Klinisk gradering av hästens luftvägsstatus

Respiratory disease with airway inflammation as main characteristic is common in the horse. It is a syndrome that is not yet fully understood. The etiology, pathogenesis and classification into different disease states are subjects for discussion and under continuous revision. Despite a number of modern techniques, the diagnostic procedure is challenging. There is no test considered to be gold standard when diagnosing these diseases. The clinical examination remains an important approach to the horse with suspected respiratory disease. The need for a standardized clinical scoring system for the equine airways has been addressed by clinicians and researchers. The clinical scoring systems used today are of varying complexity and contain different parameters that are graded in various ways. The aim of this study was to compare different clinical scoring systems for inflammatory airway disease in the horse and their relation to measured indices of inflammation in bronchoalveolar lavage fluid (BALF) and to clinical field status. Four of the protocols used in the study were taken from publications in the field of interest and one has been developed by the author of this under graduate thesis. Data collected from 70 clinical examinations (44 horses) have been used to compare the clinical scoring systems. The registered parameters were graded according to the different protocols and a total clinical score was achieved for each examination. Pearson correlation was used to study the covariance between the clinical scores from the different protocols and their relation to neutrophil elevation in BALF and clinical status. The results show that clinical scoring systems of varying complexity were of approximately equal value in predicting overall respiratory health or disease in horses with RAO/IAD versus clinically normal horses. It appears however that none of the scoring systems examined were predictive of neutrophil elevation in BALF as an objective measure of airway inflammation. The pair-wise correlation between individual scoring systems also varied when used on the same group of horses. Future refinement of scoring systems, possibly using individual factor analysis, may aid in identifying key clinical findings of value in a scoring system that could be standardized for interlaboratory use

Sport surfaces in show jumping

Properties of sport surfaces influence the occurrence of injuries and the performance of equine athletes. The sports governing body seeks to develop standards for safety and performance of show jumping surfaces. Limited information is available to guide this process. Objective methods are warranted in order to define surface properties that can be associated to injury and performance data. Description of the discipline-specific interaction between the horse and the ground is important in order to display the characteristics and diversity of loading patterns applied to the sport surfaces as well as to enable understanding of the mechanical challenges that lead to injuries. The aims of this thesis were to describe the hoof-ground interaction in show jumping and to study functional properties of surfaces through rider assessments and by using a standardized biomechanical method that enables comparisons between arenas. Hoof landing characteristics of elite horses in jump landing from 1.30–1.50 m competition fences on two different surfaces were evaluated from high-speed videos. Hoof landing kinematics differed among the leading/trailing fore and hind limbs. Data increased our understanding of hoof-ground interaction and related events, which is a prerequisite for developing surface testing devices. Hoof impact was also investigated using hoof-mounted accelerometers in an experimental setup with five horses in canter, jump take-off and landing. Leading/trailing fore and hind limbs, stride types and surface affected the hoof-surface impact. The vertical deceleration at impact ranked in the same order, for three surface conditions, as when the impact from a metal hoof of a biomechanical surface testing device was measured. Subjective assessments of surface properties by riders were compared to objective in-situ measurements of the same properties with a biomechanical surface tester in 25 show jumping competition and warm-up arena surfaces at top-level events. Significant associations between the subjective and objective assessments were found. The data from this thesis contribute to the description of the discipline-specific hoof-surface interaction in show jumping. The objective method used for in-situ characterisation of functional surface properties can enable further objective comparisons which in the future can be related to injury and performance data of show jumping surfaces

The Descriptions and Attitudes of Riders and Arena Owners to 656 Equestrian Sport Surfaces in Sweden

Horses in equestrian sports are commonly trained in arenas with prepared footing. Information on the number and variants of such arenas is generally unknown. This paper provides an overview of the primary construction types of riding surfaces in Sweden including details on composition, constructions principles, usage frequency, maintenance, and cost of operation as well as to investigate rider perception of the ideal arena properties using a large population of riders. Data on 656 equestrian surfaces in Sweden obtained up to 2014 are presented, of which 373 were outdoor and 283 were indoor arenas. Dressage and show-jumping were the main disciplines conducted in the arenas. Sand-mineral arenas were most common outdoors and sand-woodchips arenas most common indoors, followed by sand-fibre arenas and even fewer synthetic arenas. Comparing the three most common arena types, dragging was most often done on sand-woodchips and sand-fibre arenas. Harrowing was less often done on sand-mineral arenas compared to sand-woodchips and sand-fibre arenas. Combining dragging, harrowing, deep harrowing, and rolling, arenas with higher usage were maintained more frequently, compared to those used less frequently. It was commonly claimed that the top-layer needs renovation every other-4th year or every 5th to 10th year. Few respondents allocated more than 10,000 SEK in yearly maintenance costs, with the exception for sand-woodchips and sand-fibre arenas followed by synthetic arenas. The shortest duration perceived between required renovations was found for sand-woodchips top-layer arenas. Ideal surface properties were evaluated by 3,158 riders. Dressage and show-jumping riders differed somewhat regarding ideal spans of functional arena properties: for impact firmness, responsiveness, and grip. The current study likely included well-utilised arenas, compared to those less well-utilised. The resources necessary to keep an arena consistent over time seemed underestimated. Knowledge of maintenance and priorities for arenas are important to users and arenas managers, be they construction companies or arena managers in order to maximise the outcome of efforts for arena improvement and optimise locomotor health for horses that use them. Further, many arenas were new and research into organic arena management is important, especially if equestrians continue to build and renew arena surfaces

Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain

Objective: This study investigated the relationship between orthopedic pain experienced at rest, and degree of movement asymmetry during trot in horses with induced reversible acute arthritis. Orthopedic pain was assessed with the Horse Grimace Scale (HGS), the Equine Utrecht University Scale of Facial Assessment of Pain (EQUUS-FAP), the Equine Pain Scale (EPS), and the Composite Orthopedic Pain Scale (CPS). Reliability and diagnostic accuracy were evaluated with intraclass correlation coefficients (ICC) and area under the curve (AUC).Study design and animals: Eight healthy horses were included in this experimental study, with each horse acting as its own control.Methods: Orthopedic pain was induced by intra-articular lipopolysaccharide (LPS) administration. Serial pain assessments were performed before induction and during pain progression and regression, where three observers independently and simultaneously assessed pain at rest with the four scales. Movement asymmetry was measured once before induction and a minimum of four times after induction, using objective gait analysis.Results: On average 6.6 (standard deviation 1.2) objective gait analyses and 12.1 (2.4) pain assessments were performed per horse. The ICC for each scale was 0.75 (CPS), 0.65 (EPS), 0.52 (HGS), and 0.43 (EQUUS-FAP). Total pain scores of all scales were significantly associated with an increase in movement asymmetry (R2 values ranging from −0.0649 to 0.493); with CPS pain scores being most closely associated with movement asymmetry. AUC varied between scales and observers, and CPS was the only scale where all observers had a good diagnostic accuracy (AUC > 0.72).Conclusions and clinical relevance: This study identified significant associations between pain experienced at rest and degree of movement asymmetry for all scales. Pain scores obtained using CPS were most closely associated with movement asymmetry. CPS was also the most accurate and reliable pain scale. All scales had varying linear and non-linear relations between total pain scores and movement asymmetry, illustrating challenges with orthopedic pain assessment during rest in subtly lame horses since movement asymmetry needs to be rather high before total pain score increase

Effect of Speed and Surface Type on Individual Rein and Combined Left-Right Circle Movement Asymmetry in Horses on the Lunge

Differences in movement asymmetry between surfaces and with increasing speed increase the complexity of incorporating gait analysis measurements from lunging into clinical decision making. This observational study sets out to quantify by means of quantitative gait analysis the influence of surface and speed on individual-rein movement asymmetry measurements and their averages across reins (average-rein measurements). Head, withers, and pelvic movement asymmetry was quantified in 27 horses, identified previously as presenting with considerable movement asymmetries on the straight, during trot in hand and on the lunge on two surfaces at two speeds. Mixed linear models (p < 0.05) with horse as the random factor and surface and speed category (and direction) as fixed factors analyzed the effects on 11 individual-rein and average-rein asymmetry measures. Limits of agreement quantified differences between individual-rein and average-rein measurements. A higher number of individual-rein asymmetry variables-particularly when the limb that contributed to movement asymmetry on the straight was on the inside of the circle-were affected by speed (nine variables, all p <= 0.047) and surface (three variables, all p <= 0.037) compared with average-rein asymmetry variables (two for speed, all p <= 0.003; two for surface, all p <= 0.046). Six variables were significantly different between straight-line and average-rein assessments (all p <= 0.031), and asymmetry values were smaller for average-rein assessments. Limits of agreement bias varied between +0.4 and +4.0 mm with standard deviations between 3.2 and 12.9 mm. Fewer average-rein variables were affected by speed highlighting the benefit of comparing left and right rein measurements. Only one asymmetry variable showed a surface difference for individual-rein and average-rein data, emphasizing the benefit of assessing surface differences on each rein individually. Variability in straight-line vs. average-rein measurements across horses and exercise conditions highlight the potential for average-rein measurements during the diagnostic process; further studies after diagnostic analgesia are needed

Evaluation of feedback methods for improved detection of hindlimb lameness in horses among riding instructors and trainers

