Repeatability of gait analysis measurements in Thoroughbreds in training

Comparing Inertial Measurement Units to Markerless Video Analysis for Movement Symmetry in Quarter Horses

BACKGROUND

With an increasing number of systems for quantifying lameness-related movement asymmetry, between-system comparisons under non-laboratory conditions are important for multi-centre or referral-level studies. This study compares an artificial intelligence video app to a validated inertial measurement unit (IMU) gait analysis system in a specific group of horses.

METHODS

Twenty-two reining Quarter horses were equipped with nine body-mounted IMUs while being videoed with a smartphone app. Both systems quantified head and pelvic movement symmetry during in-hand trot (hard/soft ground) and on the lunge (left/right rein, soft ground). Proportional limits of agreement (pLoA) were established.

RESULTS

Widths of pLoA were larger for head movement (29% to 50% in-hand; 22% to 38% on lunge) than for pelvic movement (13% to 24% in-hand; 14% to 24% on lunge).

CONCLUSION

The between-system pLoAs exceed current "lameness thresholds" aimed at identifying the affected limb(s) in lame horses. They also exceed published limits of agreement for stride-matched data but are similar to repeatability values and "lameness thresholds" from "non-lame" horses. This is encouraging for multi-centre studies and referral-level veterinary practice. The narrower pLoA values for pelvic movement asymmetry are particularly encouraging, given the difficulty of grading hind limb lameness "by eye".

Poor Association between Facial Expression and Mild Lameness in Thoroughbred Trot-Up Examinations

Musculoskeletal injuries in racehorses are difficult to detect prior to catastrophic breakdown. Lameness is commonly attributed to orthopaedic pain in horses, therefore, subtle lameness may be a pre-clinical sign of injury and, if identified early, could allow for preventative intervention. Our objective was to determine if facial expressions could be used to detect mild lameness as an indicator of orthopaedic pain in 'fit to race' horses. The Horse Grimace Scale (HGS) and the facial expressions in ridden horses (FEReq), were used to score images (n = 380) of mildly lame (n = 21) and non-lame (n = 17) Thoroughbred horses by two independent observers. Using an Equinosis Lameness Locator®, the lameness status of each horse was determined according to published thresholds [forelimb lameness (>|14.5 mm|) and hindlimb lameness (>|7.5 mm|)]. Inter and intraobserver reliability were assessed using two-way random-effects models. Univariable associations between lameness and facial expression parameters were identified using logistic and linear regression. Interobserver reliability was moderate (κ 0.45; 95% CI 0.36, 0.55). Horses with moderate mouth strain (HGS) and tense and extended upper lip (FEReq) were less likely to be lame (p = 0.042 and p = 0.027, respectively). Exposed sclera was associated with lameness (p = 0.045). Higher orbital tightening (HGS) scores were associated with a lower degree of maximum head amplitude (HDmax) lameness (p = 0.044). Tension and moderate tension above the eye, for the HGS and FEReq scores, were associated with increasing amplitude of HDmax (p = 0.048 and p = 0.034, respectively). Inconsistent associations between lameness status and HGS and FEReq scores may limit the potential use of the facial expression for the prediction of mild orthopaedic pain during pre-race lameness examinations. More objective parameters associated with mild orthopaedic pain should be explored.

A Pilot Study on the Inter-Operator Reproducibility of a Wireless Sensors-Based System for Quantifying Gait Asymmetries in Horses

Repeatability and reproducibility of any measuring system must be evaluated to assess possible limitations for its use. The objective of this study was to establish the repeatability and the inter-operator reproducibility of a sensors-based system (EQUISYM^®) for quantifying gait asymmetries in horses.. Seven wireless IMUs were placed on the head, the withers, the pelvis, and the 4 cannon bones on three horses, by four different operators, four times on each horse, which led to a total of 48 repetitions randomly assigned. Data were collected along three consecutive days and analysed to calculate total variance, standard deviation and the variance attributable to the operator on multiple asymmetry variables. Maximal percentage of variance due to the operator (calculated out of the total variance) was 5.3% and was related to the sensor placed on the head. The results suggest a good reproducibility of IMU-based gait analysis systems for different operators repositioning the system and repeating the same measurements at a succession of time intervals. Future studies will be useful to confirm that inter-operator reproducibility remains valid in larger groups and on horses with different degrees of locomotor asymmetry.

