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Topic:Joint Health

Joint health in horses involves the study of anatomical structures such as cartilage, synovial fluid, ligaments, and bones that contribute to the function and mobility of equine joints. Research in this area focuses on understanding the physiology of equine joints, the mechanisms of joint disorders, and the effects of wear and tear over time. Common joint issues in horses include osteoarthritis, synovitis, and joint effusion, which can impact performance and quality of life. Diagnostic techniques often involve imaging, synovial fluid analysis, and clinical evaluation to assess joint condition. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, pathology, diagnostics, and therapeutic approaches related to joint health in horses.
Factors Associated With Survival and Return to Function Following Synovial Infections in Horses.
Frontiers in veterinary science    October 22, 2019   Volume 6 367 doi: 10.3389/fvets.2019.00367
Crosby DE, Labens R, Hughes KJ, Nielsen S, Hilbert BJ.Synovial infections (SI) are common in horses of all ages and can be associated with high rates of morbidity and mortality. Identifying factors influencing survival and return to function may be useful for management of affected individuals and determination of prognosis. The objectives of this study were to identify factors associated with survival and return to function of horses and foals with SI presented to an equine hospital. This study is a retrospective case series. Data were collected from medical records of all horses with SI that were presented to a single equine hospital between Ap...
Elastic properties of collateral and sesamoid ligaments in the forelimbs of equine cadavers.
American journal of veterinary research    September 27, 2019   Volume 80, Issue 10 923-930 doi: 10.2460/ajvr.80.10.923
Legg KA, Colborne GR, Gee EK, Rogers CW.To evaluate the elastic modulus of various ligaments of the forelimbs of cadaveric horses. Methods: 408 ligaments from 37 forelimbs of 10 Thoroughbred cadavers and cadavers of 9 other horse breeds. Methods: Collateral ligaments and straight and oblique sesamoid ligaments were harvested from the proximal interphalangeal, metacarpophalangeal, carpal, and elbow joints of both forelimbs of all 19 horses. Ligament dimensions were measured, and the elastic modulus was determined by tensile testing the ligaments with a strain rate of 1 mm•s. Results: Elastic modulus of the ligaments differed signif...
The Use of the Water Treadmill for the Rehabilitation of Musculoskeletal Injuries in the Sport Horse.
Journal of veterinary research    September 13, 2019   Volume 63, Issue 3 439-445 doi: 10.2478/jvetres-2019-0050
Muñoz A, Saitua A, Becero M, Riber C, Satué K, de Medina AS, Argüelles D, Castejón-Riber C.In recent years, exercise on a water treadmill has come to have great relevance in rehabilitation and training centres for sport horses. Its use exploits certain physical properties of water, related to the fundamental principles of hydrodynamics, such as buoyancy, viscosity, hydrostatic pressure, and water temperature. These properties together with deliberate specification of the depth of the water and the velocity of the treadmill provide a combination of parameters that can be varied according to the purpose of the rehabilitation or training programme, the disease to rehabilitate, or the h...
Avocado/Soybean Unsaponifiables, Glucosamine and Chondroitin Sulfate Combination Inhibits Proinflammatory COX-2 Expression and Prostaglandin E2 Production in Tendon-Derived Cells.
Journal of medicinal food    September 5, 2019   Volume 23, Issue 2 139-146 doi: 10.1089/jmf.2019.0022
Grzanna MW, Au RY, Au AY, Rashmir AM, Frondoza CG.Tendinopathy, a common disorder in man and horses, is characterized by pain, dysfunction, and tendon degeneration. Inflammation plays a key role in the pathogenesis of tendinopathy. Tendon cells produce proinflammatory molecules that induce pain and tissue deterioration. Currently used nonsteroidal anti-inflammatory drugs are palliative but have been associated with adverse side effects prompting the search for safe, alternative compounds. This study determined whether tendon-derived cells' expression of proinflammatory cyclooxygenase (COX)-2 and production of prostaglandin E2 (PGE) could be a...
Comparison of efficacy and safety of single versus repeated intra-articular injection of allogeneic neonatal mesenchymal stem cells for treatment of osteoarthritis of the metacarpophalangeal/metatarsophalangeal joint in horses: A clinical pilot study.
