Kinetics and kinematics of the equine hind limb: in vivo tendon strain and joint kinematics

Strains of the suspensory ligament and deep digital flexor, superficial digital flexor, and long digital extensor tendons in the equine (pony) hind limb were recorded in vivo, using implanted strain gauges consisting of silicone rubber tubes filled with mercury. The relationship between strain gauge signals and tendon strains was obtained from tension-strain tests performed on isolated tendons after death of the ponies. During normal walking, maximal tendon strain (elongation over initial length, relative to the length of the structures at first ground contact) was 3.1% in the suspensory ligament and 3.4%, 2.3%, and 0.3% in the deep digital flexor, the superficial digital flexor, and the long digital extensor tendons, respectively. Changes (that occurred during walking) in the distance from origin to insertion of these musculotendinous structures were computed from limb geometric configuration and limb conformation. Maximal increase in origin to insertion length was 3.1% in the suspensory ligament and 2%, 1.6%, and 1.5% in the deep digital flexor, superficial digital flexor, and long digital extensor musculotendinous structures, respectively. The differences in strain, comparing the entire musculotendinous structure and its tendon, were explained by muscular contraction or relaxation.     

The origins of acupuncture channel imbalance in pain of the equine hindlimb

Objective: A study was conducted to define the relationship between oriental channel imbalance and pain of the equine hindlimb.Methods: One hundred eighty-five lame and muscle sore horses from a general equine practice in Virginia were examined by a single observer using traditional manual palpation of the acupuncture channels. The six hindlimb channels were evaluated and graded with particular emphasis on the reactivity of three transpositional acupoints, BL 18, BL 19, BL 20, and five traditional veterinary acupoints Yao Zhong, Shen Shu, Xie Qi, Feng Men, and Fu Tu. All lame patients were evaluated with western methods to establish an anatomical diagnosis. All nonlame horses with channel imbalance were treated with either an intra-articular anesthetic, an intra-articular cortisone, methylprednisolone acetate, or a hyaluronate and triamcinalone combination. The medications were injected into either the three compartments of the stifle joint, tarso-metatarsal and distal inter-tarsal joints, metatarsophalangeal joint, or the distal interphalangeal joint The joint injections were conducted in sequence, distal to proximal, until a definitive change in channel imbalance had occurred. Chi Square analysis was used to assess different frequencies of channel imbalance and the sites responsible for that imbalance, with P<0.05.Results: Channel imbalance was only indirectly associated with extra-articular pathology. Intra-articular structures of three joints of the distal hindlimb, the distal tarsus, metatarsophalangeal, and distal interphalangeal, accounted for all the observed abnormal, referred diagnostic acupoints. In the examined population, channel imbalance was significantly more frequently related to the distal tarsus than the hind fetlock, and both of these were significantly more frequently involved than the distal interphalangeal joint. Channel imbalance relating to the dorsal aspect of the digit was significantly more frequent in metatarsophalangeal lameness than in distal tarsal lameness. Neither the stifle nor midback pain was directly associated with projected, as opposed to local, channel imbalance. If projected channel imbalance could be defined as the presence of reactive acupoints not in the immediate vicinity of the local site of pain, then the projected acupoints detected in stifle lameness or back pain were associated with the tarsus or the hind fetlock.Conclusions: The sites of hindlimb pathology resulting in channel imbalance were intra-articular, and they were located within the distal tarsal, the metatarsophalangeal and the distal interphalangeal joints. Channel diagnosis reflected intra-articular inflammation of only these three joints, and further diagnostic procedures were required to establish a definitive western diagnosis. The presence of channel imbalance should be used to determine pattern differentiation in Traditional Chinese Medicine.     

The gait of pacers. 1: kinematics of the racing stride

Standardbred pacers have been studied under race conditions to describe the gait of the pacer, and to determine relationships between stage of the race, finish order and selected gait kinematics. Overlap increased with the stage of the race while pacing speed decreased marginally for low order pacers and increased for high order finishers. High order finishing pacers appear to have greater stance and stride lengths than do low order finishers. Pacers could be separated into low order and high order groups on the basis of their movement patterns. High order pacers exhibited greater ranges of limb motion than did low order finishers.     