Linear Discriminant Analysis for Investigating Differences in Upper Body Movement Symmetry in Horses before/after Diagnostic Analgesia in Relation to Expert Judgement

Simple Summary

Identifying the anatomical structures involved in causing pain and an associated lameness in a horse typically requires assessment in straight lines and circles and using regional administration of local anesthetic drugs (diagnostic analgesia). Visual assessment of changes in movement are affected by bias, i.e., expected changes influence decisions. Quantitative measurements with inertial sensors aim at removing this bias. The current study is aimed at investigating how a specific data-driven method, linear discriminant analysis (LDA), may be useful for aiding veterinary decision making about perceived changes in lameness. Changes in movement data after diagnostic analgesia and expert judgements from 53 lame horses were used to study (a) the accuracy of LDA-based decision making, (b) differences between straight-line and circular movement and (c) which commonly used movement features are most useful in this context. Accuracy was comparatively low and varied considerably between 36% and 57%, indicating considerable overlap between movement symmetry data of the diagnostic analgesia categories. The best data-driven separation between categories was observed when the limb in which perineural anaesthesia had been performed was on the inside of the circle (on hard ground for forelimb and on soft ground for hindlimb diagnostic analgesia). Movement features of all three landmarks (head, withers, pelvis) were important for data-driven classification, emphasizing the complexity of the movement pattern changes after diagnostic analgesia observed in lame horses.

Abstract

Diagnostic analgesia and lunging are parts of the equine lameness examination, aiding veterinarians in localizing the anatomical region(s) causing pain-related movement deficits. Expectation bias of visual assessment and complex movement asymmetry changes in lame horses on the lunge highlight the need to investigate data-driven approaches for optimally integrating quantitative gait data into veterinary decision-making to remove bias. A retrospective analysis was conducted with inertial sensor movement symmetry data before/after diagnostic analgesia relative to subjective judgement of efficacy of diagnostic analgesia in 53 horses. Horses were trotted on the straight and on the lunge. Linear discriminant analysis (LDA) applied to ten movement asymmetry features quantified the accuracy of classifying negative, partial and complete responses to diagnostic analgesia and investigated the influence of movement direction and surface type on the quality of the data-driven separation between diagnostic analgesia categories. The contribution of movement asymmetry features to decision-making was also studied. Leave-one-out classification accuracy varied considerably (38.3–57.4% for forelimb and 36.1–56.1% for hindlimb diagnostic analgesia). The highest inter-category distances (best separation) were found with the blocked limb on the inside of the circle, on hard ground for forelimb diagnostic analgesia and on soft ground for hindlimb diagnostic analgesia. These exercises deserve special attention when consulting quantitative gait data in lame horses. Head and pelvic upward movement and withers minimum differences were the features with the highest weighting within the first canonical LDA function across exercises and forelimb and hindlimb diagnostic analgesia. This highlights that movement changes after diagnostic analgesia affect the whole upper body. Classification accuracies based on quantitative movement asymmetry changes indicate considerable overlap between subjective diagnostic analgesia categories.

Upper Body Movement Symmetry in Reining Quarter Horses during Trot In-Hand, on the Lunge and during Ridden Exercise

Veterinary lameness examinations often comprise assessing ridden horses. Quantitative movement symmetry measurements can aid evidence-based decision making. While these are available for ‘English’ style riding, they are not for ‘Western’ style riding. This quantitative observational study quantified movement symmetry in reining Quarter Horses (QHs). Movement symmetry of the head, withers and sacrum (differences between minima, maxima and upward amplitudes) were quantified with inertial sensors in N = 30 medium/high level reining QHs during trot in-hand, on the lunge and ridden by one experienced rider (straight-line/circles) on reining-purpose riding surfaces. Mixed linear models for movement symmetry assessed the effects of ridden exercise and movement direction (fixed factors), stride time (covariate) and horse (random factor): single factors and two-way interactions with Bonferroni correction at p < 0.05. Three withers and pelvic parameters showed marginally more symmetrical movement when ridden (p ≤ 0.044; 1−5 mm differences). Three withers, three sacrum and one head parameter were significantly affected by movement direction (all p ≤ 0.026), five showed increased asymmetry on the inside rein, and two, quantifying vertical displacement maximum difference, showed the opposite. Riding QHs in ‘Western’ style showed small movement symmetry differences. Circular exercise confirmed increases in weight bearing asymmetry on the inside rein and in pushoff asymmetry on the outside rein. This should be further investigated for differentiating between different causes of lameness.

