The musculoskeletal system in horses encompasses the bones, muscles, tendons, ligaments, and joints that facilitate movement and provide structural support. This system is essential for locomotion, athletic performance, and overall health in equine species. The equine skeleton consists of approximately 205 bones, which are connected by joints and supported by a network of muscles and connective tissues. Tendons connect muscles to bones, while ligaments link bones to other bones, contributing to joint stability. The musculoskeletal system is subject to various conditions, including injuries, degenerative diseases, and developmental disorders, which can impact a horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, pathology, and treatment of musculoskeletal conditions in horses.
Snow DH, Baxter P, Rose RJ.An investigation into fibre composition and glycogen depletion pattern within the middle gluteal of 16 horses participating in an 80 km endurance ride was carried out. Although the proportion of slow twitch high oxidative (ST) fibres in the horses varied between 7 and 38 per cent, it was found that the horses with the highest proportion of these fibres usually had the best performance records. The cross-sectional area of the fast twitch low oxidative (FT) fibres was greatest, with the ST and fast twitch high oxidative (FTH) being similar in size. Most marked histological evidence of glycogen d...
Gunn HM.A modification of the histochemical reaction to demonstrate myosin adenosine triphosphatase activity in skeletal (striated) muscle was used to define the density of capillaries in transverse sections of 3 muscles (semitendinosus, diaphragm, and pectoralis transversus) of horses and dogs. Thoroughbred horses and Greyhound dogs, breeds noted for their speed in running, were compared with other members of their respective species. Thoroughbred cross horses were grouped with non-Thoroughbreds for comparison with Thoroughbreds. The area of muscle supplied by a capillary was remarkably similar in mu...
Nyack B, Morgan JP, Pool R, Meagher D.Osteochondrosis of the shoulder joint in the horse was diagnosed radiographically in 54 shoulders of 38 horses. Clinical signs were those of an intermittent lameness characterized as a swinging leg shoulder lameness with pain elicited by extension, flexion or abduction of the limb. Diagnosis of shoulder lameness was supported by blocking the shoulder joint with local anesthetics. Radiographic changes consisted of: (1) alteration in the contour of the humeral head and glenoid cavity, (2) periarticular osteophyte formation, (3) sclerosis of the subchondral bone, and (4) bone cyst formation. The ...
Irwin DH, Howell DW.An easy diagnostic technique for recognising fibrotic myopathy and scarring in the caudal popliteal area is described. A simplified corrective surgical technique is offered and discussed briefly. Some aspects of haematomas are reviewed.
Gingerich DA, Auer JA, Fackelman GE.A single intra-articular injection of 20 or 40 mg of purified hyaluronic acid of rooster comb origin resulted in restoration of normal joint function in horses with experimentally induced osteoarthritis. The functional improvement, measured by pressure sensitive force plate techniques, was detectable within one week after treatment and persisted throughout a four week experimental period despite continued use of the joints. The response was dose dependent in that injection of 0 (saline), 5 or 10 mg hyaluronic acid per joint space resulted in no significant change in joint function while dosage...
Goyal HO, MacCallum FJ, Brown MP, Delack JB.Measurements were made of growth at the extremities of all the long bones of the left limbs of 23 horses between 52 and 104 days of age. Growth rates were more rapid in the younger than in the older animals. Growth was more rapid in the hind limb than in the forelimb. Growth rates were greater for males than in females. Although this age group represents only two of the 60 or so months necessary for maturity to be reached, oxytetracycline bone-labelling produced results which are more precise than measurements obtained by other methods. This study provides a substantial amount of data for an a...
McLaughlin BG, Doige CE, Fretz PB, Pharr JW.Six foals with angular limb deformities present at birth or shortly after were examined. The limb deformities were caused by abnormalities of the carpal bones and included hypoplasia and osteochondritis dissecans. The 3rd carpal bone was affected most frequently.
