (Bradypus variegatus; N=6) to test this hypothesis. EMG was recorded at 2000 Hz via fine-wire electrodes implanted into two suites of four muscles in the left forelimb while sloths performed suspensory hanging (SH), suspensory walking (SW) and vertical climbing (VC). All muscles were minimally active for SH. During SW and VC, sloths moved slowly (duty factor: 0.83) and activation patterns were consistent between behaviors; the flexors were activated early and for a large percentage of limb contact, whereas the extensors were activated for shorter burst durations on average and showed biphasic (contact and swing) activity. Muscle activities were maximal for the elbow flexors and lowest for the carpal/digital flexors, and overall activity was significantly greater for SW and VC compared with SH. Wavelet analysis indicated high mean EMG frequencies from the myoelectric intensity spectra coupled with low burst intensities for SH, although the opposite pattern occurred for SW and VC, with the shoulder flexors and elbow flexor, m. brachioradialis, having extremely low mean EMG frequencies that are consistent with recruitment of slow fibers. Collectively, these findings support the hypothesis and suggest that sloths may selectively recruit smaller, fast motor units for suspensory postures but have the ability to offset the cost of force production by recruitment of large, slow motor units during locomotion.

Equine musculoskeletal development and performance: impact of the production system and early training

The welfare debate around horse racing appears to be focussed on musculoskeletal injury and the racing of 2-year-olds. Much of this debate appears contrary to the evolutionary history of the horse as a cursorial animal and the capability of the equine musculoskeletal system to respond to the demands of race training. Epidemiological studies have reported that 2-year-old racehorses have a longer time period from entering training to the first race and a greater number of lost training days than older horses. However, this is, in part, due to the time taken to learn to train and the impact of dorsal metacarpal disease, which is due to loading of naïve as opposed to immature tissue. Across several racing jurisdictions and codes, it has been demonstrated that horses that train and race as 2-year-olds have longer, more successful, careers than those that start racing later in life. This positive trend has also been observed with horses starting in equestrian sport at an early age. The literature on the growth and development of the horse indicates that the musculoskeletal system is primed for activity and loading from an early age. Additional exercise for the young horse has a positive rather the negative effect, with many tissues having a sensitive period for ‘priming’ when the horse is a juvenile. This implies that under many modern management systems, the challenge to horse welfare is not ‘too much exercise too soon’ but ‘too little too late’. The current limitation in our understanding is the lack of knowledge of what is the correct exercise dose to optimise the musculoskeletal system. Modern management systems invariably provide too little exercise, but is the exercise data from feral horses the ‘gold standard’, or more a reflection of what the horse is capable of if resources such as food and water are limited? Further research is required to refine our understanding of the optimal exercise levels required and development of greater precision in identifying the sensitive periods for priming the musculoskeletal system.

Effect of Fatigue on Equine Metacarpophalangeal Joint Kinematics-A Single Horse Pilot Study

The objective was to validate a scientific method for characterizing equine metacarpophalangeal joint (MCPJ) motion in the nonfatigued and fatigued states using a single horse at trot, slow canter, and fast canter. One healthy Thoroughbred gelding exercised on a treadmill to exhaustion (fatigued state) (heart rate >190 BPM and blood lactate >10 mmol/L) while bilateral MCPJ angular data were acquired using electrogoniometry. Blood lactate and heart rate reflected transition from nonfatigued to fatigued states with increasing exercise duration and treadmill speed. Electrogoniometry consistently demonstrated: increase in mean MCPJ maximum extension angle with onset of fatigue; altered extension and flexion angular velocities with onset of fatigue; and increasing stride duration and decreasing stride frequency with onset of fatigue. The method allowed a preliminary but comprehensive characterization of the dynamic relationship between MCPJ kinematics and fatigue, prompting the need for multisubject studies that may enhance our ability to moderate exercise-related distal limb injury in equine athletes.

The equine forelimb suspensory ligament exhibits a heterogeneous strain pattern under tensile load

Objectives: To determine if regional variations in strain patterns occur within the suspensory ligament under tensile load. Local increases in strain may put certain regions of the suspensory ligament at risk and may explain the poor healing and high recurrence rates associated with suspensory branch injuries.

