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Topic:Rehabilitation

Rehabilitation for horses refers to the process of restoring physical function and performance following injury, illness, or surgery. This process often involves a combination of veterinary care, physical therapy, and specialized training techniques. Rehabilitation aims to promote healing, improve mobility, and prevent further injury. Common methods used in equine rehabilitation include controlled exercise programs, hydrotherapy, and the use of therapeutic modalities such as laser therapy and ultrasound. The effectiveness of these methods is evaluated through clinical assessments and performance metrics. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies, outcomes, and advancements in the field of equine rehabilitation.
In vivo effects of cold therapy and bandaging on core temperatures of equine superficial and deep digital flexor tendons.
Veterinary surgery : VS    February 25, 2025   Volume 54, Issue 3 470-477 doi: 10.1111/vsu.14235
McCarthy RD, Ordóñez HJ, Semevolos SA.To compare core temperatures of superficial and deep digital flexor tendons (SDFT, DDFT) during application of a compression cooling system versus ice boots and during subsequent lower limb bandaging. Methods: Experimental study. Methods: Paired forelimbs of six sedated horses. Methods: Thermocouples were placed in the core of SDFT and DDFT of both front limbs of each horse. A compression cooling system was applied to one front limb and an ice boot was applied to the other front limb for 60 min and then removed for 60 min. Standing bandages were then applied to both front limbs for 60 mi...
The Use of an Air-Inflated Pillow for Assisted Recovery After General Anaesthesia in Horses: A Preliminary Study.
Animals : an open access journal from MDPI    February 15, 2025   Volume 15, Issue 4 doi: 10.3390/ani15040564
Vandaele Z, Van den Broeke C, Merchiers A, Schauvliege S.Different assisted recovery techniques have been developed to enhance the safety and quality of equine recoveries. This case series evaluates the recovery of horses using an air-inflated pillow (Equi-lift®). With owner consent, the following data were collected from 19 horses undergoing open castration and 21 horses where a difficult recovery was anticipated: age, bodyweight, procedure, anaesthetic protocol, time required for proper positioning in the Equi-lift®, time to extubation, time to standing, number of attempts to stand, number of stimuli, behaviour during recumbency/first attempts, ...
Heart rate variability responses of horses and veterans with post-traumatic stress disorder to ground-based adaptive horsemanship lessons: a pilot study.
Translational animal science    February 12, 2025   Volume 9 txaf019 doi: 10.1093/tas/txaf019
Rankins EM, Faremi BE, Hartmann K, Quinn A, Posada-Quintero HF, McKeever KH, Malinowski K.Heart rate variability (HRV) can be measured as an indicator of autonomic nervous system (ANS) balance and thus, stress and affective arousal. Mixed results have been reported in the limited literature addressing the effects of equine-assisted services (EAS) on HRV in the human and horse participants. The aims of the present study were to determine the effects of ground-based adaptive horsemanship (AH) lessons on veterans' and horses' HRV during weekly lessons as well as veterans' resting HRV outside of lessons. Veterans with post-traumatic stress disorder (PTSD) were randomly assigned to 8 w...
Return to Athletic Activity of a Shetland Pony Mare with Coxofemoral Luxation Treated by Femoral Head Ostectomy.
Animals : an open access journal from MDPI    February 10, 2025   Volume 15, Issue 4 497 doi: 10.3390/ani15040497
Carnevale L, Tagliabue T, Rabbogliatti V, Bona R, Cavallier F.Femoral head ostectomy is considered a salvage procedure in the treatment of chronic coxofemoral joint luxation in small equids. Permanent lameness of varying degrees, largely depending on the animal's weight, and potential contralateral limb deformity may occur. The purpose of this study was to report the outcome of a small equid that, despite undergoing a femoral head ostectomy for a chronic coxofemoral joint luxation, was able to return to being ridden by children and to athletic activities. Methods: An 8-year-old Shetland pony mare (180 kg) was presented for a chronic right hind limb lamen...
Treatment of traumatic disruption of the suspensory apparatus in Thoroughbred racehorses at risk of proximal interphalangeal joint subluxation using a locking compression-distal femur plate for double arthrodesis.
