Summary
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.

Repeatability of subjective evaluation of lameness in horses

Objective—To determine repeatability of a wireless, inertial sensor–based lameness evaluation system in horses. Animals—236 horses. Procedures—Horses were from 2 to 29 years of age and of various breeds and lameness disposition. All horses were instrumented with a wireless, inertial sensor-based motion analysis system on the head (accelerometer), pelvis (midline croup region [accelerometer]), and right forelimb (gyroscope) before evaluation in 2 consecutive trials, approximately 5 minutes apart, as the horse was trotted in a straight line. Signal-processing algorithms generated overall trial asymmetry measures for vertical head and pelvic movement and stride-by-stride differences in head and pelvic maximum and minimum positions between right and left sides of each stride. Repeatability was determined, and trial difference was determined for groups of horses with various numbers of strides for which data were collected per trial. Results—Inertial sensor–based measures of torso movement asymmetry were repea...

Assessment of repeatability of a wireless, inertial sensor-based lameness evaluation system for horses

Hoof Pathologies Influence Kinematic Measures of Dairy Cow Gait

Summary Reasons for performing study: Subjective evaluation of mild lameness has been shown to have poor interobserver reliability Traditional methods of objective lameness evaluation require specialised conditions and equipment Wireless inertial sensor systems have been developed to allow for simple, rapid, objective lameness detection in horses trotted over ground Objective: The purpose of this study was to compare the sensitivities of an inertial sensor system and subjective evaluation performed by experienced equine practitioners at detecting lameness in horses We hypothesised that the inertial sensor system would identify lameness at a lower level of sole pressure than a consensus of 3 experienced equine veterinarians Methods: Fifteen horses were fitted with special shoes that allowed for lameness induction via sole pressure Horses were simultaneously evaluated by 3 equine veterinarians and a wireless inertial sensor system Horses were subjected to multiple trials: 1) before inserting the screw; 2) after inserting the screw to just touch the sole; and 3) after tightening the screw in half turn increments The number of screw turns required for lameness identification in the correct limb by the inertial sensors and by consensus of 3 equine veterinarians was compared using the Wilcoxon test Results: The inertial sensor system selected the limb with the induced lameness after fewer screw turns than did the 3 veterinarians (P<00001) The inertial sensor system selected the correct limb before the 3 veterinarians in 35 trials (5833%), the evaluators selected the correct limb before the inertial sensors in 5 trials (833%), and in 20 trials (3333%) they selected the correct limb at the same time Potential relevance: The inertial sensor system was able to identify lameness at a lower level of sole pressure than the consensus of 3 equine veterinarians The inertial sensor system may be an effective aid to lameness localisation in clinical cases

Comparison of an inertial sensor system of lameness quantification with subjective lameness evaluation

Objective— To evaluate the relationship between previously used subjective and objective measures of limb function in normal dogs that had an induced lameness.

Study Design— Prospective, blinded, and induced animal model trial.

Animals— Normal, adult, and mixed-breed dogs (n=24) weighing 25–35 kg.

Methods— Force platform gait analysis was collected in all dogs before and after induction of lameness. All gait trials were videotaped; 60 video trials were evaluated by 3 surgeons with practice limited to small animal orthopedics and 3 first year veterinary students in an effort to establish the relationship between subjective and objective measures of lameness. Evaluators were unaware of the force platform data.

Results— Concordance coefficients were low for all observers and were similar between students and surgeons. These values were further decreased when normal and non-weight bearing trials were removed. Agreement with the force platform data was low even when observers only had to be within ±10% of the ground reaction forces. When repeat trials were evaluated surgeons had a much higher repeatability compared with students.

Conclusions— Subjective evaluation of the lameness in this study varied greatly between observers and agreed poorly with objective measures of limb function.

Clinical Relevance— Subjective evaluation of gait should be interpreted cautiously as an outcome measure whether performed from a single or from multiple observers.

