EFFECT OF TWO BANDAGE PROTOCOLS ON EQUINE FETLOCK KINEMATICS Except where reference is made to the work of others, the work described in this thesis is my own or was done in collaboration with my advisory committee. This thesis does not include proprietary or classified information. __________________________ Jennifer Shea Sanders Certificate of Approval: ____________________________ John Schumacher Professor Clinical Sciences ____________________________ Christine C. Dykstra Associate Professor Pathobiology _____________________________ Robert L. Gillette, Chair Director Auburn University Veterinary Sports Medicine Program ______________________________ George T. Flowers Dean Graduate School EFFECT OF TWO BANDAGE PROTOCOLS ON EQUINE FETLOCK KINEMATICS Jennifer Shea Sanders A Thesis Submitted to the Graduate Faculty of Auburn University in Partial Fulfillment of the Requirements for the Degree of Master of Science Auburn, Alabama May 9, 2009 iii EFFECT OF TWO BANDAGE PROTOCOLS ON EQUINE FETLOCK KINEMATICS Jennifer Shea Sanders Permission is granted to Auburn University to make copies of this thesis at its discretion, upon request of individuals or institutions and at their expense. The author reserves all publication rights. ___________________________ Signature of Author ___________________________ Date of Graduation iv VITA Jennifer Shea Sanders, daughter of Richard Barre Sanders and Mary Susan (Nichols) Sanders, was born in Birmingham, Alabama on 6 October 1982. In 2001, she graduated with Honors from S.S. Murphy High School, Mobile, Alabama. She graduated from Auburn University on May 11, 2006. She received a Bachelor of Science in Biomedical Sciences and a Bachelor of Arts in Psychology. In the spring of 2006, Jenni met with Dr. Robert Gillette, Director of the Auburn University Veterinary Sports Medicine Program, Auburn, Alabama. Their purpose was to develop a Master?s program in Biomedical Sciences with a concentration in Veterinary Sports Medicine. She entered the program in the fall of 2006, and was brought on as a student worker in the program during her studies. v THESIS ABSTRACT EFFECT OF TWO BANDAGE PROTOCOLS ON EQUINE FETLOCK KINEMATICS Jennifer Shea Sanders Master of Science, May 9, 2009 (B.S., Auburn University, 2006) (B.A., Auburn University, 2006) 63 Typed Pages Directed by Robert L. Gillette The purpose of this study was to assess the kinematic effects of the Sports Medicine Boot II? and the Twenty X? Polo Wrap in the forelimbs of horses while trotting. This study provides valuable kinematic data for use in future studies of equine locomotion kinematics and possible extensions of this study. The hypothesis of the study was that applying the Twenty X? Polo Wrap or the Sports Medicine Boot II? to the forelimb of a horse would result in reduced peak fetlock extension compared to a non- treated limb. Kinematic data was collected from eight horses in this study, 2 Thoroughbreds, 5 Quarter Horses and 1 draft horse cross. The horses had a mean weight of 565.1 + 57.3 kg, age of 10.0 + 3.2 years and height of 1.6 + 0.06 m at the withers. Hemispherical retro-reflective joint markers were placed on the lateral aspect of the elbow, carpal, and vi metacarpophalangeal joints, and the lateral aspect of each hoof of the left and right forelimbs. Horses were filmed while trotting in a straight, level path across an asphalt surface while wearing a Sports Medicine Boot II?, again while wearing a Twenty X? Polo Wrap, and again with the limbs untreated (control). Kinematic data was evaluated for the forelimb fetlock joint angles. Peak extension, peak flexion, and range of motion of the forelimb fetlock joints were evaluated as parameters. Velocity data was evaluated using a one-way repeated measures analysis of variance (ANOVA). T-tests for left and right trials were analyzed for each horse and each of the three treatments on the forelimbs. A one-way ANOVA was performed to assess the effects of applying the treatments on the forelimb fetlock joints for each of the parameters. The results of this study indicated that use of the Sports Medicine Boot II? or the Twenty X? Polo Wrap caused no significant change in peak extension of the fetlock joint. Use of the Sports Medicine Boot II? significantly reduced flexion in the fetlock joint when compared to the non-treated limbs and the limbs to which the Twenty X? Polo Wrap had been applied. Range of motion in the fetlock joint was significantly decreased with the use of the Twenty X? Polo Wrap and the Sports Medicine Boot II? when compared to the non-treated limbs. The range of motion, however, was significantly greater in the Twenty X? Polo Wrap when compared only to the Sports Medicine Boot II?. Reduction in the range of motion of fetlock joint, however, suggests that this boot provides some support to the fetlock. This study has provided valuable kinematic data that documents the changes in the stride of horses at the trot when wearing protective leg gear. vii DEDICATION Mom and Dad, you have been and will always be my greatest mentors. This research is dedicated to you. Thank you for being my biggest fans and pushing me to accomplish my dreams. I express my deepest gratitude and respect for the many years of your dedication to my life. God has truly blessed me with an incredible family! viii ACKNOWLEDGMENTS First, I would like to thank the Lord for his continued guidance and love. Without Him, none of this would be possible. Thank you to Dr. Gillette for allowing me to be your first Master?s student, sharing your knowledge, and teaching me invaluable lessons in research. Thanks are due to my committee members, Dr. Schumacher and Dr. Dykstra, for their many contributions to my research. Thank you to Dr. Wright and Dr. Billor for your assistance with statistical analysis. To the rest of the staff at the Auburn University Veterinary Sports Medicine Program: Craig Angle, Lauren Ballard, and Beth Morrell, I am greatly indebted to you for your continued encouragement, advice, assistance, and friendship. Thank you to Dr. Taintor, Mike Huggins, Michelle Flurry, and the administration at the College of Veterinary Medicine for your support of my research. Thank you to the horses that participated in my study. A special thank you is due to ?Rocky?, for letting me learn how to wrap all of the bandages on him first and teaching me so many life lessons. A heartfelt thank you to his owner, and my co-worker, Sherry Johnston, for spending countless hours patiently teaching me the basics and providing a constant listening ear. Thank you to Gina Palmer and Professional?s Choice Sports Medicine Products Inc. for their generous donation of Sports Medicine Boots. To my parents, Barre and Susan Sanders, my siblings and their spouses, Rick and Shana Sanders, and Keri and Jonathan Spurlin, thank you for all of the love, guidance, and support. ix Style manual used: Publication Manual of the American Psychological Association, 5th Edition. Computer software used: Microsoft Excel 2003, Microsoft Word 2003, SAS, Peak Motus 8.1. x TABLE OF CONTENTS LIST OF TABLES ............................................................................................................ xii LIST OF FIGURES .......................................................................................................... xiii CHAPTER I. INTRODUCTION ........................................................................................ 1 Purpose of Study ..................................................................................................... 4 Hypotheses .............................................................................................................. 4 CHAPTER II. LITERATURE REVIEW ............................................................................ 5 Kinematic Analysis ................................................................................................. 6 The Distal Portion of the Equine Limb ................................................................... 8 Surface Impact....................................................................................................... 11 Body-to-surface interactions ..................................................................... 11 Effect of surface composition ................................................................... 11 Training effects ......................................................................................... 13 Shoeing effects ...................................................................................................... 13 Bandages and Boots .............................................................................................. 14 CHAPTER III. METHODS AND MATERIALS ............................................................. 19 Horses .................................................................................................................... 