Compensatory load redistribution of horses with induced weightbearing hindlimb lameness trotting on a treadmill

REASONS FOR PERFORMING STUDY: The compensatory mechanisms of horses with weightbearing hindlimb lameness are still not fully understood. HYPOTHESIS: That weightbearing, unilateral hindlimb lameness would not only alter stride characteristics to diminish structural stress in the affected limb but also induce compensatory load adjustments in the other supporting limbs. OBJECTIVE: To document the load and time shifting mechanisms of horses with unilateral weightbearing hindlimb lameness. METHODS: Reversible lameness was induced in 8 clinically sound horses by applying a solar pressure model. Three degrees of lameness (subtle, mild and moderate) were induced and compared with the nonlame (sound) control measurement. Vertical ground reaction forces were recorded for all 4 limbs simultaneously on an instrumented treadmill. RESULTS: Compared to the sound situation, moderate hindlimb hoof lameness induced a decrease in stride duration (-3.3%) and stride impulse (-3.1%). Diagonal impulse decreased selectively in the lame diagonal stance (-7.7%). Within the diagonal limb pair, vertical impulse was shifted to the forelimb during the lame diagonal stance (+6.5%) and to the hindlimb during the sound diagonal stance (+3.2%). Peak vertical force and vertical impulse decreased in the lame limb (-15%), but only vertical impulse increased in the contralateral hindlimb (+5.7%). Stance duration was prolonged in both hindlimbs (+2.5%). Suspension duration was reduced to a greater extent after push-off of the lame diagonal limb pair (-21%) than after the sound diagonal limb pair (-9.2%). CONCLUSIONS: Four compensatory mechanisms could be identified that served to reduce structural stress, i.e. peak vertical force on the affected limb: 1) reduction of the total vertical impulse per stride; 2) diagonal impulse decreased selectively in the lame diagonal; 3) impulse was shifted within the lame diagonal to the forelimb and in the sound diagonal to the hindlimb; and 4) the rate of loading and peak forces were reduced by prolonging the stance duration. POTENTIAL RELEVANCE: Load shifting mechanisms are not only effective in diminishing peak forces in the affected limb, but also suppress compensatory overload in other limbs. Selected force and time parameters allow the unequivocal identification of the lame limb. Future studies have to examine how far these compensatory mechanisms may be generalised for other defined orthopaedic problems in the hindlimb.     

Signal decomposition method of evaluating head movement to measure induced forelimb lameness in horses trotting on a treadmill

In horses at a trot, the head moves up and down twice in one stride. In horses with unilateral forelimb lameness this movement is asymmetric. Computer-assisted kinematic analysis of vertical head movement can be used to quantify objectively lameness in horses in clinical trials. However, in mild lameness, absolute measurements of vertical head height may not be sensitive enough to detect small differences in lameness, and extraneous head movement by the horse due to curiosity, excitement or nervousness interferes with the accurate measurement of vertical head movement asymmetry. We describe a simple, signal-decompensation method of evaluating vertical head movement using a model of induced mild foot lameness in 9 horses. The technique assumes that the vertical head movement pattern can be broken down into 3 components; the vertical head movement caused by forelimb lameness (A1), the amplitude of the natural biphasic vertical head movement (A2) and extraneous head movement. Extraneous head movement is mathematically removed from the vertical head movement pattern. A1 and A2 are then calculated. After induction of lameness, mean A1 increased by 1.63 cm (range 0.10-3.33 cm, P = 0:005). Mean A2 did not significantly change after lameness induction. Error in reproduction of the original head movement pattern was 0.3-0.5%. We calculated that a hypothetical clinical trial would require 12 subjects for testing to be 80% certain that this difference would be successfully detected using this method of lameness evaluation.     

