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Equine veterinary journal2023; doi: 10.1111/evj.13986

History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking.

Abstract: In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. Objective: To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). Methods: Retrospective observational study. Methods: Seven masked observers with different experience used HRE-S to score 40 video recordings taken during rest and lungeing including five duplicates. Video recordings were taken from nine horses with TMHS and three controls. Inter- and intraobserver reliability and practicability of HRE-S were assessed. For every video recording severity of clinical signs was graded by every observer using an intuitive global-type-scale and interobserver reliability was calculated. Convergent validity was evaluated comparing HRE-S to groups created by an existing score (grade 0-3). Discriminant validity was analysed comparing HRE-S to groups created by intuitive global-type-scale. Results: Reliability for HRE-S was excellent, irrespective of observers experience: Spearman's Rho = 0.946, p < 0.001 (intraobserver reliability) and intraclass correlation coefficient = 0.98, p < 0.001 (interobserver reliability). Interobserver reliability for intuitive global-type-scale was fair to substantial: Fleiss' κappa = 0.48 (R-S) -0.63 (E-S). Groups created by intuitive global-type-scale had significantly different R-S and E-S (p < 0.05), demonstrating discriminant validity. Convergent validity was proven as horses with grade 3/3 had significantly higher average E-S and total scores compared with an existing score than those with grade 0/3 or 1/3 (p < 0.001). Conclusions: Retrospective nature, video recordings, sample size. Conclusions: HRE-S is a valid and reliable score evaluating disease severity in TMHS, independent of observers' experience.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-08-22 PubMed ID: 37608443DOI: 10.1111/evj.13986Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article focuses on the development and validation of a new scoring system called History, Rest and Exercise Score (HRE-S) for the assessment of disease severity in horses with trigeminal-mediated headshaking (TMHS).

Objective of the Study

  • The primary aim of the research was to create and validate a precise scoring system—HRE-S—for assessing the severity of TMHS in horses.

Method of the Study

  • The study was a retrospective observational study that involved seven observers who evaluated 40 video recordings of horses, which also included five duplicates.
  • These recordings featuring nine horses with TMHS and three controls were made during rest and lungeing.
  • To test the reliability of HRE-S, both inter- and intraobserver reliability and practicability were examined through statistical computations.
  • The researchers also used an intuitive global-type-scale to grade the severity of the clinical signs in each video recording and determined the interobserver reliability here.
  • They pursued two types of validations—Convergent and Discriminant. The former compared HRE-S with groups formed via an existing score (grades 0-3), while the latter contrasted HRE-S with groups devised by the intuitive global-type-scale.

Results of the Study

  • The findings confirmed the high reliability of HRE-S, irrespective of observers’ experience. This was established through Spearman’s Rho for intraobserver reliability and the intraclass correlation coefficient for interobserver reliability.
  • Meanwhile, the interobserver reliability for the intuitive global-type-scale was found to range from fair to substantial. This was ascertained via Fleiss’s kappa.
  • Demonstrating the discriminant validity of HRE-S, the study found significant differences in the resting and exercise scores among groups formed by the intuitive global-type-scale.
  • The convergent validity was validated since the horses with the maximum grade (3/3) had significantly higher average exercise scores and total scores when compared with the existing system than those with grade 0/3 or 1/3.

Conclusions of the Study

  • Despite the retrospective nature of the study and the limited sample size, the research established HRE-S as a valid and highly reliable scoring system for evaluating TMHS severity, regardless of an observer’s experience.

Cite This Article

APA
Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T. (2023). History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking. Equine Vet J. https://doi.org/10.1111/evj.13986

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Kloock, Tanja
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Pickles, Kirstie J
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
Roberts, Veronica
  • Bristol Veterinary School, University of Bristol, Bristol, UK.
Uhlendorf, Frauke
  • IDEXX Med Labor GmbH, Kornwestheim, Germany.
Twele, Lara
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Wilkens, Henriette L
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Stehle, Eva
  • Celle, Germany.
Feige, Karsten
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.
Niebuhr, Tobias
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany.