19 Procedure ............................................................................................................... 19 Equipment ............................................................................................................. 21 Statistical Analysis ............................................................................................................ 25 xi CHAPTER IV. RESULTS ................................................................................................ 26 CHAPTER V. DISCUSSION ........................................................................................... 31 REFERENCES .................................................................................................................. 36 APPENDIX: Institutional Animal Care and Use Committee Approval Form.................. 43 xii LIST OF TABLES Table 1: One-way repeated measures ANOVA results for the fetlock joint of horses wearing a Twenty X? Polo Wrap, or Sports Medicine Boot II? (SMB II?), or wearing no support device (control) based on the mean angular joint data ....................................................................................... 27 xiii LIST OF FIGURES Figure 1: The finish timing gate for a left side view of the horse ..................................... 21 Figure 2: Skeletal view of a forelimb with markers applied ............................................. 22 Figure 3: Thoroughbred with markers applied to treated and untreated limbs ................. 23 Figure 4: Quarter Horse with a marker applied over a SMB II......................................... 24 Figure 5: Mean fetlock joint angles for one complete stride during motion analysis of the control.................................................................................................................... 28 Figure 7: Mean fetlock joint angles for one complete stride for horses trotting while wearing a Sports Medicine Boot II? .................................................................... 29 Figure 8: Mean fetlock joint angles for one complete stride for horses trotting while wearing a Twenty X? Polo Wrap ........................................................................ 30 1 INTRODUCTION Equine locomotion is accomplished biomechanically through the complex interaction of multiple body systems. The horse has innate responses and structures that make locomotion more efficient, such as a lowered body position in the trot and the elastic recoil of tendons in the swing phase (Back, 2001); however, the body systems are fine tuned in athletic and performance horses to create the outcomes that trainers and owners desire. This is often accomplished through years of extensive training that predisposes the horse to musculoskeletal injuries. Injuries may occur from overuse, fatigue, contact with objects or other horses, or problems arising from contact with the bearing surface as a result of poor conformation of the limb, application of shoes, surface composition, or training. Boots and wraps were developed for use during equine sporting events and training sessions to protect musculoskeletal structures and the outer surface of the limb. Quarter Horses in particular are bred to participate in a variety of speed events such as reining, cutting, roping, and racing. Thoroughbreds are most known for racing, but they also perform as hunters, jumpers, in polo matches, and three-day eventing. Eventing generally includes dressage, show jumping, cross-country, steeplechase, and track phases, requiring a high demand on the body on multiple surface types (Dyson, 2000). These equestrian events and the training that takes place in preparation create 2 stress on the musculoskeletal structures, give rise to opportunity for damage to the outer body surface, and bring about the possibility for injury from fatigue. Bandages, or wraps, and boots are designed to provide protection to the surface of the lower portion of the limb. In addition, boots are claimed to also provide support to the metacarpophalangeal joint, or fetlock joint. Sports Medicine Boots and polo wraps are commonly used during training, turn out for exercise, and athletic events. The degree of impact of the limb with the bearing surface during training and athletic events is contingent on a number of factors. The lower portion of the limb is susceptible to high shock waves upon impact (Clayton, 2004). The detrimental results that occur from impact shock waves are affected by structures within the hoof and joints, proper surface composition, training, and shoeing (Clayton, 2004). The structural make- up of the hoof, fetlock joint, ligaments, and tendons are designed to respond to the forces of concussion upon impact (Smythe and Goody, 1993). Surface composition plays a large role in the amount of force that is transferred to the limb. In general, harder surfaces (Williams et al., 2001 as cited in O? Sullivan, 2002) and greater stance time result in greater forces upon impact (Buchner, Savelburg, Schamhardt, Merkens, Barneveld, 1994). An increase in the stance time increases the load placed on the limb. Shoeing also increases the effects of shock on the limb at impact (Benoit et al., 1993, as cited in Clayton, 2004). Benoit et al. (1993) suggested that shock reduction was greater in horses wearing shoes constructed of aluminum and polymer than in steel shoes (as cited in Barrey, 1999). Barrey (1999) suggested that visco-elastic shoes may be beneficial for damping the forces that lead to injury. Understanding the role that distal limb structures, surface composition, training, and shoeing play in the interaction with the bearing surface 3 is beneficial for maximizing the effects of the Twenty X? Polo Wrap (Professional?s Choice, 2008b) and Sports Medicine Boot II? (SMB II?) (Professional?s Choice, 2008a) in producing improved performance. Little research has been performed to assess the biomechanical effects of protective boots and wraps such as the SMB II?, and similar boots, or even the traditional Twenty X? Polo Wrap used in trotting horses. The kinematic effects of the SMB II? have been little studied to date because it is relatively new to the equine industry. Kinematic analysis through motion analysis systems provides a way to measure the short-term biomechanical effects of applying boots and wraps to the distal portion of the limb. Measuring limb movement in the sagittal plane gives two dimensional kinematic analyses of joint flexion, extension, and range of motion in the fetlock joint. Two-dimensional kinematic analyses provide data necessary to evaluate the short-term biomechanical effects of boots and wraps. 4 Purpose of the Study The purpose of this study was to assess effects of protective leg gear, such as the Twenty X? Polo Wrap and SMB II?, on the kinematics of the fetlock joint of the forelimb of the horse while trotting. Analysis of temporo-spatial data provided the means to detect significance changes in joint angle data. The examination of angular data of the horses at the trot determined whether or not there were significant changes in the short- term biomechanical effects from these treatments on the distal portion of the limb. This study provided valuable baseline kinematic data for use in future studies of equine locomotion kinematics. Hypothesis ? There will be a significant difference at the trot in peak fetlock extension after applying a Twenty X? Polo Wrap or the SMB II? to the forelimbs when compared to a non-treated limb. Primary Objective ? The primary objective of the study was to compare the short-term biomechanical effects of the following on the fetlock joint of the equine forelimb at the trot: the Twenty X? Polo Wrap, SMB II?, and a non-bandaged limb. Secondary Objective ? The secondary objective of the study was to provide kinematic data on the effects of the SMB II? and the Twenty X? Polo Wrap on the distal portion of the limb at the trot for use in future studies. 