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Use of the flexion test of the distal forelimb in the sound horse: repeatability and effect of age, gender, weight, height and fetlock joint range of motion.
Abstract: The flexion test of the distal limb is a commonly used clinical tool in both lame and sound horses. In the latter use it is given some predictive value. In recent studies it has been shown that examiner-related factors (force, time) may strongly influence the outcome of the test. In the present study, the possible influences of a number of horse-related factors and short- and long-term repeatability were investigated. Flexion tests were performed by the same researcher in 100 clinically sound horses under standardized conditions. The outcome of the test was scored on a 9-point semiquantitative scale. The maximum flexion angles of the fetlock joints were measured and the range of motion (ROM) of the fetlock joint was calculated. In the second part of the study, flexion tests were repeated, at intervals of 10 min, 30 min, 48 h and 6 months in 23 horses to assess repeatability. Over 60% of the 100 sound horses had a positive flexion test. Of these, about 50% showed a slight lameness, 35% a mild lameness, and 15% a distinct lameness. There was no influence of weight, height or ROM on the score of the flexion test. The outcome of the flexion test increased significantly with age and was significantly higher in mares than in geldings. When repeating the flexion test with short intervals of 10 and 30 min, the score increased significantly after the second test. Repeated flexion after 48 h did not result in a significantly different outcome. Over a 6-month period, the outcome of the test decreased significantly and the ROM increased significantly. It is concluded that most clinically sound horses have a (slightly) positive flexion test of the distal limb. This and the lack of long-term consistency of the test cast doubt on the presumption that a positive flexion test may be an indication for subclinical joint disorders and question the possible value of the test as a predictor of future joint-related problems. There exists a wide individual variation in ROM of the fetlock joint with, in sound horses, no relationship between ROM and the outcome of the flexion test. The factors age and gender should be taken into account when interpreting the results of a flexion test.
Publication Date: 2001-10-16 PubMed ID: 11599679DOI: 10.1046/j.1439-0442.2001.00373.xGoogle Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research aims to determine the influences on and repeatability of a flexion test on a horse’s distal limb – a common clinical test used to determine both manifest and potential joint issues. The study was conducted on 100 sound horses and repeated at various intervals, indicating that factors such as age, gender, and time can significantly affect the results.
Objective and Methodology of the Research
- The study’s prime focus was on the flexion test of the distal forelimb in horses – a routine clinical examination procedure used in assessing potential joint problems. Although it is widely used, factors influencing its outcome and its repeatability remained vague and were the central focus of this research.
- The authors of the study performed the flexion test on 100 clinically sound horses under standard conditions to assess the impact of various horse-related factors. Factors examined included the horse’s age, gender, weight, height, and the range of motion (ROM) in the fetlock joint.
- Additionally, the researchers conducted repeated flexion tests over different durations (10 min, 30 min, 48 hours, and 6 months) on a subset of 23 horses, to assess the repeatability of the test results.
Findings of the Research
- Over 60% of the sound horses demonstrated a positive result on the flexion test, indicating some level of lameness. Yet there was no influence of weight, height or ROM on the flexion test’s score.
- The study discovered a significant correlation between a horse’s age and the outcome of the flexion test, with aging horses presenting higher scores.
- The gender of the horse was also found to affect the results, with mares typically scoring higher than geldings.
- When the flexion test was repeated in short intervals of 10 and 30 minutes, the score notably increased after the second test. However, testing again after 48 hours didn’t result in a significant difference in the outcome.
- Over a 6-month period, the test results significantly decreased, while the ROM significantly increased.
Conclusion and Implications
- The results showed that the scores from the flexion test of the distal limb in clinically sound horses varied slightly positive. Coupled with a lack of long-term consistency, this questioned the prevalent assumption that a positive flexion test is indicative of underlying joint disorders.
- Additionally, because no clear correlation was found between the ROM and outcome of the flexion test, the potential value of this test as a predictive tool for future joint-related issues is doubtful.
- A significant revelation of the study is that the factors age and gender play a crucial role in interpreting the results of a flexion test and should be considered when utilizing the test.
Cite This Article
APA
Busschers E, van Weeren PR.
(2001).
Use of the flexion test of the distal forelimb in the sound horse: repeatability and effect of age, gender, weight, height and fetlock joint range of motion.
J Vet Med A Physiol Pathol Clin Med, 48(7), 413-427.
https://doi.org/10.1046/j.1439-0442.2001.00373.x Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
MeSH Terms
- Age Factors
- Animals
- Biomechanical Phenomena
- Body Weight
- Female
- Forelimb / physiology
- Horses / anatomy & histology
- Horses / physiology
- Lameness, Animal / diagnosis
- Male
- Physical Examination
- Range of Motion, Articular
- Reproducibility of Results
- Sex Factors
Citations
This article has been cited 3 times.- Grosjean D, De Bakker E, Mugnier A, Forterre F, Saunders J, Van Ryssen B, Samoy YCA. Effect of dog-related parameters on the flexion test outcome: A large cohort retrospective study on physiological and orthopedic pathological-related factors. Front Vet Sci 2022;9:1064795.
- Merridale-Punter MS, Wiethoelter AK, El-Hage CM, Hitchens PL. Prevalence and Factors Associated with Working Equid Lameness in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Animals (Basel) 2022 Nov 10;12(22).
- Jönsson L, Roepstorff L, Egenvall A, Näsholm A, Dalin G, Philipsson J. Prevalence of clinical findings at examinations of young Swedish warmblood riding horses. Acta Vet Scand 2013 Apr 18;55(1):34.
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