Veterinary surgery : VS    February 3, 2025   Volume 54, Issue 3 439-452 doi: 10.1111/vsu.14219
Orozco Lopez D, Garcia-Lopez JM, Carpenter R, Bras JJ, Richardson DW, Ortved KF.To describe the outcome of metacarpophalangeal (MCPJ) and proximal interphalangeal joint (PIPJ) arthrodesis using a locking compression-distal femur plate (LCP-DFP) in Thoroughbred racehorses with traumatic disruption of the suspensory apparatus (TDSA) at risk of PIPJ subluxation. Methods: Multicenter retrospective study. Methods: Twenty-six Thoroughbred racehorses. Methods: Records of Thoroughbred racehorses with TDSA that had undergone MCPJ and PIPJ arthrodesis using an LCP-DFP at three referral hospitals between 2020 and 2024 were reviewed for inclusion. The preoperative data collected incl...
Therapeutic Exercises for Rehabilitation of Muscle Injury.
The Veterinary clinics of North America. Equine practice    January 31, 2025   Volume 41, Issue 1 213-225 doi: 10.1016/j.cveq.2024.11.011
King MR, Colla S.Successful rehabilitation of muscle injury requires a comprehensive understanding of the injury process, healing phases, and resources to be employed. The initial phase is characterized by acute inflammatory signs, followed by the regenerative and remodeling phases. Therapeutic exercises can be utilized in all 3 phases, progressing from isometric exercises to aquatic therapies. The classification and phase of injury and the individual response to the applied therapies will guide the progression of the therapeutic exercises through the rehabilitation program.
The Value of a Modified Posterior Thigh Flap with Z-Plasty for Reconstruction of Ischial Tuberosity Pressure Ulcers: A Retrospective Single Center Analysis.
Life (Basel, Switzerland)    January 22, 2025   Volume 15, Issue 2 146 doi: 10.3390/life15020146
Stumpfe MC, Horch RE, Müller-Seubert W.Pressure ulcers are a persistent and growing challenge in modern medicine, with prevalence rates ranging from 3.4% to 32.4% globally. Demographic changes suggest an increasing number of patients at risk, emphasizing the need for effective prevention and advanced treatment strategies. These ulcers, particularly stages III and IV, often require surgical intervention due to severe tissue damage. Among the surgical options, the Posterior Thigh Flap has emerged as a reliable fasciocutaneous flap, frequently referred to as a "work-horse flap", for defect coverage in the ischial region. To improve ou...
Description and Analysis of Horse Swimming Strategies in a U-Shaped Pool.
Animals : an open access journal from MDPI    January 13, 2025   Volume 15, Issue 2 195 doi: 10.3390/ani15020195
Gaulmin P, Marin F, Moiroud C, Beaumont A, Jacquet S, De Azevedo E, Martin P, Audigié F, Chateau H, Giraudet C.Aquatic training has been integrated into equine rehabilitation and training programs for several decades. While the cardiovascular effects of this training have been explored in previous studies, limited research exists on the locomotor patterns exhibited during the swimming cycle. This study aimed to analyze three distinct swimming strategies, identified by veterinarians, based on the propulsion phases of each limb: (S1) two-beat cycle with lateral overlap, (S2) two-beat cycle with diagonal overlap, and (S3) four-beat cycle. 125 underwater videos from eleven horses accustomed to swimming wer...
Effectiveness of acupuncture for equine laminitis: Systematic review and meta-analysis.
Veterinary world    January 9, 2025   Volume 18, Issue 1 60-66 doi: 10.14202/vetworld.2025.60-66
Fikri F, Purnomo A, Maslamama ST, Purnama MTE.In the past 20 years, acupuncture has been utilized as an alternative therapy for equine laminitis despite a lack of clinical evidence to support its effectiveness. Information from previous studies needs to be evaluated holistically to verify the effectiveness of acupuncture. This meta-analysis aimed to comprehensively investigate the effectiveness of acupuncture as a treatment for laminitis in horses. Unassigned: A total of 7 studies out of 145 were selected in the PubMed, Scopus, Cochrane Library, and ProQuest databases using the keywords "equine laminitis," "acupuncture," "horses," and "la...
