Use of a stand-alone pressure plate for the objective evaluation of forelimb symmetry in sound ponies at walk and trot

Subtle lameness in horses may be difficult to diagnose and methods to evaluate lameness objectively are useful when equine clinicians fail to reach a consensus. The aim of this study was to determine whether equine pressure plate measurements are repeatable when used to calculate forelimb loading (peak vertical pressure [PVP], peak vertical force [PVF], vertical impulse [VI]) and symmetry ratios, and to establish if these data are similar to the ‘gold standard’ force plate values. Since plate dimensions are relatively small, ponies were used to enable recordings to be taken from both forelimbs in one trial. Five sound ponies were walked and trotted over a pressure plate which was embedded in a custom-made runway. For each pony, five valid trials were recorded during two different days. A trial was considered valid if complete prints of both fore hooves were recorded consecutively and if velocity was within a preset range.The PVP, PVF and VI values showed an acceptable variability (CV ? 16%), with PVF (130% of bodyweight [BW], n = 5) similar to previously reported force plate data (128% BW, n = 48). Mean symmetry ratios appeared to be high (>95%) and showed a low variability (CV < 5%). The stand-alone pressure plate permitted adequate registration of forelimb PVF, VI and limb symmetry with a high level of precision in sound ponies.     

Shoeing sound warmblood horses with a rolled toe optimises hoof-unrollment and lowers peak loading during breakover

REASONS FOR PERFORMING STUDY: Overload injuries in sport horses commonly occur; shoeing techniques are believed to be important in prevention of these injuries, but there is a paucity of scientific information identifying the potential connection. OBJECTIVES: To test a horseshoe with a modified rolled toe designed to ease the process of breakover and decrease loading of lesion-prone structures of the distal limb. METHODS: Twenty clinically sound Warmblood horses trotted over a track containing a pressure/force measuring system and 6 infrared cameras. The horses were measured with 2 types of shoes, standard flat shoes and shoes with a rolled toe. The shoeing procedure was randomised and horses had 2 days between measurements to adapt to the shoes. RESULTS: Limb placement and timing characteristics, e.g. breakover duration, did not change significantly. There was an improvement in the ease of movement to roll over the toe in the shoes with a rolled toe, due mainly to a smoother hoof-unrollment pattern. The peak indicative moment decreased substantially at the onset of breakover in the shoe with the rolled toe. CONCLUSIONS: With a rolled toe the process of hoof-unrollment is smoother, which improves the coordination of this process, and lowers peak loading of the distal limb during breakover. POTENTIAL RELEVANCE: This study stresses the importance of proper shoeing in sound horses, showing that shoe modifications can optimise the loading characteristics of the distal limb and therefore might be a means to prevent sport horses from overload injuries.     

Use of an instrument sandwiched between the hoof and shoe to measure vertical ground reaction forces and three-dimensional acceleration at the walk, trot, and canter in horses

OBJECTIVE: To develop an instrument that could be sandwiched between the hoof and shoe of horses and that would reliably measure vertical ground reaction forces and three-dimensional acceleration at the walk, trot, and canter. ANIMALS: 5 clinically sound Thoroughbreds. PROCEDURES: The recording instrument (weight, 350 g) consisted of 2 metal plates, 2 bolts, 4 load cells, and 3 accelerometers. It was mounted to the hoof with a glue-on shoe and devised to support as much load exerted by a limb as possible. The load cells and accelerometers were wired to a 16-channel transmitter, and transmitted signals were received and amplified with a telemetry receiver. RESULTS: The recording instrument could measure in real time the 4 components of the ground reaction force or their resultant force along with acceleration in 3 dimensions as horses walked, trotted, or cantered on a treadmill. Patterns of force-time curves recorded for consecutive strides were similar to each other and to those previously reported, using a force plate. CONCLUSIONS AND CLINICAL RELEVANCE: The recording instrument developed for use in the present study allowed us to record vertical ground reaction force and acceleration in 3 dimensions in horses at the walk, trot, and canter.     

Changes in digital venous pressures of horses moving at the walk and trot

Blood pressures from the catheterized lateral digital vein of the fore-limbs of 6 clinically normal horses were measured at rest, at the walk, and at the trot. Digital venous pressures were compared with the phases of the stride and weight-bearing forces, using electrogoniometry and a force platform. Rapid increases in digital venous pressures to maximal values were observed immediately before maximal forces during the support period of the stride. At the trot, increases in peak vertical forces were paralleled by increases in peak digital venous pressures. Seemingly, the hydrodynamics of the digital circulatory system help to dissipate the initial impact of hoof strike at the walk and the trot.     

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.     

