34th Annual Scientific Meeting proceedings

Abdominal and epaxial muscle loss and weakness is a frequent consequence during the convalescent period following colic surgery.¹ The impairments in the agonist - antagonist muscle groups of the abdomen and thoracolumbar spine result in global losses of core strength and spinal stability. In the presence of decreased muscle function, there is corresponding suboptimal stabilizing forces throughout the spinal column, overloading the joints and surrounding soft tissue structures leading to additional nociceptive pain and loss of spinal segment stabilization. Dysfunction in spinal and abdominal support structures can result in diminished return to athletic performance and or increase the risk for injury following the return to sport. In human patients requiring abdominal surgery there is significant atrophy of the deep stabilizing spinal musculature within days following surgery.² Even after the resolution of post operative pain, muscle atrophy persists and contributes to poor core strength, balance deficits and global functional impairments.³  Individuals who return to sport with poor cores stability have increased odds of developing a lower limb injury.   Pursuant to the equine patient, several core strengthening exercises and their role in activating deep epaxial musculature to subsequently improve postural motor control and alter thoracolumbar kinematics have been investigated.⁴  Both baited and passive exercises offer opportunities to facilitate stretching during dynamic phases and strengthening during static phases of the exercise. Institution of dynamic mobilization exercises over a 3 month time period have been shown to increase both size and symmetry of the multifidus muscle as assessed through longitudinal ultrasonographic evaluation.⁴ Similar targeted rehabilitation protocols initiated 4-weeks following colic surgery have demonstrated an earlier return to performance, with 82% of horses improving the level of performance a year after surgery compared to only 8% of horses that did not include core rehabilitation exercises during the convalescent phase.⁵ The results of this study suggest that initiating a core strengthening program for horses following colic surgery may result in improved postsurgical performance outcomes.⁵ Blanket recommendations regarding prescription of exercises is not advised, individual patient prescription should be considered in context of handler safety, specific rehabilitation goals and patient ability to effectively complete each exercise.

References

1. Clayton HM. Core training and rehabilitation in horses. Vet Clin North AM Equine Pract 2016;32:49-71.
2. Ito A, Iijima S. Changes in spinal alignment one month post abdominal surgery: A prospective cohort study. Medicine. 2023 Apr 25;102(17).
3. Kavcic, N., S. Grenier, and S.M. McGill, Determining the Stabilizing Role of Individual Torso Muscles During Rehabilitation Exercises. Spine 2004;29(11):1254-1265.
4. Stubbs, N.C., et al., Dynamic mobilisation exercises increase cross sectional area of musculus multifidus. Equine Vet J 2011. 43(5): p. 522-529.
5. Holcombe SJ, Shearer TR, Valberg SJ. The effect of core abdominal muscle rehabilitation exercises on retrun to training and performance in horses after colic surgery. J Equine Vet Sci. 2019. 75;14-18.