Muscle Rehabilitation Techniques and Prevention of Injury.
The Veterinary clinics of North America. Equine practice    January 8, 2025   S0749-0739(24)00103-2 doi: 10.1016/j.cveq.2024.11.010
King MR, Colla S.Rehabilitation following muscle injury is critical in restoring the equine athlete to full function. Rehabilitation protocols should be tailored to each patient's global functional assessment, taking into account sports-specific demands, goals for return-to-performance, and overall prognosis. Rehabilitation protocols are often designed to modulate pain, enhance repair, improve proprioception, increase flexibility, restore muscle strength, joint range-of-motion, and neuromotor control. This article will review mechanisms of muscle injury, various physical modalities commonly employed in the reh...
Prevalence of Lower Back Pain and Risk Factors in Equestrians: A Systematic Review.
Sports (Basel, Switzerland)    December 19, 2024   Volume 12, Issue 12 doi: 10.3390/sports12120355
Duarte CR, Raimundo A, Sousa JP, Fernandes O, Santos R.This systematic review aimed to determine the prevalence of lower back pain (LBP) in equestrian athletes (EAs) and identify associated risk factors. Following the PRISMA guidelines, observational studies published between 2004 and 2024 in English, Portuguese, Spanish, and German were included. The review identified relevant studies through the Web of Science, EBSCO, MEDLINE, and SCOPUS (last search performed on 30 October 2024), yielding 14 studies with a total of 4527 participants. The question format for the included studies specified the population as equestrian athletes, the exposure as eq...
Performance of Warmblood horses following tenoscopic desmotomy of the main part of the accessory ligament of the superficial digital flexor tendon for treatment of tendinopathy: 62 cases.
Equine veterinary journal    December 5, 2024   doi: 10.1111/evj.14437
Blatter M, Chapman HS, Heinzel-Gutenbrunner M, von Plato G, Rijkenhuizen A.Desmotomy of the accessory ligament of the superficial digital flexor tendon (AL-SDFT) has been described for the treatment of superficial digital flexor tendon (SDFT) tendinopathy in Thoroughbred and Standardbred racehorses, and in event horses. To our knowledge, the outcome of this procedure has not been described in a population of warmblood horses. Objective: To report on the outcome of treatment of SDFT tendinopathy in warmblood horses using tenoscopic desmotomy of the main part of the AL-SDFT. Methods: Prospective observational case series. Methods: All 62 horses included in the case ser...
Clinical insights: Current progress in multidisciplinary management of soft tissue surgical cases.
Equine veterinary journal    October 4, 2024   Volume 56, Issue 6 1088-1091 doi: 10.1111/evj.14417
Barnett T, Epstein K, Southwood L.No abstract available
Electromyographic and behavioral analysis of horses submitted to medial patellar desmotomy.
Veterinary research communications    September 21, 2024   doi: 10.1007/s11259-024-10548-0
da Silva NV, Bernardino Júnior R, Nomelini QSS, Pereira GF, Delfiol DJZ, Nogueira GM.The passive stay apparatus works by blocking flexion of the knee and tarsus joints in the horse, preventing muscle fatigue. During ambulation, if this mechanism fails to release, the animal will present upward fixation of the patella, which in severe cases, can only be treated by medial patellar desmotomy (MPD). The objective of this study was to investigate the possible electromyographic and behavioral changes, after the impairment of the passive stay apparatus, in horses who have undergone MPD surgery. Five horses presenting dorsal fixation of the patella underwent electromyographic measurem...
EFFECTS OF DIFFERENT SHOEING CONDITIONS ON EQUINE CERVICAL AND BACK KINEMATICS DURING WALKING AND TROTTING ON A SOFT SURFACE.
Journal of equine veterinary science    September 12, 2024   105194 doi: 10.1016/j.jevs.2024.105194
Caure S, Dendauw P, Thesee L, Villedey E, Malinvaud A, Cousty M, Prie V, Horan K, Weller R.There is a paucity of scientific data on the effect of shoeing on equine neck and back kinematics during locomotion over commonly used sand training surfaces. A better appreciation of how alterations at hoof-ground interface influence equine upper body movements is relevant for improving horse's health and performance. Our objectives were to determine the effects of different shoeing conditions on equine neck and back kinematics at walk and trot in straight line over sand. Two-dimensional kinematic video analysis was performed under seven shoeing conditions: front feet shod with aluminum shoes...