Lameness, a wellknown issue in sport horses, impedes performance and impairs welfare. Early detection of lameness is essential for horses to receive needed treatment, but detection of hindlimb lameness is challenging. Riding instructors and trainers observe horses in motion in their daily work and could contribute to more efficient lameness detection. In this cross-sectional and prospective study, we evaluated the ability of riding instructors and trainers to assess hindlimb lameness. We also evaluated different feedback methods for improved lameness detection. For the cross-sectional part, n = 64 riding instructors and trainers of varying level and n = 23 high-level trainers were shown 13 videos of trotting horses, lameness degree: 0-3.5 (test 1) and tasked with classifying the horses as sound, left hindlimb lame, or right hindlimb lame. For the prospective part, the riding instructors and trainers of varying levels were randomly allocated to three different groups (a, b, c) and given 14 days of feedback-based, computer-aided training in identifying hindlimb lameness, where they assessed 13 videos (of which three were repeated from test 1) of horses trotting in a straight line. Participants in groups a-c received different feedback after each video (group a: correct answer and re-viewing of video at full and 65% speed; group b: correct answer, re-viewing of video at full and 65% speed, narrator providing explanations; group c: correct answer and re-viewing of video at full speed). After computer-aided training, the participants were again subjected to the video test (test 2). Participants also provided background information regarding level of training etcetera. Effects of participants' background on results were analyzed using analysis of variance, and effects of the different feedback methods were analyzed using generalized estimation equations. On test 1, 44% (group a), 48% (b), 46% (c), and 47% (high-level trainers) of horses were correctly classified. Group a participants significantly improved their test score, both with (p < 0.0001) and without (p = 0.0086) inclusion of repeated videos. For group c, significant improvement was only seen with inclusion of repeated videos (p = 0.041). For group b, no significant improvement was seen (p = 0.51). Although test 2 scores were low, computer-aided training may be useful for improving hindlimb lameness detection

Patellar ligament desmopathy in the horse – a review and comparison to human patellar tendinopathy (‘Jumper’s knee’)

Patellar ligament desmopathy in horses is regarded as an uncommon condition with unclear aetiology. Of the three patellar ligaments in the horse, the intermediate is the one most often diagnosed with desmopathy in horses presenting with chronic lameness. This structure corresponds to the patellar tendon in humans. As diagnostic imaging modalities continuously improve, changes in echogenicity of the patellar ligaments are identified ultrasonographically with increasing frequency. However, disruption of the normal fibre pattern may be present also in patellar ligaments in horses that show no signs of lameness. Similarly, there is a poor correlation between pain and diagnostic imaging findings in human patellar tendinopathy. Consequently, there appears to be a knowledge gap pertaining to normal ultrasonographic variation and diagnostic criteria for disease of the patellar ligaments in horses. Furthermore, local anaesthetic techniques to verify the diagnosis are poorly described, and due to the low number of treated cases, no specific treatment modality can be recommended on a scientific basis. The aim of this paper is to review the current knowledge regarding the pathogenesis, diagnosis and management of patellar ligament desmopathy in horses, compare this condition with patellar tendinopathy in humans, and identify areas for further research to increase the diagnostic accuracy in horses. We conclude that there is a profound need for better descriptions of ultrasonographic variation and pathological changes of the equine patellar ligaments. Identification of areas of maximal ligament strain and descriptions of early histopathological changes could render more information on the possible aetiology, preventive measurements and treatment options of desmopathy. Description of regional innervation could aid in development of methods for diagnostic anaesthesia to verify pain originating from the ligaments

Prevalence of vertical movement asymmetries at trot in Standardbred and Swedish Warmblood foals

Many horses, just before and during their athletic career, show vertical movement asymmetries, to the same degree as clinically lame horses. It is unknown whether these asymmetries are caused by pain or have alternative explanations, such as inherent biological variation. In the latter case, movement asymmetries would be expected to be present at a very young age. This study aimed to investigate the prevalence of movement asymmetries in foals. Motion analysis, using an inertial measurement unit-based system (Equinosis), was performed on 54 foals (31 Swedish Warmbloods, 23 Standardbreds) during straight-line trot. The foals were between 4–13 weeks old and considered sound by their owners. Differences between the vertical minimum and maximum values recorded for the head (HDmin, HDmax) and pelvis (PDmin, PDmax) between left and right stance were calculated for each stride and an average was computed for each trial. Thresholds for asymmetry were defined as absolute trial mean >6 mm for HDmin and HDmax, and >3 mm for PDmin and PDmax. These thresholds were exceeded for one or several parameters by 83% of Standardbred foals and 45% of Swedish Warmblood foals, demonstrating surprisingly high prevalence of asymmetries in young foals, although the risk of repetitive strain injuries and cumulative risk of trauma injuries was expected to be low in this age group. Standardbred foals showed similar prevalence of asymmetries to that reported previously for yearling Standardbred trotters, so relatively higher prevalence of movement asymmetries may be expected among trotters as a breed. In general, vertical head and pelvic movement asymmetries can be anticipated among foals considered sound by their owners. A better understanding of the aetiology of asymmetries is needed for correct interpretation of objective symmetry measurements in different populations of horses