On the brink of daily clinical application of objective gait analysis: What evidence do we have so far from studies using an induced lameness model?

Quantitative gait analysis has the potential to offer objective and unbiased gait information that can assist clinical decision-making. In recent years, a growing number of gait analysis systems have come onto the market, highlighting the demand for such technology in equine orthopaedics. However, it is imperative that the measured variables which are used as outcome parameters are supported by scientific evidence and that the interpretation of such measurements is backed by a proper understanding of the biomechanical principles of equine locomotion. This review, which is based on studies on experimentally induced lameness, summarises the currently most widely used methods for gait analysis and the available evidence concerning gait parameters that can be used to quantify gait changes due to lameness. These are discussed regarding their current and future potential for routine clinical application

Validation of Distal Limb Mounted Imu Sensors for Stride Detection and Locomotor Quantification in Warmblood Horses at Walk and Trot

Reasons for performing study: IMU-sensor based techniques arebecoming more popular in horses as a tool for objective locomotorassessment. Using currently proposed methods only limited informationabout stride variables can be obtained for walk and trot.Objectives: To describe, evaluate and validate a method of stridedetection and quantification (i.e. hoof-on/off detection and stanceduration calculation) at walk and trot using distal limb mounted IMU-sensors.Study design: Validation study.Methods: To compare IMU-sensors and motion capture (MoCap) withforce plate data as the gold standard, 7 warmblood horses equippedwith metacarpal/metatarsal IMU-sensors (range: low-g accelerometer16 g; high-g accelerometer 200 g) and reflective markers for MoCapwere hand walked and trotted over a force plate. All instruments wereframe synchronised and data were collec ted at 200 Hz. Using fourcustom-built algorithms hoof-on/off timing over the force plate andstance duration were calculated for each trial from the IMU data.Accuracy of the computed parameters was calculated as the meandifference in milliseco nds between the IMU/MoCap generated data andthe data from the force plate (bias) and precision as the standarddeviation of these differences.Results: The best performing IMU algorithm achieved for stanceduration at walk an accuracy, precision and percentage of error of28.5 ms/31.6 ms/3.7% for the forelimbs and 5.5 ms/20.1 ms/2.2% forthe hindlimbs respectively. At trot the best performing algorithmachieved an accuracy, precision and percentage of error of 27.6 ms/8.8 ms/8.4% for the forelimbs and 6.3 ms/33.5 ms/9.1% for thehindlimbs. Using IMU algorithms for hoof-off detection a better overallaccuracy and precision was obtained, than when using MoCap.Conclusions: The observed IMU validation performance appears verypromising, and seems ready to practically and accurately determineimportant stride variables at walk and also at trot, being the key gait forlameness assessment and training evaluation.Ethical animal research: This study was approved by the local ethicscommittee. Horses were owned by the University. Sources of funding:This study was funded by STW Valorisation Grant 13448. Competinginterests: None declared

The development of hoof balance and landing preference in the post-natal period

BACKGROUND: Foals can follow the herd within hours of birth, but it has been shown that kinetic gait parameters and static balance still have to mature. However, development of dynamic balance has not been investigated. OBJECTIVES: To objectively quantify landing and pressure pattern dynamics under the hoof during the first half year of life. STUDY DESIGN: Prospective, cohort study performed at a single stud farm. METHODS: Pressure plate measurements at walk and trot from ten Dutch warmblood foals during the first 24 weeks of life were used to quantify toe-heel and medial-lateral hoof balance asymmetry indexes and to determine preferred landing strategy. Concurrently, radiographs of the tarsocrural and femoropatellar joints were taken at 4-6 weeks and after 6 months to check for osteochondrosis. A linear mixed model was used to determine the effects of time point, limb pair (front/hind), side (left/right) and osteochondrosis status of every foal. RESULTS: At 25% of stance duration at walk, front limbs were more loaded in the heel region in weeks 6-20 (P≤0.04), the medial-lateral balance was more to the lateral side from week 6 onwards at both walk and trot (P≤0.04). Landing preference gradually changed in the same directions. Variability in pressure distribution decreased over time. (Subclinical) osteochondrosis did not influence any of the measured parameters. MAIN LIMITATIONS: This study is limited by the relatively small sample size only containing one breed from a single stud farm. CONCLUSIONS: Dynamic hoof balance in new-born foals is more variable and less oriented towards the lateral side of the hoof and to the heel than in mature horses. This pattern changes gradually during the first weeks of life. Knowledge of this process is essential for the clinician when considering interventions in this area in early life