Characteristics of equestrian accidents and injuries leading to permanent medical impairment.
BMC sports science, medicine & rehabilitation    September 4, 2024   Volume 16, Issue 1 184 doi: 10.1186/s13102-024-00973-8
Stigson H, Klingegård M.Equestrian sports, also referred to as equestrianism, is practiced all over the world and a popular leisure activity in Sweden. Equestrianism is the country's second-largest youth sport, and previous studies indicate that accidents are common in equestrianism. However, few previous studies have examined acute equestrian injuries leading to permanent medical impairment (PMI). Methods: By using nationwide insurance data comprising all injured equestrians registered in the Swedish Equestrian Federation, the aim was to analyse characteristics of equestrian accidents and particularly injuries leadi...
The feasibility of occupational therapy using Zones of Regulation™ Concepts in an equine environment.
Frontiers in psychiatry    September 3, 2024   Volume 15 1401222 doi: 10.3389/fpsyt.2024.1401222
Peters BC, Gabriels RL, Schmid AA, Pan Z, Merritt T, Hoffman A, Hepburn S.The current paper aimed to assess the feasibility of a modified intervention protocol named "Occupational Therapy using Zones of Regulation Concepts in an Equine Environment" (OT-ZOR Equine). Unassigned: A single arm A-B feasibility study was conducted, involving 14 autistic youth ages 6-13 years who first received 10-weeks of occupational therapy without horses (OT-ZOR Clinic) followed by 10-weeks of OT-ZOR Equine. Unassigned: All participants completed the study and attended 95% of OT-ZOR Equine sessions. Occupational therapists maintained 91% fidelity to the OT-ZOR Equine intervention proto...
Return of showjumping horses to sporting activity after colic surgery.
Equine veterinary journal    August 28, 2024   doi: 10.1111/evj.14407
Giusto G, Gandini M.The return to performance after colic surgery is crucial for competition horses. While studies have investigated racehorse performance following colic surgery by analysing racing participation and earnings, this approach does not apply to showjumping horses, leaving a gap in the literature regarding their objective performance evaluation. Objective: To assess the short- and long-term survival and return to performance in showjumping horses after colic surgery. Methods: Retrospective case series. Methods: Medical records of horses with acute colic requiring surgical treatment were analysed, and...
Kinematic Responses to Water Treadmill Exercise When Used Regularly within a Sport Horse Training Programme: A Longitudinal, Observational Study.
Animals : an open access journal from MDPI    August 18, 2024   Volume 14, Issue 16 doi: 10.3390/ani14162393
Nankervis K, Tranquille C, Tacey J, Deckers I, MacKechnie-Guire R, Walker V, Hopkins E, Newton R, Murray R.Repeated exposure to water treadmill (WT) exercise could elicit kinematic responses reflecting adaptation to WT exercise. The study's aim was to compare the responses of a group of sport horses to a standardised WT exercise test (WTSET) carried out at three time points, week 0 (n = 48), week 20 (n = 38), and week 40 (n = 29), throughout a normal training programme incorporating WT exercise. Horses were recruited from the existing client populations of two commercial water treadmill venues for the purpose of this longitudinal, observational study. Limb, back, poll, wither, and pelvic kinematics...
Return to sport activity following ultrasonographic diagnosis and conservative management of spontaneous injuries of the serratus cervicis ventralis and serratus thoracis ventralis muscles in 11 endurance horses.
Journal of the American Veterinary Medical Association    August 2, 2024   1-6 doi: 10.2460/javma.24.03.0211
Puccetti M, Pilati N, Beccati F, Denoix JM.To describe the clinical diagnosis, ultrasound findings, and outcome of 11 endurance horses with injuries to the serratus ventralis thoracis (SVT) or serratus ventralis cervicis (SVC) muscle. Methods: 11 endurance horses competing in medium- to high-level competitions and presenting with lameness caused by injuries to the SVT or SVC muscle, as confirmed by ultrasonography. Methods: Physical examinations revealed swelling caudal to the shoulder region associated with dorsocranial displacement of the scapula and edema of the ventral thorax for horses with SVT injuries. Swelling cranial to the sc...
