4. Discussion
The present study was conducted with the purpose of investigating the efficacy of recurring WT exercise with incline resistance to cause increases in thoracic epaxial muscles of horses. To the authors’ knowledge, the present study is the first of its kind to periodically measure the difference in equine back profile musculature over a four-week period, using back traces at four different points along the thoracic vertebrae. Current literature regarding the use of the WT as a rehabilitation tool is limited with respect to its efficacy in activating and building the paraspinal musculature in the thoracic region.
This study demonstrates statistically significant increases in muscle development at each of the anatomical reference points (T5, T9, T14 and T18) at three centimetres ventral to the dorsal midline, with the most significant increases in muscle development noted at T18. A possible explanation could be that the greatest level of dorsoventral flexion and extension has occurred in the thoracolumbar joint plexus due to the relative thickness of the intervertebral discs which allow for greater mobility. This may in turn have led to increased activation of the
m. longissimus dorsi and
m. rectus abdominis to stabilise the vertebral column, to counteract excessive rotation and dorsoventral flexion/extension. It is well know that incline of treadmill plays a role in epaxial muscles activation, particularly
longissimus dorsii. [
6,
31] When treadmill inclination changed from 0 to 6%, EMG activity of the
longissimus dorsii began and ended later; therefore, a longer activity duration was noted. [
31] Lower inclinations as 3% has also been reported to increase EMG values for the longissimus dorsi [
32] and this effect of the incline has contributed towards the increased epaxial profile reported in our study, as we have used an incline of 4%.
The next most statistically significant increases in muscle growth were found at T5, noted as the highest point of the withers, and as such is subject to the greatest level of shear forces during ridden exercise due to direct transmission of rider weight through the stirrups, which may affect the muscles responsible for protraction and retraction of the forelimbs. [
10] It could be suggested that the muscle development in this region may be due to the horse being able to freely engage the muscles in this area without the negative influence of a rider or saddle during the WT exercise. [
3] Additionally, it could be postulated that the increases in size of the musculature was facilitated by the water level being set low enough to allow the horses to lower their head and neck, causing traction on the withers from the nuchal and supraspinous ligaments. [
11,
12] This creates cranial thoracic flexion [
2,
13] and activates the vertebral stabilisation muscles [
14] Furthermore, research has reported that WT exercise increases considerably activation of
m. splenius [
33], and as this muscle inserts at T5, its activations during WT exercises could have contributed towards the muscle profile observed at this level in our study.
Statistical significance was also apparent at T9 between different timepoints, which may be associated with the specific anatomical characteristics of the vertebrae involved in the adjacent articulations, which determines the degree of movement at each joint complex. [
16] The body of vertebral segments T2-T9 are shorter but provide larger points of attachment for the nuchal and supraspinous ligaments as well as for the relevant muscles which produce the movements of the back. [
17] Therefore, possessing the capacity for greater amounts of intervertebral movement, displacement, and axial rotation between these joint complexes, due to the elasticity of the ligaments. [
11,
17,
18] The aforementioned biomechanical characteristics of the ninth thoracic vertebrae may have contributed to muscle build by allowing increased spinal ROM, stimulating antagonistic epaxial and hypaxial muscle contractions to resist excessive displacement of the vertebral column. [
19] Furthermore, it has been discovered that movements of the back, limbs, head and neck are closely associated, [
16,
20] therefore it can be assumed that exercising on an incline will require synergistic contractions of both the back and hindlimb muscles to produce propulsion in the sagittal plane. [
6]
We therefore hypothesise that the benefits of the incline associated with the benefits of water at mid cannon bone, have created a synergic benefit for the muscular development in our study.
The vertebral segment which revealed the least differences in muscle build between the various timepoints was T14, only demonstrating a statistically significant average increase of 2.9 cm between week one and four of WT intervention. Upon closer inspection of the results, apart from an initial decrease following the first week of WT exercise, it is clear that a smaller cumulative increase in gross muscle size occurred each week, however these may have been too minimal to reach statistical significance. The statistically significant increase in muscle mass between week one and four may have occurred as the greatest amounts of axial rotation and lateral bending occur at the vertebral level of T14 [
17,
18] due to the presence of asternal ribs, which are indirectly attached to the sternum [
17] Hence, the increased axial rotation and lateral bending experienced in this vertebral region, along with the increased dorsoventral flexion-extension caused by exercising on an incline [
5,
6,
7] are both expected to have influenced the facilitation and therefore also the gradual increase in mass of the
m. longissimus dorsi and
m. rectus abdominis in the current study as they are required for vertebral stabilisation in the horse [
5] What is worthy of note is that the timing of increases correlate with the effect of resistance training and the process of hypertrophy, whereby a minimum of two to four weeks of resistance training are required in the horse to facilitate skeletal muscle hypertrophy. [
21]
At 7cm, our results indicated that the most significant increases in overall thoracic musculature development occurred at T5 and T18. A possible explanation for the differences noted between the back traces at three and seven cm could be attributable to the function of the hypaxial muscles which are situated ventrally to the transverse processes of the spine. [
22] The hypaxial muscles mainly function to produce flexion of the cranial thoracic spine [
22] while the
m. rectus femoris is activated to counter spinal extension [
23] Furthermore, as the
m. rectus abdominis inserts onto the head of the femur [
24] it could be postulated that this muscle plays a role in the synergistic contractions of the back and hindlimbs during forward propulsion [
6] possibly explaining the significantly increased muscle mass in the region.
