Anna Bergh

Goniometry: is it a reliable tool to monitor passive joint range of motion in horses?

REASONS FOR PERFORMING STUDY Simple objective assessment tools are essential to monitor the clinical efficacy of therapeutic interventions used in equine orthopaedics and rehabilitation. In human medicine, goniometry is a validated tool to quantify restrictions in joint range of motion (ROM); however, the technique is not validated in horses. OBJECTIVES To validate 2 different goniometry techniques for the measurement of passive flexion of the fetlock, carpus and hock by examining; 1) the intra- and inter-tester reliability; 2) the differences between 2 goniometry techniques and 3) differences between standing and anaesthetised horses. METHODS The study is composed of three parts: 1) the intra- and inter-tester reliability was examined on 10 horses, where each horse was assessed by 5 pairs of testers measuring ROM with a universal goniometer; 2) the differences between 2 goniometry techniques were examined on 14 horses, each assessed by 2 investigators (either working in pairs with one investigator holding the limb and the other measuring the joint angle, or working individually at the same time holding and measuring); 3) on 6 horses, the differences between standing and anaesthetised horses were assessed by 2 investigators with the same techniques as described above. Nonparametric tests (Mann-Whitney, Wilcoxon sign-rank) and Intraclass Correlation Coefficient (ICC) were used for statistical analysis (P < 0.05). RESULTS 1) The intra-tester reliability was high to excellent (ICC 0.8-1) and the inter-tester reliability low to average (ICC 0.1-0.5); 2) significant differences in joint ROM were registered in carpus and hock when measuring in pairs compared to singly and 3) significant differences in joint ROM were registered measuring anaesthetised compared to standing horses. CONCLUSIONS As shown in human studies, goniometry is a promising tool in documenting passive flexion of fetlock, carpus and hock, if used by the same investigator. However, additional studies are needed for further validation.

Effect of Defocused CO2 Laser on Equine Tissue Perfusion

Treatment with defocused CO2 laser can have a therapeutic effect on equine injuries, but the mechanisms involved are unclear. A recent study has shown that laser causes an increase in equine superficial tissue temperature, which may result in an increase in blood perfusion and a stimulating effect on tissue regeneration. However, no studies have described the effects on equine tissue perfusion. The aim of the present study was to investigate the effect of defocused CO2 laser on blood perfusion and to correlate it with temperature in skin and underlying muscle in anaesthetized horses. Differences between clipped and unclipped haircoat were also assessed. Eight horses and two controls received CO2 laser treatment (91 J/cm2) in a randomised order, on a clipped and unclipped area of the hamstring muscles, respectively. The significant increase in clipped skin perfusion and temperature was on average 146.3 ± 33.4 perfusion units (334%) and 5.5 ± 1.5°C, respectively. The significant increase in perfusion and temperature in unclipped skin were 80.6 ± 20.4 perfusion units (264%) and 4.8 ± 1.4°C. No significant changes were seen in muscle perfusion or temperature. In conclusion, treatment with defocused CO2 laser causes a significant increase in skin perfusion, which is correlated to an increase in skin temperature.SammanfattningLokala blodflödesförändringar hos häst vid behandling med defokuserad CO2 laser.Laserbehandling sägs stimulera och påskynda nedsänktsprocessen, men dess verkningsmekanism är oklar. En nyligen publicerad studie visar att behandling med defokuserad CO2 laser ger en ökning av temperaturen i ytliga vävnader hos häst. En ökning av vävnadstemperatur åtföljs ofta av en ökning av det lokala blodflödet, med en positiv inverkan på vävnaders läkning. Så vitt vi vet saknas publicerade studier om defokuserad CO2 lasers effekt på blodflöde hos häst. Syftet med denna studie var att undersöka effekten av defokuserad CO2 laser på lokalt blodflöde (med hjälp av Laser Doppler Flowmetry) och att korrelera blodflödet till temperaturen i rakad och orakad hud, samt i underliggande muskelvävnad. Tio hästar inkluderades i studien, varav åtta fick aktiv laser och två placebo. Den aktiva laserdosen var 91 J/cm2 och gavs på ett 42 cm2 stort område över semimembranosus muskulaturen. Den aktiva laserbehandlingen ökade signifikant blodflöde och temperatur, med i genomsnitt 146.3±33.4 perfusionsenheter (334%) och 5.5±1.5 °C i rakad hud, och 80.6±20.4 perfusionsenheter (264%) och 4.8±1.4 °C i orakad hud. Inga statistiskt signifikanta skillnader kunde noteras i blodflöde och temperatur i underliggande muskel, eller mellan rakad och orakad hud. Fortsatta studier får visa om denna temperatur- och blodflödesökning kan leda till smärtlindring och förbättrad läkning.

