Kevin G. Keegan

Assessment of repeatability of a wireless, inertial sensor–based lameness evaluation system for horses

OBJECTIVE To determine repeatability of a wireless, inertial sensor-based lameness evaluation system in horses. ANIMALS 236 horses. PROCEDURES Horses were from 2 to 29 years of age and of various breeds and lameness disposition. All horses were instrumented with a wireless, inertial sensor-based motion analysis system on the head (accelerometer), pelvis (midline croup region [accelerometer]), and right forelimb (gyroscope) before evaluation in 2 consecutive trials, approximately 5 minutes apart, as the horse was trotted in a straight line. Signal-processing algorithms generated overall trial asymmetry measures for vertical head and pelvic movement and stride-by-stride differences in head and pelvic maximum and minimum positions between right and left sides of each stride. Repeatability was determined, and trial difference was determined for groups of horses with various numbers of strides for which data were collected per trial. RESULTS Inertial sensor-based measures of torso movement asymmetry were repeatable. Repeatability for measures of torso asymmetry for determination of hind limb lameness was slightly greater than that for forelimb lameness. Collecting large numbers of strides degraded stride-to-stride repeatability but did not degrade intertrial repeatability. CONCLUSIONS AND CLINICAL RELEVANCE The inertial sensor system used to measure asymmetry of head and pelvic movement as an aid in the detection and evaluation of lameness in horses trotting in a straight line was sufficiently repeatable to investigate for clinical use.

Comparison of an inertial sensor system with a stationary force plate for evaluation of horses with bilateral forelimb lameness

OBJECTIVE To assess the analytic sensitivity of an inertial sensor system for detection of the more severely affected forelimb in horses with bilateral lameness. ANIMALS 18 adult horses with forelimb lameness. PROCEDURES Horses were fitted with inertial sensors and evaluated for lameness with a stationary force plate as they were trotted in a straight line. Inertial sensor-derived measurements for vertical head movement asymmetry (HMA) and vector sum (VS) of maximum and minimum head height differences between right and left halves of the stride were used to predict differences in mean peak vertical force (PVF) as a percentage of body weight between the right and left forelimbs. Repeatability was compared by calculation of the intraclass correlation coefficient (ICC) for each variable. Correct classification percentages for the lamer forelimb were determined by use of a stationary force plate as the standard. RESULTS SEs of the prediction of difference in PVF between the right and left forelimbs from HMA and VS were 6.1% and 5.2%, respectively. Head movement asymmetry (ICC, 0.72) was less repeatable than PVF (ICC, 0.86) and VS (ICC, 0.84). Associations were positive and significant between HMA (R(2) = 0.73) and VS (R(2) = 0.81) and the difference in PVF between the right and left forelimbs. Correct classification percentages for HMA and VS for detecting the lamer forelimb were 83.3% and 77.8%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that an inertial sensor system to measure vertical asymmetry (HMA and VS) due to forelimb lameness in horses trotting in a straight line has adequate analytic sensitivity for clinical use. Additional studies are required to assess specificity of the system.

Signal decomposition method of evaluating head movement to measure induced forelimb lameness in horses trotting on a treadmill.

In horses at a trot, the head moves up and down twice in one stride. In horses with unilateral forelimb lameness this movement is asymmetric. Computer-assisted kinematic analysis of vertical head movement can be used to quantify objectively lameness in horses in clinical trials. However, in mild lameness, absolute measurements of vertical head height may not be sensitive enough to detect small differences in lameness, and extraneous head movement by the horse due to curiosity, excitement or nervousness interferes with the accurate measurement of vertical head movement asymmetry. We describe a simple, signal-decompensation method of evaluating vertical head movement using a model of induced mild foot lameness in 9 horses. The technique assumes that the vertical head movement pattern can be broken down into 3 components; the vertical head movement caused by forelimb lameness (A1), the amplitude of the natural biphasic vertical head movement (A2) and extraneous head movement. Extraneous head movement is mathematically removed from the vertical head movement pattern. A1 and A2 are then calculated. After induction of lameness, mean A1 increased by 1.63 cm (range 0.10-3.33 cm, P = 0:005). Mean A2 did not significantly change after lameness induction. Error in reproduction of the original head movement pattern was 0.3-0.5%. We calculated that a hypothetical clinical trial would require 12 subjects for testing to be 80% certain that this difference would be successfully detected using this method of lameness evaluation.

