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Animals : an open access journal from MDPI2022; 12(4); 439; doi: 10.3390/ani12040439

Development of a Composite Pain Scale in Foals: A Pilot Study.

Abstract: Prompt pain management is crucial in horses; however, tools to assess pain are limited. This study aimed to develop and pilot a composite scale for pain estimation in foals. The "Foal Composite Pain Scale" (FCPS) was developed based on literature and authors' expertise. The FCPS consisted of 11 facial expressions, 4 behavioural items, and 5 physical items. Thirty-five pain-free foals (Control Group) and 15 foals experiencing pain (Pain Group) were used. Foals were video-recorded at different time points: the Control Group only at inclusion (C), while the Pain Group at inclusion (T1), after an analgesic treatment (T2), and at recovery (T3). Physical items were also recorded at the same time points. Videos were scored twice by five trained observers, blinded to group and time points, to calculate inter- and intra-observer reliability of each scale item. Fleiss' kappa values ranged from moderate to almost perfect for the majority of the items, while the intraclass correlation coefficient was excellent (ICC = 0.923). The consistency of FCPS was also excellent (Cronbach's alpha = 0.842). A cut-off ≥ 7 indicated the presence of pain. The Pain Group scores were significantly higher ( T3; = 0.001). Overall, FCPS seems clinically applicable to quantify pain and improve the judgment of the quality of life in foals, but it needs modifications based on these preliminary findings. Consequently, further studies on a larger sample size are needed to test the feasibility and validity of the refined FCPS.
Publication Date: 2022-02-11 PubMed ID: 35203146PubMed Central: PMC8868425DOI: 10.3390/ani12040439Google Scholar: Lookup
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  • Journal Article

Summary

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This research article presents a study aimed at developing and pilot testing a new composite scale for estimating pain in foals. The newly developed composite scale, termed as “Foal Composite Pain Scale” (FCPS), is based on facial expressions, behavioural patterns, and physical signs. The study reveals that FCPS has potential application in quantifying pain in foals, although further studies are required for refinement.

Objective and Methodology

  • The objective of the research was to create a reliable and precise tool for assessing pain in foals, particularly for effective, prompt pain management. The researchers set out to develop and pilot test a composite scale, termed the Foal Composite Pain Scale (FCPS).
  • The FCPS was developed based upon extensive literature reviews and the research team’s expertise. It integrated three key aspects: 11 different facial expressions, 4 behavioural cues indicative of pain, and 5 physical signs.
  • The researchers tested the scale using 50 foals, split into two groups. The Control Group consisted of pain-free foals, whereas the Pain Group comprised foals experiencing pain.
  • Applying the FCPS, the researchers recorded videos of the foals at different points in time, scoring facial expressions, behaviours, and physical signs.
  • To assess the reliability of each scale item, the researchers determined inter- and intra-observer consistency through blind scoring by five trained individuals.

Findings and Implications

  • The inter-observer reliability of the majority of the FCPS items was rated from moderate to almost perfect, with an intraclass correlation coefficient (ICC) indicating excellent agreement.
  • The results also demonstrated excellent consistency within the FCPS items (as evidenced by a high Cronbach’s alpha score).
  • The FCPS scores of the Pain Group were significantly higher than those of the Control Group and demonstrated a decreasing pattern over time.
  • This suggests that the FCPS might be a viable tool for the quantification of pain in foals, which has significant implications for improving judgment related to the quality of life in foals.

Further Research

  • However, the researchers acknowledged that the FCPS needs some refinements based on the findings of this pilot study.
  • Therefore, it was concluded that further investigations involving larger sample sizes are necessitated for testing the viability and validity of the refined FCPS.

Cite This Article

APA
Lanci A, Benedetti B, Freccero F, Castagnetti C, Mariella J, van Loon JPAM, Padalino B. (2022). Development of a Composite Pain Scale in Foals: A Pilot Study. Animals (Basel), 12(4), 439. https://doi.org/10.3390/ani12040439

Publication

ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 12
Issue: 4
PII: 439

Researcher Affiliations

Lanci, Aliai
  • Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sora 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
Benedetti, Beatrice
  • Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sora 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
Freccero, Francesca
  • Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sora 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
Castagnetti, Carolina
  • Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sora 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
  • Health Science and Technologies Interdepartmental Center for Industrial Research (HST-ICIR), University of Bologna, Ozzano dell'Emilia, 40064 Bologna, Italy.
Mariella, Jole
  • Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sora 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
van Loon, Johannes P A M
  • Department of Clinical Sciences, Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112-114, 3584 CM Utrecht, The Netherlands.
  • Sporthorse Medical Diagnostic Centre (SMDC), Hooge Wijststraat 7, 5384 RC Heesch, The Netherlands.
Padalino, Barbara
  • Department of Agricultural and Food Sciences (DISTAL), University of Bologna, Viale Fanin 46, 40127 Bologna, Italy.

Grant Funding

  • ISES student award 2020 / International Society for Equitation Science

Conflict of Interest Statement

The authors declare no conflict of interest.

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