Methods: The suspensory ligament and its bone attachments were isolated from each of 10 adult equine cadaveric forelimbs and radiodense reference beads were inserted throughout the length of the ligament. Specimens were attached to a custom fixture secured to a materials testing system. Radio-graphs were acquired at 50, 445, 1112, and 2224 N of applied tensile load. Changes in distances between the beads in each region of the suspensory ligament were measured and the regional strain was calculated. Significant differences were determined using a repeated-measures analysis of variance.

Results: The suspensory ligament exhibited significant differences in regional strain (p <0.001). The distal branches of the suspensory ligament had significantly greater strains than the proximal (p = 0.025) and mid-body (p = 0.002) regions. The mid-body of the suspensory ligament also exhibited local strain variation, with the distal mid-body having significantly higher strains than the proximal mid-body (p = 0.038).

Clinical significance: The equine suspensory ligament demonstrates a heterogeneous strain pattern during tensile loading, with the distal regions exhibiting significantly more strain than the proximal region. The nonhomogenous strain pattern could explain the regional difference in injury and re-injury rates.

Biomechanical and histologic evaluation of the effects of underwater treadmill exercise on horses with experimentally induced osteoarthritis of the middle carpal joint

OBJECTIVE To evaluate the effects of exercise in an underwater treadmill (UWT) on forelimb biomechanics and articular histologic outcomes in horses with experimentally induced osteoarthritis of the middle carpal joint. ANIMALS 16 horses. PROCEDURES An osteochondral fragment was induced arthroscopically (day 0) in 1 middle carpal joint of each horse. Beginning on day 15, horses were assigned to exercise in a UWT or in the UWT without water (simulating controlled hand walking) at the same speed, frequency, and duration. Thoracic and pelvic limb ground reaction forces, thoracic limb kinematics, and electromyographic results for select thoracic limb muscles acting on the carpi were collected on days -7 (baseline), 14, 42, and 70. Weekly evaluations included clinical assessments of lameness, response to carpal joint flexion, and goniometric measurements of thoracic limb articulations. At study conclusion, articular cartilage and synovial membrane from the middle carpal joints was histologically examined. RESULTS Exercise in a UWT significantly reduced synovial membrane inflammation and resulted in significant clinical improvements with regard to symmetric thoracic limb loading, uniform activation patterns of select thoracic limb muscles, and return to baseline values for carpal joint flexion, compared with results for horses with simulated hand walking. CONCLUSIONS AND CLINICAL RELEVANCE Overall improvements in thoracic limb function, joint range of motion, and synovial membrane integrity indicated that exercise in a UWT was a potentially viable therapeutic option for the management of carpal joint osteoarthritis in horses.

Effects of training at a walk on conventional and underwater treadmills on fiber properties and metabolic responses of superficial digital flexor and gluteal muscles to high-speed exercise in horses

OBJECTIVE

To compare effects of training on conventional and underwater treadmills on fiber properties and metabolic responses of the superficial digital flexor (SDF) and gluteal muscles to high-speed exercise in horses.

SAMPLE

6 unconditioned Quarter Horse-type horses.

PROCEDURES

6 horses were walked on underwater and conventional treadmills for 5 d/wk (maximum, 40 min/d) for 8 weeks in a randomized crossover design (60-day detraining period). Horses underwent a standardized exercise test (SET) at high speed before and after training. Analyte concentrations and fiber characteristics were measured in muscle biopsy specimens obtained from horses before and after each SET.

RESULTS

Lactate concentration increased 2- to 3-fold in SDF and gluteal muscle after SETs. No training effect was identified on muscle fiber type composition, type II fiber diameter, muscle analyte concentrations, blood lactate concentration, or heart rate responses. Maximum diameters of type I fibers decreased significantly in gluteal muscle with conventional treadmill training and decreased in SDF muscle with both types of training, with maximum diameters greater for horses after underwater versus conventional treadmill training. No change was identified in minimum fiber diameters.

CONCLUSIONS AND CLINICAL RELEVANCE

SETs involving near-maximal exertion resulted in an anaerobic response in SDF and gluteal muscles of horses. Eight weeks of conventional or underwater treadmill training resulted in minor changes in type I muscle fiber sizes, with no effect on muscle metabolic or heart rate responses to SETs. After rehabilitation involving underwater treadmills, training at progressing speeds is recommended for horses to develop the required fitness for speed work.