Gait and jump analysis in healthy cats using a pressure mat system.

Physical orthopaedic examination in cats does not always reveal signs of lameness and no objective gait analysis method has yet been standardised for use in cats. The aims of the present study were to define appropriate parameters for pressure mat analyses during walk and jump, and to define reference values for gait parameters of healthy cats. Further, the distribution of the vertical force within the paws and the influence of a non-centred head position were investigated. The hypothesis was that cats have a symmetrical gait, a front/hindlimb asymmetry similar to dogs, and that peak vertical force (PVF) and vertical impulse (VI) have high intraclass correlation coefficients, confirming the reliability of these parameters. Data for walking (n = 46) showed gait symmetry indices of close to 1.0, besides PVF front/hind (1.3 ± 0.2). The PVF front/hind for jumping cats (n = 16) was 1.7 ± 0.6. Results from the distribution of the vertical force within the paw (n = 39) showed that the main weight during a strike is transferred from the caudal towards the craniomedial part of the paw. The findings support the hypothesis that healthy cats have similar gait symmetry to healthy dogs and that PVF and VI are reliable gait parameters. In conclusion, the present study provides a reference interval for healthy cats. Further studies are needed to investigate gait parameters in cats with orthopaedic disease.

Evaluation of neuromuscular electrical stimulation on fibre characteristics and oxidative capacity in equine skeletal muscles

REASONS FOR PERFORMING STUDY Neuromuscular electrical stimulation (NMES) is used to increase or maintain muscle strength during rehabilitation. Human studies investigating different protocols show that some treatments induce changes in muscle characteristics. Despite the frequent use of NMES in horses, no studies have been published describing its efficacy. OBJECTIVES To investigate the effects of a NMES protocol on equine fibre types and areas, glycogen concentrations and enzyme activities. METHODS NMES was administrated to m. gluteus medius and m. longissimus dorsi, on one side of 6 healthy Standardbred horses. The contralateral side of each muscle served as a nonstimulated control. The horses were stimulated at 50 Hz a day, with 21-39 mA, for 45-60 min, 5 days a week for 4 weeks. Needle biopsies were obtained from the muscles on both sides before and after the experimental period. Muscle samples were analysed for fibre type proportions and area using histochemical methods and for glycogen and enzyme activities (citrate synthase, 3-OH-acyl CoA dehydrogenase, hexokinase and lactate dehydrogenase) using biochemical methods. Muscle contractions at the location and depth of the muscle biopsy were confirmed by diagnostic ultrasound. Nonparametric tests (Mann-Whitney, Wilcoxon sign-rank) were used for statistical analysis. RESULTS No significant differences were observed in the percentage of types I, IIA or IIX fibres, fibre areas, glycogen levels or enzyme activities either when comparing stimulated and nonstimulated muscles before and after the NMES treatment, or when comparing the left and right muscle samples. CONCLUSIONS The NMES treatment was well tolerated by the horses, but the present protocol did not induce significant muscle adaptations. Further studies are needed to describe the effect of more intense and/or prolonged NMES treatment protocols on muscles of healthy horses, and to describe if stimulation protocols induce positive changes in atrophied muscles.

