Hi Group B,
Welcome to Equine SEL sign off blog, 556AVN - Biomechanical assessment and exercise prescription.
In your group, using your allocated scenario, discuss a remedial exercise program appropriate to your case and stage of repair, which would improve locomotion and proprioception. You need to include groundwork and ridden work, explain the concept of "core stability" and how this is achieved. Give the pros and cons of the use of lunging, long reining, and the use of training aids, in relation to your case. You all have from now until the end of the week (16.12.22 - 5 pm) to contribute to this blog. You must contribute to this blog to get your SEL signed off. Ensure that your entries are based on evidence and that you are reactive to one another to allow a good discussion of the topic. I will be keeping an eye on the blog, but if you have any issues, you should email me. Please ensure that you register your name with your comments so that I know who has written what.
Rosa
Case study:
You have been referred a 15.2 hh, 8
year old Welsh Cob gelding who is used for RDA, Pony club and hacking. He
sustained a grade 2, superficial digital flexor tendon injury.
He was initially box rested for 14
days, received NSAIDs, cryotherapy and bandaging treatments.
He has been on an in-hand walking
program for the last 12 weeks, gradually increasing. He is now walking 40
minutes per day split in 2, 20 minutes in hand walks daily. During which time
you have attended him and completed 4 veterinary physiotherapy sessions with no
change in his REP programme. He has gradually
been re-introduced to a small individual paddock.
The veterinary surgeon has re-scanned him and is satisfied with the healing progress. He has now recommended that REP can begin in order to improve stability, muscle mass and strength for the left forelimb and core, to start getting him back into ridden work.
First would be determining the goals that we would want to achieve, so in this case I would say improving RoM and proprioception to then aid in increasing muscle mass and strength in the longer term. From this, exercises could be determined and then chosen to be put into the REP. So exercises could include poles for proprioception but also increase RoM - raised/in different shapes eg. fan shaped, tail pulls or weight shifting to encourage the horse to maintain weight on the limb and maybe using vet wrap or something similar which would increase the horses awareness of their limb and encourage them to use it more.
ReplyDeleteCore stability - the bow and string theory comes into consideration when talking about the concept of core stability. A strong core supports the animals back allowing for correct balance and movement commonly described as the bow and string theory. Which allows for the weight of the rider to be carried, without core stability the horse will not be able to work correctly and efficiently
ReplyDeleteGoals:
Short term goals:
Improve tensile strength of SDFT
Improve proprioception
Increase muscle mass
Long term goals:
Getting the rider back on
Improving core stability
Week 1
Long lining (20 mins straight lines twice daily)
Carrot/baited stretches (3 reps hold for 5 seconds twice a day)
Thoracic lifts (3 reps hold for 5 seconds twice a day)
Week 2
Long lining - serpentines and scatter poles (15 mins normal with 5 mins of serpentines and then 5 mins of poles included in the 20 mins every other day)
Thoracic lifts (3 reps hold for 5 seconds twice a day)
Carrot/baited stretches (3 reps hold for 5 seconds twice a day)
Week 3
Long lining - linear poles and incline decline walking (30 mins - 5 mins of poles and 5 mins of incline/decline included in that 30 mins)
Thoracic lifts (5 reps 5 seconds twice daily)
Carrot/baited stretches (5 reps 5 seconds twice daily)
Week 4
Ideally start introducing the rider on a non slip surface for short periods of time
Thoracic lifts (5 reps 5 seconds twice daily)
Carrot/baited stretches (5 reps 5 seconds twice daily)
Trot poles can be used if progression can be seen (O’Sullivan, 2007)
Carrot/baited stretches are common stretches that activate the neck and trunk that assist in increasing flexion, extension and also help back musculature (Haussler, 2018; Sayers and Tabor, 2020)
Long lining is a technique that is commonly used for building up topline musculature rhythm, balance as well as straightness. It has a therapeutic benefit as it influences both sides of the body equally and develops symmetry. In addition it allows for core engagement and therefore the development of the epaxial and abdominal muscles. The additional incorporation of serpentines in the REP plan will aid in suppleness, straightness and balance for the horse. (Lilley, 2012; Haussler, 2020)
Polework: this exercise is beneficial for improving core strength as well as the horse's proprioception, it allows for the development of the back muscles, bodily awareness, balance and joint flexion. (Brown et al., 2014)
The reason this REP plan includes long lining rather than lunging is because lunging would put too much weight on the weaker limb when it is on the inside of the circle.
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ReplyDeleteFollowing initial immobilisation of the tendon and the gradual build up of exercise in previous weeks we could increase this remedial exercise programme through introduction of inclines to his in hand walking. Papers including Denoix (2001) and Takahashi et al (2014) have highlighted how incline can be used in strengthening hindlimb musculature, helping strengthen the limb and support joints while the superficial tendon continues to strengthen. Incline causes an elevation of peak forces and shift of weight to the hind making them work harder (Kaufman et al, 2009). These papers measuring muscle activity, saw an increase in myofibril activity in the gluteus medius, tensor fascia lata, biceps femoris, vastus lateralis and quadriceps . One study found 10% slope proved most effective for increasing muscle activity in the hind (Wilson and Hodson 2010) although paper suggests no studies have highlighted effect of slopes greater than 10% at this current time.
