Visual lameness assessment in comparison to quantitative gait analysis data in horses.
Abstract: Quantitative gait analysis offers objective information to support clinical decision-making during lameness workups including advantages in terms of documentation, communication, education, and avoidance of expectation bias. Nevertheless, hardly any data exist comparing outcome of subjective scoring with the output of objective gait analysis systems. Objective: To investigate between- and within-veterinarian agreement on primary lame limb and lameness grade, and to determine relationships between subjective lameness grade and quantitative data, focusing on differences between (1) veterinarians, (2) live vs video assessment, (3) baseline assessment vs assessment following diagnostic analgesia. Methods: Clinical observational study. Methods: Kinematic data were compared to subjective lameness assessment by clinicians with ≥8 years of orthopaedic experience. Subjective assessments and kinematic data for baseline trot-ups and response to 48 diagnostic analgesia interventions in 23 cases were included. Between and within-veterinarian agreement was investigated using Cohen's Kappa (κ). Asymmetry parameters for kinematic data ('forelimb lame pattern', 'hindlimb lame pattern', 'overall symmetry', 'vector sum head', 'pelvic sum') were determined, and used as outcome variables in mixed models; explanatory variables were subjective lameness grade and its interaction with (1) veterinarian, (2) live or video evaluation and (3) baseline or diagnostic analgesia assessment. Results: Agreement on lame limb between live and video assessment was 'good' between and within veterinarians (median κ = 0.64 and κ = 0.53). There was a positive correlation between subjective scoring and measured asymmetry. The relationship between lameness grade and objective asymmetry differed slightly between (1) veterinarians (for all combined parameters, p-values between P < .001 and 0.04), (2) between live and video assessments ('forelimb lame pattern', 'overall symmetry', both P ≤ .001), and (3) between baseline and diagnostic analgesia assessment (all combined parameters, between P < .001 and .007). Conclusions: Limited number of veterinarians (n = 4) and cases (n = 23), only straight-line soft surface data, different number of subjective assessments live vs from video. Conclusions: Overall, between- and within-veterinarian agreement on lame limb was 'good', whereas agreement on lameness grade was 'acceptable' to 'poor'. Quantitative data and subjective assessments correlated well, with minor though significant differences in the number of millimetres, equivalent to one lameness grade between veterinarians, and between assessment conditions. Differences between baseline assessment vs assessment following diagnostic analgesia suggest that addition of objective data can be beneficial to reduce expectation bias. The small differences between live and video assessments support the use of high-quality videos for documentation, communication, and education, thus, complementing objective gait analysis data.
© 2021 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2022-01-10 PubMed ID: 34913524PubMed Central: PMC9786350DOI: 10.1111/evj.13545Google Scholar: Lookup
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- Journal Article
- Observational Study
- Veterinary
Summary
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The research explores the agreement between clinical observations made by veterinarians and quantitative gait analysis data in identifying lameness in horses. It also examines whether there are any significant discrepancies between observations made during live examinations, video assessments, and post-analgesia evaluations.
Research Methods
- The study was conducted on 23 horses that underwent 48 diagnostic analgesia procedures.
- The horses’ movement patterns were recorded through kinematic data — a mathematical technique used to measure motion.
- The kinematic data gathered was compared with the subjective assessment of the horses’ health by veterinarians with a minimum of 8 years of orthopedic experience.
- The researchers used differing analytic models to ascertain how subjective observation of lameness grade interacted with veterinarian identity, whether the assessment was made during live exams or on video, and whether it occurred before or after diagnostic analgesia.
Research Results
- The study found a significant agreement among veterinarians’ opinions on which limb was lame in both live exams and video reviews. Cohen’s Kappa, a statistical measure of inter-rater reliability, was utilized here.
- A strong correlation was found between subjective scoring of lameness and measured asymmetry.
- Notable, though minor, differences were reported between veterinarians, and between live and video assessments. Similarly, the study also discovered a discrepancy between baseline (pre-treatment) assessments and assessments made after diagnostic analgesia.
Conclusion
- Despite only involving four veterinarians and twenty-three cases, the research provided valuable insights. The results suggested that there was a general consensus on which limb was lame amongst the veterinarians, although agreement on the degree of lameness varied between ‘acceptable’ to ‘poor’.
- Objective gait analysis data correlated well with subjective evaluations, with minor but significant differences observed between different veterinarians, and different assessment conditions.
- The findings suggested that incorporating objective data can help minimize expectation bias introduced after the administration of analgesia.
- Despite minor deviations, the minimal difference between live and video assessments reinforced the practicality of using high-quality video footage for documentation, communication, and education purposes in veterinary practice.
Cite This Article
APA
Hardeman AM, Egenvall A, Serra Bragança FM, Swagemakers JH, Koene MHW, Roepstorff L, van Weeren R, Byström A.
(2022).
Visual lameness assessment in comparison to quantitative gait analysis data in horses.
Equine Vet J, 54(6), 1076-1085.
https://doi.org/10.1111/evj.13545 Publication
Researcher Affiliations
- Tierklinik Luesche GmbH, Lüsche, Germany.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Utrecht, The Netherlands.
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Utrecht, The Netherlands.
- Tierklinik Luesche GmbH, Lüsche, Germany.
- Tierklinik Luesche GmbH, Lüsche, Germany.
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Utrecht, The Netherlands.
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
MeSH Terms
- Animals
- Biomechanical Phenomena
- Forelimb
- Gait / physiology
- Gait Analysis / veterinary
- Hindlimb / physiology
- Horse Diseases / diagnosis
- Horses
- Lameness, Animal / diagnosis
Conflict of Interest Statement
No competing interests have been declared.
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This article includes 18 references
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