Computed tomographic contrast tenography of the digital flexor tendon sheath of the equine hindlimb

Pre‐surgical investigation of digital flexor tendon sheath pathology remains challenging with current standard imaging techniques. The aim of this prospective, anatomical, pilot study was to describe the anatomy of the equine hind limb digital flexor tendon sheath using a combination of computed tomography (CT) and computed tomographic contrast tenography in clinically normal cadaver limbs. Ten pairs of hind limbs with no external abnormalities were examined from the level of the tarsometatarsal joint distally. Limbs initially underwent non‐contrast CT examination using 120 kVp, 300 mAs, and 1.5 mm slice thickness. Sixty millilitres of ioversol iodinated contrast media and saline (final concentration 100 mg/ml) were injected using a basilar sesamoidean approach. The computed tomographic contrast tenography examination was then repeated, before dissection of the specimens to compare gross and imaging findings. The combined CT and computed tomographic contrast tenography examinations provided excellent anatomical detail of intra‐thecal structures. The borders of the superficial and deep digital flexor tendons, and the manica flexoria were consistently identifiable in all limbs. Detailed anatomy including that of the mesotenons, two of which are previously undescribed, and the plantar annular ligament were also consistently identifiable. Dissection of all 10 pairs of limbs revealed there to be no pathology, in accordance with the imaging findings. In conclusion, the combination of CT and computed tomographic contrast tenography may be useful adjunctive diagnostic techniques to define digital flexor tendon sheath pathology prior to surgical exploration in horses.     

Three-dimensional kinematics of the equine interphalangeal joints: articular impact of asymmetric bearing

The objective of this study was to assess the effects of asymmetric placement of the foot on the three-dimensional motions of the interphalangeal joints. Four isolated forelimbs were used. Trihedrons, made of three axes fitted with reflective markers, were screwed into each phalanx. They allowed to establish a local frame associated with each bone and thus to define the spatial orientation of the phalanges. The limbs were then placed under a power press, and subjected to compression with gradually increasing force (from 500 to 6 000 N). The procedure was performed in neutral position and with the lateral or medial part of the foot raised by a 12 degrees wedge. Flexion, collateromotion (passive abduction/adduction) and axial rotation of the interphalangeal joints were measured using a cardan angle decomposition according to the principle of the "Joint Coordinate System" described by Grood and Suntay. Raising the lateral or medial part of the hoof induced collateromotion (about 5.6 degrees +/- 0.8) and axial rotation (about 6.5 degrees +/- 0.5) of the distal interphalangeal joint. The proximal interphalangeal joint underwent axial rotation (about 4.7 degrees +/- 0.5 at 6 000 N) and slight collateromotion. Both interphalangeal joints underwent collateromotion in the direction of the raised part of the foot (i.e., narrowing of the articular space on the side of the wedge), whereas axial rotation occurred in the direction opposite to the raised part of the foot. These results confirm the functional importance of interphalangeal joint movements outside the sagittal plane. In particular they demonstrate the involvement of the proximal interphalangeal joint in the digital balance. These data are helpful for the identification of biomechanical factors that may predispose to interphalangeal joint injury. Also the data may be of use for the rational decision making with respect to exercise management and corrective shoeing of the lame horse.     

Short-term habituation of equine limb kinematics to tactile stimulation of the coronet.