O'Brien TR, Hornof WJ, Meagher DM.Subchondral lesions were identified in the distal palmar region of the third metacarpus in 21 fetlock joints of 15 Thoroughbred horses. The lesions were more commonly identified on the lateromedial and flexed lateral projection, with the flexed lateral projection permitting optimal visualization of the lesion. Lesions appeared as poorly marginated, radiolucent defects and were located at the level of the base of the proximal sesamoid bones. The shape and distribution of the radiolucent defects were: crescent, 4; flattened, 4; shallow concavity, 5; deep concavity, 3; oval, 3; and circular, 2. S...
Baker JR, Ellis CE.The causes of death recorded in 480 consecutive post mortem examinations of horses performed at the department of pathology, Veterinary Field Station, University of Liverpool, between February 1958 and February 1980, are reported. The alimentary, locomotor and nervous systems were those most frequently diseased. The most common specific entities were those associated with grass sickness, fractures and endoparasitism.
Arnoldi CC, Reimann I, Mortensen S, Christensen SB, Kristoffersen J, Sønnichsen HV, Smith M.Six metacarpo-phalangeal joints of adult horses were studied. Pressure measurements were made in the joint and the metacarpal bone with simultaneous measurement of the systemic arterial blood pressure. Investigations performed to study the effect of joint position on juxta-articular bone marrow pressure showed that an increase in joint flexion was always followed by a rise in intraosseous pressure with a significant increase at flexion above 60 degrees. Increase in intra-articular pressure which was achieved by injection of saline was always followed by a slower rise in intraosseous pressure. ...
van Veenendaal JC, Moffatt RE.Eight cases of sessile, intra-articular soft tissue masses originating from the cranio-dorsal attachment of the capsule of the fetlock joint of horses are presented. In 4 of these cases an osteochondral fracture of the first phalanx was also present. Clinically the condition closely resembled villonodular synovitis; however the microscopic changes did not correspond to those reported. The clinical signs included lameness after exercise, joint effusion and pain on manipulation. The offending masses were surgically resected and their histology indicated a chronic proliferative synovitis. The res...
Owen RR.Physiologic features of the equine diarthrodial joint and the effects of intra-articular corticosteroid therapy were investigated. It was concluded that intra-articular injection of corticosteroids may be beneficial when lesions are confined to soft tissues of the joint, excluding injuries involving joint laxity. Rest following therapy is important.
Updike SJ, Diesem CD.The vascular supply of the equine stifle joint was investigated, using latex vascular injections of pelvic limbs from 3 adult horses and 6 ponies. Vessels were grossly dissected to the small arteriole level. The primary source of blood supply was the femoral artery and its branches which entered the joint on the caudal and medial surfaces. The superficial vasculature arose from the caudal branch of the deep circumflex iliac artery cranially and laterally, and from the saphenous and descending genicular arteries medially. The deep vasculature arose from the popliteal artery and its branches on ...
Essén B, Lindholm A, Thornton J.Fibre characteristics and enzyme activities were determined for the gluteus, semitendinosus, vastus lateralis and triceps brachii muscles of 55 Standardbred trotters of different ages. Four fibre types (I, IIA, IIB, IIC) were demonstrated by histochemical staining of myofibrillar adenosine triphosphatase after preincubation at different pH values. Type II fibres predominated in all the muscles and the type IIA/IIB ratio was higher in horses over 5 years than in younger horses, except in the vastus in which the IIA/IIB ratio did not change with age. The vastus had the highest proportion of type...
Jeffcott LB.The survey comprised 443 horses, referred to the clinical department of the Equine Research Station, with a history of a thoracolumbar (TL) complaint. A wide range of lesions were capable of producing back problems and more than one condition or site of injury was found in 75 animals (17 per cent). There were 103 horses (19.7 per cent) with no evidence of damage to the TL spine or its associated structures. In 66 of these cases, clinical signs were attributed to a variety of hindlimb lamenesses and, in 37, no specific diagnosis could be made. Soft tissue injury was diagnosed in 203 cases (38.8...