Relationship of foot conformation and force applied to the navicular bone of sound horses at the trot

REASONS FOR PERFORMING STUDY: Collapsed heels conformation has been implicated as causing radical biomechanical alterations, predisposing horses to navicular disease. However, the correlation between hoof conformation and the forces exerted on the navicular bone has not been documented. HYPOTHESIS: The angle of the distal phalanx in relation to the ground is correlated to the degree of heel collapse and foot conformation is correlated to the compressive force exerted by the deep digital flexor tendon on the navicular bone. METHODS: Thirty-one shod Irish Draught-cross type horses in routine work and farriery care were trotted over a forceplate, with 3-dimensional (3D) motion analysis system. A lateromedial radiograph of the right fore foot was obtained for each horse, and various measurements taken. Correlation coefficients were determined between hoof conformation measurements and between each of these and the force parameters at the beginning (15%) of stance phase, the middle of stance (50%) and at the beginning of breakover (86% of stance phase). Significance was defined as P<0.05. RESULTS: The force exerted on the navicular bone was negatively correlated (P<0.05) to the angle of the distal phalanx to the ground and to the ratio between heel and toe height. This was attributed to a smaller extending moment at the distal interphalangeal joint. There was not a significant correlation between the angle of the distal phalanx and the degree of heel collapse, and heel collapse was not significantly correlated to any of the force parameters. CONCLUSIONS: Hoof conformation has a marked correlation to the forces applied to the equine foot. Heel collapse, as defined by the change in heel angle in relation to toe angle, appears to be an inaccurate parameter. The forces applied on the foot are well correlated to the changes in the ratio of heel to toe heights and the angles of the distal phalanx. POTENTIAL RELEVANCE: Assessment of hoof conformation should be judged based on these parameters, as they may have clinical significance, whereas parallelism of the heel and toe is of less importance.     

The influence of head and neck position on kinematics of the back in riding horses at the walk and trot

REASONS FOR PERFORMING STUDY: A common opinion among riders and in the literature is that the positioning of the head and neck influences the back of the horse, but this has not yet been measured objectively. OBJECTIVES: To evaluate the effect of head and neck position on the kinematics of the back in riding horses. METHODS: Eight Warmblood riding horses in regular work were studied on a treadmill at walk and trot with the head and neck in 3 different predetermined positions achieved by side reins attached to the bit and to an anticast roller. The 3-dimensional movement of the thoracolumbar spine was measured from the position of skin-fixed markers recorded by infrared videocameras. RESULTS: Head and neck position influenced the movements of the back, especially at the walk. When the head was fixed in a high position at the walk, the flexion-extension movement and lateral bending of the lumbar back, as well as the axial rotation, were significantly reduced when compared to movements with the head free or in a low position. At walk, head and neck position also significantly influenced stride length, which was shortest with the head in a high position. At trot, the stride length was independent of head position. CONCLUSIONS: Restricting and restraining the position and movement of the head and neck alters the movement of the back and stride characteristics. With the head and neck in a high position stride length and flexion and extension of the caudal back were significantly reduced. POTENTIAL RELEVANCE: Use of side reins in training and rehabilitation programmes should be used with an understanding of the possible effects on the horse's back.     

The force and contact stress on the navicular bone during trot locomotion in sound horses and horses with navicular disease

Mechanical overload due to poor conformation or shoeing has been suggested to contribute to the development of navicular disease. While studies have determined the compressive force exerted on the navicular bone in normal horses, this has not been reported for horses with navicular disease. Also, the force has not been converted to stress by correction for contact area. In this study we developed a technique for the determination of the contact area between the deep digital flexor tendon and the navicular bone in vivo, and used a forceplate system to determine the force and stress on the bone at trot in 6 normal and eight diseased horses. The mean +/- s.d. peak force and peak stress were 5.62+/-1.45 N/kg and 2.74+/-0.76 MPa for the normal group and 6.97+/-1.50 N/kg and 3.07+/-0.55 MPa for the navicular disease group. The peak force and peak stress were similar for both groups but the force and stress in the horses with navicular disease were approximately double control group values early in the stance phase. This was due to a higher force in the deep digital flexor tendon, which was attributed to a contraction of the deep digital flexor muscle in early stance in an attempt to unload the heels.     

Pulmonary artery wedge pressure measurement in healthy warmblood horses and in warmblood horses with mitral valve insufficiencies of various degrees during standardised treadmill exercise

In 12 healthy warmblood horses and 10 horses with mitral valve insufficiencies (MVI) of various degrees heart rate and pulmonary artery wedge pressure (PWP) was measured at rest and during standardised exercise on a high speed treadmill. There was a significant increase in PWP with each change in speed of the treadmill (p < 0.01). The PWP of horses with mild mitral valve regurgitation under working conditions was not significantly different compared to the healthy horses. The horses with moderate mitral valve regurgitation showed a significant higher pulmonary artery wedge pressure at rest and during exercise compared to the healthy horses (p < 0.01) at rest and during treadmill velocity. The tendencies were seen that mild mitral valve regurgitation results only in mild hemodynamic changes during exercise, while moderate MVI have an important influence on haemodynamics.     