The effect of horseshoes and surfaces on horse and jockey centre of mass displacements at gallop

Horseshoes influence how horses' hooves interact with different ground surfaces, during the impact, loading and push-off phases of a stride cycle. Consequently, they impact on the biomechanics of horses' proximal limb segments and upper body. By implication, different shoe and surface combinations could drive changes in the magnitude and stability of movement patterns in horse-jockey dyads. This study aimed to quantify centre of mass (COM) displacements in horse-jockey dyads galloping on turf and artificial tracks in four shoeing conditions: 1) aluminium; 2) barefoot; 3) GluShu; and 4) steel. Thirteen retired racehorses and two jockeys at the British Racing School were recruited for this intervention study. Tri-axial acceleration data were collected close to the COM for the horse (girth) and jockey (kidney-belt), using iPhones (Apple Inc.) equipped with an iOS app (SensorLog, sample rate = 50 Hz). Shoe-surface combinations were tested in a randomized order and horse-jockey pairings remained constant. Tri-axial acceleration data from gallop runs were filtered using bandpass Butterworth filters with cut-off frequencies of 15 Hz and 1 Hz, then integrated for displacement using Matlab. Peak displacement was assessed in both directions (positive 'maxima', negative 'minima') along the cranio-caudal (CC, positive = forwards), medio-lateral (ML, positive = right) and dorso-ventral (DV, positive = up) axes for all strides with frequency ≥2 Hz (mean = 2.06 Hz). Linear mixed-models determined whether surfaces, shoes or shoe-surface interactions (fixed factors) significantly affected the displacement patterns observed, with day, run and horse-jockey pairs included as random factors; significance was set at p<0.05. Data indicated that surface-type significantly affected peak COM displacements in all directions for the horse (p<0.0005) and for all directions (p≤0.008) but forwards in the jockey. The largest differences were observed in the DV-axis, with an additional 5.7 mm and 2.5 mm of downwards displacement for the horse and jockey, respectively, on the artificial surface. Shoeing condition significantly affected all displacement parameters except ML-axis minima for the horse (p≤0.007), and all displacement parameters for the jockey (p<0.0005). Absolute differences were again largest vertically, with notable similarities amongst displacements from barefoot and aluminium trials compared to GluShu and steel. Shoe-surface interactions affected all but CC-axis minima for the jockey (p≤0.002), but only the ML-axis minima and maxima and DV-axis maxima for the horse (p≤0.008). The results support the idea that hoof-surface interface interventions can significantly affect horse and jockey upper-body displacements. Greater sink of hooves on impact, combined with increased push-off during the propulsive phase, could explain the higher vertical displacements on the artificial track. Variations in distal limb mass associated with shoe-type may drive compensatory COM displacements to minimize the energetic cost of movement. The artificial surface and steel shoes provoked the least CC-axis movement of the jockey, so may promote greatest stability. However, differences between horse and jockey mean displacements indicated DV-axis and CC-axis offsets with compensatory increases and decreases, suggesting the dyad might operate within displacement limits to maintain stability. Further work is needed to relate COM displacements to hoof kinematics and to determine whether there is an optimum configuration of COM displacement to optimise performance and minimise injury.

