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Topic:Nervous System

The nervous system in horses is a complex network responsible for transmitting signals between different parts of the body. It consists of the central nervous system (CNS), which includes the brain and spinal cord, and the peripheral nervous system (PNS), which comprises nerves that extend throughout the body. The nervous system regulates various physiological processes, including movement, sensation, and the coordination of bodily functions. It plays a critical role in processing sensory information and initiating appropriate responses. This page compiles peer-reviewed research studies and scholarly articles that explore the structure, function, and clinical implications of the equine nervous system, including its role in behavior, response to stimuli, and neurological disorders.
Anatomical and computed tomographic study of equine cervical spinal nerves and intervertebral foramina.
Equine veterinary journal    October 29, 2026   doi: 10.1002/evj.70350
Stas EKL, Ehrle A, Lischer CJ.Osseous enlargement of the cervical articular process joints due to osteoarthropathy or developmental hypertrophy can narrow the intervertebral foramen (IF), resulting in compression and neuritis of the exiting spinal nerves. Associated clinical signs may include neck pain, forelimb lameness or muscle atrophy. Computed tomography (CT) is the gold standard for IF evaluation; however, to date, visualisation of the equine spinal nerves based on CT imaging is insufficient. Objective: To improve the diagnostic accuracy of foraminal stenosis and cervical spinal nerve (CSN) compression based on CT, t...
Influence of chiropractic care on sleep-related behavior of athletic Mangalarga Marchador horses.
Journal of equine veterinary science    October 21, 2026   106181 doi: 10.1016/j.jevs.2026.106181
Toledo C, Mathias I, Coutinho I, Ribeiro L, Vega W, Oliveira T, Filippo PD.Sleep is a fundamental biological process for homeostasis in mammals. Chiropractic is a manual therapeutic approach that aims to restore joint mobility, correct biomechanical dysfunctions, and optimize welfare. Objective: The present study examined the influence of chiropractic sessions on resting behavior patterns of Mangalarga Marchador horses raised in an intensive system. Methods: Nine Mangalarga Marchador horses, with an average age of 4.2 ± 1.2 years, were evaluated for their sleep-related behavior over 72 hours, followed by a chiropractic session, and reassessed over the next 72 hours ...
Effects of Incorporating Horses into Occupational Therapy on Adrenocortical and Sympathetic Nervous System Reactivity and Regulation in Autistic Children: A Randomized Controlled Trial.
Journal of autism and developmental disorders    October 10, 2026   doi: 10.1007/s10803-026-07540-9
Rankins EM, Aichele S, Granger DA, Hepburn S, Gabriels R, Schmid AA, Peters BC.The study prospectively investigated adrenocortical and autonomic nervous system reactivity and regulation as autistic children participated in a randomized controlled trial of occupational therapy in an equine environment (OT-Equine). Methods: Autistic children (n = 72, ages 6-11 yrs) were randomly assigned for 10 weeks to OT-Equine or clinic-based occupational therapy (OT-Clinic). Saliva samples (later assayed for cortisol and alpha-amylase, [sAA]) were collected before (pre-session), during (within-session), immediately after (post-session), and 20-minutes after (post-session + 20) ...
[Atlantoaxial luxation in a neonatal Warmblood foal].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    October 9, 2026   Volume 54, Issue 5 353-360 doi: 10.1055/a-2901-5279
Längerer L, Bartmann CP, Schmidt M, Krohn J.Atlantoaxial luxation represents a rare but clinically relevant differential diagnosis in neonatal foals presenting with neurological abnormalities or dysphagia. This case report describes a newborn filly without apparent ataxia, but presenting with a stiff head-neck posture and milky nasal discharge. Clinical examination revealed a compromised general condition and abnormal swelling in the region of the fossa retromandibularis. Radiographic examination confirmed the diagnosis of an atlantoaxial luxation. Due to the poor prognosis the foal was euthanized. This case highlights the diagnostic ap...
Biomarkers of brain injury in foals with neonatal maladjustment syndrome.
