| Modality |
Proposed Mechanism of Action |
Evidence for use in Equine Medicine |
Additional notes |
| Laser Therapy (LT) |
- Modulating pain
- Reducing neuropathic pain
- Reducing inflammation
|
- One study involving 150 sport horses showed a beneficial effect of LT on tendinopathy/desmopathy, including the superficial and deep digital flexor tendons and suspensory ligament
- Another study found 10/14 horses with back pain showed clinical improvement after lasering acupuncture points
- LT may also enhance stem cell applications (experimental)
|
- Class 4 lasers are prohibited at FEI events
- Clipping hair and pigmentation of skin may alter penetration of laser
|
| Transcutaneous electrical nerve stimulation (TENS) |
- Primarily functions through pain control by blocking pain signals to the spinal cord from C-fibers and releasing endorphins
|
- No clinical studies supporting its use in equine medicine.
- Recommended in humans with chronic musculoskeletal pain together with traditional medications
|
- Clip the hair and use ultrasound gel to maximize contact between application pads and skin
- At FEI events, must be applied by a veterinarian
|
| Therapeutic ultrasound (TU) |
- Thermal use of TU reduces pain and muscle spasms and increases tissue elasticity
- Nonthermal therapeutic effects include stimulating tissue repair, collagen synthesis, and bone healing
|
- One study found that TU could heat the SDFT and DDFT but had questionable effects within the epaxial musculature
- In humans, TU reduces pain due to osteoarthritis and facilitates fracture repair
|
- Can be performed by owner/trainer with written permission from veterinarian for FEI events
- If stretching the horse, do so immediately, before the tissues cool
|
| Radiofrequency diathermy (DF) |
- Warms tissues, particularly in cases of joint and muscle effusion
|
- Has not been objectively evaluated in horses
- Human studies shows that RD improves pain, range of motion, and performance of day-to-day activities in cases of frozen shoulder, decreases pain and improves muscle performance in osteoarthritis
|
- Treating veterinarian must by obtained by FEI officials
- Contraindicated in patients with metal implants
|
| Elastic therapeutic taping |
- Thought to reduce pain, enhance proprioception (awareness of the body’s position), and improve muscle activation
|
- Limited evidence in any species supports the use of this modality
|
- Only permitted if used within stable area at FEI events and if the horse is unmounted in stable area at USEF events
|
| Pulsed electromagnetic field therapy (PEMF) |
- Primarily used to aid bone healing, regulates bony elements and maintains bone mass
- Thought to reduce pain and inflammation by stimulating nitric oxide
|
- Limited evidence in horses
- One canine study found significantly faster recovery of load bearing following tibial osteotomy
- Approved by the FDA in humans with long bone fracture nonunions and following lumbar/cervical spine fusion surgery
|
- Use is not restricted in competition
- Caution should be used for tendon healing as it might delay the process
|
| Underwater treadmill (UWT) |
- Use for rehabilitation of both acute and chronic injuries. Buoyancy allows partial weight bearing to alleviate stress and pain on lower extremity joints; improves gait if the horse is deficient in muscle strength, postural control, or motor coordination; and improves balance
- Warm water can improve muscle comfort during training, and cold water can have cryotherapeutic effects
|
- In horses, UWT improves muscle strength, postural stability, motor control, and joint range of motion
|
- No restrictions on use
- Water height must be adjusted to each patient’s condition and therapeutic goals
- Not all patients are ideal candidates for UWT
|
| Whole-body vibration therapy (WBV) |
- Presumably increases muscle strength, postural stability, and power by stimulating motor neurons, skin receptors, muscle cells, and joint mechanoreceptors
|
- The one study in horses using WBV shows maintenance of bone density in stalled horses
- WBV increases the mass of the multifidus (back) muscle and can deter back osteoarthritis
|
|
| Neuromuscular electrical stimulation (NMES) |
- Restores normal muscle function and strength following muscle atrophy and nerve injury
|
- One study supported the use of NMES for horses with injury to the recurrent laryngeal nerve and cricoarytenoid muscle that innervates the larynx (think roarers)
|
- Must be performed by a veterinarian for FEI events
- The hair may need to be clipped and should definitely be cleaned of dirt/debris before applying coupling gel
|
