494
EQUINE VETERINARY EDUCATION / AE / SEPTEMBER 2017
TABLE 1: Characteristics of horses included in the study Horse ID Breed Age (years) Gender Discipline A1
A2 A3 A4 B1 B2 B3 B4 B5
WB WB WB WB TB
ISH ISH TB
WB 9
15 19 8 8 5
10 8
10
G G G G M G G G G
Dressage Third Dressage Second Dressage Second Dressage Laid-up Eventing Eventing Eventing Eventing Eventing
Training Training Training Training Laid-up
Exercise/performance level AAEP lameness score (0–5) (Day 0) 3
1 2 3 1 3 1 1 4
WB, Warmblood; TB, Thoroughbred; ISH, Irish sport horse; G, Gelding; M, Mare; Training, performance/competition level for each discipline as defined by the United States Equestrian Federation; Laid-up, stall rest with 15 min of hand walking.
exercise, as well as diet was not a prerequisite, but for participation in the study, rider, exercise regime and diet for that individual horse were required to remain the same from 3 months prior to the start of WBV throughout the 2 months’ duration of the study.
Lameness assessment Horses were examined by a veterinarian (primary author) experienced in lameness diagnosis and ultrasound imaging. All horses demonstrated lameness, ranging from grades 1–4 on the AAEP lameness scale (Stashak 2002), before the start of WBV treatment (Table 1). Back pathology was present in six of the nine horses. Horse (A1) had grade 2 kissing spines (overriding dorsal spinous processes); three horses (B2, B3 and B5) had grade 1 kissing spines and the other two horses (B1 and B4) had grade 3 kissing spines, as well as thoracolumbar facet joint arthritis.
Whole body vibration and exercise All horses (n = 9) underwent WBV 5 days a week (Tuesday, Wednesday, Thursday, Saturday, Sunday), twice daily (morning and afternoon) for 30 min at a frequency of 40 Hz, amplitude of 0.8 mm and an acceleration of 4.9 m/s2 (0.5 g) for a total of 60 days using a mobile linear (vertical) type vibrating platform (Vitafloor VM0)1, producing an indirect vertical sinusoidal vibration applied to the feet. This was added to their normal exercise routine. The regimen of WBV and m. multifidus CSA measurement is shown in Figure 1.
Ultrasound image capture of the m. multifidus Procedures for ultrasound image capture of the m. multifidus have been previously described (Stubbs et al. 2011). All ultrasonography and image capture was performed by the primary author with the horse restrained in cross ties and light sedation (5 mg detomidine [Dormosedan]2 i.v.). After standard skin preparation, ultrasound images (Toshiba
Day -30
Group A Group B
Evaluation Day 0 Evaluation Evaluation
Viamo)3 were captured at the levels of T15–T16, T16–T17, T18– L1 and L1–L2 articular facet joints, using a curvilinear probe (Toshiba Viamo probe 6C1, convex, T4.0 Hz)3, when the bone margin of the dorsal spinous process, articular processes, mammillary process and lateral fascial border between the m. multifidus and m. erector spinae was clearly visible (Fig 2). The anatomical positions of the articular facet joints were
confirmed each time ultrasonographically, by first distinguishing the last (18th) rib, which is convex, from the transverse process of the first lumbar vertebrae, which is flat. Subsequently, the T18–L1 articular facet joint was visualised in between the last rib and transverse process of the first lumbar vertebrae. The T18–L1 facet joint was then used as the landmark to count cranially or caudally to identify the other articular facet joints L1–L2, T16–T17 and T15–T16, respectively. The primary author selected a single image at the level of the articular facet joints instead of between articular facet joints, as described by Stubbs et al. (2011), because he felt that landmarks at the level of the articular facet joints were easier and more reliably imaged. The reliability m. multifidus CSA measurement was
quantified by calculating the standard error of measurement (SEM). The total combined SEM of ultrasonographic image capture and the measurement of the CSA via imaging processing software (ImageJ)4 ranged from 0.012 to 0.014. Complete validation information is available in Supplementary Item 1.
Cross-sectional area measurement The procedure for the measurement of the CSA of the m. multifidus has been previously described (Stubbs et al. 2010). The m. multifidus CSA measurements were completed by the primary author in a nonblinded, random order and all images were measured five times. The average of the five measures was used for all statistical analysis. Imaging processing software (ImageJ)4 was used to measure the CSA
Day 30 Evaluation Evaluation Day 60 Evaluation Evaluation Whole body vibration treatment
Fig 1: The two groups of horses and the timing of whole body vibration (WBV) treatment and m. multifidus CSA determination. © 2016 EVJ Ltd
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