9 minute read
Research Digest
Manessa Faal MCSP ACPAT A
Local Back Pressure Caused by a Training Roller During Lunging With and Without a Pessoa Training Aid (2018)
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R. Mackechnie- Guire, E. MackechnieGuire, R. Bush, D. Fisher, M. Fisher, R. Weller. Pages 112-117. Vol 67. DOI: 10.1016/j.jevs.2018.03.018
Introduction:
Ground schooling (especially lunging) is routinely performed in the rehabilitation and training of horse. Training rollers are commonly used to provide attachment for training aids.
In an attempt to condition the horse’s musculature, a variety of exercises can be provided. Most commonly used is lunging with a training aid. It has been reported that the overall force acting on the horses back while trotting is equivalent to two times the body mass of a rider.
A previous study has shown that the Pessoa training aid has an effect on the whole horse locomotion, there a reduction in speed, stride length, head angle and lumbosacral angle were reported.
Aims:
To investigate the pressure distribution beneath a roller when fitted with and without a Pessoa training aid, to identify if there is a pressure beneath the roller when using a Pessoa training aid and to investigate its effect on pelvic range of motion.
Method:
10 adult sport horses were recruited. Inclusion criteria included that horses were in regular competitive work preceding the study and were deemed fit and sound by their riders. Veterinarians assessed horses on the day. As part of the normal work routine, all horses engaged with lunge exercise at least once a week using a Pessoa training aid; therefore, all horses were suitably acclimatized to lunging and the attachment of training aids.
All horses were warmbloods and of a similar conformation, all competing at affiliated dressage (elementaryadvanced medium) and displaying good muscle definition with a well-defined musculature of the thoracolumbar region.
Each horse underwent a 10-minute warm-up period on the lunge without the roller or Pessoa training aid being attached. Spherical cones positioned at a 17-m diameter marked the circumference of the circle in which trot and canter locomotion with and without the Pessoa training aid were measured.
All measurements were performed on the same outdoor sand and rubber surface, which was groomed before and in between each trial (logic, single blade leveller). All horses were handled and lunged by the same handler: female, 58 years, 5’2 height.
A crossover design was carried out, with each horse lunging on the left and right rein in trot and canter for both conditions, the order of which was randomized. If the horse lost regularity, tripped, or made an obvious alteration in gait pattern or circle size, the trial was repeated.
For two horses, circle size altered, so the trial was aborted and repeated. From IMU and pressure distribution, data were matched in relation to movement condition, and data were collected from 40consecutive strides totalling mean 40±3 being used for analysis, in trot and canter on both left and right circles for each horse. This was repeated for both conditions with and without a Pessoa training aid.
Results:
Speed – No significant differences were found in stride time between the two conditions for any of the four combinations of gait (trot/canter) and movement direction (left/right rein).
Kinetic Data – Pressure Distribution – Significantly higher peak pressures were found beneath the width of the roller, directly on top of the spinous process in the region of the 11th and 12th thoracic vertebra when using a training aid compared to no training aid. The peak pressures occurred in both forelimb stance phases. In canter, repeatable pressures were recorded in the region of T11 and T12. No significant differences were found on either side of the spine when using a training aid compared to no training aid.
Kinematics – IMU – No significant differences for any of the IMU derived movement parameters were found when using a training aid compared to no training aid in left/ right or trot/canter.
Conclusion:
When using a roller with a high withered dressage square and a wool pad, there were localised pressures similar to ridden exercise, located directly beneath the roller directly on the spinous processes.
Localized pressures increased and moved caudally beneath the roller when a Pessoa training aid was fitted, likely due to the back strap of the Pessoa training aid attaching to the ring positioned on the back of the roller.
Improved manufacturing design is needed to create clearance of the vertebrae, similar to a treed saddle, during lunge exercise.
Horse owners, veterinarians, physiotherapists, and instructors should be aware of the effect that a training roller can have on back pressures, especially in horses undergoing rehabilitation of back problems. Attempts to alleviate pressures should be made with either a pad creating clearance of the vertebrae or by placing a roller over the top of a correctly fitted saddle.
