Maarten Oosterlinck

Comparison of pressure plate and force plate gait kinetics in sound Warmbloods at walk and trot

Modern pressure plates (PP) could be an alternative to traditional force plates (FP) for quantitative equine gait analysis, thereby providing the clinician with objective data on the horses gait while unravelling the loading of different regions of the hoof during the stance phase. The aim of this study was to determine whether a stand-alone PP allows reliable measurement of gait kinetics, compared to simultaneously recorded FP variables. Six sound Warmblood horses were walked and trotted over a combined PP and FP system for collection of a set of five valid kinetic measurements for each forelimb. A measurement was considered valid if the horse was moving in a straight line at a constant pace while gait velocity was within a preset range and the hoof fully contacted the plate surface. Significant differences between FP and PP data were seen for peak vertical force (PVF), vertical impulse (VI), time at which the PVF occurs (tPVF) and forelimb symmetry ratios (SymPVF and SymVI) (P < 0.05), but not for stance phase duration (ST). Nevertheless, mean agreement indices (AIs) of ST, tPVF and SymPVF and SymVI were excellent (≥ 0.92), whereas AIs of PVF and VI were moderate (≥ 0.70). The excellent agreement between PP and FP symmetry ratios confirms that observed differences between PP and FP in symmetry ratios are small (2-7%), especially when compared to the expected decrease in symmetry associated with mild lameness (> 20%). The results indicate that a stand-alone pressure plate can be used to measure absolute (ST) and relative (tPVF) temporal variables and loading symmetry ratios and offers equine veterinarians a mobile, cost-efficient and quick gait evaluation method for routine clinical use. However, the system cannot be used interchangeably with a force plate to measure absolute values of limb loading.

Use of blood culture medium enrichment for synovial fluid culture in horses: a comparison of different culture methods.

REASONS FOR PERFORMING STUDY Standard methods for culturing equine synovial fluid (SF) are often unrewarding. Evidence-based information on the relative efficiency of different systems used for optimisation of isolation of microorganisms from equine SF is lacking. OBJECTIVES To compare the results of different culture systems performed in parallel on SF samples from horses clinically diagnosed with synovial sepsis. METHODS Synovial fluid specimens were collected between February 2007 and October 2008 from all horses admitted to a referral hospital that were clinically diagnosed with synovial sepsis and from control horses. Synovial fluid samples were cultured in parallel by: 1) direct agar culture (DA); agar culture after: 2) lysis-centrifugation pretreatment (LC); 3) conventional enrichment (CE); 4) combined LC/CE; or 5) blood culture medium enrichment using an automated system (BACTEC 9050). RESULTS Ninety SF samples from 82 horses were included, together with 40 control samples. Seventy-one of 90 samples (79%) were culture-positive by using blood culture medium enrichment (BACTEC), which was significantly higher compared to all other methods. BACTEC enrichment was never negative while any of the other methods was positive. Although agar culture following LC and/or CE resulted in a slightly higher number of positive samples compared to DA, this difference was not significant. All control samples were culture negative by the 5 different techniques. Although the majority of samples containing isolates recovered without enrichment, culture results after BACTEC enrichment were available on the same day as for agar culture with or without LC (19/23 samples), while CE postponed recovery by at least one day in 20/23 samples. CONCLUSION Blood culture medium enrichment is superior to other techniques for isolation of bacteria from SF of horses. The use of an automated system allows enrichment without substantially postponing recovery of microorganisms. POTENTIAL RELEVANCE The efficient and fast isolation of microorganisms from infected SF by the BACTEC system allows for rapid susceptibility testing and a more appropriate antibiotic treatment.

Use of a pressure plate to analyse the toe-heel load redistribution underneath a normal shoe and a shoe with a wide toe in sound warmblood horses at the walk and trot

The objective of this study was to use a pressure plate to quantify the toe-heel load redistribution in the forelimbs of sound warmblood horses with normal shoes and shoes with a wide toe and narrow branches, used empirically in the treatment of superficial digital flexor tendon or suspensory ligament injuries. In a crossover-design study, six horses, randomly shod with normal shoes and shoes with a wide toe, were led over a dynamically calibrated pressure plate to record data from both forelimbs. There were no significant differences between both shoes in the toe-heel index of stance time, peak vertical force and vertical impulse. For the adapted shoe, the peak vertical pressure was slightly lower and was exerted slightly earlier in the stance phase, albeit not significantly. However, the significantly larger toe contact area of the adapted shoe resulted in a significantly lower total vertical pressure in the toe region. Hence, the pressure plate adequately visualised the individual loading of the toe and heel region, and clearly demonstrated the altered pressure distribution underneath the shoe with a wide toe. Although further research on a deformable surface is needed to confirm this hypothesis, the pressure redistribution from the toe to the heels could promote sinking of the heels in arena footing, thereby mimicking the biomechanical effects of a toe wedge and providing a rationale for its application in the treatment of SDFT or SL injuries. The pressure measuring equipment used in this study can offer to the clinician a diagnostic tool for the evaluation of the load distribution underneath the equine hoof and for the fine-tuning of corrective shoeing.