PloS one    August 29, 2019   Volume 14, Issue 8 e0221317 doi: 10.1371/journal.pone.0221317
Magri C, Schramme M, Febre M, Cauvin E, Labadie F, Saulnier N, François I, Lechartier A, Aebischer D, Moncelet AS, Maddens S.The purpose of this prospective study was to evaluate the effects of single and repeated intra-articular administration of allogeneic, umbilical cord-derived, neonatal mesenchymal stem cells (MSC) in horses with lameness due to osteoarthritis (OA) of a metacarpophalangeal joint (MPJ). Twenty-eight horses were included. Horses were divided into two groups. Horses in group MSC1 received an MSC injection at M0 and a placebo injection at M1 (1 month after M0). Horses in group MSC2 received MSC injections at M0 and at M1. Joint injections were performed with a blinded syringe. Clinical assessment w...
Osteochondral fragments of the pastern joint at the origin of the collateral ligament of the distal sesamoid bone: performance after arthroscopic removal (2000-2015).
Veterinary surgery : VS    August 27, 2019   Volume 48, Issue 7 1181-1187 doi: 10.1111/vsu.13307
Moyer CT, Bramlage LR, Werre SR, Ruggles A, Embertson R, Hopper S.To describe the presence of fragments in the dorsal proximal interphalangeal (PIP) joint and to report flat racing performance after surgical treatment. Methods: Retrospective study. Methods: Thirty-nine affected thoroughbred flat racehorses and 169 age- and sex-matched maternal siblings. Methods: Medical records from 2000 to 2015 were reviewed for thoroughbred horses that underwent arthroscopic removal of osteochondral fragments in the dorsal aspect of the PIP joint. The horses' 2-year-old year, 3-year-old year, and career athletic performances were compared with their matched siblings. Resul...
Equine or porcine synovial fluid as a novel ex vivo model for the study of bacterial free-floating biofilms that form in human joint infections.
PloS one    August 15, 2019   Volume 14, Issue 8 e0221012 doi: 10.1371/journal.pone.0221012
Gilbertie JM, Schnabel LV, Hickok NJ, Jacob ME, Conlon BP, Shapiro IM, Parvizi J, Schaer TP.Bacterial invasion of synovial joints, as in infectious or septic arthritis, can be difficult to treat in both veterinary and human clinical practice. Biofilms, in the form of free-floating clumps or aggregates, are involved with the pathogenesis of infectious arthritis and periprosthetic joint infection (PJI). Infection of a joint containing an orthopedic implant can additionally complicate these infections due to the presence of adherent biofilms. Because of these biofilm phenotypes, bacteria within these infected joints show increased antimicrobial tolerance even at high antibiotic concentr...
Various 3D printed materials mimic bone ultrasonographically: 3D printed models of the equine cervical articular process joints as a simulator for ultrasound guided intra-articular injections.
PloS one    August 6, 2019   Volume 14, Issue 8 e0220332 doi: 10.1371/journal.pone.0220332
Beaulieu A, Linden AZ, Phillips J, Arroyo LG, Koenig J, Monteith G.In the equine racehorse industry, reduced athletic performance due to joint injury and lameness has been extensively reviewed. Intra-articular injections of glucocorticoids are routinely used to relieve pain and inflammation associated with osteoarthritis. Intra-articular injections of pharmaceutical agents require practice for precise needle placement and to minimize complications. Training on simulators or models is a viable alternative for developing these technical skills. The purpose of this study was to compare the qualitative ultrasonographic characteristics of three-dimensional (3D) pr...
Erratum to “Orientation and location of the finite helical axis of the equine forelimb joints”.
Journal of morphology    July 18, 2019   Volume 280, Issue 8 1246 doi: 10.1002/jmor.21035
No abstract available
Evaluation of four techniques for injection of the proximal interphalangeal joint in horses.
