Page 14 - Eclipse - Autumn 2021
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CLINICAL NEWS








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        Gait analysis for poor performance






                orses are frequently presented   Lameness ‘threshold values’ that exist   As an example, a dressage rider may
                to the RVC Equine Referral   with OGA were derived by comparing   notice reduced hindlimb push off during
                Hospital for investigation of   OGA measurements with veterinary   a canter pirouette in one direction
       Hpoor performance. Following         expert assessments following induced   compared to the other well before it
        acquisition of a thorough history, the   lameness. Whilst these thresholds   becomes visually evident when the horse
        horse is examined. Usually this starts   should not be interpreted as an   is trotted in hand. If OGA can detect a
        with a lameness investigation. The   absolute cut-off point, if an owner   subtle lameness, undetectable to the
        equine industry has seen a surge in   reports a drop in performance and the   human eye, and those values return to the
        interest, availability, and use of objective   values lie outside the thresholds, it is   normal accepted range following nerve
        gait analysis (OGA) for the detection   sensible to explore the reason for the   or joint blocks, and the rider reports an
        of lameness and the RVC continues   asymmetry to establish whether it is   improvement, this increases the security
        to be at the forefront of the field with   linked to the loss of performance. It   of the diagnosis. OGA gives the user
        this technology.                    certainly demonstrates the limb which is   confidence to embark on a lameness
                                            producing less force than the others.   work-up in this situation and adds
        The main advantage of using OGA is                                      objectivity to the post-block assessment.
        the potential to remove bias from clinical   Asymmetry can be so mild that it can be
        decision-making. At the RVC we are   difficult to detect. If this is the case, how   There has been debate about OGA
        pursuing its use in measuring back   can we ensure it is clinically relevant? It   focusing on the initial assessment –
        movement and seeking to correlate this   is obvious that its relevance should be   whether the user should rely solely on
        with the presence of back pain. Inertial   assessed in the context of the horse’s   it to detect pain-induced lameness –
        measurement units are placed on the   breed, use, age, history and what the   certainly we should not. However, once
        horse and the horse is assessed both   rider reports.                   lameness has been detected, and a
        unridden and under saddle.                                              lameness work up using nerve and joint
                                                                                blocks has started, improvements can
                                                                                be confirmed with OGA.
                                                                                Whilst nerve blocks may completely
                                                                                resolve lameness when the area of pain
                                                                                is desensitised, joint blocks can be
                                                                                less conclusive. The response to stifle
                                                                                blocks in particular can be modest, even
                                                                                if demonstrable pathology is ultimately
                                                                                evident on either diagnostic imaging or
                                                                                arthroscopy. Improvement well below
                                                                                50% can be expected in such cases and
                                                                                OGA can add reassurance in confirming a
                                                                                subjective perception of improvement.

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