Al-Khalidi NW, Weisbrode SE, Dubey JP.Nine ponies were fed 100,000 infective Toxoplasma gondii oocysts and were given corticosteroid injections before and after feeding the T gondii oocysts. Titers to the Sabin-Feldman dye tests (1:2 to 1:16,384) developed within postinoculation days (PID) 7 to 21 and antibodies persisted to PID 133. Toxoplasma organisms were isolated from the tissues of 4 ponies (heart of 4, brain of 2, spinal cord of 3, diaphragm of 1, skeletal muscle of 1, liver of 1, kidneys of 1) killed between PID 36 and 63, but not from 5 ponies killed between PID 117 and 150. Seemingly, ponies are one of the more resistant...
Finno CJ.In the field of equine muscle disorders, many conditions have a genetic basis. Therefore, genetic testing is an important part of the diagnostic evaluation. Validated genetic tests are currently available for 5 equine muscle disorders: hyperkalemic periodic paralysis, malignant hyperthermia, glycogen branching enzyme disease, type 1 polysaccharide storage myopathy, and myosin heavy chain myopathy. These diseases should be tested for in the appropriate breeds with clinical signs of disease or as part of breeding management. Genetic testing in veterinary medicine is not regulated, and therefore,...
Brommer H, Back W, Schamhardt HC, Rijkenhuizen AB, Barneveld A.To improve fracture treatment, in vitro experiments were performed to study the influence of a full limb cast and a walking cast on the loading regimen of bones in the distal portion of the equine forelimb. Methods: 6 forelimbs of 6 Shetland ponies. Methods: Loading of the third metacarpal bone was considered a representative measure for distal limb loading. Electrical resistance rosette strain gauges were attached to the dorsal, palmar, medial, and lateral surfaces of the midshaft of this bone in 6 forelimbs of 6 Shetland ponies. The limbs were tested in a pneumatic loading device to a maxima...
Lab on a chipMay 28, 2025
Volume 25, Issue 11 2795-2796 doi: 10.1039/d5lc90048d
Heidenberger J, Reihs EI, Strauss J, Frauenlob M, Gültekin S, Gerner I, Toegel S, Ertl P, Windhager R, Jenner F, Rothbauer M.Correction for 'The effect of cyclic fluid perfusion on the proinflammatory tissue environment in osteoarthritis using equine joint-on-a-chip models' by Johannes Heidenberger et al., Lab Chip, 2025, 25, 2256-2269, https://doi.org/10.1039/d4lc01078g.
Dzierzęcka M, Jaworski M, Purzyc H, Barszcz K.The aim of the study was to analyse selected densitometric and geometric parameters in the third metacarpal bone along the long axis in horses. The densitometric parameters included the cortical and trabecular bone mineral density, while the geometric parameters included the cortical, trabecular, and total areas, strength strain index X, strength strain index Y, and the polar strength strain index. Methods: The parameters were analysed using eight sections from 10% to 80% of the length of the bone. Peripheral quantitative computed tomography was used in the study. Statistical analysis was carr...
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Fulton IC, Derksen FJ, Stick JA, Robinson NE, Walshaw R.The efficacy of a nerve muscle pedicle (NMP) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The NMP graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38 degrees. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference betw...
Campana S, Dittmann M, Kircher P, Donati B.The distribution pattern of central tarsal bone (CTB) changes has not been described, except for slab- and dorsomedial-plantarolateral fractures. Objective: To describe CTB changes in CT and document their distribution and associations. Methods: Retrospective case series. Methods: Standing and recumbent tarsal CT studies from 94 clinical cases were retrospectively evaluated. General case information, degree of sclerosis (none-severe), lesions (demineralisation, cystoid, fissure/fracture) and their location were recorded, dividing CTBs into 8 regions. Results: Eighty five of 94 tarsi showed at ...