Journal of veterinary internal medicine    September 22, 2026   Volume 40, Issue 5 aalag228 doi: 10.1093/jvimsj/aalag228
Perez Quesada J, Coley K, Wong D, Browne N, Albrecht M, Dembek K.Plasma concentrations of brain-derived neurotrophic factor (BDNF), glial-fibrillary-acidic protein (GFAP), and astrocytic protein S100B, might be linked to the pathophysiology of Neonatal Maladjustment Syndrome (NMS). Objective: To measure serum concentration of BDNF and S100B, plasma concentration of GFAP, and neurosteroids (progesterone and 17α-hydroxyprogesterone) in foals with NMS, foals presented for other diseases, including premature, and healthy foals, and determine their association with outcome. Methods: Fourteen healthy foals, 19 NMS foals, 39 foals hospitalized for other diseases ...
Modified technique for resection of the alar folds to nasal paralysis in a mule: Case report.
Veterinary research communications    September 16, 2026   Volume 50, Issue 6 573 doi: 10.1007/s11259-026-11527-3
Watanabe MJ, de Moura Alonso J, Perandré PI, Cestari H, Gonçalves VF, Ferrari LC, Alves ALG, Hussni CA.Equids are obligate nasal breathers. Therefore, conditions that obstruct or impair this respiratory route can compromise animal welfare by causing severe respiratory distress, while also impacting athletic potential. Nasal paralysis results from injury to the facial nerve and its branches and is characterized by the lack of movement of the alar cartilage, leading to nasal collapse. Its occurrence is uncommon in horses and has not been previously reported in mules. This report describes a 9-month-old mule presented with a history of facial trauma and compression caused by a halter. After unsucc...
Human-horse interactions as complementary strategies for mental health promotion.
Annali dell'Istituto superiore di sanita    September 15, 2026   Volume 62, Issue 3 241-253 doi: 10.4415/ANN_26_03_07
Animal-assisted interventions (AAI) represent complementary rehabilitative approaches designed to address a range of physical and mental health conditions. Among these, Equine-assisted interventions (EAI) offer structured opportunities for engagement through diverse activities conducted within naturalistic settings, thereby integrating therapeutic processes with ecological contexts. Methods: Over the past years, our group has developed and implemented standardized AAI methodologies that are now embedded within comprehensive intervention planning. This overview summarizes the application of dif...
Diagnostic utility of trigeminocervical reflex and quantitative sensory testing in horses with trigeminal-mediated headshaking.
Journal of veterinary internal medicine    September 1, 2026   Volume 40, Issue 5 aalag199 doi: 10.1093/jvimsj/aalag199
Käfer-Karrer MJ, Spadavecchia C, de Preux M, Unger L.Assessment of trigeminal nerve (TN) function in horses with trigeminal-mediated headshaking (TMHS) using trigeminocervical reflex (TCR) and quantitative sensory testing (QST) has not been investigated. Objective: Horses with TMHS show lower TCR and QST thresholds than controls. A subset shows left-to-right differences. Methods: Privately owned horses with TMHS (n = 12) and secondary headshaking (sHS; n = 4), from a referral hospital. Headshaking-free controls (n = 14), from the hospital's teaching herd or privately owned. Methods: Prospective case-control-study. In unsedated horses, TCR ...
Equine neuroborreliosis in Scandinavia: cerebrospinal fluid PCR confirmation and successful treatment in a mare.
Acta veterinaria Scandinavica    September 1, 2026   Volume 68, Issue 1 38 doi: 10.1186/s13028-026-00879-0
Ruiz S, Øverlie M, Bergren A, Risnes Hellings I.Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato, is an emerging concern in human medicine, and is a controversial topic in equine medicine. Neuroborreliosis (NB), a neurologic manifestation of LB, remains challenging to diagnose due to nonspecific clinical signs and the lack of definitive diagnostic methods. This report describes the first documented case of equine NB in Scandinavia. Methods: An 11-year-old mare presented with progressive weight loss, ataxia, muscle atrophy, and hyperesthesia. Cerebrospinal fluid (CSF) analysis revealed neutrophilic pleocytosis, elevated prote...
Comparative genomics of Standardbred horses reveals candidate regions under selection for harness racing performance.
Journal of equine veterinary science    August 25, 2026   106133 doi: 10.1016/j.jevs.2026.106133
Harness racing performance in horses is a complex polygenic trait influenced by genetic background, breeding history, training, and environment. Understanding genomic patterns shaped by long-term artificial selection provides insights into performance-related traits and breed-specific genomic variation. Objective: This study aimed to characterize genomic differentiation, population structure, and candidate genomic regions potentially influenced by historical selection in Standardbred horses using comparative whole-genome sequencing involving diverse horse breeds. Methods: Whole-genome sequenci...
