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Equine veterinary journal2023; 55(5); 872-883; doi: 10.1111/evj.13904

Equine blood flow restriction training: Safety validation.

Abstract: Blood flow restriction (BFR) has become a key rehabilitative tool for human orthopaedic conditions. With modernised technology and evolution of clinical application, patient-specific delivery of occlusion percentages is now considered the standard of care in human patients due to improved therapeutic outcomes and minimised safety risks. Safety validation and limb occlusion pressure (LOP) data for horses, however, are lacking. Objective: (1) To determine if BFR exposure resulted in forelimb biomechanical gait dysfunction as safety validation and (2) to investigate inter-horse and inter-limb LOP differences. Methods: Controlled in vivo experiment. Methods: Daily unilateral forelimb BFR was performed in four horses over 56 days. Clinical examinations and objective gait analyses were performed on Days 0, 28 and 56. Daily LOP values were determined by Doppler evaluation to deliver 80% vascular occlusion at a walk. A linear mixed model evaluated for differences in lameness, kinetic and kinematic gait parameters. Results: There were no significant differences in forelimb lameness (range of Grades 0-2 across all forelimbs), kinematic or kinetic gait parameters over time or between BFR-exposed and control (contralateral) limbs (p > 0.05). Clinically apparent complications related to BFR such as thrombosis or dermatitis were not appreciated. Significant differences in mean LOP values between various horses (p < 0.001) and measured left (204.48 mmHg) and right (173.78 mmHg) forelimbs (p < 0.001) were observed. Mean LOP and standard deviation across all readings was 189.1 ± 22.2 mmHg. Conclusions: Optimal BFR occlusion percentages and protocols with documented clinical efficacy are unknown. Small study population. Conclusions: Exposure to BFR did not result in forelimb biomechanical dysfunction in four horses. Applied pressures of 75-151 mmHg would likely simulate a range of 50%-80% vascular occlusion in horses, but inherent physiological variation between horses and forelimbs warrants incorporation of individual pressures.
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Publication Date: 2023-01-04 PubMed ID: 36516310DOI: 10.1111/evj.13904Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research investigates if blood flow restriction (BFR) therapy, commonly used in human orthopaedic rehabilitation, causes biomechanical changes in horses’ forelimbs and looks into varying limb occlusion pressure (LOP) differences among horses. The outcomes show that BFR does not lead to any noticeable dysfunction in the horses’ gait and underpins the need for individual pressure adjustments due to physiological differences between horses.

Objective of the Study

The study had two primary goals:

  • The first was to determine if the application of BFR caused any dysfunction in the horse’s forelimb gait, assessing the safety of the treatment.
  • The second was to investigate the differences in LOP between individual horses and individual limbs, informing on how the therapy may need to be customized for different horses and limbs.

Methodology

The research methods involved:

  • Carrying out a controlled experiment on four horses, applying daily unilateral forelimb BFR over a period of 56 days.
  • Performing clinical examinations and objective gait analyses on the horses at the commencement of the experiment, halfway through, and at the end of the 56 days.
  • Determining daily LOP values via Doppler evaluation, aiming for 80% vascular occlusion during a walk.
  • Evaluating differences in lameness, kinetic and kinematic gait parameters using a linear mixed model.

Results of the Study

The results indicated that:

  • There were no significant differences in lameness, kinematic or kinetic gait parameters over the 56-day period. Meaning, BFR application did not appear to impact the horse’s gait negatively.
  • There were no clinically noticeable complications linked to BFR such as thrombosis or dermatitis.
  • There were significant differences in LOP readings between individual horses and between left and right forelimbs, supporting the idea that individual pressure adjustments are necessary.

Conclusions

The key conclusions were that:

  • The optimal BFR occlusion percentages and protocols that yield the most clinical benefits are unknown due to the small population size of the study.
  • The application of BFR did not cause any noticeable gait dysfunctions in the tested horses, indicating its potential safety of use.
  • Pressures of 75-151 mmHg could potentially simulate a range of 50%-80% vascular occlusion in horses. Nonetheless, the observed physiological variation between horses and limbs implies the need for individual pressure adjustments in the BFR setup.

Cite This Article

APA
Johnson SA, Frisbie DD, Griffenhagen GM, King MR. (2023). Equine blood flow restriction training: Safety validation. Equine Vet J, 55(5), 872-883. https://doi.org/10.1111/evj.13904

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 5
Pages: 872-883

Researcher Affiliations

Johnson, Sherry A
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Frisbie, David D
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Griffenhagen, Gregg M
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
King, Melissa R
  • Department of Clinical Sciences, Orthopaedic Research Center at the Translational Medicine Institute, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Humans
  • Horses
  • Animals
  • Lameness, Animal
  • Blood Flow Restriction Therapy / veterinary
  • Gait / physiology
  • Walking
  • Forelimb / physiology
  • Biomechanical Phenomena
  • Horse Diseases / therapy

Grant Funding

  • Translational Acceleration Program (TAP) of the Translational Medicine Institute (TMI), College of Veterinary Medicine and Biomedical Sciences, Colorado State University.

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