A Modified Tibial Compression Test for the Detection of Meniscal Injuries in Dogs (2017)
S. Valen, C. McCabe, E. Maddock, S. Bright, B. Keeley. Vol 58. Issue 2. DOI: 10.1111/jsap.12619
Introduction:
Cranial cruciate ligament failure is the most significant underlying factor for the development of meniscal injury in the canine stifle joint. The instability in the stifle with a cranial cruciate failure results in abnormal forces on the menisci and predisposes them to injury. Meniscal injury can contribute to degenerate joint disease in dogs with CCL failure.
The displacement of a torn meniscus during manual manipulation may create an audible click upon palpation in humans. Meniscal click may also be detected during physical testing in canine stifles, as the meniscus moves back and forth under the femoral condyle through tibial subluxation. It creates friction between the femur and the meniscus and manifests as an audible and palpable click.
Aims:
To assess diagnostic efficacy of a modified tibial compression test in predicting medial meniscal injury in dogs with cranial cruciate failure. Routine preoperative stifle surgery assessment by orthopaedic clinicians at a UK referral hospital included the TCT, cranial drawer test in flexion (CDTf) and extension (CDTe) and range of motion (ROM). Additionally, a modified tibial compression test (mTCT) was carried out by performing the TCT under axial loading through a full range of stifle motion. In this prospective study, we aimed to compare the diagnostic efficacy of the TCT, CDTf, CDTe, ROM and mTCT in predicting medial meniscal injury in dogs affected by CrCL failure.
Method:
Dogs selected for inclusion in the study were required to have orthopaedic and radiographic examination findings consistent with cruciate failure. The orthopaedic examination had to include a positive cranial drawer and, or tibial compression testing. The five tests (mTCT, TCT, CDTf, CDTe and ROM) were performed under general anaesthesia by one examiner from an intern group (novice group) and one examiner from an experienced orthopaedic surgeons group (experienced group). The novice group consisted of three novice examiners while the experienced group consisted of four examiners with a CertSAO, CertSAS or DipECVS qualification.
Examiners were blinded to case history, radiographs and to one another’s examination and findings. The examiners applied, from extension to flexion, constant axial loading through the hand grasping the dog’s metatarsus. A meniscal click represented a positive test while its absence represented a negative test. The results of the five clinical tests, being either positive or negative, were recorded separately for the examiners (surgeon database and intern database) using client numbers for patient identification.
Results:
170 dogs were included in the study, but reduced to 57. The most sensitive test for the detection of meniscal click in both the novice and experienced group was the mTCT, having a value of 63 and 59% respectively. ROM had a sensitivity of 44% (novice group) and 33% (experienced group) while the remain- ing tests ranged between 4 and 11%. The CDTe was the most specific test, with a value of 97% in both groups. The mTCT displayed the lowest specificity of the five tests, with values of 77% (novice group) and 73% (experienced group).
Menisci with displaced vertical longitudinal tears had more positive tests during physical testing than nondisplaced vertical longitudinal tears. A displaced vertical longitudinal tear was associated with a meniscal click in 72 and 61% of dogs in the novice group and experienced group, respectively. A non-displaced vertical longitudinal tear was associated with a meniscal click in 57% of dogs in both groups. The novice group identified only one of the complex tears while the experienced group identified both.
In the novice group, the CDTe exhibited the greatest PPV (75%), while the ROM test displayed the highest NPV (62%). In the experienced group, the mTCT had the highest PPV (67%) and NPV (67%). Sensitivity, specificity, PPV and NPV for all five tests can be viewed in Table 2. Thirty stifles had entire menisci at the time of arthrotomy, though 8 and 11 of these for the novice and experienced group respectively were falsely positive during the physical tests. Of the 27 stifles with concurrent meniscal damage, 9 and 10 for the novice and experienced group, respectively, were undiagnosed upon manipulation (false negatives).
Conclusion:
None of the five physical clinical tests performed in this study were accurate in reflecting meniscal integrity for dogs with cruciate failure. Out of the five tests, the mTCT was the most sensitive test for the detection of medial meniscal lesions, regardless of examiner experience. It’s sensitivity is slightly lower when compared with other non-invasive diagnostic modalities (high- field MRI, US) but has important advantages of high availability, affordability and can be easily performed. Owing to its low sensitivity, the mTCT should not be used as a sole diagnostic test for the detection of medial meniscal injury but may prove useful during the initial noninvasive assessment of a stifle with CrCL failure. The presence of a meniscal click during physical testing may also indicate stifle lesions other than medial meniscal injuries.
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