Use and repeatability of 3D light scanning to measure transverse dorsal profile size and symmetry in the thoracic region in horses

Equine epaxial muscle size, thoracolumbar profile and symmetry in horses is of clinical interest due to relationships with pain and pathology. Flexible-curve rulers have previously been used to gather reliable, objective measures of thoracic profile, however, 3D light-scanning offers a potential non-contact alternative method to estimate cross sectional area (CSA) of the region. 3D light-scans of the thoracic epaxial region were taken from ten endurance horses (7 geldings, 3 mares; 8±2 years). Total CSA of the combined epaxial musculature, using computer software, was calculated at scapula and T18 levels (depth: 15 cm). Intra and inter-rater (n=3) reliability of CSA measurements was assessed using Friedman’s analyses and post-hoc Wilcoxon rank tests (three repeated measures). Intraclass correlation estimates (ICC ± 95% confidence intervals (CI)) were calculated (mean-rating, absolute-agreement, 2-way mixedeffects model). Paired t-tests assessed differences between right and left areas. No significant differences existed for transverse plane-cuts (scapula, T18 P>0.05) between light-scans. Right and left areas were significantly different at the withers (P=0.012) with the left side larger in 70% of scans, but no significant differences were found between sides at T18. No differences existed for different plane-cuts of the same horse (P=0.53; ICC: 0.76; CIs: 0.43-0.92). While reliability was reduced between all raters (P=0.02; ICC: 0.70; CIs: 0.56-0.82), no significant differences occurred between two different assessors experienced in using the software (P=0.88; ICC: 0.90; CIs: 0.82-0.95). Intra-rater reliability for assessing thoracic profile and inter-rater reliability ICC values with experienced analysts was interpreted as good/excellent. The results suggest 3D light-scanning is an objective, non-invasive method to record size and symmetry of the epaxial region in horses and warrants validity testing against current measurement methods such as the flexible-curve ruler.

Markers of muscle atrophy and impact of treatment with pergolide in horses with pituitary pars intermedia dysfunction and muscle atrophy

Pituitary pars intermedia dysfunction (PPID) is a common endocrine disorder of aged horses, with muscle atrophy as one of the clinical signs. We sought to compare muscle mass and regulation of skeletal muscle proteolysis between horses with PPID and muscle atrophy to older horses without PPID, and to assess the impact of treatment with pergolide (dopaminergic agonist) on PPID horses. We hypothesized that PPID-associated muscle atrophy is a result of increased proteolysis, and that markers of muscle atrophy and proteolysis would improve over time with pergolide treatment. Markers of muscle atrophy, adiposity, insulin regulation, skeletal muscle composition, and proteolysis (muscle atrophy F- box/atrogin 1 [MAFbx1], muscle RING finger 1 [MuRF1], Bcl2/adenovirus EIV 19kD interacting protein 3 [Bnip3], and microtubule-associated light chain 3 [LC3]) were compared between PPID and control horses. PPID horses were treated for 12 weeks with either pergolide or placebo. Dose of pergolide was adjusted based upon monthly measurement of adrenocorticotropin, and markers of muscle atrophy, adiposity, insulin regulation, skeletal muscle composition, and proteolysis were compared after 12 weeks of treatment. Horses with PPID exhibited increased transcript abundance of MuRF1 (P= 0.04) compared to control. However, no difference was observed in transcript abundance of markers of proteolysis with treatment (P ≥ 0.25). Pergolide treated horses lost weight (P = 0.02) and improved fasting insulin (P = 0.02), while placebo treated horses gained weight and rump fat thickness (P = 0.02). Findings from this study suggest that treatment with pergolide may promote weight loss and improve insulin regulation in horses with PPID, but does not impact muscle mass or markers of muscle proteolysis.

Objective measurement in equine physiotherapy

Objective measurement should be incorporated into all areas of physiotherapy including within the assessment and treatment of horses, as there is a need to evaluate the effectiveness of treatment intervention objectively. Whilst objective measures are available in a research laboratory setting it appears that in clinical practice mostly subjective methods of recording assessment and reassessment data are used. This article reviews the objective measures currently available to equine physiotherapists for use in clinical practice, beyond those available in a research laboratory setting. Within the literature there are studies reporting the reliability and validity of objective measures for the assessment of pain, gait, posture, range of motion, palpation and muscle size in horses. Whilst these validated objective measurement tools are available, they are not presently used consistently in clinical practice. In addition, the non-verbal nature of the equine patients precludes the use of self-reporting, meaning that there are no reported functional outcome scores possible similar to use with human patients. However, the combined use of pain responses, behavioural changes and objective measures collected during clinical assessment, both pre and post treatment, could be useful in practice. Equine physiotherapists should integrate more objective methods of recording data from assessments of horses.

Generation of Domains for the Equine Musculoskeletal Rehabilitation Outcome Score: Development by Expert Consensus

Simple Summary

Within rehabilitation, measurements taken before, during and after treatments are used to judge patient progress and the effectiveness of prescribed treatments. To know which measurements to use for a given health condition, practitioners must have knowledge of what should be measured, which measurement tools are available and accurate, alongside what they intend to measure. Composite outcome measures (OMs) are tools which use grouped measurement tests to monitor patient progress; they have been tested for a variety of human and canine conditions but none have been designed or tested for use in physical rehabilitation in horses. This study asked leading equine veterinarians, physiotherapists and researchers which measures should be included in an OM for use in the rehabilitation of horses. Using a process to evaluate agreement, ten areas of measurement were included in the final model: lameness, pain at rest, pain during exercise, behaviour during exercise, muscular symmetry, performance/functional capacity, behaviour at rest, palpation, balance and proprioception. Existing reliable tests used to measure these areas were evaluated and potential new measures discussed and now should be taken forward to testing as a composite outcome score to see if they are effective in measuring effectiveness of treatment.