Smartphone-Based Pelvic Movement Asymmetry Measures for Clinical Decision Making in Equine Lameness Assessment

Simple Summary

As visual evaluation of hindlimb lameness in the horse is challenging, objective measurements could aid clinical decision making. Our study investigated the association of pelvic movement asymmetry, recorded via a smartphone, with lameness scores of one experienced veterinarian. In general, cut-off points between lameness grades increased with increasing severity of lameness. Pelvic upward movement amplitude difference was the asymmetry parameter with the highest discriminative power based on subjective lameness scoring of a specialist veterinarian. This parameter classified a higher proportion of lame and non-lame horses correctly compared to the parameters assessing differences between pelvic vertical movement minima and maxima. Although the use of a smartphone measuring only the symmetry of pelvis cannot replace a full lameness examination, it presents a useful adjunct to subjective evaluation alone. Quantification of pelvic asymmetry with a smartphone may also be a useful tool in the context of tracking progress after a treatment or during the rehabilitation process.

Abstract

Visual evaluation of hindlimb lameness in the horse is challenging. Objective measurements, simultaneous to visual assessment, are used increasingly to aid clinical decision making. The aim of this study was to investigate the association of pelvic movement asymmetry with lameness scores (UK scale 0–10) of one experienced veterinarian. Absolute values of pelvic asymmetry measures, quantifying differences between vertical minima (AbPDMin), maxima (AbPDMax) and upward movement amplitudes (AbPDUp), were recorded during straight-line trot with a smartphone attached to the sacrum (n = 301 horses). Overall, there was a significant difference between lameness grades for all three asymmetry measures (p < 0.001). Five pair-wise differences (out of 10) were significant for AbPDMin (p≤ 0.02) and seven for AbPDMax (p≤ 0.03) and AbPDUp (p≤ 0.02). Receiver operating curves assessed sensitivity and specificity of asymmetry measures against lameness scores. AbPDUp had the highest discriminative power (area under curve (AUC) = 0.801–0.852) followed by AbPDMax (AUC = 0.728–0.813) and AbPDMin (AUC = 0.688–0.785). Cut-off points between non-lame (grade 0) and lame horses (grades 1–4) with a minimum sensitivity of 75% were identified as AbPDUp ≥ 7.5 mm (67.6% specificity), AbPDMax ≥ 4.5 mm (51.9% specificity) and AbPDMin ≥ 2.5 mm (33.3% specificity). In conclusion, pelvic upward movement amplitude difference (AbPDUp) was the asymmetry parameter with the highest discriminative power in this study.

Differential Rotational Movement of the Thoracolumbosacral Spine in High-Level Dressage Horses Ridden in a Straight Line, in Sitting Trot and Seated Canter Compared to In-Hand Trot

Assessing back dysfunction is a key part of the investigative process of "loss of athletic performance" in the horse and quantitative data may help veterinary decision making. Ranges of motion of differential translational and rotational movement between adjacent inertial measurement units attached to the skin over thoracic vertebrae 5, 13 and 18 (T5, T13, T18) lumbar vertebra 3 (L3) and tuber sacrale (TS) were measured in 10 dressage horses during trot in-hand and ridden in sitting trot/canter. Straight-line motion cycles were analysed using a general linear model (random factor: horse; fixed factor: exercise condition; Bonferroni post hoc correction: p < 0.05). At T5-T13 the differential heading was smaller in sitting trot (p ≤ 0.0001, 5.1° (0.2)) and canter (p ≤ 0.0001, 3.2° (0.2)) compared to trotting in-hand (7.4° (0.4)). Compared to trotting in-hand (3.4° (0.4)) at T18-L3 differential pitch was higher in sitting trot (p ≤ 0.0001, 7.5° (0.3)) and canter (p ≤ 0.0001, 6.3° (0.3)). At L3-TS, differential pitch was increased in canter (6.5° (0.5)) compared to trotting in-hand (p = 0.006, 4.9° (0.6)) and differential heading was higher in sitting trot (4° (0.2)) compared to canter (p = 0.02, 2.9° (0.3)). Compared to in-hand, reduced heading was measured in the cranial-thoracic area and increased in the caudal-thoracic and lumbar area. Pitch increased with ridden exercise from the caudal-thoracic to the sacral area.

How low can we go? Influence of sample rate on equine pelvic displacement calculated from inertial sensor data

BACKGROUND

Low-cost sensor devices are often limited in terms of sample rate. Based on signal periodicity, the Nyquist theorem allows determining the minimum theoretical sample rate required to adequately capture cyclical events, such as pelvic movement in trotting horses.