Evaluation of skin displacement in the equine neck

Kinematic studies, using reflective skin markers, are commonly used to investigate equine joint motion in equitation science and for rehabilitation purposes. In order to interpret the registrations accurately, the degree of skin displacement has been described for the limbs and back, but not yet for the neck. The aim of the present study was to measure sagittal plane skin displacement in the equine neck. Radiopaque skin markers were applied to the skin over the first six cervical vertebrae of six healthy horses. Latero-lateral radiographs were taken in three standardised neck positions in the sagittal plane: control (horizontal neck), ‘on the bit’ and ‘nose to carpus’. The scales of the images were normalised and calculation of skin displacement was done by use of a coordinate system, dividing the displacement along an x-axis parallel to the vertebras longitudinal axis and a y-axis perpendicular to the x-axis. Mixed models analysis was employed to study the differences in distances in x- and y-directions...

Does foot pronation in unmounted horseback riders affect pelvic movement during walking

Foot pronation is a common postural condition that is related to postural asymmetry, and that may affect performance in a variety of sports. The aim of this study was to evaluate whether unmounted riders (n=18) with predominantly right or left foot pronation had an increased contralateral pelvic drop during stance of the more pronated foot when walking. This was a preliminary step toward investigating the effects of foot pronation during riding. Kinematic data were collected in 3D (250 Hz) using eight motion capture cameras during walking. The amount of foot pronation was measured by summing eversion and external rotation, and it was analysed in relation to maximal pelvic drop during stance. The results showed that during walking, the majority of the riders had significantly greater contralateral pelvic drop when the foot with the higher degree of pronation was in early stance. If the demonstrated postural asymmetry carries over to other activities where weight is distributed to the feet, e.g. at riding w...

Effect of Defocused CO2

Treatment with defocused CO2 laser can have a therapeutic effect on equine injuries, but the mechanisms involved are unclear. A recent study has shown that laser causes an increase in equine superficial tissue temperature, which may result in an increase in blood perfusion and a stimulating effect on tissue regeneration. However, no studies have described the effects on equine tissue perfusion. The aim of the present study was to investigate the effect of defocused CO2 laser on blood perfusion and to correlate it with temperature in skin and underlying muscle in anaesthetized horses. Differences between clipped and unclipped haircoat were also assessed. Eight horses and two controls received CO2 laser treatment (91 J/cm2) in a randomised order, on a clipped and unclipped area of the hamstring muscles, respectively. The significant increase in clipped skin perfusion and temperature was on average 146.3 ± 33.4 perfusion units (334%) and 5.5 ± 1.5°C, respectively. The significant increase in perfusion and temperature in unclipped skin were 80.6 ± 20.4 perfusion units (264%) and 4.8 ± 1.4°C. No significant changes were seen in muscle perfusion or temperature. In conclusion, treatment with defocused CO2 laser causes a significant increase in skin perfusion, which is correlated to an increase in skin temperature.SammanfattningLokala blodflödesförändringar hos häst vid behandling med defokuserad CO2 laser.Laserbehandling sägs stimulera och påskynda nedsänktsprocessen, men dess verkningsmekanism är oklar. En nyligen publicerad studie visar att behandling med defokuserad CO2 laser ger en ökning av temperaturen i ytliga vävnader hos häst. En ökning av vävnadstemperatur åtföljs ofta av en ökning av det lokala blodflödet, med en positiv inverkan på vävnaders läkning. Så vitt vi vet saknas publicerade studier om defokuserad CO2 lasers effekt på blodflöde hos häst. Syftet med denna studie var att undersöka effekten av defokuserad CO2 laser på lokalt blodflöde (med hjälp av Laser Doppler Flowmetry) och att korrelera blodflödet till temperaturen i rakad och orakad hud, samt i underliggande muskelvävnad. Tio hästar inkluderades i studien, varav åtta fick aktiv laser och två placebo. Den aktiva laserdosen var 91 J/cm2 och gavs på ett 42 cm2 stort område över semimembranosus muskulaturen. Den aktiva laserbehandlingen ökade signifikant blodflöde och temperatur, med i genomsnitt 146.3±33.4 perfusionsenheter (334%) och 5.5±1.5 °C i rakad hud, och 80.6±20.4 perfusionsenheter (264%) och 4.8±1.4 °C i orakad hud. Inga statistiskt signifikanta skillnader kunde noteras i blodflöde och temperatur i underliggande muskel, eller mellan rakad och orakad hud. Fortsatta studier får visa om denna temperatur- och blodflödesökning kan leda till smärtlindring och förbättrad läkning.