Equine herpesvirus myeloencephalopathy-associated mutations in equine herpesvirus 1 DNA polymerase confer the ability to replicate at elevated temperatures.
Microbiology spectrum    August 21, 2026   e0305525 doi: 10.1128/spectrum.03055-25
Fukushi N, Kirisawa R, Nishimura F, Tsujimura K, Toishi Y, Fukushi H.Equine herpesvirus myeloencephalopathy (EHM), caused by equine herpesvirus type 1 (EHV-1), poses a major threat to the equine industry because of its devastating impact on animal welfare and athletic performance. A single-nucleotide polymorphism (SNP), G2254, in ORF30 (UL30), which encodes the viral DNA polymerase, has been used as a marker of neuropathogenic EHV-1 strains, although its contribution to EHM pathogenesis remains controversial. In addition, other ORF30 SNPs have been reported in association with EHM, but their functional significance is unclear. Clinical observations indicate tha...
Leptomeningeal dissemination of a poorly differentiated carcinoma involving the trigeminal ganglion in a horse: a case report.
Journal of equine veterinary science    August 8, 2026   106123 doi: 10.1016/j.jevs.2026.106123
Rocha CSV, Ferreira CS, Jesus CVA, Silveira MDL, Gomes KMC, Júnior VAS, Gobbi FP, Fonseca SR, Oliveira AAF.Neoplastic conditions involving cranial nerves are uncommon in horses and represent a significant diagnostic challenge. Leptomeningeal dissemination is a recognized mechanism of tumor progression in aggressive neoplasms but is rarely reported in this species. A 15-year-old mixed-breed horse with a history of periocular squamous cell carcinoma treated by enucleation three years earlier developed progressive neurological signs. Initial differential diagnoses included metastatic neoplasia and equine protozoal myeloencephalitis. Due to rapid neurological deterioration, euthanasia and necropsy were...
Central nervous system lymphoma and neurolymphomatosis in equids.
Journal of veterinary internal medicine    July 29, 2026   Volume 40, Issue 4 aalag143 doi: 10.1093/jvimsj/aalag143
Aleman M, Calero MI, Woolard KD, O'Connell K, Berryhill E, Vernau W.Lymphoma affecting the central and peripheral nervous systems in equids is rarely reported. Objective: To describe the clinical presentation, neuroanatomical localization, laboratory and pathologic features, type of lymphoma, and outcome to further current knowledge. Methods: Fourteen equids (13 horses, 1 mule). Methods: Retrospective study. Medical records from a veterinary teaching hospital were reviewed (1993-2025). The inclusion criteria consisted of a definitive diagnosis of lymphoma of the nervous system. Data collected included signalment, neurologic findings, laboratory results, imagin...
Ceratohyoidectomy for Management of Unilateral and Bilateral Temporohyoid Osteoarthropathy: Long-Term Outcome in 33 Equids.
Animals : an open access journal from MDPI    July 28, 2026   Volume 16, Issue 15 2318 doi: 10.3390/ani16152318
McCrary HS, Stewart HL, Davis JG, Garcia-Lopez JM, Bubeck KA.Temporohyoid osteoarthropathy is a disease affecting the temporohyoid joint in equids caused by local inflammation and/or degeneration, leading to neurological deficits ranging from mild signs that affect performance to significant, acute neurological deficits such as facial nerve paralysis or vestibular signs. Multiple surgical treatment options are available, and while treatment has historically been performed unilaterally on the side of the clinical signs, advances in diagnostic imaging have highlighted the occurrence of bilateral disease of the temporohyoid joints, warranting evaluation of...
Perineural dexamethasone does not prolong bupivacaine sensory blockade in equine palmar digital nerve blocks: a randomized crossover trial.
