Emil Olsen

Accuracy and Precision of Equine Gait Event Detection during Walking with Limb and Trunk Mounted Inertial Sensors

The increased variations of temporal gait events when pathology is present are good candidate features for objective diagnostic tests. We hypothesised that the gait events hoof-on/off and stance can be detected accurately and precisely using features from trunk and distal limb-mounted Inertial Measurement Units (IMUs). Four IMUs were mounted on the distal limb and five IMUs were attached to the skin over the dorsal spinous processes at the withers, fourth lumbar vertebrae and sacrum as well as left and right tuber coxae. IMU data were synchronised to a force plate array and a motion capture system. Accuracy (bias) and precision (SD of bias) was calculated to compare force plate and IMU timings for gait events. Data were collected from seven horses. One hundred and twenty three (123) front limb steps were analysed; hoof-on was detected with a bias (SD) of −7 (23) ms, hoof-off with 0.7 (37) ms and front limb stance with −0.02 (37) ms. A total of 119 hind limb steps were analysed; hoof-on was found with a bias (SD) of −4 (25) ms, hoof-off with 6 (21) ms and hind limb stance with 0.2 (28) ms. IMUs mounted on the distal limbs and sacrum can detect gait events accurately and precisely.

Lungeing on hard and soft surfaces: Movement symmetry of trotting horses considered sound by their owners

REASONS FOR PERFORMING STUDY Lungeing is often part of the clinical lameness examination. The difference in movement symmetry, which is a commonly employed lameness measure, has not been quantified between surfaces. OBJECTIVES To compare head and pelvic movement symmetry between surfaces and reins during lungeing. STUDY DESIGN Quantitative gait analysis in 23 horses considered sound by their owners. METHODS Twenty-three horses were assessed in-hand and on the lunge on both reins on hard and soft surfaces with inertial sensors. Seven movement symmetry parameters were quantified and used to establish 2 groups, namely symmetrical (n = 9) and forelimb-lame horses (n = 14), based on values from straight-line assessment. Movement symmetry values for left rein measurements were side corrected to allow comparison of the amount of movement symmetry between reins. A mixed model (P<0.05) was used to study effects on movement symmetry of surface (hard/soft) and rein (inside/outside with respect to movement symmetry on the straight). RESULTS In forelimb-lame horses, surface and rein were identified as significantly affecting all head movement symmetry measures (rein, all P<0.0001; surface, all P<0.042). In the symmetrical group, no significant influence of surface or rein was identified for head movement symmetry (rein, all P>0.245; surface, all P>0.073). No significant influence of surface or rein was identified for any of the pelvic movement symmetry measures in either group. CONCLUSIONS While more symmetrical horses showed a consistent amount of movement symmetry across surfaces/reins, horses objectively quantified as lame on the straight showed decreased movement symmetry during lungeing, in particular with the lame limb on the inside of a hard circle. The variation within group questions straight-line movement symmetry as a sole measure of lameness without quantification of movement symmetry on the lunge, ideally on hard and soft surfaces to evaluate differences between reins and surfaces. In future, thresholds for lungeing need to be determined using simultaneous visual and objective assessment.

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Background Reproducible and accurate recognition of presence and severity of ataxia in horses with neurologic disease is important when establishing a diagnosis, assessing response to treatment, and making recommendations that might influence rider safety or a decision for euthanasia. Objectives To determine the reproducibility and validity of the gait assessment component in the neurologic examination of horses. Animals Twenty‐five horses referred to the Royal Veterinary College Equine Referral Hospital for neurological assessment (n = 15), purchased (without a history of gait abnormalities) for an unrelated study (n = 5), or donated because of perceived ataxia (n = 5). Methods Utilizing a prospective study design; a group of board‐certified medicine (n = 2) and surgery (n = 2) clinicians and residents (n = 2) assessed components of the equine neurologic examination (live and video recorded) and assigned individual and overall neurologic gait deficit grades (0–4). Inter‐rater agreement and assessment‐reassessment reliability were quantified using intraclass correlation coefficients (ICC). Results The ICCs of the selected components of the neurologic examination ranged from 0 to 0.69. “Backing up” and “recognition of mistakes over obstacle” were the only components with an ICC > 0.6. Assessment‐reassessment agreement was poor to fair. The agreement on gait grading was good overall (ICC = 0.74), but poor for grades ≤ 1 (ICC = 0.08) and fair for ataxia grades ≥ 2 (ICC = 0.43). Clinicians with prior knowledge of a possible gait abnormality were more likely to assign a grade higher than the median grade. Conclusion and Clinical Importance Clinicians should be aware of poor agreement even between skilled observers of equine gait abnormalities, especially when the clinical signs are subtle.