The foot-surface interaction and its impact on musculoskeletal adaptation and injury risk in the horse

The equine limb has evolved for efficient locomotion and high-speed performance, with adaptations of bone, tendon and muscle. However, the system lacks the ability seen in some species to dynamically adapt to different circumstances. The mechanical interaction of the limb and the ground is influenced by internal and external factors including fore-hind mass distribution, lead limb, moving on a curve, shoeing and surface properties. It is unclear which of the components of limb loading have the largest effect on injury and performance but peak load, impact and vibration all play a role. Factors related to the foot-ground interface that limit performance are poorly understood. Peak performance varies vastly between disciplines but at high speeds such as racing and polo, force and grip are key limits to performance.

Frequency dependence of power and its implications for contractile function of muscle fibers from the digital flexors of horses

The digital flexors of horses must produce high force to support the body weight during running, and a need for these muscles to generate power is likely limited during locomotion over level ground. Measurements of power output from horse muscle fibers close to physiological temperatures, and when cyclic strain is imposed, will help to better understand the in vivo performance of the muscles as power absorbers and generators. Skinned fibers from the deep (DDF) and superficial (SDF) digital flexors, and the soleus (SOL) underwent sinusoidal oscillations in length over a range of frequencies (0.5–16 Hz) and strain amplitudes (0.01–0.06) under maximum activation (pCa 5) at 30°C. Results were analyzed using both workloop and Nyquist plot analyses to determine the ability of the fibers to absorb or generate power and the frequency dependence of those abilities. Power absorption was dominant at most cycling frequencies and strain amplitudes in fibers from all three muscles. However, small amounts of power were generated (0.002–0.05 Wkg⁻¹) at 0.01 strain by all three muscles at relatively slow cycling frequencies: DDF (4–7 Hz), SDF (4–5 Hz) and SOL (0.5–1 Hz). Nyquist analysis, reflecting the influence of cross‐bridge kinetics on power generation, corroborated these results. The similar capacity for power generation by DDF and SDF versus lower for SOL, and the faster frequency at which this power was realized in DDF and SDF fibers, are largely explained by the fast myosin heavy chain isoform content in each muscle. Contractile function of DDF and SDF as power absorbers and generators, respectively, during locomotion may therefore be more dependent on their fiber architectural arrangement than on the physiological properties of their muscle fibers.

Equine digital flexor muscles fibers have a relatively large capacity for energy absorption. This physiological property of their muscle fibers may be important to the function of these specialized distal limb muscles during locomotion.

Effect of a bandage or tendon boot on skin temperature of the metacarpus at rest and after exercise in horses

OBJECTIVE

To determine the skin temperature of the metacarpus in horses associated with the use of bandages and tendon boots, compared with the bare limb, at rest and after 20 minutes of lunging.

ANIMALS

10 adult horses.

PROCEDURES

Skin temperature on the bare metacarpus of both forelimbs was measured at rest and after lunging. Subsequently, a bandage was applied to the left metacarpus and a tendon boot to the right metacarpus and skin temperature was measured at rest and after lunging. Skin temperature was measured with fixed sensors and thermographically.

RESULTS

Mean ± SD skin temperatures of the bare metacarpi were 14.1 ± 2.4°C (left) and 14.1 ± 3.4°C (right) at rest, and 14.4 ± 1.8°C (left) and 13.6 ± 2.6°C (right) after exercise. Skin temperatures under the bandage were 15.3 ± 1.6°C at rest and 24.8 ± 3.6°C after exercise. Skin temperatures under the tendon boot were 15.3 ± 2.6°C at rest and 20.6 ± 2.9°C after exercise. Skin temperatures under the bandage and tendon boot were significantly higher after exercise than at rest. Skin temperatures at rest were not significantly different with a bare limb, bandage, or tendon boot.

CONCLUSIONS AND CLINICAL RELEVANCE

Skin temperature of the metacarpus in horses increased significantly during exercise but not at rest when a bandage or tendon boot was used. The authors speculate that both a bandage and a tendon boot accelerate the warm up phase of exercise. Further research should focus on the effects of warm up and maximum exercise on the temperature of other anatomic structures such as tendons.