Contribution of dynamic calibration to the measurement accuracy of a pressure plate system throughout the stance phase in sound horses

The aim of this study was to evaluate the accuracy of the vertical force curve of a pressure plate (PP) using dynamic calibration with a force plate (FP) in six sound Warmblood horses. The animals were walked and trotted over a combined PP-FP system sampling at 250Hz. Five valid measurements of each forelimb were collected. The recalibration factor (RF), the ratio between the calibrated and raw PP data, was evaluated in each timeframe throughout the stance phase. Following dynamic calibration, the vertical force curve of the PP demonstrated a characteristic biphasic pattern at the walk and typical spikes at the beginning and end of stance at the trot. Both at walk and trot, the RF was considerably higher and more variable in the first 5% of stance (i.e. the impact phase) and during the final 20% of stance (i.e. the breakover phase), whereas between these phases (i.e. in the support phase), the RF was lower and remained relatively constant. These findings were confirmed by plotting the RF as a function of the vertical force and the RF in the loading part of the vertical force curve was lower than in the unloading part of the curve. Without dynamic calibration with a FP, the accuracy of the PP appears suboptimal, especially at the impact and breakover phases. However, the accuracy of the PP was relatively high and constant during the support phase, and higher loading was not associated with increasing deviation. It is therefore essential to optimise PP calibration, as this may downsize systematic measuring errors. However, in a clinical setting, where a stand-alone PP is used to objectively quantify locomotor symmetry, these errors can be readily eliminated by evaluating left:right symmetry ratios.     

Magnetic resonance imaging, ultrasonography and histology of the suspensory ligament origin: a comparative study of normal anatomy of warmblood horses

REASONS FOR PERFORMING STUDY: The diagnosis of lameness caused by proximal metacarpal and metatarsal pain can be challenging. Magnetic resonance imaging (MRI) offers the possibility for further diagnosis but there have been no studies on the normal MRI appearance of the origin of the suspensory ligament (OSL) in conjunction with ultrasonography and histology. OBJECTIVES: To describe the MRI appearance of the OSL in fore- and hindlimbs of sound horses and compare it to the ultrasonographic and histological appearance. The findings can be used as reference values to recognise pathology in the OSL. METHODS: The OSL in the fore- and hindlimbs of 6 sound horses was examined by ultrasonography prior to death, and MRI and histology post mortem. Qualitative evaluation and morphometry of the OSL were performed and results of all modalities compared. RESULTS: Muscular tissue, artefacts, variable SL size and shape complicated ultrasonographic interpretation. In MRI and histology the forelimb OSL consisted of 2 portions, the lateral being significantly thicker than medial. The hindlimb SL had a single large area of origin. In fore- and hindlimbs, the amount of muscular tissue was significantly larger laterally than medially. Overall SL measurements using MRI were significantly higher than using histology and ultrasonography and histological higher than ultrasonographic measurements. Morphologically, there was a good correlation between MRI and histology. CONCLUSIONS: MRI provides more detailed information than ultrasonography regarding muscle fibre detection and OSL dimension and correlates morphologically well with histology. Therefore, ultrasonographic results should be regarded with caution. POTENTIAL RELEVANCE: MRI may be a diagnostic aid when other modalities fail to identify clearly the cause of proximal metacarpal and metatarsal pain; and may improve selection of adequate therapy and prognosis for injuries in this region.     

Use of force plate analysis to assess the analgesic effects of etodolac in horses with navicular syndrome

OBJECTIVE: To evaluate the musculoskeletal analgesic effect of etodolac administered PO every 12 or 24 hours in chronically lame horses by use of force plate analysis. ANIMALS: 22 horses with navicular syndrome. PROCEDURE: Horses received etodolac (23 mg/kg, PO, q 12 h; n = 7), etodolac (23 mg/kg, PO, q 24 h; 8), or corn syrup (20 mL, PO, q 24 h; control treatment; 7) for 3 days. Combined forelimb peak vertical ground reaction force (PVF) was measured via force plate analysis before the first treatment (baseline) and at 6, 12, 24, and 36 hours after the last treatment. Differences in mean PVF (mPVF) between baseline and subsequent measurements were analyzed (repeated-measures ANOVA) and evaluated for treatment and time effects and treatment-time interaction. RESULTS: Once- or twice-daily administration of etodolac resulted in significant increases in mPVF from baseline at 6, 12, and 24 hours after the last treatment, compared with the control treatment. There were no significant differences in mPVF between the etodolac treatment groups at any time point. In both etodolac treatment groups, there was a significant increase in mPVF from baseline at 6, 12, and 24 hours, compared with that at 36 hours. Etodolac-associated adverse effects were not detected. CONCLUSIONS AND CLINICAL RELEVANCE: In horses with navicular syndrome, once-daily oral administration of 23 mg of etodolac/kg appears to provide effective analgesia for as long as 24 hours. Twice-daily administration of etodolac at this same dose does not appear to provide any additional analgesic efficacy or duration of effect.     

Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses

Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross‐sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow‐up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.