5 LITERATURE REVIEW Kinematic Analysis Gait analysis arose out of an interest in understanding the movement of humans and animals (Baker, 2007). Major developments in the twentieth century in the area of kinetic and kinematic analysis arose through the use of force plates (Baker, 2007). Kinetics is ?the study of internal and external forces, energy, power and efficiency involved in the movement of a body? (Deuel, 2001, p. xiv). Kinematics is the description of that movement through the study of mechanics such as temporal, angular and linear motion (Clayton, 2004). Although force plates provide valuable kinetic data, they require the researcher to ensure that the horse makes full contact with the plate and to acquire multiple passes of the hoof over the plate in order to collect a sequence of footfalls. Jules Marey?s advancements in recording kinetic data (Baker, 2007), along with Eadweard Muybridge?s motion analysis work, that led to modern kinematic analysis, (Ashley-Ross, 2002) have provided great contributions to gait analysis. The use of joint markers, videography, and motion analysis systems dates back to Muybridge and Marey?s studies of animal movement, including equine locomotion, in the late 1800s. The continued improvement of gait analysis through the combination of skin markers, videography, and computer-assisted motion analysis systems, along with 6 the force plate developments cited above, has provided an efficient means to collect both kinematic and kinetic data of sequential footfalls as well as multiple stride cycles. Analysis of motion of the distal portion of the limb begins with an understanding of equine locomotion. Since the majority of the motion at the fetlock occurs in the sagittal plane, a two-dimensional analysis of peak flexion, peak extension, and range of motion can be performed that will measure the angular displacement of the distal limb during a stride. This analysis also generates necessary kinematic data such as angular, temporal, and linear measurements needed to evaluate the effects of implementing bandage and boot protocols on the fetlock joints of the forelimbs. Barrey (2001) noted that the horse moves its entire body in repeated patterns through various gaits that are designed for use in sport, work, and pleasure. A gait can be defined as a pattern of limb movements recognized by the sequence and timing of that pattern (Clayton, 2004). Barrey (2001) explained that gaits are commonly divided into symmetrical and asymmetrical gaits depending on the symmetry of the footfalls between the limbs of the left and right sides. The walk and trot are commonly used for kinematic analysis with motion analysis systems because a wider viewing area is not often possible for faster gaits (Barrey, 1999). The trot is a two-beat symmetrical gait in which the diagonal limb pairs move similarly (Clayton, 2004). During the stance phase of the trot, one diagonal limb is in contact with the ground while the other limb is in an aerial phase (Clayton, 2004). During the trot, the horse is moving at a speed faster than a walk, but slower than a canter. The normally symmetrical nature of the trot allows evaluations between the left and right sides because asymmetry indicates lameness. Kinematic 7 analysis with motion analysis systems may detect asymmetry of gait at the trot that is not detectible to the eye of trained observers. The development of high-speed video has allowed researchers to capture the phases of the stride cycle in greater detail. These phases include stance, swing and suspension. The stance phase is commonly broken down further into toe down, full contact, breakover, and toe off. The hoof can come in contact with the ground in a toe down, heel-first or flat-footed manner depending on gait, speed and hoof wall angle (Back, 2001). The breed of the horse and leg conformation can also influence the manner in which the hoof-ground contact occurs. It is necessary that the stride cycle events, such as toe down, breakover, and toe off are predefined and that the type of surface is considered when defining these events. To ensure the accuracy of kinematic data, skin displacement correction factors have been calculated to account for error caused by skin displacement over the joint surface that occurs during locomotion (Van Weeren, Van Den Bogert, and Barneveld, 1990, 1992). Van Weeren et al. (1992) suggested, however, that skin displacement may be disregarded in the lower portion of the limbs, but is necessary for biomechanical research applications. They further claimed that skin displacement appears to be the same in all breeds of horses, but correction models may be necessary when mixed groups of horses are used in research studies (Van Weeren et al., 1990). Clayton and Schamhardt (2001), however, claimed that skin movement below the elbow in the forelimb does not require the use of correction factors. The research cited above on skin displacement is debatable. There are conflicting conclusions on the subject of skin displacement 8 correction factors in the distal portion of the limb within the cited literature. More research is needed for clarification of this issue. Surfaces used in the production of kinematic data must also be considered. The treadmill has often been used in kinematic analysis as a tool for researchers because of its ease of use in an indoor, more controlled, environment (Buchner et al., 1994). The treadmill usually has a relatively flexible rubber surface. Buchner et al. (1994) observed that on an asphalt surface the duration of the stride was shorter, but the shock of impact was higher than on a rubber surface. Asphalt surfaces have been the standard for lameness evaluations (Buchner et al., 1994). Data collected from over ground locomotion studies, however, can not be quantitatively compared to data collected in treadmill studies (Buchner et al., 1994). Therefore, caution should be used when comparing data from horses trotting on a treadmill and horses trotting over ground while using similar protective leg gear. The Distal Portion of the Equine Limb When a horse?s head and neck are in a neutral position, the forelimbs bear more weight than the hind limbs, and the center of mass lies closer to the cranial aspect of the body (Clayton, 2004). Because a horse?s center of mass lies in this position, peak vertical ground reaction forces will be greater in the forelimbs. Vertical ground reaction forces peak around mid-stance, at the time when the suspensory ligament undergoes maximal strain (Clayton, 2004). Peak vertical ground reaction forces increase with an increase in trotting speed, resulting in higher forces upon impact and having the propensity to result in greater extension of the fetlocks of the forelimbs (Clayton, 2004). The structures of the 9 equine forelimb also undergo higher maximum braking forces since braking occurs primarily in the forelimbs (Clayton, 2004). The fetlock joint consists of the junction between the third metacarpal bone and the proximal phalanx, as well as the junction between two sesamoid bones located proximal and caudal to the joint and the distal portion of the third metacarpal bone (Dyce, 2002). Weight is distributed across the sesamoids and the proximal phalanx to reduce impact forces on the joint (Dyce, 2002). The primary sources of stabilization and support during movement in the forelimb fetlock joint arise from the proximal sesamoid bones, and elastic properties of the suspensory ligament, and extensor branches of the suspensory ligament (Stashak, 2002). Support is also provided by the superficial and deep digital flexor tendons (Clayton, 2004). The superficial digital flexor tendon allows for fetlock flexion during the swing phase and extension of the fetlock joint during the stance phase (Clayton, 2004). The superficial digital flexor tendon is an extension of the superficial digital flexor muscle and inserts on the first and second phalanxes (Clayton, 2004). The fetlock joint, allows for movement in the sagittal plane through the actions of tendons and ligaments surrounding the joint, in addition to muscle function occurring in the upper portion of the limb (Back, 2001). The fetlock joint moves through a combination of negative and positive work (Clayton, 2004). As the horse moves into the stance phase active energy is transferred to the limb and energy is stored in the tendons and suspensory ligament (Clayton, 2004). During the latter portion of the stance phase, positive work is done, and energy is released as these tissues recoil (Clayton, 2004). Back (2001) claimed that the passive release of energy from the recoiling of the SDFT and 10 DDFT throughout the stride is also involved in causing flexion and extension of the fetlock joint. Clayton (2004) suggested that the storage and release of energy during the stance phase is a means of energy efficiency for the horse during locomotion. The suspensory ligament, deep and superficial digital flexor tendons, and their accessory ligaments store elastic strain energy during limb loading in the stance phase (Back, 2001). It is at this time that the fetlock undergoes maximal extension and the suspensory ligament, superficial digital flexor tendon, and deep digital flexor tendon undergo maximal strain (Back, 2001). Because the superficial digital flexor tendon experiences maximal tension in the stance phase (Meershoek et al., 2002a as cited in Clayton, 2004), it is at this point that injury caused by hyperextension is likely to occur (Clayton, 2004). Elastic strain energy that is stored in the limb during the stance phase supplies kinetic energy sufficient to allow for passive fetlock flexion during the swing phase (Back, 2001). Inertial forces primarily drive fetlock flexion in the latter part of the swing phase and forward limb movement continues until the proximal portion of the limb slows before ground contact (Back, 2001). Flexion continues until anatomical constraints, namely the tendons and ligaments on the caudal aspect of the limb, halt the ability of the limb to continue swinging forward (Back, 2001). The hoof is designed to provide energy absorption through its elastic properties and transmit forces to the rest of the skeleton (Thomason, Biewener and Bertram, 1992). Hoof wall distortion is the same regardless of speed or gait (Thomason et al.,1992), however both hoof wall angles (Clayton, 1990) and shoes play a major role in the surface interface interaction (Barrey, 1999). 