• Water treadmill exercise has gained popularity for equine athletes' training and rehabilitation. In 2019, an equine hydrotherapy working group was formed to establish best practices in using this modality.
• The guidelines describe the potential benefits, good practice, introduction of horses, factors influencing belt speed, water depth, and duration of exercise, and monitoring movement on the water treadmill.
• The long-term goal is to reach a consensus on the optimal use of the modality within training or rehabilitation programs.
• Collaboration between clinicians, researchers, and experienced users is needed to develop research programs and guidelines for specific veterinary conditions.

• Equine Rehabilitation: A scoping review of the literature on physical therapy methods and modalities used to rehabilitate horses with locomotor disorders.

• Methods: A search of electronic databases, reference lists, and other sources using keywords related to equine rehabilitation and physical therapy. Studies were selected and charted according to inclusion and exclusion criteria.

• Results: A total of 49 studies were included, mostly narrative reviews and observational/descriptive studies. The most frequently reported techniques were exercise, electrotherapy, and hydrotherapy. Few randomized clinical trials were found.

• Conclusion: The review highlights the lack of evidence-based studies and the need for more information on the type, parameterization, and outcomes of equine rehabilitation in clinical practice.

• The paper is an original research article that reports the results of an international survey on the use of rehabilitation modalities in horses.

• The survey was distributed to over 2,000 equine veterinarians from various groups and associations, and received 305 responses from over 10 geographic regions.

• The paper describes the common modalities used by respondents for different medical scenarios, such as tendon or ligament injury, neck or back injury, poor performance, etc.

• The paper also discusses the personnel involved in administering the modalities, and the factors influencing their selection and application.

• The paper concludes that a wide range of modalities are used in equine rehabilitation, and that further investigation on their efficacy and risks is needed.

Coll, J.A., Blake, S. & Ferro de Godoy, R. (2023) Surface electromyography (sEMG) of equine core muscles and kinematics of lumbo-sacral joint during core strengthening exercises. Journal of Equine Rehabilitation. 1, 100002. doi:10.1016/j.eqre.2023.100002.

• Dynamic Mobilisation Exercises (DME) and myotatic reflex exercises were developed to improve core strengthening in horses.
• DME has been shown to increase the cross sectional area and symmetry of multifidus muscle, as well as activate external oblique abdominal and superficial descending pelvic muscles.
• This study aimed to measure activity differences in m. longissimus dorsi and m. rectus abdominus (RA) during three levels of spinal flexion and lateral bending, as well as comparing thoracic and pelvic lift exercises in nine adult sport horses.
• Results showed that spinal flexion and lateral bending activate m. rectus abdominis (RA) progressively as the exercise requires further reach, with a lateral bending effect evident on the ipsilateral side of RA.
• Pelvic lifts generated the greatest flexion of the lumbo-sacral (LS) joint.

• The multifidus muscle, a key component of the multifidi muscle, has been under-researched in the field of equine sports medicine.
• A study using in-dwelling electromyography (EMG) was conducted to measure and compare the average and peak activity of the multifidus muscle in normal horses.
• The researchers hypothesized that trotting horses on a soft deformable surface would increase both average and peak activity compared to trotting on a non-deformable asphalt surface.
• The EMG signals from four horses were filtered and normalized to the maximum observed signals. The effect of two surface conditions on the average and peak muscle activity within each muscle section was assessed using unpaired t-tests.
• The results showed that average muscle activity was significantly higher when trotting over a soft surface compared to a hard asphalt surface in the right T12, right L5, and left L5 regions. Peak activity was significantly higher on soft footing in the left T18, left L5, right T12, and right L5 regions.
• Thus, the softer surface induced higher levels of muscle activity in most multifidi locations.

• Ruffoni, K.J., Lancaster, B.E. & Tabor, G. (2024) Practitioner safety and the application of learning theory related to injury risk in equine physiotherapy: A worldwide survey. Journal of Equine Rehabilitation. 2, 100005. doi:10.1016/j.eqre.2023.100005.

• Water treadmill (WT) use is increasingly common in sport horse training and rehab.
• Previous research suggested benefits for movement and conditioning, but long-term effects on muscle development (MD) were unclear.
• To determine whether incorporating WT exercise at low water depth into sport horse training improves muscle development compared to horses not using WT.
• To identify which muscle groups benefit most, and whether training level, discipline, or WT frequency influence results.

• This study aimed to identify occupational injury frequency among equine physiotherapists and investigate the relationship between injury rate and knowledge of learning theory (LT).
• An online survey received 64 valid responses, with 51 being qualified veterinary physiotherapists working with equines. The mean injury frequency was 0.59 ± 1 per year, with 36 respondents reporting at least one injury during their career.
• There was a moderate negative correlation between career length and injury frequency. The most common site of injury for practitioners was the lower limb, and the most common type of injury was bruising.
• Knowledge of LT was poor, with only 21 respondents scoring 3/9 or higher on scenario-based application of LT and 24 achieving a grade of 6/10 or higher on theoretical knowledge. There was a moderate positive correlation between theoretical knowledge scores and self-evaluation of LT terminology scores.
• The study highlights a trend of high injury rates and low levels of understanding of equine learning, indicating the urgent need for research into better prevention and safety-enhancing strategies.

• This study investigated how horses acclimate to water treadmill exercise by analysing heart rate responses, with and without sedation during initial exposure.
• Fourteen horses completed four 15-minute walking sessions over four consecutive days; sedated horses received romifidine before their first run only.
• Results showed that both sedated and non-sedated horses reached steady-state heart rates by the third or fourth session, with no significant difference in acclimation time between groups.
• The findings suggest that a minimum of two 15-minute non-sedated sessions are needed for acclimation, and sedation may be helpful only for preventing panic during the first exposure.