Superficial digital flexor tendonitis in cutting horses: 19 cases (2007-2011)

OBJECTIVE

To characterize superficial digital flexor (SDF) tendon lesions in the forelimbs of cutting horses and determine recurrence rate and prognosis for this condition.

DESIGN

Retrospective case series.

ANIMALS

19 cutting horses with SDF tendonitis.

PROCEDURES

Medical records for horses evaluated for SDF tendonitis in 2007 through 2011 were reviewed. Data regarding age, sex, lameness grade, affected limb, and treatment were collected. Ultrasonographic images were reviewed, and lesion characteristics were recorded. Follow-up telephone interviews with owners or trainers were conducted to determine recurrence of SDF tendonitis, return of horse to its previous level of activity, and duration of the convalescent period.

RESULTS

All 19 horses initially evaluated for SDF tendonitis had similar lesions in the lateral aspect of the tendon. The right forelimb was affected in 11 horses, and the left forelimb was affected in 7 horses; 1 horse was affected in both forelimbs. Mean lameness grade was 1.26 (range, 0 to 3). Of 17 horses for which follow-up information was available, 3 had recurrence of tendon lesions and 1 developed a lesion in the contralateral forelimb SDF tendon; 16 horses returned to their previous level of activity.

CONCLUSIONS AND CLINICAL RELEVANCE

The location of SDF tendonitis in cutting horses appeared to be unique in that no central core lesions were detected ultrasonographically. Lesions at the periphery of the tendon may have an increased ability to heal, compared with lesions at the central core. Results suggested that cutting horses with SDF tendonitis have a better prognosis than that reported for affected racehorses.

In vivo measurements of flexor tendon and suspensory ligament forces during trotting using the thoroughbred forelimb model

The purpose of this study was to create a lower forelimb model of the Thoroughbred horse for measuring the force in the superficial and deep digital flexor tendons (SDFT and DDFT), and the suspensory ligament (SL) during a trot. The mass, centers of gravity, and inertial moments in the metacarpus, pastern, and hoof segments were measured in 4 Thoroughbred horses. The moment arms of the SDFT, DDFT, and SL in the metacarpophalangeal (fetlock) and distal interphalangeal (coffin) joints were measured in 7 Thoroughbred horses. The relationship between the fetlock joint angle and the force in the SL was assessed in 3 limbs of 2 Thoroughbred horses. The forces in the SDFT, DDFT, and SL during a trot were also measured in 7 Thoroughbred horses. The mass of the 3 segments, and the moment arms of the SDFT and DDFT in the fetlock joint of the Thoroughbred horses were smaller than those of the Warmblood horses, whereas the other values were almost the same in the 2 types. The calculated force in the SDFT with this Thoroughbred model reached a peak (4,615 N) at 39.3% of the stance phase, whereas that in the DDFT reached a peak (5,076 N) at 51.2% of the stance phase. The force in the SL reached a peak (11,957 N) at 49.4% of the stance phase. This lower forelimb model of the Thoroughbred can be applied to studying the effects of different shoe types and change of hoof angle for the flexor tendon and SL forces.

Differences in the metabolic properties of gluteus medius and superficial digital flexor muscles and the effect of water treadmill training in the horse

REASONS FOR PERFORMING STUDY

Flexor tendon injury may be due to flexor muscle fatigue, contributing to fetlock joint hyperextension and tendon damage. A water treadmill provides resistance training on flexor tendon muscles, which might reduce the risk of tendon injury.

OBJECTIVE

To determine the effect of water treadmill training on the properties of the gluteal and superficial digital flexor (SDF) muscles and on cardiocirculatory response to a standardised exercise test.

METHODS

Five healthy unfit horses were trained on a water treadmill for 5 days/week for 4 weeks, starting with 5 min/day increasing to 20 min/day. Before and after the water treadmill training, an incremental SET was performed on a land treadmill to determine velocity at a heart rate 200 beats/min (V(200)) and resting gluteal and SDF muscle biopsies were obtained for biochemical analyses.