11 Surface Impact Quarter Horses and Thoroughbreds participate in a number of athletic performances that subject them to extreme ground contact forces, predisposing them to a greater risk for injury. Anatomical structures resist the forces placed on the body during locomotion. Detrimental results that occur from impact shock waves are affected by structures within the hoof and joints, surface composition, training, and shoeing (Clayton, 2004). Body-to-surface interactions. As the hoof comes in contact with the ground, damping of impact forces occur mainly in the metacarpophalangeal joint (Merkens and Schamhardt, 1994). Damping of impact oscillations, however, occur in the suspensory apparatus, hoof and the contact surface (Merkens and Schamhardt, 1994). The hoof has elastic properties that allow for deformation in the wall upon impact with the ground, resulting in energy absorption capabilities that are not dependent upon direction of impact (Thomason et al., 1992). Energy absorption is accomplished in other portions of the foot due in part to the role of the soft tissues of the hoof, laminae, and digital cushion in attenuating the frequency of the impact vibrations (Lanovaz, Clayton, Watson, 1998). The bones of the equine digit and interphalangeal joints attenuate amplitude to a greater extent than they attenuate frequency (Lanovaz et al., 1998). The hoof?s capabilities in providing this natural shock absorption somewhat protect the distal portion of the limb from the damaging impact forces. Effect of surface composition on strain. A case could be made that there are four major surface classifications used in the equine industry. The classifications are vegetated, non-vegetated, asphalt/concrete, and synthetic athletic surfaces. Vegetated 12 surfaces are defined as ?areas having equal to, or greater than 1% or more of the land or water surface with live vegetation cover at the peak of the growing season? (Federal Geographic Data Committee, 2008, p.57). According to the National Vegetation Classification Standard, non-vegetated surfaces have ?less than 1 % of the surface area with vegetation cover naturally or from which vegetation is removed and replaced by man (human)-made surfaces or structures? (Federal Geographic Data Committee, 2008, p. 52). Asphalt is a petroleum byproduct that may be mixed with stone or sand (?Asphalt?). Concrete is derived from mixture of cement, gravel (?Concrete?, The American Heritage? Dictionary), and water to form a thick mortar (?Concrete?, Collins Essential English Dictionary). Synthetic or athletic surfaces used in the equine industry are commonly formed from silica sand, rubber, synthetic fibers, such as elastic, and wax coatings. These surfaces are used to increase the consistency of the track surface and are thought to reduce the number of injuries that occur on the track arising from issues with the level of consistency (Thomason and Peterson, 2008). With regard to the vertical ground reaction force loading rate, surface stiffness is a more important factor of track composition than the addition of other organic substances that are normally added to enhance damping (Reiser, Peterson, McIlwraith, Woodward, 2000). The surface area of the hoof that comes in contact with the track will influence loading of the ground reaction forces to the bones and joints (Reiser et al., 2000). If there is a deficiency of surface area contact with the hoof, the vertical loading forces may mimic a significantly harder soil or surface, exposing the horse to a greater risk for injury (Reiser et al., 2000). Overall, harder surfaces and those that are unstable create the most risk for damage to the limb. (Williams et al.,2001 as cited in O?Sullivan, 2007). In 13 addition, increasing the stance time will consequently increase forces on the limb upon impact (Buchner, et al 1994). Training Effects. Exercise has the beneficial physiological effects of increasing bone density, increasing the size of tendons, and an even greater response in changing hyaline cartilage within joints (Firth, 2006). The type of exercise, duration, intensity, frequency, length of the regimen, and recovery time should be included in an exercise prescription (Rogers, Rivero, van Breda, Lindner, and Sloet van Oldruitenborgh-Oosterbaan, 2007). Burn, Wilson, and Nason (1997) suggested that dynamic limb loading causes bone changes that result in greater bone strength. Increasing the speed and allowing the horse to travel over hard surfaces increases the shock that occurs upon impact due to the deceleration of the hoof (Clayton, 2004). Radin (1991) found that repetitive exposures to oscillations that occur upon impact are linked to the development of osteoarthritis (as cited in Back, 2001). Shoeing Effects. The type of shoe selected may increase or decrease the shock upon impact (Benoit et al., 1993 as cited in Clayton, 2004). Benoit et al. (1993) suggested that shock reduction was greater in horses wearing shoes made of aluminum or polymer than in steel shoes (as cited in Barrey, 1999). Barrey (1999) suggested that visco-elastic shoes may be beneficial for damping the forces that lead to injury. Iron shoes increased both the amplitude and frequency of the impact vibrations when horses were trotted on an asphalt surface (Dyhre-Poulson, Smedegaard, Roed, and Korsdgaard, 1994). According to Willemen (1999), shod horses had a greater flexion of the carpal and fetlock joints during the swing phase than unshod horses (as cited in Singleton, Clayton, Lanovaz and Prades, 2003). 14 Bandages and Boots The distal portion of the forelimb of horses is predisposed to many different types of injury at the fetlock joint including fractures of the third metacarpal, proximal sesamoid bones, and the proximal phalanx in response to stress placed on the limb during locomotion. Fatigue and the subsequent hyperextension of the fetlock joint are often cited as the cause of injury to the fetlock and supporting ligaments and tendons (Kobluk, Martinez, Harvey-Fulton, Libbey, and Walton, 1988). Fractures of bones and trauma to tendons and ligaments commonly occur in athletic horses. Bandages, or wraps, and boots are used for protective, supportive, therapeutic and clinical treatment purposes on the lower limb. It is important that boots and bandages are expertly applied to avoiding causing further injury and to achieve the desired treatment outcome (Harris, 1997a). We are not aware of studies investigating the ability of the SMB II? and the Twenty X? Polo Wrap to prevent injury to structures in the forelimb in trotting horses over ground. It is widely accepted, however, that support boots and polo wraps are an effective means of protection from injury during training and are allowed to be worn in some equine athletic events. The SMB II? and the Twenty X? Polo Wrap were selected for this study because they are commonly used at equine athletic events and are believed to prevent injury to the lower portion of the limb. The SMB II?, which is made from a synthetic neoprene material, is fastened using three straps that circle the third metacarpal bone and another strap that circles the fetlock just below the proximal sesamoid bones. Twenty X? Polo Wraps are made of long, narrow strips of fleece material, usually with one Velcro strap, and appear to be more flexible than support boots. Polo Wraps conform to contours of the limb without the need for additional 15 padding that other wraps require (Harris, 1997a). Support boots are claimed to support the fetlock by reducing fetlock hyperextension (Balch et al., 1998). Polo wraps on the other hand do not provide support to the fetlock, and thus provide less protection than boots (Clayton as cited in Loving, 2008). When considering selection of a boot or wrap, it is important to take into account the type of work the horse will be performing, the amount of interference needed to prevent further injury, material composition of the boot or bandage (Crawford, 1990a), and the fitness of the horse. Crawford (1990a) and Morlock (1997) suggested that the technique of application and the types of surfaces for training and performance are also