Jenner F, Edwards RB, Voss JR, Southwood L, Markel MD, Richardson DW.To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. Methods: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint o...
Asperio RM, Marzola P, Sbarbati A, Osculati F, Addis F.To analyze the tendon of the deep digital flexor (TDDF) muscle of the forelimb in horses by use of a contrast radiographic agent (gadopentate dimeglumine [Gd-DTPA/Dimeg]) and magnetic resonance imaging (MRI) and to determine the concentration of water protons in the tendons by use of MRI. Methods: 8 TDDF harvested from the forelimbs of 6 horse cadavers. Methods: Examinations were performed on the same portion of each tendon. Tendons were examined by use of two techniques: MRI before and after treatment with Gd-DTPA/Dimeg as well as scanning electron microscopy. Results: Tendons did not have de...
Clayton HM.The horse's head and neck account for about 10% of body weight, and this, combined with the fact that they are cantilevered in front of the trunk, produces considerable leverage around the joints at the base of the neck. During locomotion, the neck is moved primarily by gravitational and inertial forces controlled by eccentric-concentric cycles of contraction in the topline muscles assisted by energy-saving, stretch-recoil cycles in the nuchal ligament. The functional part of the nuchal ligament is the caudal funicular region and the lamellae to the second cervical vertebra that acts as the po...
Dzierzecka M, Czerwinski E.On the basis of a digital analysis of radiograms it was checked if, and to what extent, the extended loading of one of the sides of the body of racehorses leads to differences in the microstructure of the spongy bone of the bilateral pastern bones of the thoracic limbs. The research material consisted of radiograms of the pastern bones of the right and left thoracic limbs of racehorses. On the basis of computer image radiological analysis with the use of the "Trabecula,, programme, a quantative evaluation of the structure of the spongy bone of the pastern bones was conducted. It was noted that...
Courtot D, Roux L, Mouthon G, Jeanin E.Doping with tranquilizers has appeared recently in horse-back riding sports. In this paper we study the effects of acepromazine, one of the main tranquilizers used, on various physiological and biochemical aspects of muscular activity (cardiac and respiratory rhythms, seric rates of glucose, urea, protein, creatine phosphokinase, glutamate oxalacetate transaminase, alkaline phosphatase). A low dose (0.02 mg/kg) of acepromazine is injected; the evolution of the variables is studied before and after a standardized effort. After the effort and during recuperation, acepromazine administration caus...
Ceusters JD, Mouithys-Mickalad AA, Franck TJ, Deby-Dupont GP, Derochette S, Serteyn DA.Horses are outstanding athletes, performing in many different disciplines involving different kinds of efforts and metabolic responses. Depending on exercise intensity, their skeletal muscle oxygenation decreases, and the reperfusion at cessation of the exercise can cause excessive production of free radicals. This study on cultured primary equine myoblasts investigated the effect of different kinds of anoxia/reoxygenation (A/R) on routine respiration, mitochondrial complex I specific activity and free radicals production. Our data revealed that short cycles of A/R caused a decrease of all the...
Schoenborn WC, Rick MC, Hornof WJ.A 6-year-old Thoroughbred gelding presented with a left forelimb lameness. The results of lameness examination, radiography, nuclear scintigraphy, and computed tomography are presented. Based on the diagnostic imaging, subchondral fractures and osteochondritis dissecans lesions of the proximal articular surface of the proximal phalanx were diagnosed. A brief discussion of osteochondritis dissecans is presented.
Harmel JL, Lewis CW, Sah RL, Kawcak CE, Wheeler DL.Millions of Americans suffer from osteoarthritis, a joint disease characterized by cartilage degradation and subchondral bone sclerosis. However, little is known about its pathology. It remains to be discovered which comes first in the progression of osteoarthritis: subchondral bone remodeling or cartilage degeneration. This study assessed equine cartilage degeneration, based upon measurements of cartilage thickness and Indian ink stain uptake. By gaining a greater understanding of the determining factors in cartilage degeneration, we may be able to better understand the pathomechanics of oste...