The development of hoof balance and landing preference in the post-natal period

BACKGROUND: Foals can follow the herd within hours of birth, but it has been shown that kinetic gait parameters and static balance still have to mature. However, development of dynamic balance has not been investigated. OBJECTIVES: To objectively quantify landing and pressure pattern dynamics under the hoof during the first half year of life. STUDY DESIGN: Prospective, cohort study performed at a single stud farm. METHODS: Pressure plate measurements at walk and trot from ten Dutch warmblood foals during the first 24 weeks of life were used to quantify toe-heel and medial-lateral hoof balance asymmetry indexes and to determine preferred landing strategy. Concurrently, radiographs of the tarsocrural and femoropatellar joints were taken at 4-6 weeks and after 6 months to check for osteochondrosis. A linear mixed model was used to determine the effects of time point, limb pair (front/hind), side (left/right) and osteochondrosis status of every foal. RESULTS: At 25% of stance duration at walk, front limbs were more loaded in the heel region in weeks 6-20 (P≤0.04), the medial-lateral balance was more to the lateral side from week 6 onwards at both walk and trot (P≤0.04). Landing preference gradually changed in the same directions. Variability in pressure distribution decreased over time. (Subclinical) osteochondrosis did not influence any of the measured parameters. MAIN LIMITATIONS: This study is limited by the relatively small sample size only containing one breed from a single stud farm. CONCLUSIONS: Dynamic hoof balance in new-born foals is more variable and less oriented towards the lateral side of the hoof and to the heel than in mature horses. This pattern changes gradually during the first weeks of life. Knowledge of this process is essential for the clinician when considering interventions in this area in early life

Variation in gait parameters used for objective lameness assessment in sound horses at the trot on the straight line and the lunge

Background Objective lameness assessment is gaining more importance in a clinical setting, necessitating availability of reference values. Objectives To investigate the between ‐path, ‐trial and ‐day variation, between and within horses, in the locomotion symmetry of horses in regular use that are perceived sound. Study design Observational study with replicated measurement sessions. Methods Twelve owner‐sound horses were trotted on the straight line and on the lunge. Kinematic data were collected from these horses using 3D optical motion capture. Examinations were repeated on 12 occasions over the study which lasted 42 days in total. For each horse, measurements were grouped as five replicates on the first and second measurement days and two replicates on the third measurement day. Between measurement days 2 and 3, every horse had a break from examination of at least 28 days. Previously described symmetry parameters were calculated: RUD and RDD (Range Up/Down Difference; difference in upward/downward movement between right and left halves of a stride); MinDiff and MaxDiff (difference between the two minima/maxima of the movement); HHDswing and HHDstance (Hip Hike Difference‐swing/‐stance; difference between the upward movement of the tuber coxae during swingphase/ stancephase). Data are described by the between‐measurement variation for each parameter. A linear mixed model was used to test for the effect of time, surface and path. Intraclass correlation coefficients (ICC) were calculated to access repeatability. Results Mean between‐measurement variation was (MinDiff, MaxDiff, RUD, RDD): 13, 12, 20, 16 mm (head); 4, 3, 6, 4 mm (withers) and 5, 4, 6, 6 mm (pelvis); (HHDswing, HHDstance): 7 and 7 mm. More between‐measurement variation is seen on the first measurement day compared to the second and third measurement days. In general, less variation is seen with increasing number of repetitions. Less between‐measurement variation is seen on hard surface compared to soft surface. More between‐measurement variation is seen on the circle compared to the straight line. Between‐horse variation was clearly larger than within‐horse variation. ICC values for the head, withers and pelvis symmetry parameters were 0.68 (head), 0.76 (withers), 0.85 (pelvis). Main limitations Lunge measurements on a hard surface were not performed. Conclusions Between‐measurement variation may be substantial, especially in head motion. This should be considered when interpreting clinical data after repeated measurements, as in routine lameness assessments

Variation in gait parameters used for objective lameness assessment in sound horses at the trot on the straight line and the lunge