important considerations when choosing a boot or wrap. Furthermore, each event?s governing organization has policies that dictate what equipment is permissible. For example, boots and wraps are allowed in cutting, roping, reining, but boots are restricted to training areas only in many dressage competitions. Boots are useful during training and competition, but careful selection should be made to select boots that provide optimal support to the distal portion of the limb. There are two categories of boots, interference and support boots. Brushing or interference boots include bell boots, skid, splint, and jumping boots (Nicodemus, 1999). Older style bell boots are fashioned from rubber-like material and are commonly used to prevent injuries from interference. Skid boots are applied to horses used for cutting and reining to protect from chafing of the fetlock during slide stops, but care must be taken so that dirt does not collect in them and exasperate the problem of chafing (Biggs, 2002). Splint boots are used for protection of the medial aspect of the distal portion of the limb through the use of a rigid plate (Biggs, 2002). Jumping boots are often open to the front to allow 16 the horse to feel poles when coming in contact with them and closed in the back to protect the tendons from rear leg strikes (Biggs, 2002) and contact with obstacles while jumping. Sports Medicine Boots are categorized as a support boot (Nicodemus, 1999) and have been shown to provide energy absorption capabilities as measured by Balch et al., 1998. Bandages were developed out of the need for wound care, rehabilitation, and safety in transportation (Gomez and Hanson, 2005). Few are designed to provide support, but do provide protection to the limb surface. Bandages are made from various materials and include dressings, shipping bandages, polo wraps and athletic tapes. Bandages should be used according to the type of event the horse will participate in and the type of injury that the horse is prone to. Bandages are used in both people and horses for rehabilitation, wound care, and stabilization of joints and ligaments. Athletic taping is used for the purpose of enhancing stability and strength of joints in humans (Neiger, 1990 as cited in Ramon et al., 2004). Ramon et al. (2004) compared common athletic taping materials to assess the effects of taping the metacarpophalangeal joint of horses while trotting on a rubber surface. They found that fetlock flexion during the swing phase and vertical loading forces are reduced by use of athletic taping; however, there was no significant reduction of extension of the metacarpophalangeal joint during the stance phase (Ramon, 2004). The reduction in peak vertical force was suggested to be caused by a change in proprioception (Ramon et al., 2004). Kobluk et al. (1988) found that bandaging with Vetrap? support bandage (Equisport Equine Support Bandage: 3M Corporation) reduced fetlock extension when horses were exercised to fatigue on a high-speed treadmill while imitating racing conditions. 17 Support boots, and bandages are used frequently on the equine athletes to prevent injury and provide support (Kicker, Peham, Girtler, and Licka, 2004). Substantial vertical impact forces on the distal portion of the forelimb during the trot predispose the horse to injury (Back, 1995), but this injury may be prevented by the use of bandages (Kobluk et al., 1988; Ramon et al., 2004) and support boots (Kicker et al., 2004). The application of support boots has been shown to reduce maximum fetlock extension and tension on the superficial digital flexor tendon (SDFT) of horses trotting on a treadmill (Kicker et al., 2004). The risk for overload of the SDFT, a common cause of injury in performance horses, may be reduced by use of support boots (Kicker et al., 2004). Long-term use of support boots for the purpose of rehabilitation and protection of SFDT injuries, however, may decrease the chance for proper healing (Kicker et al., 2004). Serious injury can occur to the bones and joints of the forelimb as a result of impact with the ground due to high frequency, high amplitude shock waves (Luhmann et al., 2000). Luhmann et al. (2000) found that use of a neoprene type, nylon-lined boot or a polo wrap did not attenuate shock in the third metacarpus of horses that were trotted and galloped on a high-speed treadmill. They suggested that further studies were needed to determine the effects of boots and wraps on the distal portion of the limb when used for an extended period of time (Luhmann et al., 2000). The material composition of commercial equine support boots has been found to be a significant factor in their ability to absorb energy (Crawford, 1990b). Crawford et al. (1990a) suggested that for a support boot to be useful, it is important to select a material with a higher modulus of elasticity, and wrap with the proper tension, thickness, and technique, including direction. Crawford (1990a) used Vetrap? Bandaging Tape (3M 18 Corporation) in different bandage configurations on equine cadaver limbs. Five configurations were applied with varying tensions and application techniques. Crawford et al. (1990a) suggested that assessing the purpose for bandage application is beneficial before selecting the bandage configuration. Energy absorption capacity is affected by selecting the proper tension and application technique (Crawford, 1990a). In particular, Crawford et al. (1990a) reported that racing Thoroughbreds are often wrapped with Vetrap bandaging tape applied at 50% tension using a high ?figure 8? technique. They suggested that adding a splint support to this would enhance the energy absorption capacity of the bandage (Crawford et al., 1990a). In a subsequent study Crawford, et al. (1990b) outlined situations in which certain bandaging configurations and tension applications may be more beneficial. They suggested that maximal energy absorption capacity often occurs in applications may restrict mobility in the joint (Crawford et al., 1990b). Balch et al. (1998) found that Sports Medicine Boots (Professional?s Choice Sports Medicine Products, Inc.) protect supporting structures in the lower portion of the limb by absorbing energy from ground reaction forces. Balch et al. (1998) measured the energy absorption capacity of the SMB II? (Professional?s Choice Sports Medicine Products, Inc.) and previously worn SMB II? in their trials. Balch et al. (1998) calculated the energy absorption capacities of the SMB II using load/deflection curves, and reported data as a percentage to represent the mean increase of the energy absorption capacity of the bandaged limb to a non-bandaged limb, predicted through calculation. The SMB II? was shown to increase the energy absorption capacity of an isolated hindlimb upon impact with the surface by 23.4% and previously used SMB II? increased the energy absorption capacity by 26.4% (Balch et al., 1998). 19 MATERIALS AND METHODS Horses Kinematic data was collected from eight horses in this study (2 Thoroughbreds, 5 Quarter Horses and 1 draft horse cross). This study was approved by the Auburn University?s Institutional Animal Care and Use Committee. The horses had a mean weight of 565.1 + 57.3 kg, an age of 10.0 + 3.2 years and a height of 1.6 + 0.06 m at the withers. The horses had no signs of lameness when observed while trotting on a level asphalt surface in a straight line. Procedure Each horse was trotted on the asphalt surface to acclimatize it to the handler and surroundings and to determine that it was not lame. A treatment was then selected and implemented according to the treatment order. The treatment order was designed to counterbalance the effects of fatigue during the trials. The SMB II? and the Twenty X? Polo Wrap were selected for this study. The SMB II?, which is made from a synthetic neoprene material, has three straps that circle the third metacarpal bone and one strap that circles the base of the fetlock joint on its caudal aspect. Twenty X? Polo Wraps are made of a fleece material, 5 inches wide and 9 feet long, which is secured to the limb with one Velcro strap. Polo wraps appear to be 20 more flexible than support boots, and they conform well to the limb without the need for additional underlying material that other bandaging materials require (Harris, 1997a). Twenty X? Polo Wraps were applied by the lead graduate student (see Appendix) according to the method described by Luhmann, et al. (2000). SMB IIs? were applied by the lead graduate student according to the first protocol shown in an instructional video (Professional?s Choice, 2008c). The horse was trotted in a straight line between timing gates, in a path in front of and perpendicular to the view of a video recorder. Six film sequences were collected for each of the three treatment groups [i.e., SMB II?, Twenty X? Polo Wrap, non-treated limbs (control)]. Six video taped sequences (three left and three right body side views) were recorded of each horse while trotting for data analysis. Electronic timing gates (Signature Gear Corporation) were placed at the start and finish of the motion path to record the time that the transmitted beam is broken at the start until the beam is broken at the finish. The start gate and finish gate each had two poles placed on either side on the horse?s path to create a 6-meter wide gate. The start gate poles were placed 9.27 m from the finish gate poles (Figure 1). Data from the timing gates were recorded to calculate velocity for each pass for all treatments and horses. 