Hollenbach E, Robert MP, le Roux C, Smit Y.If the number of events alone is considered, endurance riding is the fastest growing and the second-most popular Fédération Equestre Internationale (FEI) discipline. Lameness is the most common cause of elimination from endurance races worldwide. To the authors' knowledge, no studies have been published investigating the prevalence of radiographic changes in the forelimb digits and metacarpophalangeal joints (MCP) of endurance racehorses in South Africa. Unassigned: Investigate the prevalence of radiographic changes in the forelimb digits and MCP joints of South African endurance racehorses....
Stewart M.The structure of vertebrate skeletal muscle is reviewed. The mechanism of muscular contraction and its control is then discussed from the point of view of molecular structure. Contraction takes place by a sliding filament mechanism produced by cross-bridges which form between thick and thin filaments. Control is exercised by tropomyosin and troponin. When the calcium concentration is low, these proteins interfere with the formation of cross-bridges and prevent contraction, but when the calcium concentration is increased, they no longer interfere and contraction proceeds.
Lusi CM, Davies HMS.Passive dynamics is an aspect of locomotion which is entirely dependent on the mechanical configuration and linkages of adjacent body segments. Tension distribution along mechanical linkages enables the execution of movement patterns with reduced need for complex neurological pathways and may play a role in reestablishing postural stability following external disturbances. Here we demonstrate a uni-directional mechanical relationship between the equine forelimb, head and neck, which may have implications for balance and forelimb loading in the horse. These observations suggest that forelimb, h...
Jose-Cunilleras E, Wijnberg ID.Reference values for quantitative electromyography (QEMG) in shoulder and hindlimb muscles of horses are limited. Objective: To determine normative data on QEMG analysis of supraspinatus (SS), infraspinatus (IS), deltoideus (DT) and biceps femoris (BF) muscles. Methods: Experimental observational study and retrospective case series. Methods: Seven adult healthy Royal Dutch sport horses underwent quantitative motor unit action potential analysis of each muscle using commercial electromyography equipment. Measurements were made according to published methods. One-way ANOVA was used to compare qu...
Busse NI, Gonzalez ML, Wagner AL, Johnson SE.Optimal athletic performance requires meeting the energetic demands of the muscle fibers, which are a function of myosin ATPase enzymatic activity. Skeletal muscle with a predominant oxidative metabolism underlies equine athletic success. Sodium butyrate, a short-chain fatty acid, can affect muscle fiber composition in pigs. To determine if a similar scenario exists in horses, 12 adult Thoroughbred geldings (7.4 ± 0.6 yr of age; mean ± SEM) were fed 16 g of calcium butyrate (CB) or an equivalent amount of carrier (CON) daily for 30 d in a crossover design. Middle gluteal muscle biopsies were...
Maia BT, Vendruscolo CDP, de Souza AF, Zoppa ALDV.The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4- or 6-point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Images were obtained for measurements of the cross-sectional area of the nerve, distances between the nerve and the skin ...
Flieger S, Sławomirski J, Boratyński Z, Jastrzebski M.Two medullae oblongatae of horses were cut into 15 microns cross-sections and stained according to the modified method of Nissel. The lateral motor nucleus lies in the lateral and median part of the ventral column of spinal cord grey matter. It adjoins medially nucleus motorius medialis of the spinal ventral column. Cells of this nucleus occur both along the whole lumbar and sacral segment of the spinal cord. In the lateral motor nucleus three cell groups are distinguished-median, basal and lateral. The latter is divided in some segments into subgroups-dorsal and ventral. Along the nucleus qui...
Rose PL, Hightower D, Auer JA, Hulse D, Schenk RK.In the present study, radionuclide scintigraphy and radiography were used to evaluate the rate and degree of healing that occurred in surgically created subchondral bone defects in horses. Following radionuclide scintigraphy and radiography the horses were killed, and histomorphometric analysis was performed on the defect sites. The histomorphometric results were compared to the radionuclide scintigraphic and radiographic results to determine which noninvasive technique provided the most accurate information concerning healing of the bone defects. It was concluded that radionuclide scintigraph...
