Dr Gillian Tabor discusses a rehabilitation exercises paper by Ellis & King.
Dr Gillian Tabor, a Chartered Physiotherapist who specialises in the treatment and rehabilitation of horses, takes a look into a journal article that was published last year by Ellis & King. Discuss what they did, how they measured it and what they found. The article references the rehabilitation exercises that Gillian also recommends that you can do with your horses of different ages and experiences.
Here is a link to read more about the specific study – CLICK HERE
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Here is a transcription of the podcast. (Please note this is an automated transcription, so we apologise for any errors from the original podcast.)
So in this presentation I am going to talk you through a journal article that was published last year and I’m going to discuss what they did and how they measured it and what they found because this paper has specific relevance to the rehabilitation exercises that I suggest people do with their horses.
They’re also exercises that are useful for all horses, those in normal training, those that are elderly, those that are young and haven’t been in written work yet. So I think this is quite a relevant paper and the paper that we’re going to discuss is the one by Ellis and King.
It was published august in the general equine veterinary Science. It’s got a long title and I’ll explain the concept of postural stability, para spinal muscle adaptation as I go through.
Doctor King actually is from Colorado State University and works quite a lot with another prolific publisher of research called Dr Kevin Haeusler if you come across any of his research.
So what did they do first thing with any article is that you read the introduction, which is the background and it gives you the rationale for why the authors chose to do the study. It also reviews a lot of the literature that has gone before them and it gives you the aims of the study. But basically these authors were looking at horses and they are interested in postural stability.
Now, postural stability is a concept rather than a single construct or a single a single event or part of the body. But postural stability is about how we control ourselves and our movement.And as they say in the article, it is necessary to maintain balance and to stabilize as well as protect the spinal column. So immediately we’re thinking about the deep stability muscles, the nerves that supply them and the passive structures around there that all come together to provide the control for movement.
We need postural stability to be able to cope with those forces that destabilize us. So if we get pushed we return back to our neutral position. If we are something like you know stepping on even ground, we need to have very good postural stability.
If we wobble we need to return to our equilibrium equilibrium to our normal neutral position.
And that requires very good postural stability.
What we do know certainly with humans is people that have poor postural stability at higher risk of falling.
So this is certainly the case if you’ve got a musculoskeletal injury or you have an illness or disease that reduces your proper reception. And actually with age we actually, unless we train it specifically we get a reduction in our postural stability. My second point there I put C. O. P. Area.
Now that’s the center of pressure.
And the reason that I have mentioned that is because this is how we can measure postural stability.
So we can put people on a force platform and then we collate all the forces that come down through their feet to one single point that’s called the center of pressure.
And if you imagine somebody that’s wobbling around and um that center point, the center of pressure actually drew a line on the force platform which it does on the clever software that measures forces.
You would imagine that that would waver around any of you that old enough to have a Nintendo wii balance board.
That’s exactly what it used to do.
Used to get a red dot and you could deliberately move it around or you could see how still you can stand and keep that spot in the same point.
So somebody with poor postural stability, the area that that dot draws around is larger and also the speed that it moves changes as well. And the reason for that is that our prop receptive responses that measure how much we’re wobbling might not be that efficient, might not be that effective.
So we are slower at correcting ourselves back into equilibrium.
And also we take longer to acknowledge that we’ve gone out of equilibrium.
The other part that these authors talk about is multitudinous.
This is quite a hot topic in the horse’s spine because we can measure it and we know when we do dynamic mobilization exercises those baited stretches, we can increase the size of multitudinous.
But what we don’t know is whether mult if otis as a postural stabilizer actually has an effect on the measured postural stability because we haven’t done that bit yet.
Well the authors realized that we hadn’t done it.
nd then they set about this study to try and demonstrate how the effect of multiple otis size has an effect on postural stability.
So they’re sort of making the links in the chain really from things that we have made assumptions about.
So what they did is they took seven horses that they had access to.
So they’re all client horses that were in the equine rehabilitation center.
They were there for rehabilitation.
Now these horses didn’t have any back pain or back pathology.
Um they were there for landless reasons and they were there for 12 weeks.
