Rehabilitation for horses with soft tissue injuries

Question 1

List 8 aims of rehabilitation

Answer 1

Hasten return to function following injury
Improve function of the structure involved
Reduce pain and inflammation
Reduce re-injury rates
Improve quality of life
Improve range of motion or flexibility
Improve proprioception and balance
Adopt a whole animal approach

Question 2

After soft tissue injuries what consitently improves outcomes

Answer 2

controlled exercise programs

Question 3

List 6 things that variation in controlled exercise programs are based on

Answer 3

Structure involved
Severity of injury
Practitioner preference
Past experiences
Discipline of horse
Time of year

Question 4

List 3 things that can monitor progress during rehabilitation

Answer 4

lameness
palpation of affected tissue
ultrasound

Question 5

when should we commence exercise during rehabilitation of soft tissue injury

Answer 5

start rehab program at end of inflammatory phase- 2-4 weeks after injury

Question 6

Describe how to increase exercise intensity slowly during rehabilitation

Answer 6

Walking in hand or under saddle
Trotting under saddle in straight lines
Trotting under saddle on circles and bends
Canter work in straight lines
Canter work on circles and bends

Question 7

when can uncontrolled exercise occur during rehabilitation of soft tissue injury

Answer 7

This decision making will depend on temperament,
- a calm horse with access to small individual paddock can be turned out sooner
- An anxious horse living in a herd will be kept indoors for longer

Question 8

what can we use to help with uncontrolled exercise

Answer 8

Anxiolysis – acepromazine, can be safely used medium-long term
Enrichement – access to stimuli and food

Question 9

List 5 ways we can directly influence the injury site

Answer 9

Extracorporeal shockwave therapy (ESWT)
Laser (class 4)
Cold/heat treatment
Therapeutic ultrasound
Pulsed magnetic field therapy

Question 10

describe shockwave therapy

Answer 10

Delivery of high-pressure waves to tissues – probably most focused at the junction between soft tissue and bone

Question 11

when is shockwave therapy used

Answer 11

Commonly applied to chronic injuries as part of a management plan

Question 12

what effects does shockwave therapy have

Answer 12

Shockwave seems to temporarily improve lameness, but has limited effects on structure and function

Question 13

What effects can class 4 lasers have

Answer 13

Reduce lesion size, increase doppler signal, change collagen deposition, improve US fibre pattern
No evidence yet that this leads to reduce re-injury rates

Question 14

List 4 contrainidciations for the use of high powered (class 4) lasers

Answer 14

eye exposure
neoplasia
haemorrhage
pregnancy??

Question 15

what injuries are most impacted by laser treatment

Answer 15

superficial structures- suspensory branches, flexor tendons

Question 16

what does core stability sim to improve

Answer 16

improve neuromuscular control
reduce force/stride variability
negate compensatory mechanisms
reduce frequency and severity of abnormal loading events.

Question 17

List 4 methods to improve core stability

Answer 17

Water treadmill exercise
Swimming
Ridden or in-hand exercises
Whole body vibration (lacking evidence!)

Question 18

List 4 things that water treadmill are recommended for improving

Answer 18

strength
coordination
stability
postural control

Question 19

what is swimming recommended for improving

Answer 19

aerobic fitness
brachiocephalicus tone
reducing stress on joints and soft tissues

Question 20

what is a possible problem with using swimming on racehorses

Answer 20

increases aerobic fitness with reduced bone stimulation

Question 21

List 4 things that owners can do to increase core stability in horse

Answer 21

Hill work (trot up and walk down)
Pole exercises (raised)
Working on a range of surface types
“cross training”