Upper body movement analysis of multiple limb asymmetry in 367 clinically lame horses

Background Compensatory lameness is common in horses and evaluation can be challenging. Objectives To investigate patterns of compensatory movements in clinical cases with fore- or hindlimb lameness before and after diagnostic analgesia. Study design Retrospective clinical study. Methods Multiple limb lameness of 367 horses was characterised by type (push-off, impact or mixed), limb (fore- or hindlimb in predominant lameness) and side (ipsi- or contralateral in concurrent lameness) using a body-mounted inertial sensor (BMIS). Diagnostic analgesia was performed until the percentage improvement of the vector sum in forelimb lameness and the mean difference of the maximum or minimum pelvic height (PDmax or PDmin) in hindlimb lameness was >= 50%. Linear mixed model and post-estimation of effects were performed by contrast command with multiple comparisons adjusted by Bonferroni method. Correlation of pre- and post-analgesia of all head and pelvis asymmetry parameters was tested with Spearman's rank correlation. Results Improvement in vector sum per mm after diagnostic analgesia in forelimb impact lameness positively correlated with decrease in PDmax in contralateral mixed lameness (0.187 mm, r = .58, P < .05). Improvement in PDmin per mm after diagnostic analgesia in hindlimb mixed and PDmax in hindlimb push-off lameness decreased vector sum in ipsilateral forelimb impact lameness by 0.570 and 0.696 mm, respectively (P < .05), with no positive correlation. Main limitations A variety of cases with inhomogeneous distribution of lameness patterns was investigated retrospectively, therefore, it is impossible to distinguish between true multiple limb lameness and compensatory lameness in this clinical material. Conclusions Various asymmetry patterns of concurrent lameness were seen in horses with naturally occurring primary forelimb impact lameness with contralateral compensatory hindlimb lameness with a mixed component being the most common. In horses with hindlimb lameness, compensatory movements were seen in ipsilateral forelimbs, mostly as an ipsilateral impact lameness during straight line trot

Functional Locomotor Consequences of Uneven Forefeet for Trot Symmetry in Individual Riding Horses

ABSTRACT: Left-right symmetrical distal limb conformation can be an important prerequisite for a successful performance, and it is often hypothesized that asymmetric or uneven feet are important enhancing factors for the development of lameness. On a population level, it has been demonstrated that uneven footed horses are retiring earlier from elite level competition, but the biomechanical consequences are not yet known. The objectives of this study were to compare the functional locomotor asymmetries of horses with uneven to those with even feet. Hoof kinetics and distal limb kinematics were collected from horses (n = 34) at trot. Dorsal hoof wall angle was used to classify horses as even or uneven (1.5° difference between forefeet respectively) and individual feet as flat (55°). Functional kinetic parameters were compared between even and uneven forefeet using MANOVA followed by ANOVA. The relative influences of differences in hoof angle between the forefeet and of absolute hoof angle on functional parameters were analysed using multiple regression analysis (P<0.05). In horses with uneven feet, the side with the flatter foot showed a significantly larger maximal horizontal braking and vertical ground reaction force, a larger vertical fetlock displacement and a suppler fetlock spring. The foot with a steeper hoof angle was linearly correlated with an earlier braking-propulsion transition. The conformational differences between both forefeet were more important for loading characteristics than the individual foot conformation of each individual horse. The differences in vertical force and braking force between uneven forefeet could imply either an asymmetrical loading pattern without a pathological component or a subclinical lameness as a result of a pathological development in the steeper foot

Ist es von Bedeutung, wer Feedback niederschreibt? Die Wirkung des Ausfüllens einer Feedbackkarte durch Lehrende vs. Studierende während der klinischen Rotationen im veterinärmedizinischen Studium