Veterinary surgery : VS    July 16, 2019   Volume 48, Issue 8 1437-1443 doi: 10.1111/vsu.13296
Mereu M, Hawkes C, Cuddy LC, Perez Olmos JF, Pazzola M, McNally TP.To describe a dorsoproximal midline (DPM) standing technique for proximal interphalangeal joint (PIPJ) injection and to compare it to established dorsolateral flexed (DLF), palmaroproximal (PP), and dorsolateral standing (DLS) techniques. Methods: Ex vivo study. Methods: Sixty cadaver equine thoracic limbs. Methods: Limbs were divided into four groups (n = 15 each group), DLF, DPM, PP, and DLS. For each technique, three operators injected radiopaque contrast and methylene blue into the PIPJ in five limbs. The number of attempts required was recorded. Successful injection was confirmed by radio...
An equine-assisted therapy intervention to improve pain, range of motion, and quality of life in adults and older adults with arthritis: A randomized controlled trial.
Applied nursing research : ANR    July 10, 2019   Volume 49 5-12 doi: 10.1016/j.apnr.2019.07.002
White-Lewis S, Johnson R, Ye S, Russell C.To compare equine-assisted therapy to exercise education on pain, range of motion, and quality of life in adults and older adults with arthritis. Quality of life for adults and older adults is negatively impacted by arthritis pain, stiffness, and decreased function. Equine-assisted therapy provides unique movements to the rider's joints and muscles improving pain, range of motion, and quality of life and has improved outcomes in balance, gait, strength, functional mobility, and spasticity for older adults, stroke, spinal cord injury, and multiple sclerosis patients. No research has investigate...
Effects of blood-derived products and sodium hyaluronate on equine synovial fluid cells and on synovial fluid from osteochondrotic joints of horses after arthroscopy and administration of treatment.
American journal of veterinary research    June 28, 2019   Volume 80, Issue 7 646-656 doi: 10.2460/ajvr.80.7.646
Machado TSL, Massoco CO, Silva LCLC, Fülber J, Moreira JJ, Baccarin RYA.To compare effects of platelet-rich plasma (PRP), interleukin-1 receptor antagonist protein (IRAP), autologous processed plasma (APP), and sodium hyaluronate treatments on synovial fluid cells in vitro and on synovial fluid obtained from osteochondrotic joints of horses. Methods: Synovial fluid cells from 8 healthy equine tibiotarsal joints (in vitro experiment) and synovial fluid samples from 40 tibiotarsal joints of 25 horses with osteochondrosis dissecans (in vivo experiment). Methods: Effects of various treatments on concentrations of prostaglandin (PG) E2, interleukin (IL)-1β, tumor necr...
Allogeneic vs. autologous intra-articular mesenchymal stem cell injection within normal horses: Clinical and cytological comparisons suggest safety.
Equine veterinary journal    June 24, 2019   Volume 52, Issue 1 144-151 doi: 10.1111/evj.13136
Colbath AC, Dow SW, Hopkins LS, Phillips JN, McIlwraith CW, Goodrich LR.Allogeneic bone marrow-derived mesenchymal stem cells (BMDMSCs) could provide multiple advantages over autologous BMDMSCs, including creating an 'off-the-shelf' treatment together with the ability to control for donor variation. Objective: The objective of the study was to compare the clinical and synovial fluid response of the normal equine joint to autologous and pooled-allogeneic BMDMSCs while controlling for individual variation and joint variations in response to intra-articular injections. We hypothesised that, by controlling for individual animal and joint variation, we could identify d...
Disposition and effect of intra-articularly administered dexamethasone on lipopolysaccharide induced equine synovitis.
Acta veterinaria Scandinavica    June 20, 2019   Volume 61, Issue 1 28 doi: 10.1186/s13028-019-0464-2
Ekstrand C, Bondesson U, Giving E, Hedeland M, Ingvast-Larsson C, Jacobsen S, Löfgren M, Moen L, Rhodin M, Saetra T, Ranheim B.Dexamethasone is used for the intra-articular route of administration in management of aseptic arthritis in horses. Despite its widespread use there is very little quantitative data of the disposition and response to dexamethasone. The aim of this study was to investigate and describe the synovial fluid and plasma dexamethasone concentration over time and to explore the relation between synovial fluid concentration and response using clinical endpoints as response biomarkers after IA injection of dexamethasone disodium salt solution in an equine model of synovitis. Results: Inflammation was in...