Comparison of an inertial sensor system of lameness quantification with subjective lameness evaluation

REASONS FOR PERFORMING STUDY Subjective evaluation of mild lameness has been shown to have poor interobserver reliability. Traditional methods of objective lameness evaluation require specialised conditions and equipment. Wireless inertial sensor systems have been developed to allow for simple, rapid, objective lameness detection in horses trotted over ground. OBJECTIVE The purpose of this study was to compare the sensitivities of an inertial sensor system and subjective evaluation performed by experienced equine practitioners at detecting lameness in horses. We hypothesised that the inertial sensor system would identify lameness at a lower level of sole pressure than a consensus of 3 experienced equine veterinarians. METHODS Fifteen horses were fitted with special shoes that allowed for lameness induction via sole pressure. Horses were simultaneously evaluated by 3 equine veterinarians and a wireless inertial sensor system. Horses were subjected to multiple trials: 1) before inserting the screw; 2) after inserting the screw to just touch the sole; and 3) after tightening the screw in half turn increments. The number of screw turns required for lameness identification in the correct limb by the inertial sensors and by consensus of 3 equine veterinarians was compared using the Wilcoxon test. RESULTS The inertial sensor system selected the limb with the induced lameness after fewer screw turns than did the 3 veterinarians (P<0.0001). The inertial sensor system selected the correct limb before the 3 veterinarians in 35 trials (58.33%), the evaluators selected the correct limb before the inertial sensors in 5 trials (8.33%), and in 20 trials (33.33%) they selected the correct limb at the same time. POTENTIAL RELEVANCE The inertial sensor system was able to identify lameness at a lower level of sole pressure than the consensus of 3 equine veterinarians. The inertial sensor system may be an effective aid to lameness localisation in clinical cases.

Effects of intra-articular botulinum toxin type A in an equine model of acute synovitis: a pilot study.

DePuy T, Howard R, Keegan K, Wilson D, Kramer J, Cook JL, Childers MK: Effects of intra-articular botulinum toxin type A in an equine model of acute synovitis: a pilot study. Am J Phys Med Rehabil 2007;86:777–783. Objective:To test the hypothesis that botulinum toxin type A (BoNT-A) can attenuate lameness associated with acute synovitis in an equine model. Design:Four horses 2–6 yrs of age with clinically normal carpi were studied for 15 days. Kinematic gait analysis and clinical measures of lameness were conducted before and after experimental interventions. Horses were randomly assigned to either placebo (saline) or treatment (BoNT-A) groups. On day 0 of the intervention, 50 units of BoNT-A or an equivalent volume of saline (0.09%) was given into the middle carpal joints. On day 14, acute synovitis was induced with intra-articular injection of recombinant equine interleukin-1 beta (IL-1&bgr;) 100 ng. Synovial fluid, clinical evaluation of lameness, and kinematic gait analysis were evaluated on day 15. Results:Synovitis was observed on histology and cytology in all horses after IL-1&bgr;, indicating acute suppurative inflammation. In the BoNT-A group, one horse developed lameness, whereas the other demonstrated no change in baseline gait evaluation. No adverse effects were observed in joints injected with BoNT-A or with saline alone. Conclusions:Our findings support the idea that BoNT-A can attenuate lameness in an equine model of acute synovitis. Our findings further suggest that BoNT-A might be a potential new treatment for painful arthritis; this warrants further study.

Head and pelvic movement asymmetry during lungeing in horses with symmetrical movement on the straight

Summary Reasons for performing study Lungeing is commonly used as part of standard lameness examinations in horses. Knowledge of how lungeing influences motion symmetry in sound horses is needed. Objectives The aim of this study was to objectively evaluate the symmetry of vertical head and pelvic motion during lungeing in a large number of horses with symmetric motion during straight line evaluation. Study design Cross‐sectional prospective study. Methods A pool of 201 riding horses, all functioning well and considered sound by their owners, were evaluated in trot on a straight line and during lungeing to the left and right. From this pool, horses with symmetric vertical head and pelvic movement during the straight line trot (n = 94) were retained for analysis. Vertical head and pelvic movements were measured with body mounted uniaxial accelerometers. Differences between vertical maximum and minimum head (HDmax, HDmin) and pelvic (PDmax, PDmin) heights between left and right forelimb and hindlimb stances were compared between straight line trot and lungeing in either direction. Results Vertical head and pelvic movements during lungeing were more asymmetric than during trot on a straight line. Common asymmetric patterns seen in the head were more upward movement during push‐off of the outside forelimb and less downward movement during impact of the inside limb. Common asymmetric patterns seen in the pelvis were less upward movement during push‐off of the outside hindlimb and less downward movement of the pelvis during impact of the inside hindlimb. Asymmetric patterns in one lunge direction were frequently not the same as in the opposite direction. Conclusions Lungeing induces systematic asymmetries in vertical head and pelvic motion patterns in horses that may not be the same in both directions. These asymmetries may mask or mimic fore‐ or hindlimb lameness.