Pressure plate analysis of toe-heel and medio-lateral hoof balance at the walk and trot in sound sport horses.

Empirically, equine distal limb lameness is often linked to hoof imbalance. To objectively quantify dynamic toe-heel and medio-lateral hoof balance of the vertical ground reaction force in sound sport horses, seven Royal Dutch Sport Horses were led at the walk and trot over a dynamically calibrated pressure plate. Forelimb hoof prints were divided into a toe and heel region and a medial and lateral zone. Toe-heel and medio-lateral hoof balance of the vertical ground reaction force were calculated throughout the stance. Toe-heel balance was highly symmetrical between contralateral limbs at both gaits. At the walk, medio-lateral balance of both forelimbs presented higher loading in the lateral part of the hoof throughout the stance. However, at the trot, left medio-lateral balance presented higher loading of the medial part of the hoof at impact, whereas the right limb showed higher loading of the lateral part of the hoof in all horses, and both limbs presented increased lateral loading at the end of the stance. This study provides objective data for toe-heel and medio-lateral hoof balance in sound sport horses.

Evaluation of an automated blood culture system for the isolation of bacteria from equine synovial fluid

The objective of this study was to evaluate an automated blood culture system for the isolation of microorganisms from infected equine synovial fluid (SF). Samples were collected from 220 severely inflamed synovial joints and classified as either presumably infected (group A: n=149) or not infected (group B: n=71), based on a combination of clinical history, clinical signs and cytological analysis of the SF. Samples were inoculated into blood culture bottles and after incubation were subcultured onto agar media to confirm the results and to facilitate full bacterial identification. Microorganisms were isolated from 107 group A samples (71.8%) and from three group B samples (4.2%). Overall, the detection system identified 117 bottles as positive and 103 as negative, including nine instrument-false-positives and two instrument-false-negatives. The median time-to-detection for Gram-positive bacteria, Gram-negative bacteria, and for fungi was 14.3 (interquartile range [I.R.] 10.0) h, 8.8 (I.R. 12.8) h, and 72.0 (range 60.8-74.8) h, respectively. It was concluded that culture of infected SF using the automated system combines the advantages of enrichment in specialised medium with the rapid detection of bacterial growth.

Quantitative and Qualitative Evaluation of Dermal Elastin of Draught Horses with Chronic Progressive Lymphoedema

Chronic progressive lymphoedema (CPL) in horses, a disease of certain draught breeds, is associated with altered elastin metabolism. The characteristic lesions are seen in the skin of the lower (distal) limbs. This study was based on horses of susceptible breeds, with and without CPL, and on horses of a non-susceptible breed. Skin samples were obtained for examination from the neck (considered a non-affected region) and from the distal limb. The skin lesions were characterized histologically and the dermal elastic fibres were evaluated morphologically and quantitatively. In all horses the mean elastin concentrations were highest in the superficial dermis, gradually decreasing in the mid-dermis and deep dermis. As compared with horses of a non-susceptible breed, affected horses had increased amounts of dermal elastin in both the distal limb and neck, while non-affected horses of a susceptible breed had decreased amounts. The findings support an earlier hypothesis that CPL of horses is a generalized disease. Reduced efficiency of the elastic network in supporting the dermal lymphatics may explain the development of CPL.

Effect of Clostridium botulinum toxin type A injections into the deep digital flexor muscle on the range of motion of the metacarpus and carpus, and the force distribution underneath the hooves, of sound horses at the walk

In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. botulinum toxin type A on the gait characteristics of sound horses at the walk are not known. The aim of this study was to test if a reduced DDFM activity would lead to (1) alterations of the sagittal range of motion of the metacarpus (SROM) and range of motion of the carpal joint (CROM); (2) changes in the force distribution underneath the hoof (toe vs. heel region: balance index); and (3) changes in the force distribution between the treated and untreated limb (symmetry index). The DDFMs of the left forelimbs of seven sound Royal Dutch Sport Horses were injected with 200 IU C. botulinum toxin type A using electromyography and ultrasound guidance. Measurements using an inertial sensor system and dynamically calibrated pressure plate were performed before and after injections. The SROM and CROM of the treated limb were significantly increased after C. botulinum toxin type A injections. No significant changes were detected in the balance index or in the symmetry index, indicating that no lameness was induced. C. botulinum toxin type A injections into the DDFM of sound horses do not appear to result in substantial gait alterations at the walk.