Comparatively, the next most statistically significant increases in thoracic muscle development was observed at T18. It could be inferred that the increased muscle growth observed when measured further ventrally, could be linked to the slightly more lateral and ventral origin of the
m. obliquus abdominis externus on the lateral surface of ribs 4- 18 and the thoracolumbar fascia. [
24] Likewise, the
m. rectus abdominis is recruited during the second half of the stride in the region of T18 once the forelimb is protracted and ipsilateral hindlimb is retracted to counter the excessive thoracolumbar extension caused by the downward movement of the internal visceral mass, [
19] possibly further explaining the increase in muscle development when exercising against increased resistance from both the water [
25] and inclination [
6,
7,
8] Statistical significance was also evident at T14, although not to the same extent as T5 and T18 as only two of the timepoints demonstrated increases in gross muscle development. This could also be attributable to the more controlled exercise in the sagittal plane without the added weight of a saddle or rider [
2,
26] which may allow for more symmetrical muscle development than when exercising on land. [
7]As for the significant increases in thoracic musculature observed at T14, the greatest amounts of axial rotation and lateral bending occur in this region during locomotion. [
17,
18] Moreover, the horse also shows increases in hindlimb ROM when walking in water. [
25] Research by Mooij [
1] has also suggested in order to produce hindlimb movement in the water, there must first be a further increase in axial rotation of the caudal thoracic spine, which may explain the resulting increased muscle development at the level of T14.
No statistically significant increases in thoracic back profile musculature, were observed at T9 when measured at 7 cm, however there was evidence of cumulative weekly increases in the back trace widths when compared to the individual means.
Overall, our research agrees with a study recently presented, which performed a semi-qualitative analysis of muscle development in horses undergoing WT work and has concluded that WT can increase thoracic epaxial muscle development, after 20-weeks of exercise. [
15] However, our study has found earlier improvements at muscle development at thoracic epaxial musculature. We attribute this earlier muscle development due to the fact we have used an incline on the WT, while the previous study [
15] did not mention incline so was probably performed under flat WT. As mentioned before, both water and incline have an influence on epaxial musculature activation and, therefore, growth. Hence, we believe that the combination of these two elements have contributed to the earlier positive results observed in our study.
That said, our study also had its limitations. The first could be small sample size, which could lead to the assumption that our results may lack ecological value; that being said, the majority of our results demonstrated statistical significance between different timepoints, which warrants further investigation with a larger sample size in the future to more precisely evaluate the effects of the intervention, to allow more definitive conclusions to be drawn. A potential limitation concerning the repeated measures study design is the effect that the treatment intervention has on subsequent treatments. [
28] As this study utilised a longitudinal layout over the course of four weeks, it could be said that biased estimates of the treatment efficacy may be made due to the carry-over effect of the treatment modality. [
28] However, this study design emphasised comparisons within each horse over time, and as horses had a similar trend on muscular growth, we can attribute this to the WT with a good certainty.. In an effort to counterbalance this; the six days of consecutive WT activity per week were succeeded by a rest day on the seventh day. It is our belief that the current study presents an insightful account into the rate and size of paraspinal muscle growth in the thoracic region and offers several explanations as to how these outcomes may have been achieved through the implementation of repeated WT exercise with incline resistance. Another limitation is that as a result of being reshaped repeatedly the flexible curve ruler is susceptible to deterioration over time, therefore it is advised to frequently replace the flexible curve ruler used for data collection to ensure the results remain consistent. We have used the same piece of equipment all throughout the measurements and we have not noticed any significant misshapen of the ruler. We also acknowledge, that there are other more objective means to measure epaxial muscle changes in size as evaluation of cross-sectional area with ultrasound scans as described in the literature [
34,
35]. However, our choice to use the flexible curve ruler was due to equipment availability and the fact there is a validation for the use of this tool [
9].
The results of this study support the original hypothesis, revealing that repeated WT exercise on an incline setting does in fact have a significant effect on the rate and size of growth of the equine thoracic back profile musculature, although further research should be conducted to determine the muscles recruited during WT intervention with incline resistance and to establish the increases in cross-sectional area of the individual muscles rather than just the total increases in overall muscle development.