Haussler Kevin K, Manchon Philippe T, Donnell Josh R, Frisbie David D
Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
Scone Equine Hospital, New South Wales, Australia.
J Equine Vet Sci. 2020 Mar;86:102891. doi: 10.1016/j.jevs.2019.102891. Epub 2019 Dec 10.
Low-level laser therapy has been used clinically to treat musculoskeletal pain; however, there is limited evidence available to support its use in treating back pain in horses. The objective of this study was to evaluate the clinical effectiveness of low-level laser therapy and chiropractic care in treating thoracolumbar pain in competitive western performance horses. The subjects included 61 Quarter Horses actively involved in national western performance competitions judged to have back pain. A randomized, clinical trial was conducted by assigning affected horses to either laser therapy, chiropractic, or combined laser and chiropractic treatment groups. Outcome parameters included a visual analog scale (VAS) of perceived back pain and dysfunction and detailed spinal examinations evaluating pain, muscle tone, and stiffness. Mechanical nociceptive thresholds were measured along the dorsal trunk and values were compared before and after treatment. Repeated measures with post-hoc analysis were used to assess treatment group differences. Low-level laser therapy, as applied in this study, produced significant reductions in back pain, epaxial muscle hypertonicity, and trunk stiffness. Combined laser therapy and chiropractic care produced similar reductions, with additional significant decreases in the severity of epaxial muscle hypertonicity and trunk stiffness. Chiropractic treatment by itself did not produce any significant changes in back pain, muscle hypertonicity, or trunk stiffness; however, there were improvements in trunk and pelvic flexion reflexes. The combination of laser therapy and chiropractic care seemed to provide additive effects in treating back pain and trunk stiffness that were not present with chiropractic treatment alone. The results of this study support the concept that a multimodal approach of laser therapy and chiropractic care is beneficial in treating back pain in horses involved in active competition.
低强度激光疗法已在临床上用于治疗肌肉骨骼疼痛；然而，支持其用于治疗马匹背部疼痛的证据有限。本研究的目的是评估低强度激光疗法和脊椎按摩疗法对竞技西部表演马胸腰椎疼痛的临床疗效。研究对象包括61匹积极参加全国西部表演比赛且被判定有背部疼痛的夸特马。通过将受影响的马匹随机分配到激光疗法组、脊椎按摩疗法组或激光与脊椎按摩联合治疗组进行了一项随机临床试验。结果参数包括感知背部疼痛和功能障碍的视觉模拟量表（VAS），以及评估疼痛、肌肉张力和僵硬程度的详细脊柱检查。测量沿背侧躯干的机械性伤害感受阈值，并比较治疗前后的值。采用重复测量和事后分析来评估治疗组之间的差异。本研究中应用的低强度激光疗法显著减轻了背部疼痛、轴上肌高张力和躯干僵硬。激光疗法与脊椎按摩疗法联合治疗产生了类似的减轻效果，轴上肌高张力和躯干僵硬的严重程度进一步显著降低。单独的脊椎按摩疗法在背部疼痛、肌肉高张力或躯干僵硬方面未产生任何显著变化；然而，躯干和骨盆屈曲反射有所改善。激光疗法与脊椎按摩疗法联合治疗似乎在治疗背部疼痛和躯干僵硬方面具有单独的脊椎按摩疗法所没有的累加效应。本研究结果支持这样一种观念，即激光疗法和脊椎按摩疗法的多模式方法对治疗参加活跃比赛的马匹背部疼痛有益。