A preliminary study on pressure-plate evaluation of forelimb toe-heel and mediolateral hoof balance on a hard vs. a soft surface in sound ponies at the walk and trot

REASONS FOR PERFORMING STUDY Thus far, pressure-plate analysis has been limited to measurements on a hard surface, whereas equine athletes routinely perform on a deformable substrate. OBJECTIVES To explore pressure-plate analysis on arena footing. STUDY DESIGN Nonrandomised crossover study using noninvasive techniques. METHODS Five sound, unshod ponies were walked and trotted over a pressure plate in 2 different conditions. In the first session, the plate was covered with only a 5 mm rubber mat, and in the second session, with an additional 50 mm layer of sand and synthetic fibres. Limb loading and timing variables (peak vertical force, vertical impulse, peak vertical pressure, hoof contact area and stance phase duration) were obtained. Toe-heel and mediolateral hoof balance of the vertical force were calculated throughout stance (126 Hz). RESULTS Peak vertical force, vertical impulse, peak vertical pressure and stance phase duration were decreased on the soft substrate, while hoof contact area increased. At impact, there was more even load distribution between the toe and heel region on the soft vs. hard surface. At mid-stance, there was more loading of the toe region on the soft compared with the hard surface. At impact, there was more even load distribution between lateral and medial on the soft vs. hard surface at walk, but not at trot. CONCLUSIONS Comparison of observed vs. expected impulse indicated that the main factor involved in the lower loading on the soft surface is the dampening effect of the soft substrate, although definitive conclusions require concurrent force-plate analysis. The pressure plate permitted quantitative evaluation of hoof balance of the vertical force on a deformable surface at the walk and trot and proved that there is more even load distribution on arena footing.

Does long-term unilateral circling affect locomotor symmetry in ponies used for carousel rides?

There is ethical debate on the use of ponies for carousel rides at city fairs, as these animals may develop progressive locomotor asymmetry during their career. To investigate this issue, 21 ponies used for carousel rides were walked and trotted over a pressure plate system. Non-directional symmetry ratios and directional asymmetry indices of forelimb peak vertical force (PVF), vertical impulse (VI), stance time (ST) and hoof contact area (CA) were calculated and compared to reference data. In both the carousel and reference groups, most ponies presented higher loading of the right forelimb at the walk and trot. Carousel ponies presented slightly, though significantly, lower symmetry ratios and more negative asymmetry indices than the reference group for PVF and VI, but not for ST and CA. However, repeated analysis after exclusion of the ponies with visually observed lameness revealed no significant differences in asymmetry indices, whereas symmetry ratios remained lower in the carousel group. Interestingly, Ten of 21 carousel ponies were subjectively more difficult to lunge on the circle opposite to their routine working direction, whereas the ponies in the reference group were easily lunged in both directions. In the absence of clear unilateral lameness or locomotor asymmetry in the majority of ponies, it is reasonable to assume a behavioural explanation for this observation. There was no significant association between the duration of the career and all symmetry indices. These results indicate an overall less symmetric locomotion in carousel ponies, but progressive locomotor asymmetry due to long-term unilateral circling seems to be unlikely.

Mouldable, thermoplastic, glue‐on frog‐supportive shoes change hoof kinetics in normal and obese Shetland ponies

Summary Background Obesity and hyperinsulinaemia are frequently encountered in the equine population and risk factors for the development of laminitis. There are many options for hoof support that claim a beneficial effect, but often the scientific evidence is scarce. Objectives To quantify the effect of frog‐supportive shoes on hoof kinetics in normal and obese ponies. Study design Controlled in vivo trial. Methods Ten Shetland mares (n = 10) with a normal (n = 5) or obese (n = 5) body condition were led over a dynamically calibrated pressure plate before (T0), immediately after (T1) and 72 h (T2) after application of the shoes. The following locomotor variables were measured: stance duration (StDur), vertical impulse (VI), peak vertical force (PVF), time to PVF and time from PVF to lift off. The hoof print was divided into a toe and heel region and the StDur toe–heel index was calculated. The toe–heel hoof balance curves of the vertical force were plotted throughout the stance phase. Results The VI and PVF increased significantly 72 h after application of the shoes, when compared with T0 and T1. The StDur toe–heel index and toe–heel balance curves were significantly different between the normal and obese ponies. These variables became more comparable between the groups after application of the frog‐supportive shoes. Main limitations It would have been interesting to measure the effect of the shoe in patients with acute laminitis. However, this would have had major welfare implications. Conclusions The obese ponies moved more carefully than the normal group, demonstrated by a decreased loading of the toe area. The data illustrate that the ponies became more comfortable 72 h after application of the shoes, with a pronounced effect in the obese group. Thus, these results suggest that frog‐supportive shoes could be beneficial, especially for obese ponies.