Changes in kinematic variables observed during pressure-induced forelimb lameness in adult horses trotting on a treadmill

OBJECTIVE: To determine whether kinematic changes induced by heel pressure in horses differ from those induced by toe pressure. ANIMALS: 10 adult Quarter Horses. PROCEDURE: A shoe that applied pressure on the cuneus ungulae (frog) or on the toe was used. Kinematic analyses were performed before and after 2 levels of frog pressure and after 1 level of toe pressure. Values for stride displacement and time and joint angles were determined from horses trotting on a treadmill. RESULTS: The first level of frog pressure caused decreases in metacarpophalangeal (fetlock) joint extension during stance and increases in head vertical movement and asymmetry. The second level of frog pressure caused these changes but also caused decreases in stride duration and carpal joint extension during stance as well as increases in relative stance duration. Toe pressure caused changes in these same variables but also caused maximum extension of the fetlock joint to occur before midstance, maximum hoof height to be closer to midswing, and forelimb protraction to increase. CONCLUSION AND CLINICAL RELEVANCE: Decreased fetlock joint extension during stance and increased head vertical movement and asymmetry are sensitive indicators of forelimb lameness. Decreased stride duration, increased relative stance duration, and decreased carpal joint extension during stance are general but insensitive indicators of forelimb lameness. Increased forelimb protraction, hoof flight pattern with maximum hoof height near midswing, and maximum fetlock joint extension in cranial stance may be specific indicators of lameness in the toe region. Observation of forelimb movement may enable clinicians to differentiate lameness of the heel from lameness of the toe.     

Individual speed dependency of forelimb lameness in trotting horses

Using a system for motion analysis, linear correlation of speed and forelimb lameness was measured in 16 horses trotting on a treadmill at a minimum of three different trotting speeds. Forelimb lameness was determined as asymmetry of vertical head motion during left and right forelimb stance.In seven horses with a moderate forelimb lameness (head motion asymmetry >40%), lameness increased significantly with trotting speed. In a further seven horses with mild or subclinical forelimb lameness (head motion asymmetry <40%) and in two horses with a moderate forelimb lameness, no significant correlation between speed and motion asymmetry was found.The results indicate that moderate forelimb lameness measured as head motion asymmetry depends on the speed at which the measurements are taken. If head motion asymmetry is measured at two trotting speeds, it can be standardized to any speed within the trotting speed range.     

Computer-assisted kinematic evaluation of induced compensatory movements resembling lameness in horses trotting on a treadmill

OBJECTIVE: To characterize compensatory movements of the head and pelvis that resemble lameness in horses. ANIMALS: 17 adult horses. PROCEDURE: Kinematic evaluations were performed while horses trotted on a treadmill before and after shoe-induced lameness. Lameness was quantified and the affected limb determined by algorithms that measured asymmetry in vertical movement of the head and pelvis. Induced primary lameness and compensatory movements resembling lameness were assessed by the Friedman test. Association between induced lameness and compensatory movements was examined by regression analysis. RESULTS: Compensatory movements resembling lameness in the ipsilateral forelimb were seen with induced lameness of a hind limb. There was less downward and less upward head movement during and after the stance phase of the ipsilateral forelimb. Doubling the severity of lameness in the hind limb increased severity of the compensatory movements in the ipsilateral forelimb by 50%. Compensatory movements resembling lameness of the hind limb were seen after induced lameness in a forelimb. There was less upward movement of the pelvis after the stance phase of the contralateral hind limb and, to a lesser extent, less downward movement of the pelvis during the stance phase of the ipsilateral hind limb. Doubling the severity of lameness in the forelimb increased compensatory movements of the contralateral hind limb by 5%. CONCLUSIONS AND CLINICAL RELEVANCE: Induced lameness in a hind limb causes prominent compensatory movements resembling lameness in the ipsilateral forelimb. Induced lameness in a forelimb causes slight compensatory movements resembling lameness in the ipsilateral and contralateral hind limbs.     