References

This article includes 33 references
  1. Roberts V. Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies.. Vet Med Res Reports 2019;10:1-8.
    doi: 10.2147/vmrr.s163805google scholar: lookup
  2. Pickles K, Madigan J, Aleman M. Idiopathic headshaking: is it still idiopathic?. Vet J 2014;201:21-30.
    doi: 10.1016/j.tvjl.2014.03.031google scholar: lookup
  3. Lane G, Mair TS. Observations on headshaking in the horse.. Equine Vet J 1987;19(4):331-336.
    doi: 10.1111/j.2042-3306.1987.tb01424.xgoogle scholar: lookup
  4. Newton SA, Knottenbelt DC, Eldridge PR. Headshaking in horses: possible aetiopathogenesis suggested by the results of diagnostic tests and several treatment regimes used in 20 cases.. Equine Vet J 2000;32(3):208-216.
    doi: 10.2746/042516400776563617google scholar: lookup
  5. Mair TS, Lane G. Headshaking in horses.. In Pract 1990;12(5):183-186.
  6. Madigan J, Bell S. Owner survey of headshaking in horses.. J Am Vet Med Assoc 2001;219(3):334-337.
    doi: 10.2460/javma.2001.219.334google scholar: lookup
  7. Mills D, Cook S, Taylor K, Jones B. Analysis of the variations in clinical signs shown by 254 cases of equine headshaking.. Vet Record 2002;150(8):236-240.
  8. Stange LM, Krieter J, Czycholl I. Overview of the current situation in a sample of headshakers and owner assessment of effective therapeutic measures used in Germany.. J Equine Vet Sci 2020;95:103270.
    doi: 10.1016/j.jevs.2020.103270google scholar: lookup
  9. Aleman M, Williams DC, Brosnan RJ, Nieto JE, Pickles K, Berger J. Sensory nerve conduction and somatosensory evoked potentials of the trigeminal nerve in horses with idiopathic headshaking.. J Vet Intern Med 2013;27(6):1571-1580.
    doi: 10.1111/jvim.12191google scholar: lookup
  10. Gambeta E, Chichorro JG, Zamponi GW. Trigeminal neuralgia: an overview from pathophysiology to pharmacological treatments.. Mol Pain 2020;16:1744806920901890.
    doi: 10.1177/1744806920901890google scholar: lookup
  11. Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia - Diagnosis and treatment.. Cephalalgia 2017;37(7):648-657.
    doi: 10.1177/0333102416687280google scholar: lookup
  12. Dalla Costa E, Minero M, Lebelt D, Stucke D, Canali E, Leach MC. Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration.. PloS One 2014;9(3):e92281.
    doi: 10.1371/journal.pone.0092281google scholar: lookup
  13. Madigan J, Bell S. Characterisation of headshaking syndrome-31 cases.. Equine Vet J 1998;27(27):28-29.
    doi: 10.1111/j.2042-3306.1998.tb05141.xgoogle scholar: lookup
  14. Roberts V. Idiopathic headshaking: is it still idiopathic?. Vet J 2014;201(1):7-8.
    doi: 10.1016/j.tvjl.2014.05.006google scholar: lookup
  15. Talbot WA, Pinchbeck GL, Knottenbelt DC, Graham H, McKane SA. A randomised, blinded, crossover study to assess the efficacy of a feed supplement in alleviating the clinical signs of headshaking in 32 horses.. Equine Vet J 2013;45(3):293-297.
    doi: 10.1111/j.2042-3306.2012.00618.xgoogle scholar: lookup
  16. Sutton GA, Atamna R, Steinman A, Mair TS. Comparison of three acute colic pain scales: reliability, validity and usability.. Vet J 2019;246:71-77.
    doi: 10.1016/j.tvjl.2019.01.004google scholar: lookup
  17. Kruskal WH, Wallis A. Use of ranks in one-criterion variance analysis.. J Am Stat Assoc 1952;47(260):583-621.
    doi: 10.1080/01621459.1952.10483441google scholar: lookup
  18. Mann HB, Whitney DR. On a test of whether one of two random variables is stochastically larger than the other.. Ann Math Stat 1947;18(1):50-60.
  19. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability.. Psychol Bull 1979;86(2):420-428.
  20. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research.. J Chiropr Med 2016;15:155-163.
    doi: 10.1016/j.jcm.2016.02.012google scholar: lookup