Trunk kinematics and limb movement of horses walking backwards and forwards in hand and lifting a single limb.
Veterinary journal (London, England : 1997)    July 20, 2024   Volume 306 106202 doi: 10.1016/j.tvjl.2024.106202
Jobst ID, Zsoldos RR, Licka TF.Equine physiotherapy commonly includes basic exercises such as walking backward (BW) and voluntary lifting of single limbs (SLL), but trunk movements during these have not been studied. In order to compare the trunk kinematics during BW and SLL with forward walking (FW), nine horses were measured in FW, BW and during SLL triggered by tactile cue. Kinematics were obtained from skin markers captured by ten high-speed video cameras. Trunk angles were calculated in sagittal and horizontal planes from withers, dorsal to spinous processes of the 16th thoracic vertebra (T16), 2nd and 4th sacral verte...
The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015-2023).
Animals : an open access journal from MDPI    June 8, 2024   Volume 14, Issue 12 1731 doi: 10.3390/ani14121731
van Veggel ECS, Vanderperren K, Selberg KT, Bergman HJ, Hoogelander B.This study evaluates the change in an MRI of the proximal metacarpal region in a group of sport horses that returned to work. This retrospective analysis evaluated 18 limbs represented by 17 horses. Results: The hyperintense signal within the dorsal collagenous part of the proximal suspensory ligament (PSL) on T1W/T2*W GRE sequences decreased or stayed the same in the majority of cases. The hyperintense STIR signal within the dorsal collagenous part of the PSL resolved in the majority of the patients, and the third metacarpal bone (McIII) hyperintense STIR signal resolved in all patients. The ...
[Navicular bone fractures in horses: Prognosis after conservative and surgical treatment].
Schweizer Archiv fur Tierheilkunde    May 29, 2024   Volume 166, Issue 6 309-320 doi: 10.17236/sat00425
Stucki G, Fürst AE, Jackson MA.The aim of this retrospective study is to describe and compare conservative and surgical treatment of navicular fractures in horses. An attempt is made to identify critical points that can favorably influence the prognosis of this orthopedic disease. All horses treated for a navicular fracture at the Equine Clinic, Vetsuisse Faculty, University of Zurich between 2005 and 2017 were included in this study. The severity of lameness at initial examination, radiographic assessment, hoof conformation, treatment (conservative or surgical), complications and outcome were determined from the medical re...
The Application of Infrared Thermography in the Assessment of BEMER Physical Vascular Therapy on Body Surface Temperature in Racing Thoroughbreds: A Preliminary Study.
Animals : an open access journal from MDPI    May 23, 2024   Volume 14, Issue 11 1538 doi: 10.3390/ani14111538
Nawrot K, Soroko-Dubrovina M, Zielińska P, Dudek K, Howell K.The study aimed to evaluate the impact of BEMER (Physical Vascular Therapy) on body surface temperature using infrared thermography (IRT) in the distal parts of the forelimbs in Thoroughbreds. The study tested the hypothesis that BEMER therapy leads to an increase in body surface temperature and blood vessel diameter in the distal parts of the forelimbs. The study involved 16 horses, split into 2 groups: active BEMER ( = 8) and sham ( = 8). The active BEMER group had BEMER boots applied to the distal parts of the forelimbs, whereas the sham group had BEMER boots applied without activation of t...
Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium.
Frontiers in veterinary science    May 22, 2024   Volume 11 1403174 doi: 10.3389/fvets.2024.1403174
Reis IL, Lopes B, Sousa P, Sousa AC, Rêma A, Caseiro AR, Briote I, Rocha AM, Pereira JP, Mendonça CM, Santos JM, Lamas L, Atayde LM, Alvites RD....Here, we describe a case of a 5-year-old show-jumping stallion presented with severe lameness, swelling, and pain on palpation of the left metacarpophalangeal joint (MCj). Diagnostic imaging revealed full and partial-thickness articular defects over the lateral condyle of the third metacarpus (MC3) and the dorsolateral aspect of the first phalanx (P1). After the lesion's arthroscopic curettage, the patient was subjected to an innovative regenerative treatment consisting of two intra-articular injections of equine synovial membrane mesenchymal stem/stromal cells (eSM-MSCs) combined with umbilic...