Compensatory load redistribution in naturally occurring osteoarthritis of the elbow joint and induced weight-bearing lameness of the forelimbs compared with clinically sound dogs

The current study investigated the compensatory load redistribution due to osteoarthritis of the elbow joint using ground reaction forces of all four legs, simultaneously measured on a treadmill with integrated force plates. Three groups of dogs were used: the first group was clinically sound; the second group suffered from a naturally occurring osteoarthritis of the elbow joint, and a reversible lameness was induced in the third group. The naturally occurring osteoarthritis resulted in a compensatory gait pattern to reduce the stress on the affected limb. The load was reduced on the lame limb and increased on the contralateral hindlimb. The symmetry index indicated a weight-shift to the contralateral forelimb and diagonal hindlimb, which resulted in a more balanced weight distribution than in normal dogs. Dogs with induced lameness showed comparable but less pronounced alterations. These results suggested that forelimb lameness could lead to overload on non-affected extremities and the vertebral spine.     

Influence of rider on lameness in trotting horses

REASONS FOR PERFORMING STUDY: Equine lameness is commonly evaluated when the horse is being ridden, but the influence of the rider on the lameness has not been documented. OBJECTIVE: To document the effect of 2 riders of different training levels on the vertical movement of the head and croup. METHODS: Twenty mature horses were ridden at trot by an experienced dressage rider and a novice rider, as well as trotted in hand. Kinematic measurements of markers placed on the horse's head and sacral bone were carried out. The asymmetries of the vertical head and sacral bone motion were calculated as lameness parameters and compared with paired t tests. RESULTS: Trotting in hand, 17 horses showed forelimb lameness (1-4/10) and 13 hindlimb lameness (1-2/10). Intra-individually, 11 horses showed significant differences in forelimb lameness and 4 horses showed significant differences in hindlimb lameness when ridden. Over all horses, hindlimb lameness increased significantly under the dressage rider compared to unridden horses. CONCLUSIONS: The presence of a rider can alter the degree of lameness; however, its influence cannot be predicted for an individual horse. POTENTIAL RELEVANCE: In order to evaluate mild lameness, horses should be evaluated at trot both under saddle and in hand. If lameness is exacerbated, a second rider may be helpful; the level of training of the rider should be taken into consideration.     

The effect of induced forelimb lameness on thoracolumbar kinematics during treadmill locomotion

REASONS FOR PERFORMING STUDY: Lameness has often been suggested to result in altered movement of the back, but there are no detailed studies describing such a relationship in quantitative terms. OBJECTIVES: To quantify the effect of induced subtle forelimb lameness on thoracolumbar kinematics in the horse. METHODS: Kinematics of 6 riding horses was measured at walk and at trot on a treadmill before and after the induction of reversible forelimb lameness grade 2 (AAEP scale 1-5). Ground reaction forces (GRF) for individual limbs were calculated from kinematics. RESULTS: The horses significantly unloaded the painful limb by 11.5% at trot, while unloading at walk was not significant. The overall flexion-extension range of back motion decreased on average by 0.2 degrees at walk and increased by 3.3 degrees at trot (P<0.05). Changes in angular motion patterns of vertebral joints were noted only at trot, with an increase in flexion of 0.9 degrees at T10 (i.e. angle between T6, T10 and T13) during the stance phase of the sound diagonal and an increase in extension of the thoracolumbar area during stance of the lame diagonal (0.7degrees at T13, 0.8 degres at T17, 0.5 degres at L1, 0.4 degrees at L3 and 0.3 degrees at L5) (P<0.05). Lameness further caused a lateral bending of the cranial thoracic vertebral column towards the lame side (1.3 degrees at T10 and 0.9 degrees at T13) (P<0.05) during stance of the lame diagonal. CONCLUSIONS: Both range of motion and vertebral angular motion patterns are affected by subtle forelimb lameness. At walk, the effect is minimal, at trot the horses increased the vertebral range of motion and changed the pattern of thoracolumbar motion in the sagittal and horizontal planes, presumably in an attempt to move the centre of gravity away from the lame side and reduce the force on the affected limb. POTENTIAL RELEVANCE: Subtle forelimb lameness affects thoracolumbar kinematics. Future studies should aim at elucidating whether the altered movement patterns lead to back and/or neck dysfunction in the case of chronic lameness.     

