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Frontiers in veterinary science2022; 9; 938022; doi: 10.3389/fvets.2022.938022

Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain.

Abstract: This study investigated the relationship between orthopedic pain experienced at rest, and degree of movement asymmetry during trot in horses with induced reversible acute arthritis. Orthopedic pain was assessed with the Horse Grimace Scale (HGS), the Equine Utrecht University Scale of Facial Assessment of Pain (EQUUS-FAP), the Equine Pain Scale (EPS), and the Composite Orthopedic Pain Scale (CPS). Reliability and diagnostic accuracy were evaluated with intraclass correlation coefficients (ICC) and area under the curve (AUC). Unassigned: Eight healthy horses were included in this experimental study, with each horse acting as its own control. Unassigned: Orthopedic pain was induced by intra-articular lipopolysaccharide (LPS) administration. Serial pain assessments were performed before induction and during pain progression and regression, where three observers independently and simultaneously assessed pain at rest with the four scales. Movement asymmetry was measured once before induction and a minimum of four times after induction, using objective gait analysis. Unassigned: On average 6.6 (standard deviation 1.2) objective gait analyses and 12.1 (2.4) pain assessments were performed per horse. The ICC for each scale was 0.75 (CPS), 0.65 (EPS), 0.52 (HGS), and 0.43 (EQUUS-FAP). Total pain scores of all scales were significantly associated with an increase in movement asymmetry (R 2 values ranging from -0.0649 to 0.493); with CPS pain scores being most closely associated with movement asymmetry. AUC varied between scales and observers, and CPS was the only scale where all observers had a good diagnostic accuracy (AUC > 0.72). Unassigned: This study identified significant associations between pain experienced at rest and degree of movement asymmetry for all scales. Pain scores obtained using CPS were most closely associated with movement asymmetry. CPS was also the most accurate and reliable pain scale. All scales had varying linear and non-linear relations between total pain scores and movement asymmetry, illustrating challenges with orthopedic pain assessment during rest in subtly lame horses since movement asymmetry needs to be rather high before total pain score increase.
Copyright © 2022 Ask, Andersen, Tamminen, Rhodin and Hernlund.
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Publication Date: 2022-08-12 PubMed ID: 36032285PubMed Central: PMC9411665DOI: 10.3389/fvets.2022.938022Google 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 study explores the connection between restful orthopedic pain and movement asymmetry, using four pain scales in horses with induced acute arthritis. It discovered that pain assessments using the Composite Orthopedic Pain Scale (CPS) were most accurately aligned with movement asymmetry.

Introduction

  • The researchers in this study aimed to shed light on the relationship between pain experienced at rest and the degree of movement asymmetry in trotting horses, who have had acute arthritis artificially induced.
  • Orthopedic pain was evaluated using four distinct pain scales, each one aimed at measuring the extent of observed pain in horses. These scales were the Horse Grimace Scale (HGS), the Equine Utrecht University Scale of Facial Assessment of Pain (EQUUS-FAP), the Equine Pain Scale (EPS), and the Composite Orthopedic Pain Scale (CPS).
  • The reliability and diagnostic accuracy of these scales were assessed. This was done using statistical methods known as intraclass correlation coefficients (ICC) and area under the curve (AUC) analysis.

Methodology

  • The study included eight healthy horses and was designed in such a way that each horse would act as its own control for comparisons.
  • A condition causing orthopedic pain was artificially induced in these horses using a substance called lipopolysaccharide (LPS).
  • To follow the progression and regression of this induced pain, the researchers conducted regular pain assessments using the four pain scales.
  • Correlation between pain at rest and movement asymmetry was established by conducting objective gait analysis before and after the induction of the pain.

Results

  • Each horse was assessed multiple times for pain and gaits, providing a rich set of data points for analysis.
  • The reliability of each scale was different, with the Composite Pain Scale (CPS) offering the highest ICC value (0.75), followed by the EPS, HGS, and finally the EQUUS-FAP.
  • All scales showed a significant correlation with movement asymmetry, with the CPS showing the closest alignment.
  • The AUC, which hints at the diagnostic accuracy, varied among scales and observers. However, CPS was found to be the only scale demonstrating good diagnostic accuracy across all observers.

Conclusion

  • This research pinpointed significant associations between the pain a horse experiences at rest and the degree of movement asymmetry.
  • Among the four scales used, CPS proved to be the most accurate and reliable for pain quantification and was most closely associated with movement asymmetry.
  • The study also noted challenges in assessing orthopedic pain during rest in subtly lame horses, as movement asymmetry needs to be considerably high before the total pain score sees a noticeable increase.

Cite This Article

APA
Ask K, Andersen PH, Tamminen LM, Rhodin M, Hernlund E. (2022). Performance of four equine pain scales and their association to movement asymmetry in horses with induced orthopedic pain. Front Vet Sci, 9, 938022. https://doi.org/10.3389/fvets.2022.938022

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 9
Pages: 938022

Researcher Affiliations

Ask, Katrina
  • Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Andersen, Pia Haubro
  • Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Tamminen, Lena-Mari
  • Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Rhodin, Marie
  • Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Hernlund, Elin
  • Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Citations

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