Relationship Between Objective and Subjective Assessment of Limb Function in Normal Dogs with an Experimentally Induced Lameness

OBJECTIVE: To estimate sensitivity and accuracy of subjective evaluation of mild lameness in horses during treadmill locomotion and to correlate subjective evaluation with kinematic analysis. ANIMALS: 19 lame and 5 clinically normal horses. PROCEDURE: Lameness was evaluated by subjective score and kinematic analysis before and after palmar digital nerve block (PDNB). Evaluations were made by 6 clinicians and 7 interns or residents. Within- and between-observer agreement analyses (kappa values) were calculated and compared, using a Student's t-test. Pearson's product-moment correlation coefficients were calculated between clinician's change in score and the change in kinematic variables after PDNB. RESULTS: Within-observer agreement was within the range expected for conditions of moderate diagnostic difficulty. Within-observer agreement was higher for clinicians than for interns or residents. Between-observer agreement was acceptable for scores within 1 value of each other. Between-observer agreement of change in lameness score after PDNB was poor. When kinematic variables were ranked with each clinician's subjective change in score, only 2 were among the top 3 for the majority of clinicians. Asymmetry of vertical head movement between contralateral forelimb stance phases and the point of maximum hoof height during swing decreased as lameness subjectively improved. CONCLUSION: Mild lameness may be difficult to evaluate during treadmill locomotion. Although clinicians were more repeatable in their subjective evaluation of lameness than interns or residents, they were not more reliable at detecting the true state of lameness. CLINICAL RELEVANCE: Lack of agreement between clinician scoring of mild lameness emphasizes the need to use more objective measures for quantifying lameness.

Evaluation of mild lameness in horses trotting on a treadmill by clinicians and interns or residents and correlation of their assessments with kinematic gait analysis

Purulent pericarditis as a sequela to clostridial myositis in a horse.

BACKGROUND: Although extracorporeal shockwave therapy (ESWT) is a common treatment for horses with back pain, effects on mechanical nociceptive threshold (MNT) and multifidus muscle cross sectional area (CSA) in the spine are unknown. OBJECTIVES: To evaluate effects of ESWT on spinal MNT and multifidus muscle CSA in horses with thoracolumbar pain. STUDY DESIGN: Non‐randomised trial. METHODS: Thoracolumbar spines of 12 horses with thoracolumbar pain were radiographed to document existing pathology. Each horse received three ESWT treatments, 2 weeks apart (days 0, 14, 28). Palpation scores were documented (days 0, 45 and 65). Ultrasonographic CSA of left and right multifidus muscles was recorded at T12, T14, T16, T18, L3 and L5 (days 0, 45 and 65). MNT was measured at the same spinal sites every 7 days (day 0–56). RESULTS: Mechanical nociceptive threshold in 10/12 horses (83%) was greater at each time point compared with day 0 (P < 0.05). Mechanical nociceptive threshold increased at all time points at six sites in 2/12 (16%), at five sites in 3/12 (25%), at four sites in 4/12 (33%) and at one site in 1/12 (8%; P < 0.05). Mechanical nociceptive threshold average per cent increase from day 0 to 56 was 64% for the thoracic region (T12–T18) and 29% for the lumbar region (L3–L5). There was no statistical difference in MNT from day 35 to 56 (P = 0.25). A bimodal analgesic trend was observed following ESWT. Degree of radiographic change was not associated with response to treatment. No significant change in multifidus muscle CSA was observed. MAIN LIMITATIONS: Small study size and lack of control group. CONCLUSIONS: Three treatments of ESWT 2 weeks apart raised MNT over a 56‐day period in horses with back pain, but did not influence change in CSA of the multifidus muscle. While ESWT appears justifiable for analgesia, physiotherapeutic techniques may be necessary in conjunction for concurrent muscle rehabilitation.

R. S. Pleasant

Papers

Evaluation of mild lameness in horses trotting on a treadmill by clinicians and interns or residents and correlation of their assessments with kinematic gait analysis

Purulent pericarditis as a sequela to clostridial myositis in a horse.

Extracorporeal shockwave therapy raises mechanical nociceptive threshold in horses with thoracolumbar pain.

Unilateral Leydig cell tumour resulting in acute colic and scrotal swelling in a stallion with descended testes

Chylothorax and meconium impaction in a neonatal colt.