Do cats with a cranial cruciate ligament injury and osteoarthritis demonstrate a different gait pattern and behaviour compared to sound cats

BackgroundOsteoarthritis (OA) is a common cause of chronic pain and dysfunction in older cats. The majority of cats with OA do not show signs of overt lameness, yet cats with orthopaedic disease are known to redistribute their body weight from the affected limb. OA can cause changes in the cat’s behaviour, which is often misinterpreted as signs of aging. The aim of the present study was to investigate if cats with a previous cranial cruciate ligament (CCL) injury perform differently on the pressure mat and exhibit different behaviour compared to sound cats according to the owner´s subjective assessment. Ten cats with a previous CCL injury were assessed with a pressure mat system and their owners were asked to complete an assessment questionnaire. The results were compared to those of 15 sound cats, matched to have the same weight and body condition score.ResultsThe front/hind limb index for peak vertical force (PVF) was significantly higher for CCL cats, and there was a decreased PVF and vertical impulse (VI) on the affected hindlimb compared to the unaffected one. The results indicate that cats with a previous CCL injury put less weight, on the affected hindlimb but for a longer time. There was a significantly higher owner assessment questionnaire score for the group of cats with CCL injury compared to sound cats.ConclusionsCats with a previous CCL injury have a different gait pattern compared to sound cats and a different behaviour according to owner subjective assessment. It is of great importance that further studies are performed to investigate the long term effects of CCL injury as a cause of pain and physical dysfunction, and its role in the development of OA in cats. Improved assessment tools for chronic pain caused by OA in cats are needed, both to facilitate diagnosis and to evaluate pain-relieving treatment.

Defocused CO 2 laser therapy in traumatic arthritis of the metacarpophalangeal joint: A randomized clinical study

A prospective, blinded, randomized and controlled study was conducted in horses with traumatic arthritis of the metacarpophalangeal joint in order to evaluate the efficacy of defocused carbon dioxide (CO2) laser therapy. Sixteen horses were randomly assigned to two groups: active laser (an output power of 16W, scanned over 42 cm, an average dose of 91 J cm) and sham laser (the laser beam directed at the non-reflecting floor). All the horses received a total of five treatments during 1week. The horses were evaluated with respect to the degree of initial lameness by conventional lameness examination and an objective accelerometer technique before the onset of treatment, and at 1 and 3weeks. The concentrations of substance P (SP), prostaglandin E2 (PGE2) and Met-enkephalin-Arg-Phe (MEAP) in synovial fluid were also assessed. Our study demonstrates that there was no significant difference in lameness score between the laserand the sham-treated group before the treatment and at 1 and 3weeks after the initial examination. Moreover, no significant difference in the concentrations of SP, PGE2 and MEAP in synovial fluid in the active laser group compared with the sham-treated group was observed. In conclusion, this study suggests that treatment with defocused CO2 laser in the management of traumatic arthritis of the metacarpophalangeal joint is not statistically better than sham treatment at reducing the grade of lameness as evaluated by conventional lameness examination and accelerometer technique.

Validation of two simple, objective tools for the assessment of synovial swelling in the equine fetlock region

Simple objective assessment tools are essential to monitor the efficacy of therapeutic interventions used in clinical settings. The purpose of present study was to investigate different ways of assessing synovial swelling of the equine fetlock region: tape measure and slide calliper, and to examine the method’s inter- and intra-examiner reliability. The hypotheses were that inter-examiner reliability would be fair and intra-examiner reliability strong. Measurements were performed on both hind limbs, on 16 horses. Palpation was done once for each limb, over the plantar pouch of the fetlock joint and the plantar digital flexor tendon sheath (PDFTS). Tape measure and slide calliper registrations were made, in triplicate by two independent assessors blinded to the measurements, horizontally over the fetlock joint and PDFTS areas, respectively. Intra-class correlation was used to measure inter- and intra-examiner reliability. The inter-examiner reliability was fair for the tape measurement of the plantar pouch...