American journal of veterinary research    July 27, 2026   1-6 doi: 10.2460/ajvr.26.05.0207
Larriva DS, Lopez JS, Garcia-Collao M, Farnsworth K, Villarino NF, Hall NP.To determine whether dexamethasone sodium phosphate (dexamethasone SP) prolongs the sensory blockade produced by perineural bupivacaine during medial and lateral palmar digital nerve blocks in horses. Unassigned: 8 healthy adult horses were enrolled in a blinded, randomized 4 X 4 crossover trial. Each horse received 1 of 4 perineural treatments over the palmar digital nerves of the left forelimb: bupivacaine, bupivacaine + dexamethasone SP, dexamethasone SP alone, or saline. A minimum 7-day washout was used between treatments. Mechanical nociceptive threshold (MNT) was measured at baseline and...
The Transcriptomic and Proteomic Molecular Signatures of Equine Multiple-System Neuropathy (Grass Sickness).
Cells    July 24, 2026   Volume 15, Issue 15 1328 doi: 10.3390/cells15151328
Summers KM, Karagianni AE, Fernandez PL, Beard PM, Pirie RS, Keen JA, Wishart TM, McGorum BC.Equine grass sickness (EGS or equine dysautonomia) is a predominantly fatal multi-system neuropathy affecting grazing horses, likely caused by a neurotoxic phospholipase A2 (nPLA2) derived from a plant or microorganism. We studied neuronal tissue gene and protein expression patterns in EGS to elucidate the possible mechanisms of neurotoxicity and neurodegeneration. Tissue from the cranial cervical ganglion of eight EGS horses and six controls was examined histologically and used for transcriptomic analysis. These transcriptomic data were compared with previously published EGS-related proteomic...
In-Hand Training of Piaffe and Passage with Leg Stimulation: A Literature-Based Biomechanical Argument for Why This Method Fails to Produce True Collection.
Journal of equine veterinary science    July 18, 2026   106098 doi: 10.1016/j.jevs.2026.106098
Scheibenpflug M.In-hand training of piaffe and passage via tactile leg stimulation (Handarbeit mit Touchieren) is widely practised in dressage, yet consistently produces horses that elevate their legs without achieving collection - a pattern termed Schenkelgänger (leg-movers) in classical German equitation. Based on published kinetic, kinematic, and electromyographic literature, this review argues that tactile leg stimulation activates the spinal nociceptive withdrawal reflex, an unloading movement mechanistically opposed to the elastic tendon rebound and ventral muscular chain activation that define true co...
Recognition of unfamiliar predators in domestic horses through only visual predator cues.
PloS one    July 15, 2026   Volume 21, Issue 7 e0349298 doi: 10.1371/journal.pone.0349298
Hofacker R, Sebunia N, Pihlblad J, Benderlioglu Z.Acoustic, olfactory, and visual predator cues trigger various adaptive responses among a variety of prey species even when they are under human protection since birth. Previous studies have found that domesticated animals show increased vigilance, stress, flight, and aggregation behaviors in response to predation threats. These investigations, however, did not directly test visual threatening cues alone in animals that communicate more with body language than vocalizations while considering individual temperament and social status. The current study aims to address this issue. Eighteen horses ...
Sensory-driven neck-limb coordination mechanisms for walk-trot-gallop gait transitions.
Scientific reports    July 12, 2026   doi: 10.1038/s41598-026-61565-9
Suzuki S, Norita A, Asaoka Y, Fukuhara A, Ishikawa M, Kobayashi R, Ishiguro A.Quadruped animals exhibit various gait patterns and switch from one to another depending on their speed. These gait patterns involve complex whole-body coordination and are mainly controlled by a distributed neural network consisting of central pattern generators (CPGs) and peripheral sensory feedback. However, how these neural networks generate various types of whole-body coordination remains unclear. Here, we focus on horse locomotion and present a neural network model that reproduces walk-trot-gallop transitions by changing only a single parameter related to speed. This model uses ground re...
Influence of collection site on cerebrospinal fluid test results in horses with equine protozoal myeloencephalitis.
Journal of veterinary internal medicine    July 8, 2026   Volume 40, Issue 4 aalag135 doi: 10.1093/jvimsj/aalag135
Furr MO.Cerebrospinal fluid (CSF) analysis is a critical component in the diagnosis of equine protozoal myeloencephalitis (EPM). Test results obtained may differ based on different collection sites. Objective: Compare results of EPM-specific diagnostic tests obtained from different collections sites in EPM-affected and non-EPM affected horses. Methods: Twenty control and 7 EPM-affected horses. Methods: Prospective observational study. CSF was collected from the lumbosacral (LS) and cranial sites (atlantooccipital or C1-2) in 27 horses and EPM-specific diagnostic tests were performed. Data were summari...