• This study surveyed 270 Australian Standardbred trainers to investigate how swimming is used in training and rehabilitation, including its perceived benefits and limitations.
• About 38% of trainers—particularly 60% of leading trainers—used swimming, mainly to replace trackwork for limb injuries, improve fitness, or provide mental variety; free swimming was far more common than tethered.
• There was wide variation in frequency and duration, with a median of four sessions per week lasting around seven minutes, and most trainers relied on observation rather than heart rate monitoring to assess effort.
• The study concluded that swimming is a popular but inconsistently applied form of cross-training, and further research is needed to establish evidence-based protocols and clarify its effects on performance and injury prevention.

• This study developed and tested a low-cost, 3D underwater motion capture system to analyse the biomechanics of horse swimming, aiming to make accurate kinematic assessment more accessible for research and clinical use.
• Six horses were filmed underwater using six waterproof GoPro cameras, with 24 painted anatomical markers tracked to calculate joint angles in 3D. Calibration and reconstruction methods achieved high accuracy, with segment length errors under 10 mm and angular errors under 1°.
• During swimming, most joints showed greater ranges of motion compared to movement on land—particularly due to increased flexion—while fetlock joints showed little change. The system successfully captured coordinated limb motion throughout full swimming cycles.
• The authors concluded that this low-cost, non-invasive setup provides reliable 3D kinematic data and could support future research and clinical monitoring of horses in hydrotherapy. They noted that automation of marker tracking and inclusion of more subjects would improve efficiency and generalisability.

• This study investigated how increasing water height affects stride frequency, stride length, and heart rate in horses walking on a water treadmill.
• Nine horses with no previous water treadmill experience underwent six acclimation sessions, after which stride frequency stabilised. Eight of these horses then completed three sessions at four water heights: hoof (control), proximal interphalangeal joint, carpus, and ulna levels.
• As water depth increased, stride frequency decreased while stride length increased—both significantly at carpus and ulna heights. Heart rate, however, remained unchanged across all water levels.
• The study concluded that deeper water alters gait mechanics by promoting longer, slower strides without increasing cardiovascular effort, suggesting that adjusting water height can be used to target specific therapeutic or conditioning outcomes during equine rehabilitation.

• This study examined how walking on a water treadmill at different water depths affects the biomechanics of the horse’s back.
• Twelve riding horses with no previous water treadmill experience completed sessions at water heights ranging from hoof to shoulder level over a ten-day period. Skin markers placed along the spine and pelvis were used to measure axial rotation, lateral bending, and pelvic flexion.
• As water depth increased, axial rotation of the back also increased, while lateral bending decreased at deeper levels (elbow and shoulder height). Pelvic flexion increased at all water depths except hoof level. After ten days of training, horses showed slightly greater lateral bending compared to the first session.
• The study concluded that water depth significantly influences spinal motion, with deeper water promoting greater back rotation and flexion but reducing side-to-side bending. These effects should be considered when using water treadmill exercise for rehabilitation or core conditioning in horses.

• Water treadmill (WT) exercise is increasingly used in equine training and rehabilitation, but current protocols largely rely on anecdotal evidence rather than robust scientific data.
• Findings from human and canine studies show that water depth, temperature, and speed have major effects on physiological and biomechanical responses, but these factors have been poorly standardised in equine research.
• Existing equine studies indicate that WT exercise functions primarily as an aerobic activity, though there is limited evidence that it improves overall fitness or performance.
• Water depth influences limb kinematics, increasing joint flexion and altering stride patterns, yet few studies have examined the combined effects of speed and depth in horses.
• The authors highlight the need for systematic research to determine optimal WT protocols for conditioning and rehabilitation, ensuring that parameters such as depth, speed, and duration are matched to specific therapeutic goals.
  

• Both dry land and water treadmills are increasingly used in equine rehabilitation because they allow precise control of exercise speed, intensity, and duration, which is valuable when managing injured horses.
• Land treadmills can support rehabilitation of distal limb injuries and back pain by enabling controlled, consistent movement while reducing the risk of unpredictable loading.
• Water treadmills alter limb and back kinematics by increasing buoyancy and reducing weight-bearing; however, the therapeutic effect depends on careful selection of water depth and speed.
• The review emphasises that inappropriate treadmill settings can be detrimental, highlighting the importance of tailoring exercise parameters to each horse’s condition.
• Because many horses have multiple musculoskeletal issues, treadmill programmes should be designed and monitored on a case-by-case basis to ensure safe and effective rehabilitation.

• This study investigated how changes in belt speed and water height affect oxygen consumption and cardiorespiratory responses in horses exercising on a water treadmill.
• Fifteen Quarter Horses were walked at three speeds (1.11, 1.25, and 1.39 m/s) and three water heights (mid-cannon, carpus, and stifle), along with a dry treadmill control.
• Water height had a greater effect on workload than speed. The highest water level (stifle) combined with the fastest speed produced the highest oxygen consumption, tidal volume, and heart rate.
• Respiratory rate increased at moderate water depths, while blood lactate remained low across all conditions, indicating that the exercise intensity was aerobic and low-to-moderate overall.
• The study concluded that increasing water depth is more effective than increasing speed for raising exercise intensity on a water treadmill, but even the most demanding conditions tested represented low-intensity work suitable for rehabilitation or light conditioning.