Visually Assessing Equine Quality of Movement: A Survey to Identify Key Movements and Patient-Specific Measures.

Outcome measures are essential for monitoring treatment efficacy. The lack of measures for quality of movement in equine physiotherapy and rehabilitation impairs evidence-based practice. To develop a new field-based outcome measure, it is necessary to determine movements most frequently observed during assessment of rehabilitation and performance management cases. An online survey of 81 equine sports medicine veterinarians and equine allied-health clinicians was conducted. The key movements identified included walk and trot on both firm and soft surfaces in a straight line and on a small circle, plus step back, hind leg cross-over, transitions and lunging at walk, trot and canter. The main barriers to observing some movements are access to suitable surfaces and the training level of the horse and handler. Subjective visual assessment of live or videoed horses was the most common method used to track progress of complex movements. The majority (82%) of survey participants agreed or strongly agreed that a modified Patient-Specific Functional Scale would be useful for measuring complex movements. Comments from all professions show a desire to have outcome measures relevant to their needs. This survey identified 24 in-hand movements, which can be used to form the foundation of a simple field-based outcome measure for quality of movement.

Injury Risk Factors Associated With Training and Competition in Flyball Dogs.

Flyball is a fast-paced, high-energy canine sport which has received negative press regarding the potential for injury, and possible welfare implications for canine competitors. Whilst frequency of injury within the sport has been investigated, evidence gaps remain regarding cause. The aim of this study was therefore to identify risk factors for injury within the sport, with a view to improving competitor safety. An online questionnaire was used to obtain data on dogs that had competed in flyball in the last 5 years but remained injury free, and a second questionnaire obtained data on dogs that had also competed within the last 5 years but sustained an injury. Data relating to conformation and performance was collected for 581 dogs, with the same data plus information relating to injury collected from an additional 75 injured dogs. Data were then compared using univariable, multivariable and multinomial logistic regression. Dogs completing a flyball course in less than 4 seconds had the highest level of injury risk (P = .029), which reduced as time taken increased. There was an association between risk of injury and increasing age, with dogs over 10 years old most likely to be injured during their career in the sport (P = .004). Furthermore, dogs using an angle of flyball box of between 45° and 55° had a greater risk of injury, while using an angle between 66° and 75° reduced the risk of injury by 67.2% (OR: 0.328). Use of carpal bandaging was significantly associated with carpal injuries (P = .042). These findings identify new risk factors for injury within flyball which can be used to improve welfare and safety for competitors.

An exploration of clinical reasoning and practices used by physiotherapists in the rehabilitation of horses following interspinous ligament desmotomy surgery.

INTRODUCTION: Clinical reasoning has not been studied in veterinary physiotherapy and so the methods used and factors involved are unknown. Similarly, the practices of veterinary physiotherapists within a certain rehabilitation programme have not been documented. The aim of this study was to explore the clinical reasoning and practices of veterinary physiotherapists during rehabilitation of horses following interspinous ligament desmotomy surgery. METHODOLOGY: A qualitative approach was taken and six members of the Association of Chartered Physiotherapists in Animal Therapy were interviewed using a semi-structured approach. The data were transcribed and analysed using Thematic Analysis. RESULTS: Five themes were identified as relevant to the participants clinical reasoning. These related to structure of the assessment, modalities and reasoning of treatment, involvement of owner and veterinarian and the impact of comorbidities. The data highlight several different factors that influence clinical reasoning and decision making throughout the rehabilitation. An insight into practices involved is also documented. CONCLUSION: The process of clinical reasoning and decision making described appears complex. The input of both owner and veterinarian are evidently important and require the physiotherapists consideration. Decisions regarding assessment and treatment are influenced by many factors. A mixture of clinical experience and research evidence were used as support.

An Investigation into the Effects of Changing Dorso-Plantar Hoof Balance on Equine Hind Limb Posture.

Links between poor hind hoof balance, pathologies in the hind limb and associated altered posture have been suggested but not quantified. The hoof is proposed as a neuro-sensory organ responsible for informing equine stance with implications for musculoskeletal health in the hind limb and trunk of the horse. This study aims to quantify equine limb posture and its relationship with hoof balance. Twelve horses presenting with negative plantar angles were photographed and limb posture documented before and after the creation of positive plantar angles and improved three-dimensional proportions around the centre of rotation of the distal-interphalangeal joint, using farriery prosthetics. The results showed that horses presenting with negative plantar angles had canted-in postures and that farriery intervention had a significant effect on hind limb orientation in seven of these horses. There was a significant difference in metatarsal angle pre and post intervention with the mean for pre intervention being 81.3° ± 5.1 and post intervention being 88.0° ± 3.8 in the right hind and 74.4° ± 3.7 and 87.1° ± 2.9 in the left hind. The findings of this study support the hypothesis that the hoof balance informs equine stance and can play a role in affecting limb posture.

The Effect of a Physiotherapy Intervention on Thoracolumbar Posture in Horses.