Equine Musculoskeletal Pathologies: Clinical Approaches and Therapeutical Perspectives-A Review.
Veterinary sciences    April 26, 2024   Volume 11, Issue 5 doi: 10.3390/vetsci11050190
Reis IL, Lopes B, Sousa P, Sousa AC, Caseiro AR, Mendonça CM, Santos JM, Atayde LM, Alvites RD, Maurício AC.Musculoskeletal injuries such as equine osteoarthritis, osteoarticular defects, tendonitis/desmitis, and muscular disorders are prevalent among sport horses, with a fair prognosis for returning to exercise or previous performance levels. The field of equine medicine has witnessed rapid and fruitful development, resulting in a diverse range of therapeutic options for musculoskeletal problems. Staying abreast of these advancements can be challenging, prompting the need for a comprehensive review of commonly used and recent treatments. The aim is to compile current therapeutic options for managin...
Review of skin grafting in equine wounds: indications and techniques.
Equine veterinary education    February 28, 2024   Volume 36, Issue 9 484-493 doi: 10.1111/eve.13964
Williams ZJ, Pezzanite LM, Hendrickson DA.Skin grafting is a simple technique that can be performed by equine practitioners to improve cosmetic outcomes in wounds with large skin defects that would not heal functionally or cosmetically with standard wound therapy interventions. Successful skin grafting is not difficult but relies upon appropriate preparation of the wound bed and effective immobilisation of the grafted area after skin graft placement. Prior to grafting, the wound bed should be treated with a moist wound healing dressing to prepare the granulation tissue bed to receive the graft. For best results, skin grafts should be ...
Advances in the Clinical Diagnostics to Equine Back Pain: A Review of Imaging and Functional Modalities.
Animals : an open access journal from MDPI    February 23, 2024   Volume 14, Issue 5 doi: 10.3390/ani14050698
Domańska-Kruppa N, Wierzbicka M, Stefanik E.Back pain is common in ridden horses. Back diseases in horses include Impinging Dorsal Spinous Processes, Ventral Spondylosis, Osteoarthritis of Articular Process, Intervertebral Discs Disease, Vertebral Fractures, Conformational Abnormalities, Desmopathy of the Supraspinous Ligament, Desmopathy of the Intraspinous Ligament, and Longissimus Muscle Strain. Back pain may also develop as a result of lameness (particularly hindlimb lameness). A poorly fitting saddle and an unbalanced rider are also considered important factors influencing the development of back pain in horses. The conventional di...
International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes.
The Veterinary record    February 20, 2024   Volume 194, Issue 10 e3899 doi: 10.1002/vetr.3899
Treß D, Lischer C, Merle R, Ehrle A.Overriding spinous processes, also known as 'kissing spines', are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection. An online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaed...
Treatment of Equine Tarsus Long Medial Collateral Ligament Desmitis with Allogenic Synovial Membrane Mesenchymal Stem/Stromal Cells Enhanced by Umbilical Cord Mesenchymal Stem/Stromal Cell-Derived Conditioned Medium: Proof of Concept.
Animals : an open access journal from MDPI    January 24, 2024   Volume 14, Issue 3 doi: 10.3390/ani14030370
Leal Reis I, Lopes B, Sousa P, Sousa AC, Branquinho MV, Caseiro AR, Rêma A, Briote I, Mendonça CM, Santos JM, Atayde LM, Alvites RD, Maurício AC.Horses are high-performance athletes prone to sportive injuries such as tendonitis and desmitis. The formation of fibrous tissue in tendon repair remains a challenge to overcome. This impels regenerative medicine to develop innovative therapies that enhance regeneration, retrieving original tissue properties. Multipotent Mesenchymal Stem/Stromal Cells (MSCs) have been successfully used to develop therapeutic products, as they secrete a variety of bioactive molecules that play a pivotal role in tissue regeneration. These factors are released in culture media for producing a conditioned medium (...