Evaluation of the effect of experimentally induced cartilage defect and intra-articular hyaluronan on synovial fluid biomarkers in intercarpal joints of horses.
Acta veterinaria Scandinavica    May 30, 2019   Volume 61, Issue 1 24 doi: 10.1186/s13028-019-0460-6
Niemelä TM, Tulamo RM, Carmona JU, López C.Inflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory m...
Standing Needle Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joint for Removal of Dorsal Osteochondral Fragmentation in 21 Horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    May 24, 2019   Volume 32, Issue 5 420-426 doi: 10.1055/s-0039-1688984
Bonilla AG. The aim of this study was to report the technique, experience and outcome of standing arthroscopic removal of dorsal osteochondral fragmentation of the metacarpophalangeal and metatarsophalangeal joint using a 1.2-mm needle arthroscope. Methods:  This was a prospective clinical study. Methods:  All horses referred for standing arthroscopic removal of dorsoproximal first phalanx fragments or fragments embedded in the distal aspect of the synovial plica were included. Relevant information from the cases was recorded. Follow-up was obtained by a telephone questionnaire. Results:  Twenty-...
Clinical findings, synovial fluid cytology and growth factor concentrations after intra-articular use of a platelet-rich product in horses with osteoarthritis.
Journal of the South African Veterinary Association    May 23, 2019   Volume 90 e1-e9 doi: 10.4102/jsava.v90i0.1721
Smit Y, Marais HJ, Thompson PN, Mahne AT, Goddard A.Osteoarthritis is a common cause of lameness in horses, resulting in poor performance. Intra-articular platelet-rich plasma can deliver a collection of bioactive molecules, such as autologous growth factors and proteins involved in the quality of tissue repair. Horses (n=5) with osteoarthritis affecting antebrachiocarpal, middle carpal or metacarpophalangeal joints, and horses (n=5) without osteoarthritis of the corresponding joints (radiographically free of osteoarthritis), were used for the production of platelet-rich plasma which was subsequently injected into selected joints. Clinical and ...
Arthrodesis of the metacarpophalangeal and metatarsophalangeal joints to treat osteoarthritis in 17 horses.
Veterinary surgery : VS    May 23, 2019   Volume 48, Issue 5 850-857 doi: 10.1111/vsu.13236
Chapman HS, Richardson DW, Ortved KF.To describe arthrodesis of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint with a locking compression plate (LCP) and a metallic tension band and report the outcome of horses treated for osteoarthritis (OA) with this technique. Methods: Retrospective case series. Methods: Seventeen horses with OA of the MCP or MTP joint treated with arthrodesis. Methods: Medical records (2004-2017) of horses treated for OA with arthrodesis of the MCP or MTP joint with an LCP and metallic tension band were reviewed. Preoperative variables included age, sex, breed, affected limb, and lameness gr...
Genome-Wide Association Studies Based on Equine Joint Angle Measurements Reveal New QTL Affecting the Conformation of Horses.
Genes    May 14, 2019   Volume 10, Issue 5 doi: 10.3390/genes10050370
Gmel AI, Druml T, von Niederhäusern R, Leeb T, Neuditschko M.The evaluation of conformation traits is an important part of selection for breeding stallions and mares. Some of these judged conformation traits involve joint angles that are associated with performance, health, and longevity. To improve our understanding of the genetic background of joint angles in horses, we have objectively measured the angles of the poll, elbow, carpal, fetlock (front and hind), hip, stifle, and hock joints based on one photograph of each of the 300 Franches-Montagnes (FM) and 224 Lipizzan (LIP) horses. After quality control, genome-wide association studies (GWASs) for t...
The synovial fluid proteome differentiates between septic and nonseptic articular pathologies.
Journal of proteomics    April 25, 2019   Volume 202 103370 doi: 10.1016/j.jprot.2019.04.020
Anderson JR, Smagul A, Simpson D, Clegg PD, Rubio-Martinez LM, Peffers MJ.Articular conditions are common in horses and can result in loss of function, chronic pain and/or inability to work. Common conditions include osteoarthritis, osteochondrosis and synovial sepsis, which can be life-threatening, but despite the high clinical prevalence of these conditions, rapid and specific diagnosis, monitoring and prognostication remains a challenge for practicing veterinarians. Synovial fluid from a range of arthropathies was enriched for low abundance proteins using combinatorial peptide ligand ProteoMiner™ beads and analysed via liquid chromatography-tandem mass spectrom...