A lightweight bracelet that provides tactile stimulation to the horse's pastern and coronet induces a higher flight arc of the hoof. This study addresses the pattern of habituation to these devices. OBJECTIVE: To evaluate short-term habituation to tactile stimulation of the pastern and coronet in trotting horses. METHODS: Tactile stimulation was provided by a lightweight (55 g) device consisting of a strap with seven chains that was attached loosely around the pastern. Reflective markers were fixed to the dorsal hoof wall, the forehead and over the tenth thoracic vertebra of eight sound horses. The horses trotted in hand 10 times at a consistent velocity along a 30 m runway under three conditions applied in random order at two-hour intervals: no stimulators, stimulators on both front hooves or stimulators on both hind hooves. One stride per trial was analyzed to determine peak hoof heights in the swing phase. Sequential trials with stimulators were compared with unstimulated trials using a nested ANCOVA and Bonferronni's post hoc test (P < 0.005). RESULTS: Peak hind hoof height increased significantly for all 10 trials when wearing hind stimulators, whereas peak fore hoof height increased during the first six trials only when wearing fore stimulators. The first trial with stimulators showed the greatest elevation, followed by a rapid decrease over the next three trials and then a more gradual decrease. CONCLUSIONS: If the goal is to facilitate a generalized muscular response, a short burst of tactile stimulation is likely to be most effective, whereas longer periods of stimulation will be more effective for strength training.     

Force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness.

OBJECTIVE: To evaluate the accuracy of force plate gait analysis at the walk and trot in dogs with low-grade hindlimb lameness. MATERIAL AND METHODS: Nineteen healthy dogs and 41 dogs with low-grade unilateral hindlimb lameness due to stifle or hip joint problems were walked and trotted over a force plate. Peak vertical forces (PVF) were recorded, and a symmetry index (SI) was calculated from the PVF of the hindlimbs. 'Cut-off' values were determined from the SI of the normal dogs. These cut-off values were used to discriminate lame dogs from normal ones. Sensitivity and specificity were evaluated for measurements at walk and trot, and the Cohen's Kappa coefficient (k) was used to determine the agreement between clinical lameness and force plate measurements, and between force plate results at walk and trot. Receiver Operating Characteristics (ROC) curve were plotted for both gaits to evaluate accuracy. RESULTS: The sensitivity of the measurements at walk was 0.63, and specifity was 0.95. The sensitivity of the measurements at trot was 0.90, and specificity was 1.0. Moderate agreement was found between force plate measurements at walk and trot, and between clinical gait assessment and force plate measurements at walk. Good agreement was found between clinical gait assessment and measurements at trot. ROC analyses revealed the trot (94.7% [91.7%; 97.7%]) to be the more accurate test than the walk (85.0% [80.1%; 89.9%]). CONCLUSION: The trotting gait was more sensitive and accurate than the walking gait for the differentiation of dogs with a low-grade hindlimb lameness from normal ones using force plate gait analysis.     

Use of immunohistochemical methods for diagnosis of equine pythiosis

Excisional biopsy specimens were received from 8 horses with lesions suspected of being caused by Pythium sp. Pythium sp was isolated from all specimens. An indirect peroxidase technique was applied to formalin-fixed tissues from the biopsy material and there was distinct staining of hyphal cell walls in all specimens. Sections containing hyphae, other than those of Pythium sp, failed to stain. The indirect peroxidase technique could be used for confirmation of suspected cases of pythiosis.     

The influence of rider:horse bodyweight ratio and rider-horse-saddle fit on equine gait and behaviour: A pilot study