So it was quite a long period of rehabilitation.
They measured the size of motivated at the start and at the end of the rehabilitation and then they measured this postural sway.
So there’s a picture here of a horse stood on a force platform and you can see various markers on there, but there’s a square that they stood on that measures that center of pressure, which roughly when the horses stood, still falls below the 11th rib, sort of end of the stern and down towards the ground.
And in this picture you can see that the horses standing on balance pads.
So these are foam pads.
And the reason for those is we know that those actually increased the r struggle to maintain our hostel stability.
So they measured the horse stood on the force platform directly and then also on those foam pads.
So you can see that they were challenging the horse.
They were making it a little bit wobbly and they were seeing how good the horse was actually restoring it’s equilibrium, i. E.
Trying to keep its center of pressure area small With the exercises they did those five days a week for the whole of the 12 weeks.
And I will show you what they did.
And they took a nice record of them.
So there’s a range of exercises, stable based exercises as well as in hand work.
So they did the rounding reflexes, the sternum lift and the reflex rounding of the hind quarters.
So that’s the second column there.
The lumber sacred tux with the reflexes as well.
They did lateral bending, and they also did extension.
They ask the horse to go into ventral flexion.
They did passive range of movement and bringing the legs forward and backwards.
And also they did the rocking exercises that I talked about.
So they did the weather and the tail pools, pulling the horse just gently to the side and asking the muscles to work to correct them to go back to their equilibrium in most of the horses, except for let seven horse, three.
They used the underwater treadmill and so the horse was trained in hand on that as well.
All the horses had some time stood on these balance pads and the ones they used were the shore footpads by wendi Murdoch and then all the horses also had in hand walking.
And they used the equal band on them as well whilst they were doing that program of walking.
So what did they find?
Well all the horses became more sound during the program. So they started off with a landless grade out of five between a one and a five, I think it was a four and then they all decreased that landless grade. So there was an improvement in that.
Although the amount of improvement didn’t actually correlate with the other findings, um there was a significant increase in multiple this cross sectional area now that we would expect because we know that when you do your baited stretches and when you do these um stable based exercises, it’s going to work on increasing the activity of multiple tous. So that was quite good.
We’ve got some more evidence about the increase in size and motivate us with them.
But also or more importantly,is this final part there was a significant decrease in postural sway.
So there was a change when they were not stood on the pads in terms of their center of pressure speed.
Um And the area as well.
Now this is really, really interesting and this is why this study goes a lot further than the ones we’ve had up to that point because they found as multitudinous increased in size, the amount of the area and the speed of the movement of the center of the center of pressure actually decreased.
So the postural stability increased.
Now isn’t that brilliant?
This is really showing that we are targeting those muscles that are close to the spine with these exercises.
There are some limitations to the study though. It was relatively small numbers only seven horses and they were there for a variety of problems. So there was no sort of normalization between them.
The other factor was that not all horses did all the exercises and a really crucial part is we don’t know which part of the rehabilitation program actually was the one or was it all of the parts that had the effect?
Because they were doing in hand walking?
They were doing treadmill as well as the rehab exercises.
So there’s a little bit of sort of critical analysis there to be thinking about what can we take away from it.
My thoughts are is wouldn’t it be amazing if we had had a control group that didn’t have lameness or maybe we had a group that only underwent the water treadmill,
some that only underwear went the stable based and in hand walking and broke it down further.
But I know from conducting research that is immensely challenging to try and get the horses that you need to follow a program, you know, for three months, these horses were doing it.
So, you know, I commend the authors for being able to draw together this information and publish it.
I think the critical thing is is that what we need to do is we need to include exercises in our rehab that are targeting increasing multitudinous because if that increases and we improve our postural stability, then that is going to stand us in good stead for when we go on to do our ridden exercises and we progress and potentially in a horse that doesn’t have issues.
Maybe that is going to reduce our risk of injury as we go through a normal training process.
So there we go.
A little summary of a research paper that was recently published.
I’ll see if we have any more that will come out and I’ll do more of these research reviews because I think they are very good for actually applying the research into practice.
And that’s what I’m all about, all about evidence based equine physiotherapy.