Clinical objective assessment of diagnostic anaesthesia and investigation of compensatory lameness in the horse

SF600 Veterinary Medicine

Maliye, Sylvia ; Marshall, John F.

University:University of Glasgow

Department:School of Veterinary Medicine

关键词: equine lameness, orthopaedics, diagnostic anaesthesia, compensatory lameness, forelimb, hindlimb, inertial sensor-based, objective;   

Others  :  http://theses.gla.ac.uk/6430/7/2015maliyemvm.pdf

来源: University of Glasgow

【 摘 要 】

Objectives: Objective assessment of lameness in a clinical setting has been limited by the need for complex equipment. The introduction of a commercially available inertial sensor-based system of lameness diagnosis has made objective lameness assessment clinically available. The objective of the first part of this study was to validate the use of an inertial sensor-based system of lameness diagnosis to objectively identify a positive response to diagnostic anaesthesia of the equine foot. The second part of the study objectively examined clinical compensatory lameness, investigating the relationship between primary and compensatory lameness.Study design: A retrospective study of data obtained from horses that underwent clinical diagnostic anaesthesia while instrumented with an inertial sensor-based system of lameness diagnosis between August 2011 and October 2014 was performed.Method: Horses were grouped as positive or negative (referring to the change to lameness) depending on the response to diagnostic anaesthesia. Those horses categorized as positive were further grouped into those with forelimb lameness only, hindlimb lameness only, ipsilateral limb lameness, or contralateral limb lameness. Kinematic parameters of head and pelvic movement asymmetry were measured and the change in the parameters was calculated. The effect of diagnostic anaesthesia was determined using the Mann-Whitney rank sum test.Results:Assessment of local anaesthesia of the foot in horses with forelimb lameness: A positive response to diagnostic anaesthesia resulted in a significant improvement to the symmetry of movement in the affected limb. ROC curve analysis showed that the change in head movement asymmetry (vector sum) is an excellent diagnostic test (AUC=1.0).Forelimb compensatory lameness study: Improvement in forelimb lameness resulted in a significant decrease in pelvic movement asymmetry associated with the contralateral hindlimb (p<0.05). This was associated with improvement in push-off from the contralateral limb (p<0.01).Hindlimb compensatory lameness study:Improvement in hindlimb lameness resulted in a significant decrease in head movement asymmetry associated with the ipsilateral forelimb (p<0.05).Conclusions: It is possible to classify changes that occur and assess the response following a diagnostic anaesthesia procedure using an inertial sensor-based system of lameness diagnosis. Significant change to hindlimb movement following diagnostic anaesthesia of the forelimb in horses with forelimb lameness was demonstrated. In addition, significant change to forelimb movement following diagnostic anaesthesia of the hindlimb of horses with hindlimb lameness was demonstrated. In summary, this study supports the use of the inertial sensor-based system of lameness diagnosis in objective assessment of lameness in the horse, and provides significant evidence to support the “law of sides” in horses with naturally occurring lameness. Furthermore, the objective assessment of lameness is possible in a range of clinical settings.