ReplyDeleteWeek 1
ReplyDeleteTail pulls - 3 reps, twice per day, hold for 3 seconds - improve core strength by targeting the use if abdominal and pelvic stabilisers (Culpeck, 2016)
Long lining - 2 x 20 mins per day, beneficial for increasing range of motion, maintaining symmetrical development and balance (Jones, 2014 and Charles, 2018)
Baited stretches - 3 reps both sides hold for 3 seconds twice per day - improves abdominal musculature (Stubbs et al. 2011)
Week 2
Tail pulls - Hold for 5 seconds 5 reps twice per day
Long lining - 20 mins every other day - Add some turns - weave through cones (start 2 far apart and progress) inclines/hillwork - maintains concentration of horse and improves hindlimb muscle mass and strength (Jones, 2014) - add scatter poles - these can aid in increasing core strength, encourage proprioception and improve range of motion when stepping over the poles and adjusting strides (Walker, 2022)
Baited stretches - Hold for 5 seconds 5 reps twice per day
Week 3
Tail pulls - Hold for 5 seconds 5 reps twice per day
Long lining - 30 mins every other day - Inclines/circles/serpentines to encourage weight shifting, introduce linear poles
Baited stretches - 5 seconds 5 reps twice per day
Week 4
Tail pulls - Hold for 5 seconds 5 reps twice per day
Long lining - Continue walking/circles/serpentines - Introduce raised poles (begin with one at the end so horse understands then raise all) - increases joint RoM more than ground poles so is the next step (Shaw et al. 2021) A study showed that raised poles increased hoof elevation and proprioception more than pastern weights which is why it could be used at this stage (Brown et al. 2014)
Begin to introduce rider - short amounts of time
Baited stretches - 5 seconds 5 reps every other day
Lunging is useful as it allows the horse to be controlled more easily and has many benefits such as increasing strength and RoM, however due to its weaknesses, the risk of asymmetrical movement and muscle mass build up (Robartes et al. 2013), it was better not to use this exercise and use long lining instead.
Well done for the 3 of you for trying to come up with some suitable exercises and plans for this case. The exercises chosen are appropriate for the stage of recovery. Please be careful with frequencies though. Long lining 2x per day would be too much for the horse and the owner, maybe keep it at 1x per day. Also DMEs and baited stretches should not be performed everyday. The research suggest that 3 to 5 x per week is sufficient to have the desired effect. You must allow time for muscular recovery as well to avoid DOMS. I am happy to sign off your SELs (Hope, Tia and Rebecca)
ReplyDeleteWell done for the 3 of you for trying to come up with some suitable exercises and plans for this case. The exercises chosen are appropriate for the stage of recovery. Please be careful with frequencies though. Long lining 2x per day would be too much for the horse and the owner, maybe keep it at 1x per day. Also DMEs and baited stretches should not be performed everyday. The research suggest that 3 to 5 x per week is sufficient to have the desired effect. You must allow time for muscular recovery as well to avoid DOMS. I am happy to sign off your SELs (Hope, Tia and Rebecca)
ReplyDeleteWell done for the 3 of you for trying to come up with some suitable exercises and plans for this case. The exercises chosen are appropriate for the stage of recovery. Please be careful with frequencies though. Long lining 2x per day would be too much for the horse and the owner, maybe keep it at 1x per day. Also DMEs and baited stretches should not be performed everyday. The research suggest that 3 to 5 x per week is sufficient to have the desired effect. You must allow time for muscular recovery as well to avoid DOMS. I am happy to sign off your SELs (Hope, Tia and Rebecca)
ReplyDeleteWell done for the 3 of you for trying to come up with some suitable exercises and plans for this case. The exercises chosen are appropriate for the stage of recovery. Please be careful with frequencies though. Long lining 2x per day would be too much for the horse and the owner, maybe keep it at 1x per day. Also DMEs and baited stretches should not be performed everyday. The research suggest that 3 to 5 x per week is sufficient to have the desired effect. You must allow time for muscular recovery as well to avoid DOMS. I am happy to sign off your SELs (Hope, Tia and Rebecca)
ReplyDeleteWell done for the 3 of you for trying to come up with some suitable exercises and plans for this case. The exercises chosen are appropriate for the stage of recovery. Please be careful with frequencies though. Long lining 2x per day would be too much for the horse and the owner, maybe keep it at 1x per day. Also DMEs and baited stretches should not be performed everyday. The research suggest that 3 to 5 x per week is sufficient to have the desired effect. You must allow time for muscular recovery as well to avoid DOMS. I am happy to sign off your SELs (Hope, Tia and Rebecca)
ReplyDelete