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2001 Research

1993 - 1996 Research        September 2001 Research

THE EFFICACY OF THE THERMOTEX INFRARED HEATING BLANKET ON THE STANDARDBRED RACEHORSE. Study conducted by Dr. Ronald J. Riegel D.V.M.

Hypothesis

Harness racing is one of the most demanding of all of the equine athletic endeavors. Months of foundation miles are accomplished before this athlete is even close to race condition and speed. After this long period of training, the animal must then drop in time, over the mile distance, to be competitive. This hard training regime is extremely taxing upon the equine athlete and all methods must be considered to alleviate the pain and inflammation within the musculature to ensure the success of this equine athlete.

The Thermotex™ Infrared heating blanket has been scientifically proven to be effective in providing deep heat to the musculature of the equine athlete. Infrared thermographs correlated with blood chemistry analysis will provide proof that this physical therapy modality is effective in relieving both pain and inflammation within the muscle tissues of these equine athletes.

Infrared Heat as a Physical Therapy Modality

The use of infrared thermography as a measurement of the efficacy of different therapeutic modalities is easily accomplished. Changes within thermal gradients can depict a decrease or increase in circulation, a decrease or increase in inflammation and even nerve irritation somewhere along the neuron pathway. Therapeutic results can be visualized by a series of infrared thermographs taken over a period of time and then compared.

Goals

These are the questions that will be answered by this research endeavor.
1. Will the infrared thermal gradients within the musculature of the lumbar and sacral spinal anatomical areas be reduced when treatment with the Thermotex™ infrared heating equipment is applied?
2. What are the clinical pathological changes within the blood chemistry levels as an animal receives treatment with the Thermotex™ Therapy blanket?
3. Will there be a correlation between the thermographic findings and the blood serum chemistry findings?

Infrared Thermography

Racing equine have track records that are public information. Typically, as with their human athlete counterparts, the presence of injury causes a reduction in their performance. When treated with Thermotex™ (controlling for pathologies and no other clinical intervention) the animals returned to their original track records. Unlike their human counterparts, horses have limited cognitive abilities. Therefore, it would be very difficult to argue any precognition or anticipation of outcome of a clinical intervention on the part of the horse.

Blood Chemistry Analysis

AST is an abbreviation for Aspartate aminotransferase which is the synonym for the old term SGOT (serum glutamic oxaloacetic transaminase). This enzyme occurs in almost all cells within the body but it is used to primarily diagnose liver and muscle disease. The liver and muscle cells have the highest activity of this enzyme. In itself it is not specific for a liver disorder but is more diagnostic for the muscle tissues.

Aspartate aminotransferase is present in the mitochondria and the cytoplasmic fluid within the cells. The serum levels of this enzyme are increased following hard exercise or skeletal muscle injury. Circulating concentrations of this enzyme will peak approximately 24 hours after an inciting incident and return to normal within 7-10 days.

CPK (CK) is an abbreviation for Creatine phosphokinase (or Creatine kinase). This is the most organ specific of all of the clinical enzymes. Most serum CPK activity is from a muscular origin. The plasma half-life of this enzyme is short and will peak as early as six hours. This enzyme will then only take 2-3 days to return to normal.

Procedure and Methodology

1. These animals will be healthy upon physical examination.
2. The animals will be serviceably sound and not had any or be giving any systematic or intraarticular medications. This includes all steroidal and nonsteroidal anti-inflammatory medications such as phenylbutazone, flunixin meglumine and corticosteroids.
3. Training schedules and racing times are all similar and nearly in the same class of races.
4. All other physical therapy modalities and topical applications of counter-irritants discontinued at least seven days before the initiation of this project.

The study will last six weeks, have a two-week break to all equine subjects and then resume with the control group becoming the treatment group and the treatment group becoming the control group for another six weeks.

All twenty animals will be thermographed initially, and then at weekly intervals during the duration of the study. Blood samples will be taken initially from all of the animals and then repeated weekly until the conclusion of the study. These blood samples will be evaluated for a complete blood count and total serum chemistry analysis.