RESULTS

There was no measurable difference in resting concentrations of gluteal or SDF muscle glycogen, lactate, ATP or glucose-6-phosphate (G6P), or activities of citrate synthase (CS), 3-hydroxyacyl CoA dehydrogenase (HAD) and lactate dehydrogenase (LDH) after training and no change in V(200), Lactate, glycogen, G6P and ATP concentrations were 50% lower and type 1 fibres 30% higher in SDF compared to gluteal muscles. CS and HAD activities were similar between SDF and gluteal, while LDH was lower in the SDF muscle.

CONCLUSIONS

A more strenuous water treadmill conditioning protocol may be needed to induce a training effect in gluteal and SDF muscle and heart rate response. The low substrate concentrations and oxidative capacity of SDF may predispose this muscle to catastrophic fatigue during maximal exercise.

Contractile properties of muscle fibers from the deep and superficial digital flexors of horses

Equine digital flexor muscles have independent tendons but a nearly identical mechanical relationship to the main joint they act upon. Yet these muscles have remarkable diversity in architecture, ranging from long, unipennate fibers ("short" compartment of DDF) to very short, multipennate fibers (SDF). To investigate the functional relevance of the form of the digital flexor muscles, fiber contractile properties were analyzed in the context of architecture differences and in vivo function during locomotion. Myosin heavy chain (MHC) isoform fiber type was studied, and in vitro motility assays were used to measure actin filament sliding velocity (V(f)). Skinned fiber contractile properties [isometric tension (P(0)/CSA), velocity of unloaded shortening (V(US)), and force-Ca(2+) relationships] at both 10 and 30°C were characterized. Contractile properties were correlated with MHC isoform and their respective V(f). The DDF contained a higher percentage of MHC-2A fibers with myosin (heavy meromyosin) and V(f) that was twofold faster than SDF. At 30°C, P(0)/CSA was higher for DDF (103.5 ± 8.75 mN/mm(2)) than SDF fibers (81.8 ± 7.71 mN/mm(2)). Similarly, V(US) (pCa 5, 30°C) was faster for DDF (2.43 ± 0.53 FL/s) than SDF fibers (1.20 ± 0.22 FL/s). Active isometric tension increased with increasing Ca(2+) concentration, with maximal Ca(2+) activation at pCa 5 at each temperature in fibers from each muscle. In general, the collective properties of DDF and SDF were consistent with fiber MHC isoform composition, muscle architecture, and the respective functional roles of the two muscles in locomotion.

An investigation of the relationship between race performance and superficial digital flexor tendonitis in the Thoroughbred racehorse

REASONS FOR PERFORMING STUDY

There is limited information regarding the number of races and the period for evaluation of outcome which is critical for assessment of SDF tendonitis treatments.

OBJECTIVE

To evaluate the re-injury rate and racing performance of Thoroughbred racehorses that sustain SDF tendonitis in relation to matched controls in terms of number of races post treatment and maximum racing performance ratings before and after injury.

STUDY DESIGN

Clinical records and racing histories of 401 racehorses with a first occurrence of SDF tendonitis diagnosed by ultrasonography. Controls were of the same age, sex and were horses training in the same establishment at the time of injury as the case horses and where the trainer reported that the horse had not had a previous SDF tendon injury or treatment.

RESULTS

Eighty percent of both case and control horses returned to racing after the date of injury, and the re-injury proportion within 3 years of treatment was 53%. The difference in Racing Post Rating((max)) (RPR((max))) and the Racing Post Rating in the race immediately before the treatment date was significantly smaller in case horses (mean = 9.6 lbs; range = 0-75) compared to control horses (mean = 17.0 lbs; range = 0-79). No significant decrease in RPR((max)) was noted post injury. No difference between case and control horses was found for return to racing and racing 3 times, but control horses were significantly more likely to compete 5 races post treatment date than case horses.

CONCLUSION AND CLINICAL RELEVANCE

Injury was associated with an individual's pre-injury maximum performance level and return to racing and completion of 3 races are not useful indicator of the outcome of horses with SDF tendonitis. The assessment of the outcome of horses with an SDF injury in a population of racehorses using the number of races post injury requires a minimum of 5 races post injury to be a useful indicator. Further, a re-injury proportion in a population of horses in training for 3 years post treatment.