Accuracy and precision of gait events derived from motion capture in horses during walk and trot

This study aimed to create an evidence base for detection of stance-phase timings from motion capture in horses. The objective was to compare the accuracy (bias) and precision (SD) for five published algorithms for the detection of hoof-on and hoof-off using force plates as the reference standard. Six horses were walked and trotted over eight force plates surrounded by a synchronised 12-camera infrared motion capture system. The five algorithms (A-E) were based on: (A) horizontal velocity of the hoof; (B) Fetlock angle and horizontal hoof velocity; (C) horizontal displacement of the hoof relative to the centre of mass; (D) horizontal velocity of the hoof relative to the Centre of Mass and; (E) vertical acceleration of the hoof. A total of 240 stance phases in walk and 240 stance phases in trot were included in the assessment. Method D provided the most accurate and precise results in walk for stance phase duration with a bias of 4.1% for front limbs and 4.8% for hind limbs. For trot we derived a combination of method A for hoof-on and method E for hoof-off resulting in a bias of -6.2% of stance in the front limbs and method B for the hind limbs with a bias of 3.8% of stance phase duration. We conclude that motion capture yields accurate and precise detection of gait events for horses walking and trotting over ground and the results emphasise a need for different algorithms for front limbs versus hind limbs in trot.

Functional limits of agreement applied as a novel method comparison tool for accuracy and precision of inertial measurement unit derived displacement of the distal limb in horses

Over ground motion analysis in horses is limited by a small number of strides and restraints of the indoor gait laboratory. Inertial measurement units (IMUs) are transforming the knowledge of human motion and objective clinical assessment through the opportunity to obtain clinically relevant data under various conditions. When using IMUs on the limbs of horses to determine local position estimates, conditions with high dynamic range of both accelerations and rotational velocities prove particularly challenging. Here we apply traditional method agreement and suggest a novel method of functional data analysis to compare motion capture with IMUs placed over the fetlock joint in seven horses. We demonstrate acceptable accuracy and precision at less than or equal to 5% of the range of motion for detection of distal limb mounted cranio-caudal and vertical position. We do not recommend the use of the latero-medial position estimate of the distal metacarpus/metatarsus during walk where the average error is 10% and the maximum error 111% of the range. We also show that functional data analysis and functional limits of agreement are sensitive methods for comparison of cyclical data and could be applied to differentiate changes in gait for individuals across time and conditions.

Accuracy and precision of oscillometric blood pressure in standing conscious horses

BACKGROUND Arterial blood pressure (BP) is a relevant clinical parameter that can be measured in standing conscious horses to assess tissue perfusion or pain. However, there are no validated oscillometric noninvasive blood pressure (NIBP) devices for use in horses. ANIMALS Seven healthy horses from a teaching and research herd. HYPOTHESIS/OBJECTIVE To evaluate the accuracy and precision of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) in conscious horses obtained with an oscillometric NIBP device when compared to invasively measured arterial BP. METHODS An arterial catheter was placed in the facial or transverse facial artery and connected to a pressure transducer. A cuff for NIBP was placed around the tail base. The BP was recorded during normotension, dobutamine-induced hypertension, and subnormal BP induced by acepromazine administration. Agreement analysis with replicate measures was utilized to calculate bias (accuracy) and standard deviation (SD) of bias (precision). RESULTS A total of 252 pairs of invasive arterial BP and NIBP measurements were analyzed. Compared to the direct BP measures, the NIBP MAP had an accuracy of -4 mm Hg and precision of 10 mm Hg. SAP had an accuracy of -8 mm Hg and a precision of 17 mm Hg and DAP had an accuracy of -7 mm Hg and a precision of 14 mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE MAP from the evaluated NIBP monitor is accurate and precise in the adult horse across a range of BP, with higher variability during subnormal BP. MAP but not SAP or DAP can be used for clinical decision making in the conscious horse.

Is a standalone inertial measurement unit accurate and precise enough for quantification of movement symmetry in the horse

Standalone ‘low-cost’ inertial measurement units (IMUs) could facilitate large-scale studies into establishing minimal important differences (MID) for orthopaedic deficits (lameness) in horses. We investigated accuracy and limits of agreement (LoA) after correction of magnitude-dependent differences of a standalone 6 degree-of-freedom IMU compared with an established IMU-based gait analysis system (MTx) in six horses for two anatomical landmarks (sacrum and sternum). Established symmetry measures were calculated from vertical displacement: symmetry index (SI), difference between minima (MinDiff) and difference between maxima (MaxDiff). For the sacrum, LoA were ± 0.095 for SI, ± 6.6 mm for MinDiff and ± 4.3 mm for MaxDiff. For the sternum, LoA values were ± 0.088 for SI, ± 5.0 mm for MinDiff and ± 4.2 mm for MaxDiff. Compared with reference data from mildly lame horses, SI values indicate sufficient precision, whereas MinDiff and MaxDiff values are less favourable. Future studies should investigate specific calibration and processing algorithms further improving standalone IMU performance.