Page 14 - Eclipse - Autumn 2021

CLINICAL NEWS

Sign up to Clinical Connections

Clinical Connections is our publication designed to support veterinary professionals in
practice by keeping them updated on our latest news and service developments. It is
published three times a year.
Find out more and subscribe at rvc.ac.uk/clinical-connections

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.

14