Van Driessche K, Ducatelle R, Chiers K, Van Coster R, van der Kolk JH.Very few mitochondrial myopathies have been described in horses. Objective: To examine the ultrastructure of muscle mitochondria in equine cases of myopathy of unknown origin. Methods: Biopsies of vastus lateralis of the Musculus quadriceps femoris were taken predominantly immediately post mortem and processed for transmission electron microscopy. As a result, electron micrographs of 90 horses in total were available for analysis comprising 4 control horses, 16 horses suffering from myopathy and 70 otherwise diseased horses. Results: Following a thorough clinical and laboratory work-up, four o...
Dechant JE, Trotter GW, Stashak TS, Hendrickson DA.To evaluate the outcome of horses with large fragments of the extensor process of the distal phalanx that were removed by use of arthrotomy. Methods: Retrospective study. Methods: 14 horses with large fragments of the extensor process of the distal phalanx. Methods: Medical records for horses with large fragments of the extensor process that were removed by use of arthrotomy were reviewed. Data retrieved from medical records included signalment, use of horse, affected limb, lameness history, lameness examination findings, radiographic findings, surgical technique, and outcome. Follow-up evalua...
Vinardell T, David F, Morisset S.To describe a direct arthroscopic approach to the suprapatellar pouch (SPP), its intra-articular anatomy, and report our clinical experience with SPP arthroscopy. Methods: (1) Experimental study and (2) retrospective clinical study. Methods: (1) Cadaveric equine hind limbs (n=24; 14 horses) and (2) 5 horses. Methods: Four femoropatellar joints (FPJ) were dissected or injected with latex to document surface landmarks and topographic anatomy. (1) Arthroscopic exploration of 20 SPP (10 equine cadavers) was performed and described, followed by dissection. (2) Medical records of horses that had FPJ...
Breit S, Stiglhuber A, König HE.Striking synovial structures were taken and their surface was investigated by scanning electron microscopy. Depending where the probes were taken from, the stratum synovial was arranged in a different way. The synovial intima seems to miss under the tendon of the long/commune extensor muscle, the collateral ligaments and the sesamoidean collateral ligaments. That is why the subsynovial tissue forms the superficial layer. The surface of the probes taken sidewards to the tendon of the extensor muscle and of the synovial fold, which is situated between the metacarpus/metatarsus and the proximal p...
Elzer EJ, Bramlage LR.Outcomes have been reported for a limited number of short frontal plane fractures of the proximal phalanx following nonsurgical treatment and internal fixation. Objective: To describe a new approach, arthroscopic debridement, of short frontal plane fractures of the proximal phalanx in flat-racing Thoroughbreds and post-operative racing outcome. Methods: Retrospective case-control study. Methods: Medical records of 81 Thoroughbred racehorses treated with arthroscopic debridement for frontal plane fractures of the proximal phalanx were reviewed. Diagnostic images and operative reports were used ...
O'Neill HD, Bladon BM.There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999-2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were do...
Manohar M, Duren SE, Sikkes B, Day J, Baker JP.Distribution of blood flow among various respiratory muscles was examined in 8 healthy ponies during submaximal exercise lasting 30 minutes, using radionuclide labeled 15-microns diameter microspheres injected into the left ventricle. From the resting values (40 +/- 2 beats/min; 37.3 +/- 0.2 C), heart rate and pulmonary arterial blood temperature increased significantly at 5 (152 +/- 8 beats/min; 38.6 +/- 0.2 C), 15 (169 +/- 6 beats/min; 39.8 +/- 0.2 C), and 26 (186 +/- 8 beats/min; 40.8 +/- 0.2 C) minutes of exertion, and the ponies sweated profusely. Mean aortic pressure also increased progr...