  21. Pearson KX. On the criterion that a given system of deviations from the probable in the case of a correlated system of variables is such that it can be reasonably supposed to have arisen from random sampling.. Philos Mag J Sci 1900;50(302):157-175.
    doi: 10.1080/14786440009463897google scholar: lookup
  22. Wathan J, Burrows AM, Waller BM, McComb K. EquiFACS: the equine facial action coding system.. PloS One 2015;10(8):e0131738.
    doi: 10.1371/journal.pone.0131738google scholar: lookup
  23. van Loon JPAM, van Dierendonck MC. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): a scale-construction study.. Vet J 2015;206(3):356-364.
    doi: 10.1016/j.tvjl.2015.08.023google scholar: lookup
  24. Menchetti L, Costa ED, Minero M, Padalino B. Development and validation of a test for the classification of horses as broken or unbroken.. Animals 2021;11(8):2303.
    doi: 10.3390/ani11082303google scholar: lookup
  25. Mullard J, Berger J, Ellis AD, Dyson S. Development of an ethogram to describe facial expressions in ridden horses (FEReq).. J Vet Behav Clin Appl Res 2017;18:7-12.
    doi: 10.1016/j.jveb.2016.11.005google scholar: lookup
  26. Marcantonio Coneglian M, Duarte Borges T, Weber SH, Godoi Bertagnon H, Michelotto PV. Use of the horse grimace scale to identify and quantify pain due to dental disorders in horses.. Appl Anim Behav Sci 2020;225:104970.
    doi: 10.1016/j.applanim.2020.104970google scholar: lookup
  27. Dalla Costa E, Stucke D, Dai F, Minero M, Leach MC, Lebelt D. Using the horse grimace scale (HGS) to assess pain associated with acute laminitis in horses (Equus caballus).. Animals 2016;6(8):47.
    doi: 10.3390/ani6080047google scholar: lookup
  28. Dalla Costa E, Dai F, Lecchi C, Ambrogi F, Lebelt D, Stucke D. Towards an improved pain assessment in castrated horses using facial expressions (HGS) and circulating miRNAs.. Vet Rec 2021;188(9):e82.
    doi: 10.1002/vetr.82google scholar: lookup
  29. Thomson K, Chan C, Dyson S. Head tossing behaviour in six horses: trigeminal-mediated head-shaking or musculoskeletal pain?. Equine Vet Educ 2020;32(S11):58-64.
    doi: 10.1111/eve.13084google scholar: lookup
  30. Roberts V. Managing headshaking in horses: an update.. In Pract 2018;40(4):157-161.
    doi: 10.1136/inp.k1493google scholar: lookup
  31. Jackson K, Kelty E, Tennant M. A new equine peripheral caries grading system: are the caries likely active or inactive?. Equine Vet J 2021;53(4):780-786.
    doi: 10.1111/evj.13359google scholar: lookup
  32. Olsen E, Dunkel B, Barker WHJ, Finding EJT, Perkins JD, Witte TH. Rater agreement on gait assessment during neurologic examination of horses.. J Vet Intern Med 2014;28(2):630-638.
    doi: 10.1111/jvim.12320google scholar: lookup
  33. Tallon R, Hewetson M. Inter-observer variability of two grading systems for equine glandular gastric disease.. Equine Vet J 2020;53(3):495-502.
    doi: 10.1111/evj.13334google scholar: lookup

Citations

This article has been cited 4 times.
  1. Franzen V, Gruber NA, Klußmann S, Schoster A, May A. Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses. J Vet Intern Med 2024 Sep-Oct;38(5):2758-2765.
    doi: 10.1111/jvim.17194pubmed: 39264234google scholar: lookup
  2. Pickles KJ, Marlin DJ, Williams JM, Roberts VLH. Use of a poll-mounted accelerometer for quantification and characterisation of equine trigeminal-mediated headshaking. Equine Vet J 2025 May;57(3):645-653.
    doi: 10.1111/evj.14132pubmed: 39020521google scholar: lookup
  3. Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Application of the HRE-S to 140 horses with trigeminal-mediated headshaking and the association of clinical signs with diagnosis, therapy, and outcome. Front Vet Sci 2024;11:1329054.
    doi: 10.3389/fvets.2024.1329054pubmed: 38645651google scholar: lookup
  4. Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols. Animals (Basel) 2022 Nov 13;12(22).
    doi: 10.3390/ani12223125pubmed: 36428354google scholar: lookup
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