Agreement between two inertial sensor gait analysis systems for lameness examinations in horses

Gait analysis is gaining popularity for quantification of lameness and 2 commonly used inertial sensor systems assess trunk movement symmetry: can these be used interchangeably in multi‐centre studies? We compared head and pelvic movement symmetry between 2 inertial sensor gait analysis systems in 13 horses equipped simultaneously with the 2 systems. The first system quantified dorsoventral movement in the local reference frame (System A) and the second system global vertical movement (System B). Widths of limits of agreement were calculated employing a well established regression method dealing with systematically changing differences over the range of measured values. Widths of limits of agreement between Systems A and B were narrower for pelvic movement than head movement. For head movement, they ranged from 6.4 to 6.9 mm for in‐hand trot and from 7.3 to 9.7 mm on the lunge and for pelvic movement from 2.5 to 4.4 mm in‐hand and from 3.6 to 5.3 mm on the lunge. Widths of limits of agreement between the 2 investigated inertial sensor gait analysis systems are of comparable magnitude (some equivalent, some marginally higher) to the currently proposed thresholds of 6 mm for head and 3 mm for pelvic movement used in lameness investigations. Differences in measurements with 2 different systems (A and B) obtained from the same horse falling within the reported values should not be seen as a sign of a change in 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.     

Cinematographic analysis of the gait of lame horses

The gait characteristics of a horse with a non-articular fracture of the right supraglenoid tubercle are described. On physical examination, protraction of the injured limb was painful and limited in extent. Observation at the trot indicated that the horse was transferring weight onto the sound (left) diagonal by lowering the head, neck and trunk during the diagonal stance phase. There was little angular rotation of the shoulder and elbow joints present in the injured limb and consequently the toe barely cleared the ground during the swing phase.Analysis of high speed cinematography films was used to measure the stride parameters and quantify the gait asymmetries. The stance phase and the anterior phaseof the stride were significantly shorter in the right forelimb than the left (p<0.01) and the single support phase was minimized by increasing the overlap of the rightforelimb with the other limbs. Kinematic analysis showed a redistribution of body weight to relieve the load on the injured limb. During the right diagonal (RF- LH) stance phase the poll and withers sunk to their lowest point and the whole trunksegment advanced cranially over the left forelimb. In contrast during the left diagonal (LF-RH) stance phase the poll and withers were elevated and the trunk segment was shifted more caudally to transfer a greater proportion of the body weight onto the left hind limb rather than the painful right forelimb.     

The intra- and inter-assessor reliability of measurement of functional outcome by lameness scoring in horses

The objective of this study was to assess the reliability of lameness scoring in horses. One veterinary surgeon examined nineteen lame horses on four occasions. Gait was recorded by camcorder, and scored from 0 to 10 ranging from sound to non-weight bearing lameness. A global score of overall change in lameness during the study was also determined for each horse. To measure intra-assessor reliability of the scoring systems, one veterinary surgeon scored videotapes of the horses' gaits on two occasions. To measure inter-assessor reliability, three veterinary surgeons viewed the videotapes, assigning individual lameness scores plus global scores to each horse. Reliability of individual lameness scoring was good intra-assessor, but only just within our acceptable limit inter-assessor. However, global scoring of change in lameness throughout the study was found to be reliable overall. Since clinician scoring is commonly used to assess lameness in horses, this is an important finding, fundamental to future clinical studies.     

Shoulder lameness in horses: an analysis of 58 suspected cases

The results of a detailed investigation of 58 horses with suspected shoulder lameness are described. Lameness was found to originate distal to the shoulder region in 22 horses. No diagnosis was reached in five horses. Genuine shoulder problems occurred in 29 horses. The clinical signs of shoulder lameness are described and contrasted with lower limb lameness. The limitations of currently available diagnostic techniques are discussed. Problems identified in the shoulder region included osteochondritis dissecans, subchondral bone cysts, arthrosis, fracture, luxation, septic arthritis and soft tissue damage. Some of the differences between osteochondritis dissecans and subchondral bone cysts are described and it is suggested that these are two separate conditions.     

