Hydrotherapy at High Pointe Equine Center in Hunterdon
County, NJ
REHABILITATION
Hydrotherapy, or treatment in water, especially sea water
or natural hydrotherapy water has long been used for the treatment
of many health conditions.
Both hot and cold baths have been used by human exercise
physiologists and physiotherapists to treat muscle, joint
and surgical injuries. Similar use has been made of sea water
by some horse trainers in coastal locations and swimming of
horses allows massage of joints and ligaments. However, some
local government regulations now preclude the swimming of
horses at beaches, reducing the opportunity for this form
of hydrotherapy other than in purpose-built facilities.
Cold temperature effects (cryotherapy) of water immersion
are less well tolerated in humans because of hypothermia and
increases in blood pressure due to peripheral vasoconstriction2;
however, local application of cryotherapy
following injury without immersion in all species is well
documented. The standing of horses in running cold streams
was historically recognized as beneficial for soreness after
exercise. Running water maintains a constant temperature and
provides mild massage which is beneficial with cold and has
been a time-honored treatment for moderate contusion injuries
in competition horses where anti-inflammatory drug therapy
was not an option. For horses with flexor tendonitis or suspensory
desmitis, laminitis and founder, cryotherapy with an optimal
application time of 10 minutes is recommended. More recently,
improvements in technology have increased the options for
ultra sonographic diagnosis,treatment and monitoring responses
to such treatment in lower leg tendonitis and desmitis, with
time frame from injury to successful competition suggested
as just over a year. Successful return to competition in racehorses,
managed only by rest, has been described as horses which competed
in five or more races without recurrence of tendonitis but
the report made no reference to time frame of return to racing.
The opportunity to examine the benefits of agitated immersion
of the lower limbs of horses became available with the donation
of a walk-in horse hydrotherapy in 1998 following earlier
development of a trial unit in 1992. Anecdotal evidence
from that trial unit indicated rapid healing of lower leg
injuries, following treatment every other day. The first
cases treated responded quickly during winter but more slowly
during summer, and response was also found to be faster
with the addition of salts to make the water hypertonic.
MATERIALS AND METHODS
Horses had feet cleaned, legs hosed to remove dirt, and
were fitted with a lightweight fecal collection harness.
They were then walked into the spa bath chamber, doors closed
and water fill commenced. The hydrotherapy chamber has a
water storage capacity of 2500 1iters, maintained at 5 to
9°C, to which was added 20 g/l sodium chloride, 30 g/1
magnesium sulphate. Chlorine was added daily to give a regular
free chlorine value of 3 to 5% which together resulted in
a conductivity quotient of 28.6 mS (cf.blood serum of 13.5
mS/cm/sec). Once water entry achieved a depth of 30 cm air
agitation of water commenced. Water entry was continued
until the depth reached mid radius. Ten minutes following
the start of air agitation, emptying of the hydrotherapy
chamber commenced and water agitation ceased when the level
was again at a depth of 30 cm. On emptying the spa the horse
was led out, the fecal harness removed, and the legs hosed
off. Then the horse is returned to the stall after stretching
their legs out. In summary, High Pointe's rehabilitative
operations, "We complement and actively continue rehab
care from the point of post-operative and post-diagnosis.
If the patient is a horse, we can take care of it."
Results: Coldwater Salt Hydrotherapy for the Treatment
of Suspensory Ligament Injuries
Case 1: Adult Male Quarter Horse (reining)
Injury: 75% rupture of left hind proximal suspensory
ligament.
Presentation: Moderate heat, slight to moderate swelling
and pain at injury site. Lame at the walk.
Treatment: Animal was treated with conventional stem
cell therapy followed by daily coldwater salt hydrotherapy
having one day off per week. Animal was initially walked
daily for 10 minutes and gradually increased to 40 minutes.
Immediate reductions in heat and swelling were noted following
hydrotherapy treatments.
Results: After 6 weeks of hydrotherapy animal was
sound at the walk. At week 6 no visible or palpable abnormalities
were observed, animal was sound at the walk and trot and
was placed on limited turnout.
Case 2: Adult Female Warmblood (Dressage)
Injury: Deep Digital Flexor tendon injury of the
right front leg.
Presentation: Animal arrived at High Pointe Equine
to try coldwater salt hydrotherapy as a last resort. She
was not able to bear weight on the injured leg and as a
result walked on 3 legs. Moderate to severe heat and swelling
were observed at site of injury as well as laminitis on
the front left.
Treatment: Animal was treated with conventional stem
cell therapy prior to her arrival at our facility. She experienced
a reaction to the stem cells which severely impacted her
prognosis. Because of her severe lameness she was a candidate
for humane euthanasia. She began daily hydrotherapy treatments
having one day off per week. We began 2 minute walks and
increased the time as her condition improved. Over a period
of 3 months, her therapy program was extended to 40 minutes
daily.
Results: Immediate reductions in heat and swelling
were noted following hydrotherapy. After 3 weeks she was
able to walk on her injured leg. At 10 weeks no visible
or palpable abnormalities were observed. Animal is now on
daily turnout in a round-pen. She is sound at the walk and
trot and her condition continues to improve and she is back
to limited training.
DOWNLOADABLE
INFORMATIONAL PDF BROCHURE .PDF
E.R. - -HUNT STUDY PAPER .PDF-