Objective: Despite the fact that feedback (FB) provided by teachers to students is a recognised, effective teaching tool, successful use of feedback during clinical training depends on many factors. In addition to appropriate training and attitude of teachers, sustainable feedback requires an appropriate teaching culture and active commitment on the part of the students to receive, accept and use FB. This study examines the use of two different clinical encounter cards (CECs) during clinical rotation and investigates whether students take a more active part in the feedback process when using these cards. The objective of this study is to test whether it has a positive effect if students write down FB themselves and to verify this positive effect.Methodology: 161 students in their 9th semester of veterinary studies each had to use two clinical encounter cards (types 1 and 2) during their rotations on 10 wards. For this, students had to ask teachers for FB before starting a clinical activity. The oral FB given by the teachers was either written down on the CEC by the teachers (CEC type 1) or by the students (CEC type 2). Furthermore, the students were asked to assess their own performance by means of anchor criteria and to evaluate the quality of the FB provided by the teachers. Based on the entries in the CECs submitted, the following indicators for both CEC types could be calculated: (1) FB quantity and quality (length and specificity), (2) differentiation of self-assessment, as well as (3) level of satisfaction with the FB provided by the teachers.Results: With 2,377 CECs submitted, the mean CEC return rate was 74%. 99% of the cards showed positive FB, 69% contained constructive FB with suggestions for improvement, and 87% suggested specific next steps. On average, the FB written down by teachers was longer (12.4 versus 9.7 words) and more specific (1.9 versus 1.7 out of 3) than FB written down by students. Length and specificity decreased in the course of the semester. Neither the differentiation of self-assessment (proportion of differentiated entering of self-assessment) nor the students' level of satisfaction with the FB differed between the two examined CEC variants.Conclusion: The use of CECs across the cohort was successfully possible; however, the fact that students formulated and wrote down the FB themselves did not result in more comprehensive or more specific FB. Self-assessment and level of satisfaction with the teachers' FB remained unchanged.Zielsetzung: Feedback (FB) von Lehrenden an Studierende ist zwar ein anerkanntes, effektives Lehrmittel, ein erfolgreicher Einsatz in der klinischen Ausbildung aber von vielen Faktoren abhängig. Für ein nachhaltiges FB ist, neben einer entsprechenden Ausbildung und Einstellung der Lehrenden, eine entsprechende Lehrkultur nötig sowie ein aktives Engagement der Studierenden, um FB zu erhalten, anzunehmen und zu nutzen. In dieser Studie werden zwei verschiedene FB-Karten ("clinical encounter cards", CECs) während klinischer Rotationen eingesetzt und es wird untersucht, ob damit den Studierenden eine aktivere Rolle im Feedbackprozess gegeben werden kann. Als Hypothese wurde ein positiver Einfluss des eigenhändigen Niederschreibens von FB durch Studierenden postuliert und überprüft.Methodik: 161 Studierende im neunten Semester des Studiums Veterinärmedizin mussten während ihrer Rotationen auf 10 Stationen je zwei FB-Karten (Typ 1 und 2) nutzen. Dabei mussten die Studierenden vor einer klinischen Tätigkeit die zuständigen Lehrenden um FB bitten. Das von den Lehrenden mündlich gegebene FB wurde entweder von den Lehrenden (CEC Typ 1) oder von den Studierenden (CEC Typ 2) in die CEC aufgeschrieben. Weiters wurden die Studierenden aufgefordert, ihre eigene Leistung mittels Ankerkriterien zu bewerten und die Qualität des FB der Lehrenden zu beurteilen. Mittels der Eintragungen auf den abgegebenen CECs konnten die folgenden Indikatoren für beide CEC-Typen berechnet werden: (1) Quantität und Qualität des FB (Umfang und Spezifität), (2) Differenziertheit der Selbstbeurteilung, sowie (3) Zufriedenheit mit dem FB der Lehrenden.Ergebnisse: Mit 2377 CECs lag die mittlere Rücklaufquote der CEC bei 74%. In 99% der Karten war positives FB eingetragen, bei 69% konstruktives FB mit Verbesserungsvorschlägen und bei 87% wurden konkrete nächste Schritte vorgeschlagen. Durchschnittlich schrieben Lehrende längeres (12,4 versus 9,7 Wörter) und spezifischeres FB (1,9 versus 1,7 von 3) auf als Studierende. Umfang und Spezifität nahmen während des Semesters ab. Weder Differenziertheit der Selbstbeurteilung (Anteil des differenzierten Eintragens der Selbstbeurteilung) noch die Zufriedenheit der Studierenden mit dem FB war zwischen den beiden untersuchten CEC-Varianten unterschiedlich.Schlussfolgerung: Die jahrgangsweite Nutzung der CEC war erfolgreich möglich, allerdings ergab das eigenständige Formulieren und Eintragen des FB durch Studierende kein umfangreicheres oder spezifischeres FB, die Selbstbeurteilung und Zufriedenheit mit dem FB der Lehrenden war unverändert