Markers for oxidative stress in the synovial fluid of Thoroughbred horses with carpal bone fracture.
Journal of equine science    April 3, 2019   Volume 30, Issue 1 13-16 doi: 10.1294/jes.30.13
Tsuzuki N, Kanbayashi Y, Kusano K.Arthritis is thought to cause oxidative stress in synovial fluid in humans, but there have been few reports in horses. To evaluate oxidative stress in synovial fluid in horses, this study used 19 horses with unilateral fracture of the carpal joint bone. Synovial fluid was collected from the carpal joint on the fracture (arthritis group) and contralateral (control group) sides. Diacron-reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) were then measured, and the oxidative stress index (OSI) was calculated. d-ROMs and OSI of the arthritis group were significantly hi...
In vitro evaluation of a medial approach for intra-articular injection of the tarsometatarsal joints of horses.
American journal of veterinary research    March 29, 2019   Volume 80, Issue 4 396-402 doi: 10.2460/ajvr.80.4.396
Canonici P, Beccati F, Canonici F, Pepe M.To develop a reliable method for injection of the tarsometatarsal (TMT) joint of horses through a medial approach and to characterize anatomy of the synovial recesses of the TMT joint with CT. Methods: 13 pairs of fresh cadaveric equine tarsi. Methods: TMT joints were assessed with radiography and CT. Twelve pairs of TMT joints were assigned to an experienced veterinarian (8 joints) or veterinary student (16 joints) for injection with contrast medium through a medial or a lateral approach. Every TMT joint was then reexamined radiographically and with CT to assess diffusion of contrast medium. ...
Quantitative characterization of viscoelastic properties of synovial fluid from forelimb joints of orthopedically normal Thoroughbreds and warmblood horses.
American journal of veterinary research    March 29, 2019   Volume 80, Issue 4 342-346 doi: 10.2460/ajvr.80.4.342
Tyrnenopoulou PC, Rizos ED, Kritsepi-Konstantinou M, Papadopoulou PL, Patsikas MN, Papazoglou LG, Aggeli A, Diakakis NE.To determine whether differences existed in the viscoelastic properties of synovial fluid samples from the metacarpophalangeal, intercarpal, and distal interphalangeal joints of orthopedically normal athletic horses. Methods: 45 warmblood horses and 30 Thoroughbreds (age range, 4 to 16 years). Methods: Synovial fluid samples were aseptically obtained via arthrocentesis from 1 metacarpophalangeal, intercarpal, and distal interphalangeal joint of each horse, and nucleated cell counts were performed. A commercial ELISA was used to measure sample hyaluronic acid concentrations, and full rheologica...
Orientation and location of the finite helical axis of the equine forelimb joints.
Journal of morphology    March 19, 2019   Volume 280, Issue 5 712-721 doi: 10.1002/jmor.20978
Kaashoek M, Hobbs SJ, Clayton HM, Aerts P, Nauwelaerts S.To reduce anatomically unrealistic limb postures in a virtual musculoskeletal model of a horse's forelimb, accurate knowledge on forelimb joint constraints is essential. The aim of this cadaver study is to report all orientation and position changes of the finite helical axes (FHA) as a function of joint angle for different equine forelimb joints. Five horse cadaver forelimbs with standardized cuts at the midlevel of each segment were used. Bone pins with reflective marker triads were drilled into the forelimb bones. Unless joint angles were anatomically coupled, each joint was manually moved ...
Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses.
The Canadian veterinary journal = La revue veterinaire canadienne    March 16, 2019   Volume 60, Issue 3 294-299 
Dahan R, Oreff GL, Tatz AJ, Raz T, Britzi M, Kelmer G.The objectives of this study were to evaluate the compatibility and the pharmacokinetic properties of combined amikacin and penicillin administration by intravenous regional limb perfusion (IVRLP) in horses. A tourniquet was applied proximal to the carpus of 7 clinically healthy adult horses and 2 g of amikacin and 10 × 10 IU of penicillin (100 mL total volume) were sequentially injected into the cephalic vein just distal to the tourniquet. Synovial samples were collected from the joint at several times after injection. All samples were analyzed for amikacin and penicillin concentration. The ...