Bilateral lameness in horses a kinematic study

Summary

The kinematic pattern of mild bilateral lameness was studied by inducing a supporting limb lameness in both forelimbs of 11 sound Dutch Warmblood horses. The kinematics of the horses were recorded while they trotted (3.5 m/s) on a treadmill. The locomotion analysis system CODA‐3 was used to determine the temporal stride patterns, limb movements as well as head and trunk movement patterns. The transient lameness model, by which pressure‐induced pain is evoked on the hoof sole, was used. Differences between left and right limbs as well as between the sound and the lame condition were tested using a paired t‐test.

Stride and stance duration did not change significantly (p < 0.05) during bilateral lameness compared to the pattern of sound horses. Diagonal advanced placement changed to an earlier placement of both forelimbs. Fetlock hyperextension decreased also in both forelimbs, while the pro‐ and retraction, hoof impact angle, maximal hoof height, and all hind limb variables remained unchanged. Vertical head and trunk movements tended to decrease, but these changes were not significant.

It was concluded that fetlock hyperextension and diagonal advanced placement indicate locomotor disturbances, but that mild bilateral lameness may be difficult to distinguish from individual patterns in single assessments because of the lack of locomotor asymmetries. Evaluation of these variables at regular intervals may allow an early detection of bilateral lameness, which then could be confirmed by diagnostic local anaesthesia.     

Repeatability of subjective evaluation of lameness in horses

Reasons for performing study: Previous studies have suggested that agreement between equine veterinarians subjectively evaluating lameness in horses is low. These studies were limited to small numbers of horses, evaluating movement on the treadmill or to evaluating previously‐recorded videotape. Objectives: To estimate agreement between equine practitioners performing lameness evaluations in horses in the live, over ground setting. Methods: 131 mature horses were evaluated for lameness by 2–5 clinicians (mean 3.2) with a weighted‐average of 18.7 years of experience. Clinicians graded each limb using the AAEP lameness scale by first watching the horse trot in a straight line only and then after full lameness evaluation. Agreement was estimated by calculation of Fleiss' (κ). Evaluators agreed if they picked the same limb as lame or not lame regardless of the severity of perceived lameness. Results: After only evaluating the horse trot in a straight line clinicians agreed whether a limb was lame or not 76.6% of the time (κ= 0.44). After full lameness evaluation clinicians agreed whether a limb was lame or not 72.9% of the time (κ= 0.45). Agreement on forelimb lameness was slightly higher than on hindlimb lameness. When the mean AAEP lameness score was >1.5 clinicians agreed whether or not a limb was lame 93.1% of the time (κ= 0.86), but when the mean score was ≤1.5 they agreed 61.9% (κ= 0.23) of the time. When given the task of picking whether or not the horse was lame and picking the worst limb after full lameness evaluation, clinicians agreed 51.6% (κ= 0.37) of the time. Conclusions: For horses with mild lameness subjective evaluation of lameness is not very reliable. Potential relevance: A search for and the development of more objective and reliable methods of lameness evaluation is justified and should be encouraged and supported.     

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.     

Methods, applications and limitations of gait analysis in horses

Over the last 30 years, the increase in interest in horses for racing and riding activities has stimulated scientific research in equine locomotion. This paper presents a review of the measurement methods and their applications used to assess equine locomotion. After describing gaits and velocity-related changes in stride variables, the current applications of gait analysis are presented. The economic consequences of lameness justifies the great effort now being put into lameness quantification and prevention. To improve breeding and reduce the costs of training, early performance evaluation tests for each discipline are proposed. After extensive fundamental and methodological research on the various aspects of equine locomotion, the horse industry should benefit from the applications of gait analysis by improving the profitability of racing and riding activities.