Dynamic mobilisation exercises (DME) are often used as part of a physiotherapy rehabilitation programme. Whilst immediate kinematic effects have been measured, the change in posture is anecdotally reported to have a longer duration. This study aimed to test the reliability of a simple objective measurement method, suitable for use in clinical practice, and to objectively measure equine thoracolumbar posture, before and after DME. A single investigator took triplicate measurements of the sagittal thoracolumbar shape using a flexicurve ruler (FCR) then triplicate measurements of the thoracolumbar shape using an adapted FCR (aFCR) in 37 horses. Subsequently, the thoracolumbar shape of 12 horses was measured using the aFCR before random allocation into two groups. Six horses acted as a control group and six horses underwent a series of DME, which included cervical flexion and lateral flexion baited stretches. Measurements were repeated prior to DME, at thirty minutes, one hour and at twenty-four hours after DME to assess thoracolumbar posture. The aFCR ruler had excellent intra-rater reliability compared to a standard FCR (aFCR: p = 0.146; intraclass correlation coefficient (ICC) 0.971; FCR: p = 0.0001; ICC 0.979). Significant increases in flexion occurred in the thoracolumbar region at 30 min (p = 0.027) and one hour (p = 0.046) after DME, but not at 24 h (p > 0.05) with no significant differences in the control group (p > 0.05) between baseline and subsequent times. The results suggest DME create a short-term postural change, determined by using an aFCR, which supports their use as part of a veterinary physiotherapy rehabilitation programme.

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

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.

Inter- and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.

Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently using subjective tools such as manual palpation. Reliable and valid objective measures are required and use of a pressure algometer (PA) has been investigated as an assessment tool; however, it has limitations, and other more realistic methods may be better suited for the task. The aim of the study was to establish inter- and intra-rater reliability for PA, FlexiForce Sensor (FFS), and manual palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses. In group 1, 10 horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three Association of Chartered Physiotherapists in Animal Therapy (ACPAT) Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter. Manual palpation showed excellent interrater reliability with no significant differences between scores (P = .64; intraclass correlation coefficient [ICC] 90.0%). PA (P = .002) and FFS (P = .025) scores significantly differed between experimenters. Intrarater testing showed significant differences (P = .014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (P = .347; ICC 94.7%) in repeated measures with excellent reliability and consistency. The PA showed a lack of consistency in intrarater reliability conflicting with previous research findings, whereas the FFS showed greater reliability in comparison; however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent interrater reliability when using a categorical scoring system.

Kinematic analysis of the thoracic limb of healthy dogs during descending stair and ramp exercises.

OBJECTIVE To compare the kinematics of the thoracic limb of healthy dogs during descent of stairs and a ramp with those during a trot across a flat surface (control). ANIMALS 8 privately owned dogs. PROCEDURES For each dog, the left thoracic limb was instrumented with 5 anatomic markers to facilitate collection of 2-D kinematic data during each of 3 exercises (descending stairs, descending a ramp, and trotting over a flat surface). The stair exercise consisted of 4 steps with a 35° slope. For the ramp exercise, a solid plank was placed over the steps to create a ramp with a 35° slope. For the flat exercise, dogs were trotted across a flat surface for 2 m. Mean peak extension, peak flexion, and range of movement (ROM) of the shoulder, elbow, and carpal joints were compared among the 3 exercises. RESULTS Mean ROM for the shoulder and elbow joints during the stair exercise were significantly greater than during the flat exercise. Mean peak extension of the elbow joint during the flat exercise was significantly greater than that during both the stair and ramp exercises. Mean peak flexion of the elbow joint during the stair exercise was significantly greater than that during the flat exercise. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that descending stairs may be beneficial for increasing the ROM of the shoulder and elbow joints of dogs. Descending stair exercises may increase elbow joint flexion, whereas flat exercises may be better for targeting elbow joint extension.

Peak forelimb ground reaction forces experienced by dogs jumping from a simulated car boot.

Many dog owners allow their pets to jump out of a car boot; however, to date, there has been no study that has investigated whether this places dogs at risk of injury. The aim of this study was to investigate the relationship between height and peak vertical ground reaction force (vGRF) in static start jumps. Fifteen healthy adult dogs performed three jumps from a platform that represented common vehicle boot sill heights (0.55, 0.65, 0.75 m), landing on a single force platform. Kinetic data (mediolateral (Fx), craniocaudal (Fy) and vertical (Fz)) were normalised for body weight and analysed via a one-way repeated analysis of variance (ANOVA) and pairwise post hoc tests with a Bonferroni correction applied. There was a significant difference in peak forelimb vGRF between both the 0.55 m (27.35±4.14 N/kg) and the 0.65 m (30.84±3.66 N/kg) platform (P=0.001) and between the 0.65 and 0.75 m (34.12±3.63 N/kg) platform (P=0.001). There was no significant difference in mediolateral or craniocaudal forces between the heights examined. These results suggest that allowing dogs to jump from bigger cars with a higher boot sill may result in augmented levels of loading on anatomical structures. Further research is required to investigate the kinematic effects of height on static jump-down and how peak forelimb vGRF relates to anatomical loading and subsequent injury risk.