Research PaperA pilot study of the effects of acupuncture treatment on objective and subjective gait parameters in horses
Introduction
Acupuncture, which is part of traditional Chinese medicine, is increasingly incorporated into human and veterinary medicine. Traditional techniques have been adopted worldwide and numerous variations of acupuncture therapy have been developed. The mechanisms of action are still not fully understood. However, the use of modern investigation tools, including sophisticated imaging techniques, has suggested that acupuncture triggers a sequence of events involving the release of endogenous opioid- like substances, such as enkephalin, endorphin and endomorphin, which are measurable in plasma and cerebrospinal fluid, and which modulate pain signals (Wang et al., 2008, Kawakita and Okada, 2014). The limbic system has also been shown to play an important role in acupuncture-induced analgesia (Wang et al. 2008).
Although acupuncture is used in the treatment of a wide variety of diseases in people and veterinary species (Mittleman and Gaynor, 2000, Schofield, 2008, Yin and Chen, 2010, de Fourmestraux et al., 2014, Pfab et al., 2014), one of its most common applications is in the management of chronic pain, often arising from the musculoskeletal system. Large-scale clinical trials in people have demonstrated the efficacy of acupuncture in the treatment of lower back pain compared with standard care or patients not currently being treated (Brinkhaus et al., 2006, Haake et al., 2007). Over the last decades, acupuncture has been increasingly incorporated into equine medicine, but controlled clinical trials investigating its efficacy remain sparse. Anecdotally, acupuncture has been reported to be successful in alleviating a variety of painful orthopaedic conditions, particularly back pain. However, the assessment of treatment failure or success is often subjective and influenced by the owner's and the attending veterinarian's expectations. The lack of controlled studies in which objective assessments are made has led to continued scepticism about whether acupuncture has any effects at all in horses (Ramey 2005). This pilot study tested the hypothesis that acupuncture treatment would result in alterations in gait in horses and that these would be appreciable by objective and subjective gait analyses.
Section snippets
Materials and methods
Authorization was granted by the Ethics and Welfare Committee of the Royal Veterinary College, London (URN approval no. 2013 1244). Eight systemically healthy horses, as determined by physical examination (performed by BD) that belonged to the Royal Veterinary College Equine Referral Hospital teaching and blood donor herd were used. The number of horses was based on those in similar studies that demonstrated treatment effects with four to eight animals per group (Xie et al., 2001, Xie et al.,
Data analyses
Data were analysed using IBM spss for Windows Version 19.0 (IBM Corp., NY, USA). Normality of the data was assessed by the inspection of histograms. Objective gait assessments are presented as the mean ± standard error. Comparisons between subjective lameness scores are expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Data for each of the three conditions were analysed separately. Baseline objective and subjective gait analyses data (T1) from the treatment and control groups
Results
Two Irish Sports horses, two ponies and four trotters (two geldings and six mares) with a mean ± standard deviation age of 14.8 ± 5.3 years were included in the study. Acupuncture treatment was well tolerated by all horses except that in one horse the insertion of the needle at one specific point resulted in violent shaking and foot stamping. This point was left untreated during all treatment sessions. One horse developed a foot abscess between T8 and T9 while serving as a control and was not
Discussion
To the authors' knowledge, this is the first prospective, single-blinded, crossover study to evaluate the effects of acupuncture treatment on movement parameters in horses. The study was conducted as a pilot study to address the basic question of whether or not acupuncture treatment has any appreciable effect on gait in horses. Encouragingly, treatment effects were demonstrated for at least one objectively assessed pelvic limb parameter under all conditions and for all pelvic limb parameters
Acknowledgements
The authors would like to thank Amy Martin, Clinical Science and Services, The Royal Veterinary College for her help with the objective gait analysis.
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