21 Figure 1: The finish timing gate for a left side view of the horse. For the purposes of analysis, stride cycle events were predefined prior to the study. One stride was determined to occur from toe down to toe down in the same limb. Toe down occurred at the frame in the video where initial contact occurred between the hoof and the asphalt surface. Toe off was defined as first frame in the video in which the hoof left contact with the bearing surface. Breakover was defined as the first frame in which the heel bulb left the ground after full contact with the bearing surface in the stance phase. Equipment Retro-reflective markers were placed on the lateral aspect of the elbow, carpal, and metacarpophalangeal joints, and the lateral aspect of each hoof of the left and right forelimbs (Figure 2). Elbow markers were placed over the lateral epicondyle of the left and right humeri. Markers for the carpii were placed over the lateral styloid process. For the fetlock joints, the marker was placed at the distolateral aspect of the third metacarpal 22 bones. Hoof markers were placed on the lateral aspect hoof midway between the coronet and the bearing surface. Two Smith and Victor model 700 SG lights were placed on either side of the high-speed camera to increase marker reflection properties. Figure 2: Skeletal view of a forelimb with markers applied When treatments were applied, the site of marker application was identified by palpating the fetlock through the wrap (Figures 3 and 4). Each marker had a circular base constructed of a foam circle glued to reflective duct tape (Polyken? FSK). A one and one-half inch hemispherical retro-reflective object was attached to this base for each marker. The markers had adhesive backings and were placed directly onto the skin (Figures 3 and 4). At least three video-recorded sequences for both the left and right sides of the horse were collected as the horse trotted perpendicular to the view of the camera for each of the three treatment groups. 23 Figure 3: Thoroughbred with markers applied to treated and untreated limbs 24 Figure 4: Quarter Horse with a marker applied over a SMB II Video of the study was obtained through the use of a TroubleShooter portable high-speed camera (Fastec Imaging? Corporation). The high-speed camera was set at a rate of 60 pictures per second (pps) and a shutter speed of 1/600, 10 times the frame rate. Uncompressed audio video interleave (avi) files produced from this camera were analyzed through the Peak Motus? 8 motion analysis system. Positional data was generated, allowing for assessment of linear and angular displacement measurements on the forelimb fetlock with each protective/supportive implementation, and with no bandage. 25 Statistical analysis Data from gait timers was validated by using positional data from the withers marker for one horse and the known gait distance in the Peak Motus? 8 motion analysis system. Velocity data for all eight horses was processed using SigmaStat 2.03 statistical software to validate combining left and right trials in the one-way repeated measures ANOVA analysis. A one-way repeated measures ANOVA was performed to detect significant variance in the horses? velocities for both of the treatments and the control variable. The one-way repeated measures analysis of variance was performed in SigmaStat 2.03 statistical software for the fetlock joint angles using the 8 subjects to compare the biomechanical effects of the two bandages and the non-treated limbs. The kinematic parameters for this study included the following: peak extension, peak flexion, and range of motion (ROM). The left and right sides were combined for all eight horses. 26 RESULTS Gait timers were validated by using positional data from the withers marker for one horse and the known gait distance. T-tests were run to further detect any differences in the velocities between left and right sides for the control for all eight horses. No significant differences were found for the control (p>0.05). T-tests were also performed on left and right trials for the fetlock joint angles for each of the kinematic parameters. No significant differences were found for the joint angles in the left and right trials comparison (p>0.05). A one-way analysis on angular data for the fetlock joints is shown in Table 1. The results of this study indicated that there was no significant change in peak extension of the fetlock joint caused by application of the SMB II? or the Twenty X? Polo Wrap (p= 0.143). Peak flexion in the fetlock joint was reduced significantly with the use of the SMB II? when compared to the non-treated limb (p= <0.001) and the Twenty X? Polo Wrap (p= 0.004). Range of motion of the fetlock joint was significantly decreased with the use of the Twenty X? Polo Wrap and the SMB II? when compared to the non-treated limb (p= <0.001); however, range of motion of the fetlock joint was significantly greater in horses wearing the Twenty X? Polo Wrap when compared to range of motion of the fetlock joint in horses wearing the SMB II? (p= <0.001). 27 Table 1: One-way repeated measures ANOVA results for the fetlock joint of horses wearing a Twenty X? Polo Wrap, or Sports Medicine Boot II? (SMB II?), or wearing no support device (control) based on the mean angular joint data. Notes: Ext. = Extension, Flex. = Flexion, ROM = Range of motion, M = mean, SD = Standard deviation. Fetlock M SD P F Peak Ext. 0.14 2.08 Control 229.71 6.11 Polo 227.57 6.49 SMB II? 226.63 6.46 Peak Flex. <0.001 17.91 Control 155.28 5.66 Polo 158.58 8.40 SMB II? 163.49 7.34 ROM <0.001 63.50 Control 74.4 6.76 Polo 68.99 6.38 SMB II? 63.13 6.65 28 140.0 160.0 180.0 200.0 220.0 240.0 Joi nt An gle (d eg ree s) Horse 1 Horse 2 Horse 3 Horse 4 Horse 5 Horse 6 Horse 7 Horse 8 Average Percent Stance Phase 47.48 Average Percent Swing Phase 52.52 Extension Flexion Figure 5: Mean fetlock joint angles for one complete stride during motion analysis of the control. 29 140.0 160.0 180.0 200.0 220.0 240.0 Joi nt An gle (d eg ree s) Horse 7 Horse 1 Horse 2 Horse 3 Horse 4 Horse 5 Horse 6 Horse 8 Average Percent Stance Phase 48.20 Average Percent Swing Phase 51.80 Extension Flexion Figure 6: Mean fetlock joint angles for one complete stride for horses trotting while wearing a Sports Medicine Boot II ?. 30 140.0 160.0 180.0 200.0 220.0 240.0 Joi nt An gle (d eg ree s) Horse 1 Horse 2 Horse 3 Horse 4 Horse 5 Horse 6 Horse 7 Horse 8 Average Percent Swing Phase 52.67 Average Percent Stance Phase 47.33 Extension Flexion Figure 7: Mean fetlock joint angles for one complete stride for horses trotting while wearing a Twenty X? Polo Wrap. 31 DISCUSSION The objective of this investigation was to test the hypothesis that the use of the SMB II? and the Twenty X? Polo Wrap would reduce peak extension in the fetlock joint at the trot. Horses were trotted in this study because this gait provided adequate velocity, which allowed for substantial kinematic assessment of temporal and spatial parameters while providing a symmetrical gait to allow comparison of fetlock flexion and extension in each of the forelimbs, and detection of lameness prior to the start of the study. Preliminary statistical analysis of the horses? velocities indicated that there were no significant differences between each of the horses? left and right trials for the control treatment. This validated the combination of left and right sides in the one-way repeated measures ANOVA analysis for the fetlock joint angles. To further test the validity of combining the left and right trials, t-tests were performed on data collected during left and right trials that examined fetlock joint angles for horses trotting while wearing the SMB II?, or Twenty X? Polo Wraps, or control horses under each parameter; no significant differences in results were found for fetlock angles for peak extension, peak flexion, or range of motion under the treatment or control conditions. A one-way repeated measures ANOVA revealed that extension of the fetlock joint is not significantly reduced by use of the SMB II? or the Twenty X? Polo Wrap. 32 The application of support boots has been shown to reduce maximum fetlock extension and tension on the superficial digital flexor