Background Objective lameness assessment is gaining more importance in a clinical setting, necessitating availability of reference values. Objectives To investigate the between ‐path, ‐trial and ‐day variation, between and within horses, in the locomotion symmetry of horses in regular use that are perceived sound. Study design Observational study with replicated measurement sessions. Methods Twelve owner‐sound horses were trotted on the straight line and on the lunge. Kinematic data were collected from these horses using 3D optical motion capture. Examinations were repeated on 12 occasions over the study which lasted 42 days in total. For each horse, measurements were grouped as five replicates on the first and second measurement days and two replicates on the third measurement day. Between measurement days 2 and 3, every horse had a break from examination of at least 28 days. Previously described symmetry parameters were calculated: RUD and RDD (Range Up/Down Difference; difference in upward/downward movement between right and left halves of a stride); MinDiff and MaxDiff (difference between the two minima/maxima of the movement); HHDswing and HHDstance (Hip Hike Difference‐swing/‐stance; difference between the upward movement of the tuber coxae during swingphase/ stancephase). Data are described by the between‐measurement variation for each parameter. A linear mixed model was used to test for the effect of time, surface and path. Intraclass correlation coefficients (ICC) were calculated to access repeatability. Results Mean between‐measurement variation was (MinDiff, MaxDiff, RUD, RDD): 13, 12, 20, 16 mm (head); 4, 3, 6, 4 mm (withers) and 5, 4, 6, 6 mm (pelvis); (HHDswing, HHDstance): 7 and 7 mm. More between‐measurement variation is seen on the first measurement day compared to the second and third measurement days. In general, less variation is seen with increasing number of repetitions. Less between‐measurement variation is seen on hard surface compared to soft surface. More between‐measurement variation is seen on the circle compared to the straight line. Between‐horse variation was clearly larger than within‐horse variation. ICC values for the head, withers and pelvis symmetry parameters were 0.68 (head), 0.76 (withers), 0.85 (pelvis). Main limitations Lunge measurements on a hard surface were not performed. Conclusions Between‐measurement variation may be substantial, especially in head motion. This should be considered when interpreting clinical data after repeated measurements, as in routine lameness assessments

Automatic hoof-on and -off detection in horses using hoof-mounted inertial measurement unit sensors

For gait classification, hoof-on and hoof-off events are fundamental locomotion characteristics of interest. These events can be measured with inertial measurement units (IMUs) which measure the acceleration and angular velocity in three directions. The aim of this study was to present two algorithms for automatic detection of hoof-events from the acceleration and angular velocity signals measured by hoof-mounted IMUs in walk and trot on a hard surface. Seven Warmblood horses were equipped with two wireless IMUs, which were attached to the lateral wall of the right front (RF) and hind (RH) hooves. Horses were walked and trotted on a lead over a force plate for internal validation. The agreement between the algorithms for the acceleration and angular velocity signals with the force plate was evaluated by Bland Altman analysis and linear mixed model analysis. These analyses were performed for both hoof-on and hoof-off detection and for both algorithms separately. For the hoof-on detection, the angular velocity algorithm was the most accurate with an accuracy between 2.39 and 12.22 ms and a precision of around 13.80 ms, depending on gait and hoof. For hoof-off detection, the acceleration algorithm was the most accurate with an accuracy of 3.20 ms and precision of 6.39 ms, independent of gait and hoof. These algorithms look highly promising for gait classification purposes although the applicability of these algorithms should be investigated under different circumstances, such as different surfaces and different hoof trimming conditions

Reliable and clinically applicable gait event classification using upper body motion in walking and trotting horses

Objectively assessing horse movement symmetry as an adjunctive to the routine lameness evaluation is on the rise with several commercially available systems on the market. Prerequisites for quantifying such symmetries include knowledge of the gait and gait events, such as hoof to ground contact patterns over consecutive strides. Extracting this information in a robust and reliable way is essential to accurately calculate many kinematic variables commonly used in the field. In this study, optical motion capture was used to measure 222 horses of various breeds, performing a total of 82 664 steps in walk and trot under different conditions, including soft, hard and treadmill surfaces as well as moving on a straight line and in circles. Features were extracted from the pelvis and withers vertical movement and from pelvic rotations. The features were then used in a quadratic discriminant analysis to classify gait and to detect if the left/right hind limb was in contact with the ground on a step by step basis. The predictive model achieved 99.98% accuracy on the test data of 120 horses and 21 845 steps, all measured under clinical conditions. One of the benefits of the proposed method is that it does not require the use of limb kinematics making it especially suited for clinical applications where ease of use and minimal error intervention are a priority. Future research could investigate the extension of this functionality to classify other gaits and validating the use of the algorithm for inertial measurement units. (C) 2020 The Authors. Published by Elsevier Ltd