Association between subjective lameness grade and kinetic gait parameters in horses with experimentally induced forelimb lameness

OBJECTIVE: To evaluate the association between subjective lameness grades and kinetic gait parameters and assess the variability in kinetic parameters in horses with experimentally induced forelimb lameness. ANIMALS: 32 horses. PROCEDURES: Forelimb lameness was induced in each horse via injection of lipopolysaccharide into 1 metacarpophalangeal joint (40 experimental trials). Subjective lameness grading and 13 kinetic gait parameters (force plate analysis) were assessed before (baseline) and at 12, 18, and 24 hours after lipopolysaccharide injection. While horses were trotting, kinetic gait analysis was performed for 8 valid repetitions at each time point. Repeated-measures analyses were performed with 8 repetitions for each kinetic parameter as the outcome, and lameness grades, time points after lipopolysaccharide injection, and repetition order as explanatory variables. Sensitivity and specificity of kinetic parameters for classification of horses as sound or lame (in relation to subjective lameness scores) were calculated. Between- and within-horse variabilities of the 13 kinetic parameters were assessed by calculation of coefficients of variation. RESULTS: Subjective lameness grades were significantly associated with most of the kinetic parameters. Vertical force peak and impulse had the lowest between- and within-horse coefficients of variation and the highest correlations with subjective lameness grade. Vertical force peak had the highest sensitivity and specificity for lameness classification. Vertical force peak and impulse were significantly decreased even in horses with mild or unobservable lameness. CONCLUSIONS AND CLINICAL RELEVANCE: Among the kinetic gait parameters, vertical force peak and impulse had the best potential to reflect lameness severity and identify subclinical forelimb gait abnormalities.     

Three-dimensional kinematics of the distal forelimb in horses trotting on a treadmill and effects of elevation of heel and toe

REASONS FOR PERFORMING STUDY: Comprehensive understanding of the 3-dimensional (3D) kinematics of the distal forelimb and precise knowledge of alterations induced by dorsopalmar foot imbalance remains incomplete because in vivo studies performed with skin markers do not measure the actual movements of the 3 digital joints. OBJECTIVE: To quantify the effects of 6 degree heel or toe wedges on the 3D movements of the 4 distal segments of the forelimb in horses trotting on a treadmill. METHODS: Three healthy horses were equipped with ultrasonic markers fixed surgically to the 4 distal segments of the left forelimb. The 3D movements of these segments were recorded while horses were trotting on a treadmill. Rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained with 6 degree heel or toe wedges were compared to those obtained with flat standard shoes. RESULTS: Use of heel wedges significantly increased maximal flexion and decreased maximal extension of the proximal (PIPJ) and distal (DIPJ) interphalangeal joints. Inverse effects (except for PIPJ maximal extension) were observed with the toe wedges. In both cases, neither flexion-extension of the metacarpophalangeal joint nor extrasagittal motions of the digital joints were statistically different between conditions. CONCLUSIONS: At a slow trot on a treadmill, heel and toe wedges affect the sagittal plane kinematics of the interphalangeal joints. POTENTIAL RELEVANCE: Better understanding of the actual effects of toe and heel wedges on the 3D kinematics of the 3 digital joints may help to improve clinical use of sagittal alteration of hoof balance in the treatment of distal forelimb injuries.     

Basic three-dimensional kinematics of the vertebral column of horses trotting on a treadmill