OBJECTIVES

To quantify the magnitude of errors arising with reduced sample rates when capturing biological signals using the example of pelvic time-displacement series and derived minima and maxima used to quantify movement asymmetry in lame horses.

STUDY DESIGN

Data comparison.

METHODS

Root mean square (RMS) errors between the 'reference' time-displacement series, captured with a validated inertial sensor at 100 Hz sample rate, and down-sampled time-series (8 Hz to 50 Hz) are calculated. Accuracy and precision are determined for maxima and minima derived from the time-displacement series.

RESULTS

Average RMS errors are <2 mm at 50 Hz sample rate, <4 mm at 40 Hz, <7 mm between 25 and 35 Hz, and increase to up to 20 mm at 20 Hz and below. Accuracy for maxima and minima is generally below 1mm. Precision is 1 mm at 50 Hz sample rate, 3 mm at 40Hz and ≥9 mm at 20 Hz and below.

MAIN LIMITATIONS

Only sample rate, no other sensor parameters were investigated.

CONCLUSIONS

Sample rate related errors for inertial sensor derived time-displacement series of pelvic movement are <2mm at 50 Hz, a rate that many low-cost loggers, smartphones or wireless sensors can sustain hence rendering these devices valid options for quantifying parameters relevant for lameness examinations in horses.

Jockey Perception of Shoe and Surface Effects on Hoof-Ground Interactions and Implications for Safety in the Galloping Thoroughbred Racehorse

Riding racehorses is a high-risk profession and optimizing safety alongside performance is paramount. Horseshoes play a critical role in providing traction with the ground surface and are therefore a major determinant of safety. However, the subjective perceptions of expert riders influence attitudes towards using different shoes and must be taken into consideration before any changes may be implemented. This study used a questionnaire-based method to evaluate jockey opinion of four shoeing conditions (aluminum, steel, GluShu, and barefoot) trialed at gallop over turf and artificial surfaces. Nine Lickert-style questions explored impact, cushioning, responsiveness, grip, uniformity, smoothness of ride, safety, adaptation period, and overall rating for each shoe-surface combination. A total of 94 questionnaires, based on 15 horse-rider pairs, were assessed using descriptive statistics and linear mixed models performed in SPSS (P < .05). Data indicate that shoe type significantly affected all question responses, with the exception of impact. Surface-type significantly affected perception of grip and safety. Overall, jockeys showed a preference for aluminum and steel shoes across both artificial and turf tracks. These rated "excellent" and were considered to be "very supportive" in approximately 80% of trials, with a 100% "active" response, good grip, and a quick adaptation period. In contrast, barefoot and GluShu conditions were generally considered "moderately supportive," with barefoot appearing favorable on the artificial surface. On turf, barefoot was deemed the least smooth and the only condition that jockeys sometimes marked "unsafe" (17% of responses). Future work aims to investigate the relationship between jockey opinion and hoof kinematic data.

Tranquilizer effect on the Lyapunov exponents of lame horses

Tranquilization of horses with acepromazine has been used to suppress erratic head movements and increase the accuracy of a lameness examination. Some equine clinicians believe that tranquilization with acepromazine will make lameness more evident by causing the horse to focus on adjusting its gait to avoid limb pain rather than its surroundings. The aim of this study was to investigate the effect of acepromazine on the Lyapunov exponents of lame horses. Ten lame horses were trotted in a straight line for a minimum of 25 strides. Kinematic data created by head movement were analyzed. Nonlinear analysis methods were applied to lame horse locomotion. The effect of acepromazine on the largest Lyapunov exponents of the lame horses were investigated. There was no statistically significant effect of acepromazine on the maximum value of Lyapunov exponents. The nonlinear dynamic methods can be used to analyze the gait in horses. Local stability of horse gait remains unchanged after the administration of acepromazine.