A Standing Percutaneous Technique for Proximal Interphalangeal Joint Arthrodesis in Twelve Horses (2014-2017).
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    March 7, 2019   Volume 32, Issue 2 165-170 doi: 10.1055/s-0039-1677747
Heaton K, Farnsworth KD, Souza CRS, Jones ARE. This report describes the use of a minimally invasive standing pastern arthrodesis technique for the treatment of osteoarthritis in horses and documents its clinical outcome in 12 horses. Methods:  Medical records and radiographs of horses diagnosed with proximal interphalangeal joint osteoarthritis that underwent standing pastern arthrodesis using transarticular screws were reviewed. Follow-up information for determination of outcome was obtained via phone interview with the owners. Results:  Twelve horses (15 limbs) were included in the study. Radiographical findings revealed severe o...
Use of a 2.5% Cross-Linked Polyacrylamide Hydrogel in the Management of Joint Lameness in a Population of Flat Racing Thoroughbreds: A Pilot Study.
Journal of equine veterinary science    February 27, 2019   Volume 77 57-62 doi: 10.1016/j.jevs.2019.02.012
de Clifford LT, Lowe JN, McKellar CD, Bolwell C, David F.Osteoarthritis is one of the most common disease processes effecting equine athletes, causing up to 60% of all lameness. This prospective longitudinal study reports on the effect of treatment of carpal and metacarpophalangeal joint lameness with 2.5% cross-linked polyacrylamide hydrogel (PAAG). A total of 49 flat-racing Thoroughbreds at a single training facility were included in the study. The results show a significant improvement in lameness grades at weeks 1 (P < .01), 4 (P < .001), 12 (P < .001), and 24 (P < .001) when compared to baseline lameness at week 0. This pilot study ...
Evaluation of alginate hydrogel encapsulated mesenchymal stem cell migration in horses.
Research in veterinary science    February 25, 2019   Volume 124 38-45 doi: 10.1016/j.rvsc.2019.02.005
Santos VHD, Pfeifer JPH, Souza JB, Stievani FC, Hussni CA, Golim MA, Deffune E, Alves ALG.Osteoarthritis is an incapacitating disease characterized by pain and a progressive decrease in joint mobility. The implantation of mesenchymal stem cells (MSCs) has shown promising results for its treatment. The challenge remains to keep the cells longer at the site of action, increasing their therapeutic potential. The aim of this study was to evaluate the effectiveness of the Qtracker® 655 nanocrystal marking on allogeneic synovial membrane (SM) MSCs, encapsulated in alginate hydrogel, evaluating the migration of these cells. The 10 radiocarpal joints were submitted to arthroscopic surgery...
A minimally invasive partial condylectomy and temporal bone resection for the treatment of a suspected chronic synovial sepsis of the temporomandibular joint in a 3.5-year-old paint horse gelding.
The veterinary quarterly    February 19, 2019   Volume 38, Issue 1 118-124 doi: 10.1080/01652176.2018.1535216
Frietman SK, van Proosdij ER, Veraa S, de Heer N, Ter Braake F.No abstract available
[… and Riding as Well? Case Report about the Treatment of an Infant with Unresponsive Wakefulness Syndrome].
Die Rehabilitation    February 11, 2019   Volume 59, Issue 1 48-53 doi: 10.1055/a-0835-2990
Steppacher I, Kissler J.There is a growing number of children surviving birth complications with severe, multiple disabilities. Unfortunately, this is not paralleled by equal growth in knowledge about adequate therapeutic approaches. Some publications showed that Hippotherapy could, under certain circumstances, be a very useful complimentary therapy for a range of disabilities. But it remains unclear if riding could even help a quadriplegic individual with multiple brain damage and tracheal ventilation. Methods: In this case study we examined the effect of horse riding on the mobility of joints and heart rate in a li...
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