The complete blood count will have the following parameters tested:

1. RBC count
2. WBC count
3. Packed cell volume
4. The types of WBCs
5. In addition to all the normal tests

Serum chemistry analysis included:

• Albumin levels - 35 - 50% of the serum protein
• Alkaline Phosphatase levels - hepatic function
• BUN - renal function
• Calcium - calcium metabolism
• Creatinine - renal function
• Glucose - measured to monitor other diseases
• Magnesium - magnesium metabolism
• Phosphorus - phosphorus metabolism
• AST(SGOT)
• Serum protein -nutritive function
• Total bilirubin - hepatic function
• Sodium - electrolyte balance
• Potassium - electrolyte balance
• Chloride - electrolyte balance
• GGT - renal function
• CPK(CK)
• A/G ratio - albumin/globulin ratio: total protein values
• Globulin - calculated by subtracting the albumin conc. from the total
  protein concentration
• Lipemic index - hepatic function
• Hemolytic index - a value that may affect other tests
• Icteric Index - hepatic function

The animals will randomly placed into two groups: a treatment group and a control group.

Those animals within the control group will not receive any treatments with the Thermotex™ therapy blanket during that portion of the study. The animals within the treatment group will receive treatment for thirty minutes each day just before exercise. The temperature control was placed on the high setting for ten minutes and then on low for the remaining twenty minute duration of the treatment.

Infrared thermographs and blood samples were taken every seven days for a total of fourteen weeks.

Results and Discussion

The initial infrared thermograph (see initial thermograph - animal #5) revealed an increased thermal gradient over the thoracic, lumbar and lumbosacral spine. This thermograph was taken at a setting of 0.5 degrees centigrade per isothermic level. White is the highest reading and purple is the coldest or lowest level with a five-degree difference between them. These areas depicted by the color white were fairly symmetrical except within the lumbosacral area. In this anatomical area, there is an increased thermal gradient predominantly on the left side. These areas of white, gold and yellow reveal an increased thermal gradient within the tissues that is indicative of an inflammatory response within.

This particular animal (#5) was chosen as an example of the entire study since the response within this animal was close to the average of animals within the entire study. This animal also palpated digitally with a slight tenderness throughout the areas that are depicted by the color white.

After eight weeks of training without any treatment, the infrared thermograph of animal number five revealed the following comparisons to the initial thermograph. (see infrared thermograph - animal #5 - week 8) There is an increase within all of the thermal gradients as compared to the initial findings. The increased thermal gradients throughout the thoracic spine now continue into the right shoulder region. Those increased thermal gradients within the lumbar and lumbosacral areas have increased in intensity and are now more predominant on the left side continuing into the gluteal areas. These increases are due to a rigorous training schedule and are normal for an animal that is receiving no therapeutic help for this inflammation.

All ten of the animals that were in the control group depicted these types of thermographs for the first eight weeks of the study. They were all becoming increasingly sore and their thermographs all revealed increases along the lumbar and sacral spine.

Immediately after treatment with the Thermotex™ therapy blanket, there was a huge increase within the thermal gradients within the tissues. This increase lasted an average of four to five hours after the treatment was concluded. These thermographs were done before the initiation of the study just to establish a baseline of data. During the study, the animals were always exercised after their treatment, which also increased the thermal gradients found within the individual making the duration of effect impossible to measure.

The infrared thermograph taken of animal #5 at the conclusion of the study revealed large decreases within the thermal gradients along all of the anatomical areas examined. (see infrared thermograph - animal #5 - week 14) Within the lumbosacral spine area there is a remarkable 95% reduction within the thermal gradients. Clinically, this also corresponds to insensitivity upon digital palpation. The thoracic and thoracolumbar spinal areas also experienced a reduction within the thermal gradients to an extent of a 68% reduction. This area was also no longer sensitive to digital palpation.