Abstract

Outcome measures (OMs) are a requirement of professional practice standards in human and canine physiotherapy practice for measurement of health status. Measures such as pain and functional capacity of specific regions are used to track treatment impact and can be used to develop optimal management strategies. To achieve comparable patient care in equine physiotherapy, OMs must be incorporated into practice; however, no reliable and valid OMs exist for equine rehabilitation. This study utilised the experience and opinion of a panel of experts working in the equine rehabilitation sphere to gain consensus on the core areas (domains) to be included in a model, to lead to an OM scale for horses undergoing rehabilitation. The Delphi method and content validity ratio testing was used to determine agreement with domains reaching the critical value required for inclusion. The expert panel agreed on ten domains to be included in the OM scale: lameness, pain at rest, pain during exercise, behaviour during exercise, muscular symmetry, performance/functional capacity, behaviour at rest, palpation, balance and proprioception. An OM with these domains would provide a holistic objective assessment tool which could be used by equine rehabilitation professionals in clinical practice.

The Effect of Season on Muscle Growth, Fat Deposition, Travel Patterns, and Hoof Growth of Domestic Young Horses

Our objective was to determine the influence of season (winter, spring, summer, and fall) on travel patterns, hoof growth, and longissimus dorsi muscle (LM) height and fat thickness between 13th and 14th ribs in 16 horses aged <4 years (eight males and eight females) of Morgan, Quarter Horse, and Moriesian breeds. Real-time ultrasound images of LM height and fat thickness as well as measures of hoof growth were obtained at the end of each season. Global positioning system tracking was conducted for four randomly selected days and one storm day in each season. Data were analyzed using a linear mixed model procedure in SAS. Season influenced fat deposition (P < .01) with the greatest increase in fall (P < .05) but had minimal effect on muscle growth. Hoof growth was greatest in summer and least in winter (P < .01). The average distance traveled was greater in spring and summer than in fall and winter (P < .01). The horses moved for less time and traveled less distance on storm days (P < .05) compared with nonstorm days. Young horses also traveled less on storm days, which indicates that it may be especially important to provide shelter for them. It was concluded that season influenced fat deposition, distance traveled, and hoof growth of domestic young horses. A better understanding of these factors could help equine professionals manage young horses more efficiently to benefit the horses' physical well-being.

Muscle growth in young horses: Effects of age, cytokines, and growth factors

Success as equine athletes requires proper muscle growth in young horses. Muscle hypertrophy occurs through protein synthesis and the contribution of muscle satellite cells, which can be stimulated or inhibited by cytokines and growth factors present during exercise and growth. The hypotheses of this study were that 1) the LM area in young horses would increase over 1 yr, and 2) specific cytokines and growth factors (IL-1β, IL-6, tumor necrosis factor [TNF]-α, IGF-I, and fibroblast growth factor [FGF]-2) would alter proliferation and differentiation of satellite cells isolated from young horses. Fourteen horses were divided into 3 age groups: weanlings ( = 5), yearlings to 2 yr olds ( = 4), and 3 to 4 yr olds ( = 5). The area, height, and subcutaneous fat depth of the LM were measured using ultrasonography, and BW and BCS were taken in October (Fall1), April (Spring), and October of the following year (Fall2). Satellite cells obtained from 10-d-old foals ( = 4) were cultured in the presence of IL-6, IL-1β, TNF-α, IGF-I, or FGF-2 before evaluation of proliferation and differentiation. Data were analyzed using PROC MIXED in SAS. Body weight increased from Fall1 to Spring in weanlings ( < 0.001) and increased in all horses from Spring to Fall2 ( ≤ 0.02). Area and height of the LM increased over time ( < 0.001) and with increasing age group of horse ( ≤ 0.03), although there was no interaction of time and age ( > 0.61). There was a significant increase in LM area in all animals from Spring to Fall2 ( < 0.001) but not from Fall1 to Spring. Interleukin-6 and TNF-α decreased satellite cell proliferation by 14.9 and 11.5%, respectively ( ≤ 0.01). Interleukin-6 increased fusion 6.2%, whereas TNF-α decreased fusion 8.7% compared with control cells ( ≤ 0.001). Interleukin-1β had no effect on proliferation ( = 0.32) but tended to decrease fusion ( = 0.06). Satellite cell proliferation was increased 28.8 and 73.0% by IGF-I and FGF-2, respectively ( < 0.0001). Differentiation was decreased 13.1% in the presence of FGF-2 but increased 3.5% in the presence of IGF-I ( ≤ 0.01). In summary, the LM area increases over the course of a year in young horses with the most growth occurring in summer. By stimulating or inhibiting proliferation and differentiation of satellite cells, IL-6, TNF-α, IL-1β, IGF-I, and FGF-2 may alter muscle growth in young horses, thereby impacting athletic potential.