OBJECTIVE: To determine movements of the vertebral column of horses during normal locomotion. ANIMALS: 5 young Dutch Warmblood horses that did not have signs of back problems or lameness. PROCEDURE: Kinematics of 8 vertebrae (T6, T10, T13, T17, L1, L3, L5, and S3) and both tuber coxae were determined, using bone-fixated markers. Measurements were recorded when the horses were trotting on a treadmill at a constant speed of 4.0 m/s. RESULTS: Flexion-extension and axial rotation were characterized by a double sinusoidal pattern of motion during 1 stride cycle, whereas lateral bending was characterized by 1 peak and 1 trough. Ranges of motion for all vertebrae were: flexion-extension, 2.8 degrees to 4.9 degrees; lateral bending, 1.9 degrees to 3.6 degrees; axial rotation, 4.6 to 5.8 degrees, except for T10 and T13, where the amount of axial rotation decreased to 3.1 degrees and 3.3 degrees, respectively. CONCLUSION AND CLINICAL RELEVANCE: During locomotion, 3 types of rotations are evident in the thoracolumbar vertebrae. Regional differences are observed in the shape and timing of the rotations. These differences are related to actions of the limbs. The method described here for direct measurement of vertebral column motion provides insights into the complex movements of the thoracolumbar portion of the vertebral column in trotting horses. Information on normal kinematics is a prerequisite for a better understanding of abnormal function of the vertebral column in horses.     

Vertical ground reaction force-time histories of sound Warmblood horses trotting on a treadmill

The objective of this study was to establish representative treadmill ground reaction force (GRF) and interlimb co-ordination time data of clinically sound horses at the trot. It was anticipated that these normative standards would provide a reference data base against which lame horses could be compared. GRF-time histories were collected from 30 Warmblood riding horses with easy, wide natural gaits. Data were recorded of all four limbs simultaneously by the use of an instrumented treadmill. A total of 912 stride cycles per limb were analysed for force, time and spatial parameters and were averaged. The shape and amplitude of the treadmill force curves were very similar to force traces recorded with a stationary force plate. The horses showed a high degree of symmetry in all investigated parameters (95% reference interval of left-right asymmetry +/-1.8-6.8%). No significant differences were found between left and right mean values. Intra-individual coefficients of variance of the various parameters did not exceed 2.7%. Inter-individual coefficients of variance were 2.5-3.5 times larger than the respective intra-individual coefficients. An instrumented treadmill provides a number of decisive advantages, such as time-efficient data acquisition of all four feet simultaneously over successive strides, or the high regularity of the horse's gait pattern at controlled velocities, which allow the clinical assessment of locomotor performance of horses.     

Electromyographic activity of the longissimus dorsi muscles in horses during trotting on a treadmill

OBJECTIVE: To use electromyography (EMG) to measure physiologic activity of the longissimus dorsi muscles of horses during trotting on a treadmill. ANIMALS: 15 adult horses (5 to 20 years old that weighed 450 to 700 kg) that did not have clinical signs of back pain. PROCEDURE: Data were recorded for each horse during trotting on a treadmill at speeds of 2.6 to 4.4 m/s. Surface electromyography was recorded bilaterally from the longissimus dorsi muscles at the levels of T12, T16, and L3. RESULTS: In each motion cycle, 2 EMG maxima were found at the end of the diagonal stance phases. The EMG activity peaked slightly later at L3 than at T12 and T16. Maximum EMG amplitudes were highest at T12 and decreased caudally, with mean +/- SD values of 4.51 +/- 1.20 mV at T12, 3.00 +/- 0.83 mV at T16, and 1.78 +/- 0.67 mV at L3. Mean minimum EMG activity was 1.30 +/- 0.63 mV at T12, 0.83 +/- 0.35 mV at T16, and 0.80 +/- 0.39 mV at L3. The relative amplitudes (ie, [maximum - minimum]/maximum) were 67 +/- 11% at T12, 66 +/- 8% at T16, and 71 +/- 8% at L3. CONCLUSIONS AND CLINICAL RELEVANCE: Activity of the longissimus dorsi muscles is mainly responsible for stabilization of the vertebral column against dynamic forces. The difference between minimum and maximum activity may allow application of this method as a clinical tool. Data reported here can serve as reference values for comparison with values from clinically affected horses.     