Serum Chemistry Results:

The AST levels for the ten animals that served in the control group were consistently high during the first eight weeks of the study and then gradually dropped to lower levels during the last six weeks of the study.

(see table one data, graph and chart of averages)

Initially, seven of the ten animals tested with higher than normal AST levels within the serum. By week eight, eight of the ten animals depicted AST levels higher than normal. After the initiation of treatment at week eight, these levels gradually fell, in all but those animals testing normally, to a level lower than that found at the eight week tests. By week fourteen, six of the ten animals were now testing within normal limits. The results seen within chart one summarize this data.

Those animals that initially received treatment for six weeks and then were left untreated revealed quite different results within their AST levels.

(see table two data, graph and chart of averages)

Five of these ten animals depicted higher than normal AST levels at the initiation of treatment. Nine of the ten animals experienced an immediate drop within the first week of treatment. By week six, seven of the ten animals were testing within normal AST ranges. After the cessation of treatments, seven of the ten animals within this group immediately experienced a rise within the AST levels during week seven. At fourteen weeks, eight of the ten animals revealed higher AST levels than those measured initially. The data graphed on chart two reveals this decline in AST levels through week six and then a gradual increase when the use of Thermotex™ blanket was stopped.

The CK levels followed the same pattern as the AST levels within the group of ten animals that was used as a control for eight weeks and then provided treatment.

(see table three data, graph and chart of averages)

Initially, five of the ten animals tested within the normal limits for CK levels in the horse. By week eight, six of the animals tested with an increase in CK levels over those initial levels. Over the next six weeks, during treatment with the Thermotex™ therapy blanket, all ten of the animals experienced a decline in CK levels. Eight of the ten animals are now testing within normal limits. The other two animals could even be considered in the high normal range.

Chart three is a summary of all of the averages on a weekly basis. During the control part of the study, the group maintained an even level throughout the first 6-8 weeks. After the initiation of treatment, the CK levels gradually fell.

When the animals initially received treatment and then became the control group, the results mimicked those of the same AST group.

(see table four data, graph and chart of averages)

Initially, only four of the ten animals tested within normal limits for CK. After six weeks of treatment with the Thermotex™ therapy blanket, six of the ten animals were within normal limits. By the time fourteen weeks had passed, Seven of the ten animals exhibited higher than normal levels with seven of the ten animals also showing increased levels from the initial testing. Chart four exhibits the gradual decline in CK levels and then the gradual increase after treatment protocols have ceased.

The summary of the blood chemistry analysis revealed that the AST and CK levels were lower during treatment with the Thermotex™ therapy blanket.

(see table five data and graph)

As depicted on the data table and corresponding graph, the AST and CK levels increased while the animals were in training and not receiving treatment with the Thermotex™ therapy blanket and decreased when receiving treatment.

Summary and Conclusions

• There is thermographic and serum chemistry evidence that the therapy provided by the Thermotex™ therapy blanket is efficacious.
• The lowering of both the AST and CK levels indicates that treatment with the Thermotex™ therapy blanket alleviates the inflammatory response within the muscles of the standardbred racehorses that are in training.
• Thermographic evidence provides evidence of a decrease within the inflammatory response and some analgesia when the Thermotex™ therapy blanket is used on a daily basis on the standardbred racehorse.
• This evidence concludes that the Thermotex™ therapy blanket is an ideal drug free modality to use before competition, as a therapy program in itself, as an adjunct to.
   

References

1. Baxter, Michael. The Art and Science of Specialized Kinesiology. Academy of Equine Sport Therapy. 1994.
2. Bromiley, Mary. Physiotherapy in Veterinary Practice. Blackwell Scientific Publications Editorial Offices. 1991. Pg. 16-21.
3. Riegel, Ronald and Hakola, S. Illustrated Atlas of Clinical Equine Anatomy and Common Disorders of the Horse. Equistar Publications Ltd. 1996
    
4. Stashak, S. Ted. Adam's Lameness in Horses. Fourth Edition. Lea and Febiger. 1987. Philadelphia. 1962.