International Survey of Equine Water Treadmills-Why, When, and How?

Water treadmills (WTs) are becoming increasingly popular as rehabilitation and training tools. Concerns have been raised among equine professionals about injury development/exacerbation after WT use, and little knowledge of optimal WT use is available. The aim of this study was to determine how WTs are being used, using an international survey-based approach, with a view to informing future research. Venues were identified through internet searches and WT manufacturers. A questionnaire inquired about venue setup, caseload overview, and protocol overview. A case-specific questionnaire generated information about individual sessions. One hundred and twenty venue questionnaires were distributed and 41 responses (34%) were obtained; nine of these venues contributed 608 case-specific questionnaires. Water treadmills were found mostly at educational and rehabilitation centers, with four on private yards. Horse fitness, previous experience, age, weight and veterinary condition influenced individual protocols. All centers habituated their cases for 2-3 sessions, for an average of 16 minutes in hock or fetlock depth water. Significant differences between training and rehabilitation sessions were identified (deeper water, slower walk speed and longer duration for training compared to rehabilitation; P ≤ .023 for all three variables). Water treadmills were most frequently used for rehabilitation in horses with ligament and tendon injuries. Water treadmill habituation is important, and protocols were similar between venues. Water treadmills' usage was 60%:40% between training:rehabilitation with protocols varying significantly between venues.