Force platform evaluation of lameness severity following extracorporeal shock wave therapy in horses with unilateral forelimb lameness

OBJECTIVE: To measure alterations in lameness severity that occur following use of extracorporeal shock wave therapy (ESWT) in horses with naturally occurring unilateral forelimb lameness. DESIGN: Nonrandomized clinical trial. ANIMALS: 9 horses with unilateral forelimb lameness. PROCEDURES: Force platform gait analysis was performed prior to administration of any treatments (baseline) and after use of local anesthesia to eliminate the lameness. Extracorporeal shock wave therapy was then administered, and gait analysis was repeated 8 hours later and then daily for 7 days. RESULTS: Compared with the baseline value, peak vertical force was significantly increased 8 hours and 2 days after ESWT, and peak vertical force on day 2 was not significantly different from force measured after use of local anesthesia to eliminate the lameness. Similarly, vertical impulse was significantly increased, compared with the baseline value, 8 hours and 2 days after ESWT, but at all times, it was significantly lower than vertical impulse measured after use of local anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in horses with naturally occurring lameness, use of ESWT results in a period of acute improvement in lameness severity that typically persists for 2 days. Thus, in horses undergoing ESWT, exercise should be controlled for a minimum of 2 days after treatment to prevent further injury.     

Back kinematics of healthy trotting horses during treadmill versus over ground locomotion

Reasons for performing study: Treadmill locomotion is frequently used for training of sport horses, for diagnostic purposes and for research. Identification of the possible biomechanical differences and similarities between the back movement during treadmill (T) and over ground (O) locomotion is essential for the correct interpretation of research results. Objectives: To compare the kinematics of the thoracolumbar vertebral column in treadmill and over ground locomotion in healthy horses. Methods: Six sound Dutch Warmblood horses trotted on a T and O during 10 s at their own preferred velocity (mean ± s.d. 3.6 ± 0.3 m/s T and 3.6 ± 0.1 m/s O), which was the same in both conditions. Kinematics of the vertebral column was captured by infrared cameras using reflective skin markers attached over the spinous processes of selected vertebrae and other locations. Flexion‐extension and lateral bending range of motion (ROM), angular motion pattern (AMP) and intravertebral pattern symmetry (IVPS) of 5 vertebral angles (T6‐T10‐T13, T10‐T13‐T17, T13‐T17‐L1, T17‐L1‐L3 and L1‐L3‐l5) were calculated. Neck angle, linear and temporal stride parameters and protraction‐retraction angles of the limbs were also calculated. Results: The vertical ROM (flexion‐extension) was similar in both conditions, but the horizontal ROM (lateral bending) of the lumbar angles T17‐L1‐L3 and L1‐L3‐L5 was less during T locomotion (mean ± s.d. difference of 1.8 ± 0.6 and 1.7 ± 0.9°, respectively, P>0.05). During O locomotion, the symmetry pattern of the lumbar vertebral angles was diminished from 0.9 to 0.7 (1 = 100% symmetry) indicating increased irregularity of the movement (P>0.05). No differences were found in the basic linear and temporal stride parameters and neck angle. Potential relevance: Vertebral kinematics during treadmill locomotion is not identical to over ground locomotion, but the differences are minor. During treadmill locomotion lumbar motion is less, and caution should be therefore taken when interpreting lumbar kinematics.     

Maximum permissible load for Kiso horses trotting over a short,straight course

This study aimed to determine the load‐bearing capacity of trotting Kiso horses using gait analysis. Ten Kiso horses with a height at withers of 128 cm were included. Their riders were fitted with a marker (70 mm in diameter placed on their chest) recorded by two digital DVD cameras while trotting along a short, straight course. In total, eight tests were performed for each horse: the first with a 70 kg load; six with randomly loaded weights ranging 80–130 kg; and then a final test again with a 70 kg load. Three‐dimensional movement of the marker was analyzed using a motion capture system. The time series of vertical displacement of the marker underwent spectrum analysis by the maximum entropy method, and the autocorrelation coefficient was calculated. The first two peaks of the autocorrelation were defined as symmetry and regularity, and their sum was defined as stability. Regularity in the 120 kg test (0.54) was lower than that in the first 70 kg test (0.61), and stability in the 120 kg test (1.31) was lower than that in the first 70 kg test (1.42). We concluded that the maximum permissible load for a trotting Kiso horse is < 120 kg, which represents 31% of its bodyweight.