Identification of Genomic Differences Resulting from Selection in Iranian Kurdish and Turkmen Horse Breeds Using Single Nucleotide Polymorphisms.
Iranian journal of biotechnology    July 1, 2026   Volume 24, Issue 3 e4002 doi: 10.30498/ijb.2026.482549.4002
Khanahmadi A, Rahimi Mianji G, Moradi Shahrebabak H, Hafezian SH, Zandi MB.Breakthroughs in genomic technologies have enabled the formulation of methods to identify genomic variation in domestic animal species. Detection of the variation is necessary because it is associated with breed characteristics and economic importance in domestic animal genetics. Unassigned: This study aimed to identify the genomic regions in Turkmen and Kurdish horse breeds that have been the target of different selections over many years. It also sought to locate the genes and Quantitative trait loci (QTL) in these regions that contributed to the differentiation of these two breeds or the di...
Assessment of pharmacokinetic parameters, oral bioavailability, and physiological effects of amantadine in horses.
BMC veterinary research    June 23, 2026   doi: 10.1186/s12917-026-05672-9
Riley HL, Mama KR, Jacobs ME, McKemie DS, Kass PH, Knych HK.Without adequate pain management, central nervous system plasticity can result in acute or adaptive pain developing into chronic or maladaptive pain. This is difficult to manage and often unresponsive to traditional analgesics. An important mechanism associated with maladaptive pain is central sensitization which results in part from increased NMDA (N-methyl-D-aspartate) receptor activation. Amantadine is an NMDA receptor antagonist that has been used in combination with opioids and NSAIDs in humans and dogs for the treatment of conditions associated with central sensitization. The goal of the...
Neuroimmune Mechanisms in Equine Asthma: Primary Inflammatory Triggers, Neuroimmune Modulation and Chronic Airway Remodelling.
Animals : an open access journal from MDPI    June 14, 2026   Volume 16, Issue 12 1832 doi: 10.3390/ani16121832
Wierzbicka M, Samsel A, Siemieniuch-Tartanus M.Equine asthma is a chronic inflammatory disease of the lower respiratory tract, primarily associated with inhalation of organic dust, microbial particles and environmental aeroantigens. Although the inflammatory and immunological mechanisms underlying equine asthma have been extensively investigated, the potential contribution of neuroimmune pathways remains poorly understood. In humans and rodent models, asthma is increasingly recognised as a disorder involving complex bidirectional interactions between the nervous and immune systems. Sensory nerve activation, neuropeptide release, autonomic ...
Observations on Anti-Predator Defense Behavior in Feral Horses in Venezuela.
Animals : an open access journal from MDPI    June 12, 2026   Volume 16, Issue 12 1826 doi: 10.3390/ani16121826
Rees L, Kieson E.Apart from vigilance and flight, anti-predator defense behavior in horses has not been well documented despite its importance during natural selection. In this study, observations of a feral herd (around 140) of Venezuelan horses sympatric with puma and jaguar divided such defense into precaution and reaction. Group living and the avoidance of danger areas are precautionary measures enhanced by the stallion's vigilance and his actions to keep small foals with the band. Reactions to perceived threats comprise communication of alarm; bunching, or cohesion, as a primary response; massed flight fo...
Cervical spinal cord compression may affect anesthetic recovery quality and seizure incidence in horses after myelography.
American journal of veterinary research    June 5, 2026   1-8 doi: 10.2460/ajvr.26.02.0072
Theiss D, Douglas HF, Colmer SF, Owens LA, Stefanoski D, Johnson AL, Hopster K, Midon M.To compare anesthetic recovery quality and seizure incidence after cervical myelography in horses with or without cervical spinal cord compression. Unassigned: Anesthesia and medical records from January 2017 to December 2022 of horses anesthetized for myelography were retrieved. Patients with incomplete records, equine protozoal myeloencephalitis diagnosis, or an anesthetic protocol outside an established standard were excluded. Demographic analysis, ataxia score, and anesthetic management variables were recorded in an observational retrospective fashion. Each variable was compared between gr...
Psycho-Spiritual Reflections on the Horse/Human Relationship.