Range of motion and between-measurement variation of spinal kinematics in sound horses at trot on the straight line and on the lunge

Clinical assessment of spinal motion in horses is part of many routine clinical exams but remains highly subjective. A prerequisite for the quantification of spinal motion is the assessment of the expected normal range of motion and variability of back kinematics. The aim of this study was to objectively quantify spinal kinematics and between -measurement, -surface and -day variation in owner-sound horses. In an observational study, twelve owner-sound horses were trotted 12 times on four different paths (hard/soft straight line, soft lunge left and right). Measurements were divided over three days, with five repetitions on day one and two, and two repetitions on day three (recheck) which occurred 28-55 days later. Optical motion capture was used to collect kinematic data. Elements of the outcome were: 1) Ranges of Motion (ROM) with confidence intervals per path and surface, 2) a variability model to calculate between-measurement variation and test the effect of time, surface and path, 3) intraclass correlation coefficients (ICC) to determine repeatability. ROM was lowest on the hard straight line. Cervical lateral bending was doubled on the left compared to the right lunge. Mean variation for the flexion-extension and lateral bending of the whole back were 0.8 and 1 degrees. Pelvic motion showed a variation of 1.0 (pitch), 0.7 (yaw) and 1.3 (roll) degrees. For these five parameters, a tendency for more variation on the hard surface and reduced variation with increased repetitions was observed. More variation was seen on the recheck (p<0.001). ICC values for pelvic rotations were between 0.76 and 0.93, for the whole back flexion-extension and lateral bending between 0.51 and 0.91. Between-horse variation was substantially higher than within-horse variation. In conclusion, ROM and variation in spinal biomechanics are horse-specific and small, necessitating individual analysis and making subjective and objective clinical assessment of spinal kinematics challenging.

The Effect That Induced Rider Asymmetry Has on Equine Locomotion and the Range of Motion of the Thoracolumbar Spine When Ridden in Rising Trot

There is a paucity of evidence on the effect that rider asymmetry has on equine locomotion. The aim of this study was to evaluate the effect of rider asymmetry on equine locomotion by using a novel approach to induce rider asymmetry. Ten nonlame horses were recruited for this study. Joint center markers were used to capture 2D kinematics (Quintic Biomechanics) of the horse and rider and horses were equipped with seven inertial sensors positioned at the fifth (T5) and eighteenth (T18) thoracic vertebrae, third lumbar (L3) vertebra, tubera sacrale (TS), and left and right tubera coxae. Rider asymmetry was induced by shortening the ventral aspect of one stirrup by 5 cm. Kinematic data were compared between conditions using a mixed model with the horse defined as a random factor and stirrup condition (symmetrical stirrups and asymmetrical stirrups) and direction (inside and outside) defined as fixed factors. Data from riders where the right stirrup was shortened were mirrored to reflect a left stirrup being shortened. To determine differences between conditions, a significance of P ≤ .05 was set. On the rein with the shortened stirrup on the outside: an increase in lateral bending range of motion (ROM) at T5 (P = .003), L3 (P = .04), and TS (P = .02), an increase in mediolateral displacement at T5 (P = .04), T18 (P = .04), and L3 (0.03) were found. An increase in maximum fetlock extension was apparent for both the front (P = .01) and hind limb (P = .04) on the contralateral side to the shortened stirrup; for the asymmetrical stirrup condition on the rein with the shortened stirrup on the inside: an increase in flexion-extension ROM at T5 (P = .03) and L3 (P = .04), axial rotation at T5 (P = .05), and lateral bending of T5 (P = .03), L3 (P = .04), and TS (P = .02). Asymmetric rider position appears to have an effect on the kinematics of the thoracolumbar spine. These findings warrant further investigation to understand the long-term impact this may have on equine locomotor health.