The effect of rider weight on equine welfare and performance requires further investigation. The objective of this prospective, cross-over, randomised trial was to assess gait and behavioural responses of horses to riders of similar ability, but different bodyweights. Six nonlame horses in regular work were ridden by each of four riders: Light (L), Moderate (M), Heavy (H) and Very Heavy (VH). Saddle fit was assessed subjectively throughout the study. Each horse was ridden twice by riders L and M, and once by rider H. Rider VH rode five horses once and one twice. Each horse-rider combination undertook a standardised, 30-min ‘dressage-test' which was abandoned if we observed lameness grade ≥ 3/8 in one limb, grade ≥ 2/8 in ≥ 2 limbs, or ≥ 10/24 behavioural markers of pain. Horses were reassessed in hand 45–60 min after any abandonment. Mean rider bodyweights, body mass index (BMI) values and rider:horse bodyweight percentages for the L, M, H and VH riders were respectively: 60.8, 77.8, 91.0, 142.1 kg; 23.2, 28.0, 26.3, 46.9 kg/m²; 10.0–11.7%, 12.8–15.0%, 15.3–17.9%, 23.6–27.5%. All 13 H and VH rider tests (lameness, n = 12; behaviour, n = 1) and one of 12 M rider tests (lameness) were abandoned. Lameness was confirmed using inertial measurement unit data. All horses trotted sound after test abandonment and completed the study moving well when ridden. Limitations of the study were saddle fit was not ideal in all horse-rider combinations and abandonment criteria were subjective. The conclusions and clinical relevance of the study were that large riders can induce temporary lameness and behaviours consistent with musculoskeletal pain. This may relate to rider bodyweight and/or weight distribution. Riders M and H had similar BMI but markedly different test abandonment rates, therefore bodyweight is likely to be more relevant than BMI. Further work is required to determine if horse fitness, adaptation to heavier weights and better saddle fit for heavier/taller riders will increase horses' weight-carrying capacity.     

Use of electromyography for the diagnosis of equine hyperkalemic periodic paresis.

The use of electromyography (EMG) as a diagnostic aid for equine hyperkalemic periodic paresis (EHPP) was investigated in seven affected and seven control horses. Affected horses were confirmed positive for EHPP either by elevated serum potassium concentration with clinical signs of myotonia, or by inducing hyperkalemia and clinical signs using oral potassium chloride challenge. All horses were asymptomatic at the time EMG was performed, using bipolar fine wire needle electrodes. The myopotentials were recorded on magnetic tape and displayed on paper charts for analysis. Insertional and resting activity were recorded from the right supraspinatus, triceps, extensor carpi radialis and gluteal muscles in standing horses. Myotonic discharges were seen in six of seven affected horses but not in any of the controls. All seven affected horses and two control horses had prolonged insertional activity. Five out of seven affected horses and one control horse displayed spontaneous motor unit discharges unrelated to recording electrode movement. Myoelectrical potentials containing closely timed muscle potentials, i.e. doublets, were found in all affected horses, with four of seven affected horses also showing triplets. These potentials were not observed in any of the controls. No obvious difference in activity was observed among the four muscle sites tested. It is concluded that EMG is a safe and useful tool for diagnosing EHPP in horses not currently displaying clinical signs. Myotonic discharges and doublets appear to be the most diagnostically significant electromyographic abnormalities in EHPP affected horses.     

Use of cone-beam computed tomography for advanced imaging of the equine patient

Access to volumetric imaging modalities, such as magnetic resonance imaging (MRI) and computed tomography (CT), has increased over the past decade and has revolutionised the way clinicians evaluate equine anatomy. More recent advancements have resulted in the development of multiple commercially available cone-beam CT (CBCT) scanners for equine use. CBCT scanners modify the traditional fan-shaped beam of ionising radiation into a three-dimensional pyramidal- or cone-shaped beam of radiation. This modification enables the scanner to acquire sufficient data to create diagnostic images of a region of interest after a single rotation of the gantry. The rapid acquisition of data and divergent X-ray beam causes some artifacts to be more prominent on CBCT images—as well as the unique cone-beam artifact—resulting in decreased contrast resolution. While the use of CT for evaluation of the equine musculoskeletal anatomy is not new, there is a paucity of literature and scientific studies on the capabilities of CBCT for equine imaging. CBCT units do not require a specialised table for imaging and in some cases are portable for imaging in the standing or anaesthetised patient. This review article summarises the basic physics of CT technology, including how CBCT imaging differs, and provides objective information about the strengths and limitations of this modality. Finally, potential future applications and techniques for imaging with CT which will need to be explored in order to fully consider the capabilities of CT imaging in the horse are discussed.