tendon (SDFT) when horses are trotted on a treadmill (Kicker et al., 2004). The results of this study, however, showed no significant reduction in peak fetlock extension in horses trotting while wearing these protective care products, which may suggest that these boots and wraps do not offer additional support to the SDFT during motion more comparable to regular training activities than motion on a treadmill. As expected, flexion was reduced with the use of the SMB II? when compared to the other two treatments. Range of motion in the fetlock joint was reduced by the Twenty X? Polo Wrap by 5.43 degrees when compared to the control in this study. The SMB II? caused a greater reduction in range of motion (11.3 degrees) when compared to the control. We conclude that the Twenty X? Polo Wrap permitted a significantly greater range of motion than the SMB II?. The suspensory ligament and flexor tendons experience strain as a result of fetlock joint extension (Denoix, 1996 as cited in Ramon et al., 2004). Polo wraps, by nature, offer protection to the outer distal limb surface; however, there is considerable debate concerning the degree of support, if any, that polo wraps offer due to the pliable properties of their materials. Based on the results of this study, there is no evidence to suggest that either the Twenty X? Polo Wrap or the SMB II? offer any support sufficient to reduce strain on the suspensory ligament and flexor tendons that occur as a result of peak fetlock extension. Sports medicine boots, like the SMB II?, have been shown to provide energy absorption capabilities (Balch et al., 1998). The results of this study indicate that use of either the SMB II? or Twenty X? Polo Wrap significantly restricts the range of motion in the fetlock joint by reducing peak flexion. Back (2001) 33 found that there are two peaks of flexion in the fetlock joint during the swing phase, with maximal peak flexion reached at around ? of the swing phase. The present study found that maximal peak flexion is reduced by both treatments. Further studies are necessary to confirm changes in the timing of peak flexion under the influence of the SMB II? or the Twenty X? Polo Wrap. The findings of this study suggest that additional care should be taken when choosing wraps and boots for training, treatment, or competition to achieve the desired outcome. This study did not evaluate the addition of protective leg gear in providing protection to the outer surface of the limb, but it does show that use of these treatments restricts motion. If motion is restricted during the stance phase, the forces placed on structures within the limb may be increased (Buchner et al., 1994). Clayton (2004) suggested that detrimental results that occur from impact shock waves are affected by structures within the hoof and joints, surface composition, training, and shoeing. Future studies should investigate how these factors are affected by use of boots and wraps such as the SMB II? and the Twenty X? Polo Wrap. Boots, such as the SMB II?, and the Twenty X? Polo Wrap were designed to provide protection to the outer surface of the limb during equine sporting events and training sessions. Boots have also been claimed to provide support to the fetlock joint. For these reasons, these protective leg care products are commonly worn by Thoroughbreds and Quarter Horses in training, when turned out for exercise, or during competition. It is during these times that the musculoskeletal structures of the forelimbs undergo extreme forces, sufficient to cause injury. These forces are affected by a variety of factors including, but not limited to, the structures within the hoof and joints, surface 34 composition, training, and shoeing (Clayton, 2004). The benefit of the surface protection versus the limitation on movement must be carefully assessed when determining the use of protective materials during training and competition. Roping and cutting horses may lose some of the precision of movement necessary to accomplish their goals due to a reduction in flexion or range of motion. This may also result in time limitations caused by restricted movement in the joint. In roping and cutting horse events, restricting movement may jeopardize the quick movements necessary to accomplish the task, costing the rider and horse time in a competition and consequently money. This study provides objective data that will aid in such assessments. Since it is practically impossible to measure the effects of inhibiting range of motion during the actual competitions in an objective manner, studies in carefully controlled environments can only assess components of the movements expected during competition. During our literature search we found no report concerning the effects that the Twenty X? Polo Wrap or SMB II? have on fetlock joint kinematics for horses trotting on asphalt surfaces. Data from treadmill studies can not be quantitatively compared to data collected in over ground studies (Buchner et al., 1994).Therefore, this study is valuable in providing much needed kinematic data on movement of horses trotted on an asphalt surface for the comparison of the movement affected by application of the SMB II? and the Twenty X? Polo Wrap versus movement of non-treated horses. In further assessments of the SMB II?, it is important to note that circumference of the fetlock at the widest point is more important than height in assessing which size of the SMB II? to use (Professionals Choice, 2009). The present study relied on measurement of the horse?s height in hands for proper fitting of the boots, so fit may 35 affect the results. Furthermore, although there is no established direction for applying the polo wraps, this study chose to wrap the Twenty X? Polo Wraps counterclockwise when wrapping the left forelimb and clockwise when wrapping the right. Future research may include investigation of the movement of the carpus, elbow, shoulder, ear, withers, ilium, hip, stifle, tarsus, and hoof to determine the short-term biomechanical effects of these treatments on the movement of the body as a whole through evaluation of kinematic parameters. Kinematic and kinetic evaluations on stance phase durations may be beneficial in determining how forces on the limb are affected by using these treatments. 36 REFERENCES Adrian, M. J., Roy W. E., & Karpovich P.V. (1996). Normal gait of the dog: an electrogoniometric study. American Journal of Veterinary Research, 27, 90-95. Ashley-Ross, M. A. & Gillis, G. B. (2002). A brief history of vertebrate functional morphology. Integrative and Comparative Biology, 42(2), 183-189. Asphalt. (n.d.) The American Heritage? Dictionary of the English Language, Fourth Edition. (2003). Retrieved March 5 2009 from http://www.thefreedictionary.com/asphalt Back, W. (2001). Intra-limb coordination: the forelimb and hindlimb. In W. Back and H.M. Clayton (Eds.), Equine Locomotion (pp.95-134). London, England: W.B. Saunders. Back, W., Schamhardt, H. C., & Barneveld, A. (1996). Are kinematics of the walk related to the locomotion of a warmblood horse at the trot? Veterinary Quarterly, 18, S79-S84. Back, W., Schamhardt, H. C., Hartman, W., & Barneveld, A. (1995). Kinematic differences between the distal portions of the forelimbs and hind limbs of horses at the trot. American Journal of Veterinary Research, 56(11), 1522-1528. Baker, R. (2007). The history of gait analysis before the advent of modern computers. Gait & Posture, 26(3), 331-342. 37 Balch, O. K., Collier, M. A., Brusewitz, G. H., Rigney, M. P., Shult, M. J., Crawford, W. H., & McAroy, R. B. (1998). Energy absorption capacity of commercial equine support boots. Veterinary and Comparative Orthopaedics and Traumatology, 11(4), 173-177. Barrey, E. (1999). Methods, applications and limitations of gait analysis in horses. The Veterinary Journal, 157(1), 7-22. Barrey, E. (2001). Inter-limb coordination. In W. Back and H.M. Clayton (Eds.), Equine Locomotion (pp. 77-94). London, England: W.B. Saunders. Biggs, S. (2002, May 1). Safeguarding lower limbs. The Horse. Retreived December 8, 2008 from www.thehorse.com. Buchner, H. H. F., Savelberg, H. H. C. M., Schamhardt, H. C., Merkens, H. W., & Barneveld, A. (1994). Kinematics of treadmill versus overground locomotion in horses. Veterinary Quarterly, 16, S87-S90. Burn, J. F., Wilson, A. M., & Nason, G. P. (1997). Impact during equine locomotion: Techniques for measurement and analysis. Equine Veterinary Journal Supplement, 23, 9-12. Butcher, M. T., & Ashley-Ross, M. A. (2002). Fetlock joint kinematics differ with age in thoroughbred racehorses. Journal of Biomechanics, 35(5), 563-571. Clayton, H. M. (1990). The effect of an acute angulation of the hind hooves on diagonal synchrony of trotting horses. Equine Veterinary Journal Supplement, 9, 91-94. Clayton, H. M., Hodson, E., & Lanovaz, J. L. (2000). The forelimb in walking horses: 2. Net joint moments and joint powers. Equine Veterinary Journal, 32(4), 295-300. 