Effect of meloxicam treatment on movement asymmetry in riding horses in training

Quantitative gait analysis has revealed that a large proportion of horses in training, perceived as free from lameness by their owners, show movement asymmetries of equal magnitude to horses with mild clinical lameness. Whether these movement asymmetries are related to orthopaedic pain and/or pathology has yet to be further investigated. Therefore, the objective of this study was to determine whether movement asymmetries in riding horses in training are affected by anti-inflammatory treatment with meloxicam. In a crossover design, horses were treated with meloxicam or placebo for four days respectively, with a 14–16 day washout period between treatments. Objective movement analysis utilising body mounted accelerometers was performed on a hard and a soft surface before and on day four of each treatment. A trial mean was calculated for the differences between the two vertical displacement minima and maxima of head (HDmin, HDmax) and pelvis (PDmin, PDmax) per stride. Horses (n = 66) with trial mean asymmetries greater than 6 mm for HDmin or HDmax, or more than 3 mm for PDmin or PDmax, at baseline were included. The difference before and after each treatment in the measured movement asymmetry was assessed with linear mixed models. Treatment with meloxicam did not significantly affect the movement asymmetry in any of the models applied (all p>0.30). These results raise new questions: are the movement asymmetries in riding horses in training simply expressions of biological variation or are they related to pain/dysfunction that is non-responsive to meloxicam treatment?

Sensor-based equine gait analysis: more than meets the eye?

Quantitative gait analysis in the lame horse has gained in popularity, likely related to the potential to remove bias from the clinical decision-making process. Its implementation into clinical practice is, however, not without challenges. This review visits some of the challenges related to the use of thresholds and guideline values in the context of clinical decision making, as well as when applied to scientific studies based on relevant published studies: issues such as ‘normal day-to-day variation’, conformational asymmetry and the often limited number of parameters that are being quantified. Emphasis is put on outlining the basic underlying principles relating to head nod and hip hike, which are explained in the context of Newtonian mechanics associating reduced vertical acceleration of the upper body to reduced force production with the limb that is in contact with the ground during that time period. Further to quantifying what can be seen ‘by eye’, the review also visits phenomena such as asymmetries in weight bearing or pushoff and compensatory mechanisms, with emphasis on measurement of withers movement and thoughts about multilimb lameness. The review concludes with thoughts about additional parameters such as limb movement and movement of the thoraco-lumbo-sacral area, which may provide additional insights into lameness and poor performance but are at current less frequently included into clinical gait analysis in the horse.

Variation in gait parameters used for objective lameness assessment in sound horses at the trot on the straight line and the lunge

Background

Objective lameness assessment is gaining more importance in a clinical setting, necessitating availability of reference values.

Objectives

To investigate the between ‐path, ‐trial and ‐day variation, between and within horses, in the locomotion symmetry of horses in regular use that are perceived sound.

Study design

Observational study with replicated measurement sessions.

Methods

Twelve owner‐sound horses were trotted on the straight line and on the lunge. Kinematic data were collected from these horses using 3D optical motion capture. Examinations were repeated on 12 occasions over the study which lasted 42 days in total. For each horse, measurements were grouped as five replicates on the first and second measurement days and two replicates on the third measurement day. Between measurement days 2 and 3, every horse had a break from examination of at least 28 days. Previously described symmetry parameters were calculated: RUD and RDD (Range Up/Down Difference; difference in upward/downward movement between right and left halves of a stride); MinDiff and MaxDiff (difference between the two minima/maxima of the movement); HHDswing and HHDstance (Hip Hike Difference‐swing/‐stance; difference between the upward movement of the tuber coxae during swingphase/stancephase). Data are described by the between‐measurement variation for each parameter. A linear mixed model was used to test for the effect of time, surface and path. Intraclass correlation coefficients (ICC) were calculated to access repeatability.

Results

Mean between‐measurement variation was (MinDiff, MaxDiff, RUD, RDD): 13, 12, 20, 16 mm (head); 4, 3, 6, 4 mm (withers) and 5, 4, 6, 6 mm (pelvis); (HHDswing, HHDstance): 7 and 7 mm. More between‐measurement variation is seen on the first measurement day compared to the second and third measurement days. In general, less variation is seen with increasing number of repetitions. Less between‐measurement variation is seen on hard surface compared to soft surface. More between‐measurement variation is seen on the circle compared to the straight line. Between‐horse variation was clearly larger than within‐horse variation. ICC values for the head, withers and pelvis symmetry parameters were 0.68 (head), 0.76 (withers), 0.85 (pelvis).

Main limitations

Lunge measurements on a hard surface were not performed.

Conclusions

Between‐measurement variation may be substantial, especially in head motion. This should be considered when interpreting clinical data after repeated measurements, as in routine lameness assessments.