Associations of force plate and body-mounted inertial sensor measurements for identification of hind limb lameness in horses.

OBJECTIVE To investigate associations between inertial sensor and stationary force plate measurements of hind limb lameness in horses. ANIMALS 21 adult horses with no lameness or with mild hind limb lameness. PROCEDURES Horses were instrumented with inertial sensors and evaluated for lameness with a stationary force plate while trotting in a straight line. Inertial sensor-derived measurements of maximum and minimum pelvic height differences between right and left halves of the stride were compared with vertical and horizontal ground reaction forces (GRFs). Stepwise linear regression was performed to investigate the strength of association between inertial sensor measurements of hind limb lameness and amplitude, impulse, and time indices of important events in the vertical and horizontal GRF patterns. RESULTS Difference in minimum pelvic position was moderately (Ra(2) = 0.60) associated with the difference in peak vertical GRF but had little association with any horizontal GRF measurements. Difference in maximum pelvic position was strongly (Ra(2) = 0.77) associated with a transfer of vertical to horizontal ground reaction impulse in the second half of the stance but was not associated with difference in peak vertical GRF. CONCLUSIONS AND CLINICAL RELEVANCE Inertial sensor-derived measurements of asymmetric pelvic fall (difference in minimum pelvic position) indicated a decrease in vertical GRF, but similar measurements of asymmetric pelvis rise (difference in maximum pelvic position) indicated a transfer of vertical to horizontal force impulse in the second half of the stance. Evaluation of both pelvic rise and fall may be important when assessing hind limb lameness in horses.

Detection of spinal ataxia in horses using fuzzy clustering of body position uncertainty

REASONS FOR PERFORMING STUDY Subjective neurological evaluation in horses is prone to bias. An objective method of spinal ataxia detection is not subject to these limitations and could be of use in equine practice and research. HYPOTHESIS Kinematic data in the walking horse can differentiate normal and spinal ataxic horses. METHODS Twelve normal and 12 spinal ataxic horses were evaluated by kinematic analysis walking on a treadmill. Each body position signal was reduced to a scalar measure of uncertainty then fuzzy clustered into normal or ataxic groups. Correct classification percentage (CCP) was then calculated using membership values of each horse in the 2 groups. Subsequently, a guided search for measure combinations with high CCP was performed. RESULTS Eight measures of body position resulted in CCP > or = 70%. Several combinations of 4-5 measures resulted in 100% CCP. All combinations with 100% CCP could be obtained with one body marker on the back measuring vertical and horizontal movement and one body marker each on the right fore- and hindlimb measuring vertical movement. CONCLUSIONS AND POTENTIAL RELEVANCE Kinematic gait analysis using simple body marker combinations can be used objectively to detect spinal ataxia in horses.

Retrospective study of cecocolic intussusception (cecal inversion) in nine horses (1982–1998)

Summary We retrospectively evaluated the medical records and obtained follow-up information for nine horses which had been treated for cecocolic intussusception (CCI) between January 1982 and April 1998. During the 16-year study period, CCI was diagnosed in nine of 748 horses in which exploratory celiotomy was undertaken for abdominal pain, representing an incidence of 1.2%. Most affected horses (78%) were less than four years of age (median age was 12 months, age range was five months to 15 years). Cecocolic intussusception affected male horses (78%) more commonly than female horses. The most common clinical presentation was abdominal pain of a severe, acute nature or milder but recurrent signs of abdominal pain persisting in spite of conservative treatment for several days. Correction of CCI by either simple reduction or reduction followed by partial typhlectomy was successful if compromise of the intestine by devitalization and adhesion formation was not found at surgery. Definitive diagnosis of CCI necessitates exploratory celiotomy, although an ultrasonographic examination of the abdomen may confirm the diagnosis in some cases. When recognized early during the course of disease, surgical correction of CCI is associated with a favorable outcome; of the eight horses which underwent surgery in our series, five horses (63%) survived surgical correction of CCI. Handling of compromised gut during reduction of CCI necessitates extreme caution because the risk of intestinal tearing is quite high.

Combined uncertainty model for best wavelet selection

This paper discusses the use of combined uncertainty methods in the computation of wavelets that best represent horse gait signals. Combined uncertainty computes a composite of two types of uncertainties, fuzzy and probabilistic. First, we introduce fuzzy uncertainty properties and classes. Next, the gait analysis problem is discussed in the context of correctly classifying wavelet-transformed sound gait from lame horse gait signals. Continuous wavelets are selected using generalized information theory-related concepts that are enhanced through the application of uncertainty management models. Our experimental results show that models developed by maximizing combined uncertainty produce better results, in terms of neural network correct classification percentage, compared to those computed using only fuzzy uncertainty.