The Effect of a Physiotherapy Intervention on Thoracolumbar Posture in Horses.

Abstract

Simple SummaryAltered spinal posture in a horse often relates to an underlying musculoskeletal condition that results in a negative effect on performance and welfare. Equine physiotherapy aims to adapt a horse’s posture by prescribing strengthening exercises to improve spinal range of movement and facilitate contraction of specific muscles. The aim of this study was to test the reliability of an outcome measure to objectively measure thoracolumbar posture before and after physiotherapy exercises over a specific time-period. The adapted flexicurve ruler (aFCR) had excellent intra-rater reliability compared to a standard flexicurve ruler. There were significant increases in thoracolumbar flexion after physiotherapy intervention at the specific time periods, of thirty minutes and one hour, however no significant changes at twenty-four hours. The physiotherapy intervention tested was shown to produce a short-term postural change, and over time may allow a long-term postural change with frequent practice. Outcome measures are valuable within veterinary physiotherapy to support clinical reasoning and the aFCR is shown to measure thoracolumbar posture pre and post-physiotherapy. Creating a postural change in horses can aid in a rehabilitation programme with veterinary physiotherapy, aiming to relieve pain and stiffness. Dynamic mobilisation exercises (DME) are often used as part of a physiotherapy rehabilitation programme. Whilst immediate kinematic effects have been measured, the change in posture is anecdotally reported to have a longer duration. This study aimed to test the reliability of a simple objective measurement method, suitable for use in clinical practice, and to objectively measure equine thoracolumbar posture, before and after DME. A single investigator took triplicate measurements of the sagittal thoracolumbar shape using a flexicurve ruler (FCR) then triplicate measurements of the thoracolumbar shape using an adapted FCR (aFCR) in 37 horses. Subsequently, the thoracolumbar shape of 12 horses was measured using the aFCR before random allocation into two groups. Six horses acted as a control group and six horses underwent a series of DME, which included cervical flexion and lateral flexion baited stretches. Measurements were repeated prior to DME, at thirty minutes, one hour and at twenty-four hours after DME to assess thoracolumbar posture. The aFCR ruler had excellent intra-rater reliability compared to a standard FCR (aFCR: p = 0.146; intraclass correlation coefficient (ICC) 0.971; FCR: p = 0.0001; ICC 0.979). Significant increases in flexion occurred in the thoracolumbar region at 30 min (p = 0.027) and one hour (p = 0.046) after DME, but not at 24 h (p > 0.05) with no significant differences in the control group (p > 0.05) between baseline and subsequent times. The results suggest DME create a short-term postural change, determined by using an aFCR, which supports their use as part of a veterinary physiotherapy rehabilitation programme.