Psychoanalytic review    June 4, 2026   Volume 113, Issue 2 175-187 doi: 10.1521/prev.2026.113.2.175
Hamm PJ.This essay offers a psycho-spiritual and psychoanalytic meditation on the horse-human relationship as a nonverbal site of attunement, regulation, and meaning-making. Drawing on autobiographical clinical narrative, it explores how horseback riding became a medium for experiencing and reflecting upon embodied connection, mutual responsiveness, and contemplative presence. Encounters with horses illuminate forms of reciprocity that preceded and exceed speech, while also opening reflection on maternal attachment, separation, loss, and the emergence of selfhood. In dialogue with Freud, Winnicott, Pi...
Cerebral arterial mapping in the equine brain: a detailed anatomical study.
Frontiers in veterinary science    June 2, 2026   Volume 13 1828754 doi: 10.3389/fvets.2026.1828754
Al Aiyan A, Abu Hayah S, Alnahdi AF, Alshamsi A, Alshebli H, Aleissaee S, Balan R.Detailed knowledge of the cerebral arterial system in equine brain is required for advancing neuroanatomical understanding and supporting the interpretation of neurological disorders. The equine cerebrum, characterized by extensive cortical organization and functional specialization, requires a continuous arterial blood supply; however, detailed information on its arterial anatomy remains limited. This study aimed to describe the arterial supply to the equine cerebrum, including the origin, branching patterns, and distribution of the major cerebral arteries. Unassigned: Ten adult horse heads w...
Myofascial trigger points as a primary cause of equine lameness: a biomechanical, neurophysiological, and fascial review.
Frontiers in veterinary science    May 20, 2026   Volume 13 1852775 doi: 10.3389/fvets.2026.1852775
Scheibenpflug M, Haussler KK.Equine lameness diagnosis is dominated by a joint- and tendon-centric paradigm. The standard diagnostic algorithm relies on gait observation, perineural and intrasynovial anesthesia, and cross-sectional imaging. It is directed almost exclusively at skeletal and articular structures. Myofascial trigger points (MTrPs) are hypersensitive, hyperirritable loci within taut bands of skeletal muscle. They produce local and referred pain on compression or contraction. In horses, MTrPs are a clinically relevant but systematically overlooked source of primary lameness. This review synthesises evidence fr...
An intronic variant in Ferredoxin Reductase (FDXR) creates a cryptic exon in Quarter Horses with Equine Juvenile Spinocerebellar Ataxia.
PLoS genetics    May 20, 2026   Volume 22, Issue 5 e1012158 doi: 10.1371/journal.pgen.1012158
Brown BN, Dahlgren AR, Ghosh S, Durbin-Johnson B, Willis A, Olivas C, York D, Grahn R, Bellone RR, Cortopassi GA, Miller AD, Brown CT, Woolard K....Equine Juvenile Spinocerebellar Ataxia (EJSCA) is a novel autosomal recessive neurologic disease in Quarter Horses. Affected foals display a progressive proprioceptive ataxia by 1-5 weeks of age, leading to recumbency and necessitating euthanasia. Whole genome sequencing was performed on 7 EJSCA cases and unaffected horses that included 4 obligate carriers, 4 unaffected half or full-siblings, and 28 unrelated, unaffected control Quarter Horses. An 82 kb region of association was identified (EquCab3.0, chr11: 6963986-7045999), containing 9 candidate SNPs across four genes (FADS6, FDXR, GRIN2C a...
A 12-year review of equestrian related injuries at a major trauma centre in South Africa.
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie    May 20, 2026   Volume 64, Issue 1 58-61 doi: 10.36303/SAJS.03390
Wilkinson-Smith T, Kong VY, Lee D, Ahn J, Boppana A, Babu N, Wain H, Laing GL, Clarke DL.Few studies on equestrian-related injuries have specifically focused on patients in South Africa. The aim of this study was to review the spectrum of injuries and of patients treated at state-funded trauma centres in South Africa. Methods: A retrospective study was conducted over a 12-year period from July 2012 to February 2025 on all patients treated for equestrian-related injuries. Results: A total of 82 patients were included (83% male, median age: 17 years, median injury severity score (ISS): 9). The most common mechanism of injury was a fall ( = 41), followed by a kick ( = 38). Two were t...
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