38 Clayton, H. R., Willemen, M. A., Lanovaz, J. L., & Schamhardt, H. C. (2000). Effects of a heel wedge in horses with superficial digital flexor tendinitis. Veterinary and Comparative Orthopaedics and Traumatology, 13(1), 1-8. Clayton, H. M. & Schamhardt, H. C. (2001). Measurement techniques for gait analysis. In W. Back and H.M. Clayton (Eds.), Equine Locomotion (pp.55-76). London, England: W.B. Saunders. Clayton, H. M. (2004). The dynamic horse: A biomechanical guide to equine movement and performance. Mason, Michigan: Sport Horse Publications. Concrete. (n.d.) The American Heritage? Dictionary of the English Language, Fourth Edition. (2003). Retrieved March 5 2009 from http://www.thefreedictionary.com/concrete Concrete. (n.d.) Collins Essential English Dictionary 2nd Edition. (2004, 2006). Retrieved March 5 2009 from http://www.thefreedictionary.com/concrete Crawford, W. H., Vanderby Jr., R., Neirby, D., Libbey, C. J., & Nordheim, E. V. (1990a). The energy absorption capacity of equine support bandages: Part I: Comparison between bandages placed in various configurations and tensions. Veterinary and Comparative Orthopaedics and Traumatology, 1, 14-21. Crawford, W. H., Vanderby Jr., R., Neirby, D., Libbey, C. J., & Nordheim, E. V. (1990b). The energy absorption capacity of equine support bandages: Part II: Comparison between bandages from different materials. Veterinary and Comparative Orthopaedics and Traumatology, 1, 14-21. Deuel, N. R. (2001). Glossary. In W. Back and H.M. Clayton (Eds.), Equine Locomotion (pp. xii-xvi). London, England: W.B. Saunders. 39 Dyce (2002) Dyce, K. M., Sack, W. O., & Wensing, C. J. G. (2002). Textbook of Veterinary Anatomy (3rd ed.). Philadelphia: Saunders. Dyhre-Poulsen, P., Smedegaard, H. H., Roed, J., & Korsgaard, E. (1994). Equine hoof function investigated by pressure transducers inside the hoof and accelerometers mounted on the first phalanx. Equine Veterinary Journal, 26(5), 362-366. Dyson, S. (2000). Lameness and poor performance in the sports horse: Dressage, show jumping and horse trials (eventing). Proceedings of the Annual Convention of the AAEP, 46, 308-315. Federal Geographic Data Committee. (2008). National Vegetation Classification Standard (Version 2). Retrieved January 8, 2009, from (http://www.fgdc.gov/standards/projects/FGDC-standards- projects/vegetation/vegclass.pdf FGDC-STD-005 Firth, E. C. (2006). The response of bone, articular cartilage and tendon to exercise in the horse. Journal of Anatomy, 208(4): 513?526. Gomez, J. H., & Hanson, R. R. (2005). Use of dressings and bandages in equine wound management. Veterinary Clinics of North America-Equine Practice, 21(1), 91- 104. Harris, S. E. (1997a). The USPC Guide to Bandaging Your Horse. New York: Howell Book House. Harris, S.E. (1997b). The USPC Guide to Conformation, Movement and Soundness (R.R. Harvie, Ed.). New York: Howell Book House. 40 Kicker, C. J., Peham, C., Girtler, D., & Licka, T. (2004). Influence of support boots on fetlock joint angle of the forelimb of the horse at walk and trot. Equine Veterinary Journal, 36(8), 769-771. Kobluk, C. N., Martinez, L., Harvey-Fulton, K. A., Libbey, C. J., & Walton, J. (1988). A kinematic investigation of the effect of a cohesive elastic bandage on the gait of the exercising thoroughbred racehorse. Paper presented at the 34th Annual convention of the American Association of Equine Practitioners San Diego, CA. Lanovaz, J. L., Clayton, H. M., & Watson, L. G. (1998). In vitro attenuation of impact shock in equine digits. Equine Veterinary Journal Supplement, 26, 96-102. Loving, N. S. (2008, January 1). Protective boots: To support and protect. The Horse, 25(1), 47-52. Luhmann, L. M., Wickler, S. J., Hoyt, D. F., Kobluk, C. N., & Cogger, E. A. (2000). Evaluation of shock attenuation in the forelimb of horses wearing boots and wraps. Journal of Equine Veterinary Science, 20(8), 503-510. Merkens, H. W., Schamhardt, H. C., (1994). Ground Relationship between ground reaction force kinematics in the walking and trotting horse. Equine Veterinary Journal Supplement, 17, 67-70. Morlock, M., M., Nassutt, R., & Bonin, V. (1997). The Influence of Bandage Characteristics and Inter-Individual Application Variations on Underneath Bandage Pressures. Clinical Biomechanics, 12(3), S10. Nicodemus, M. (1999). The athletic horse: Leg protection. MSU Equine Newsletter. Retrieved December 8, 2008, from http://www.canr.msu.edu/horseadults/newsletter/archives/winter1999.pdf. 41 O?Sullivan, C. B. (2007). Injuries of the flexor tendons: Focus on the superficial digital flexor tendon. Clinical Techniques in Equine Practice, 6(3), 189-187. Peham, C., Licka, T., Girtler, D., & Scheidl, M. (2001). The influence of lameness on equine stride length consistency. Veterinary Journal, 162(2), 153-157. Professional Choice Sports Medicine Products Inc. (2008a). Sports Medicine Boot II. Retrieved May 28, 2008, from http://www.profchoice.com/htmldocs/prd/protgear/prd/smbii.html. Professional Choice Sports Medicine Products Inc. (2008b). Twenty X? Polo Wrap. Retrieved May 28, 2008, from http://www.profchoice.com/htmldocs/prd/wrangler/prd/wrpw.html Professional Choice Sports Medicine Products Inc. (2008c). Sports Medicine Boot Application. Retrieved May 28, 2008, from http://www.profchoice.com/htmldocs/gen/media/mov_smbii.html Professional Choice Sports Medicine Products Inc. (2009). SMB II Sizing Chart. Retrieved January 31, 2009, from http://www.profchoice.com/htmldocs/gen/custsvc/chart_smbii.html Ramon, T., Prades, M., Armengou, L., Lanovaz, J. L., Mullineaux, D. R., & Clayton, H. M. (2004). Effects of athletic taping of the fetlock on distal limb mechanics. Equine Veterinary Journal, 36(8), 764-768. Reiser, R. F., Peterson, M. L., McIlwraith, C. W., & Woodward, B. (2000). Simulated effects of racetrack material properties on the vertical loading of the equine forelimb. Sports Engineering, 3, 1-11. 42 Rogers, C. W. 1, Rivero, J. L, Breda, E., Lindner, A., & Sloet van Oldruitenborgh- Oosterbaan, M. M. (2007). Describing workload and scientific information on conditioning horses. Equine and Comparative Exercise Physiology, 4(1), 1?6. Singleton, W. H., Clayton, H. M., Lanovaz, J. L., & Prades, M. (2003). Effects of shoeing on forelimb swing phase kinetics of trotting horses. Veterinary and Comparative Orthopaedics and Traumatology, 16, 16-20. Smythe, R. H., Goody P. C. (1993). Horse structure and movement. (P. Grey, Ed.). London: J. A. Allen. Stashak, T. S. (2002). Adams' lameness in horses (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Thomason, J. J., Biewener, A.A, & Bertram, J. E.A. (1992). Surface strain on the equine hoof wall in vivo: Implications for the material design and functional morphology of the wall. Journal of Experimental Biology, 166, 145-168. Thomason, J. J. & Peterson, M. L. (2008). Biomechanical and mechanical investigations of the hoof-track interface in racing horses. Veterinary Clinics of North America: Equine Practice, 24(1), 53-77. Van Weeren, P. R., Van Den Bogert, A. J., & Barneveld, A. (1990). A quantitative analysis of skin displacement in the trotting horse. Equine Veterinary Journal Supplement, 9, 101-109. Vanweeren, P. R., Vandenbogert, A. J., & Barneveld, A. (1992). Correction Models for Skin Displacement in Equine Kinematic Gait Analysis. Journal of Equine Veterinary Science, 12(3), 178-192. 43 APPENDIX: Institutional Animal Care and Use Committee Approval Form 44 45 46 47 48 49 50 Office of Animal Resources Telephone: 334-844-5978 307 Samford Hall Fax: 334-844-4391 Auburn University, AL 36849 oar@auburn.edu May 25, 2008 MEMORANDUM TO: Robert Gillette Clinical Sciences McAdory Hall SUBJECT: Protocol Approval, ?Effect of Two Bandage Protocols on Equine Fetlock Kinematics? Your protocol, as received by the Office of Animal Resources on May 1, 2008, was reviewed and approved by the Institutional Animal Care and Use Committee (IACUC) designated member on May 14, 2008 once all training certifications were received. As requested, final approval was granted on May 25, 2008 to coincide with the start date. The assigned Protocol Review Number (PRN) is 2008-1393 and the protocol will expire on May 25, 2010. This protocol was approved for the requested lifespan of 2 years from the starting date of May 25, 2008. An official copy of the original is being returned (electronically as a PDF) for your files and the original will be maintained in the Office of Animal Resources, 307 Samford Hall. Please distribute only the final approved version of this protocol, complete with the assigned PRN on the cover sheet, to personnel working with animals on this protocol. If you have any questions or need further assistance, please call or contact us via email at oar@auburn.edu Sincerely, Dr. Robert Judd Auburn University IACUC Chairman