Equine Locomotion, 2nd Edition
Equine Locomotion, 2nd Edition
LOCOMOTION
   Edited by
   Willem Back
   DVM, Cert. KNMvD (CKRD), Cert. Pract. KNMvD (Equine Practice), PhD, Spec. KNMvD
   (Equine Surgery), Dipl. ECVS, Prof. (U Ghent)
   Department of Equine Sciences, Faculty of Veterinary Medicine
   Utrecht University
   Utrecht, The Netherlands
   and
   Department of Surgery and Anaesthesiology of Domestic Animals
   Faculty of Veterinary Medicine
   Ghent University
   Merelbeke, Belgium
   Hilary M. Clayton
   BVMS, PhD, Dipl. ACVSMR, MRCVS
   McPhail Dressage Chair in Equine Sports Medicine
   College of Veterinary Medicine, Michigan State University
   East Lansing, MI, USA
   Foreword by
   Peter D. Rossdale
   MA, PhD, Dr.h.c. (Berne, Edinburgh, Sydney), DESM, FRCVS
 Edinburgh  London  New York  Oxford  Philadelphia  St Louis  Sydney  Toronto  2013
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Notices
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                                                 Contents
	     	   Foreword	                                                                                     vii
	     	   Foreword to the first edition	                                                                 ix
	     	   Preface	                                                                                       xi
	     	   Preface to the first edition	                                                                xiii
	     	   Acknowledgments	                                                                               xv
	     	   Contributors	                                                                                xvii
	     	   Glossary	                                                                                     xxi
          Nancy R. Deuel, Hilary M. Clayton
	    1.	 History	                                                                                        1
          P. René van Weeren
	    2.	 Measurement techniques for gait analysis	                                                      31
          Hilary M. Clayton, Henk C. Schamhardt (deceased)
	    3.	 Signals from materials	                                                                        61
          Christian Peham
	    4.	 Locomotor neurobiology and development	                                                        73
          Albert Gramsbergen
	    5.	 Gaits and interlimb coordination	                                                              85
          Eric Barrey
	    6.	 Forelimb function	                                                                             99
          Hilary M. Clayton, Henry Chateau, Willem Back
	    7.	 Hind limb function	                                                                           127
          Hilary M. Clayton, Willem Back
	    8.	 The role of the hoof and shoeing	                                                             147
          Willem Back, Frederik Pille
	    9.	 Gait adaptation in lameness	                                                                  175
          H.H. Florian Buchner
	   10.	 The neck and back	                                                                            199
          Claudia Wolschrijn, Fabrice Audigié, Inge D. Wijnberg, Christopher Johnston,
          Jean-Marie Denoix, Willem Back
	   11.	 The effects of conformation	                                                                  229
          Mikael Holmström, Willem Back
	   12.	 Genetic contributions to exercise and athletic performance	                                   245
          Emmeline W. Hill, Bart J. Ducro, P. René van Weeren, Albert Barneveld, Willem Back
	   13.	 The response of musculoskeletal tissues to exercise	                                          267
          Helen L. Birch, Pieter A.J. Brama, Elwyn C. Firth, Allen E. Goodship, José Luis L. Rivero,
          P. René van Weeren
	   14.	 Performance in equestrian sports	                                                             305
          Hilary M. Clayton, P. René van Weeren
	   15.	 Horse–rider interaction	                                                                      341
          Agneta Egenvall, Anna Byström, Michael Weishaupt, Lars Roepstorff
	   16.	 Ethology and welfare aspects	                                                                 369
          Natalie K. Waran, Machteld C. Van Dierendonck
	   17.	 Rehabilitation of the locomotor apparatus	                                                    381
          Narelle Stubbs, Eveline Menke, Willem Back, Hilary M. Clayton
                                                                                                              v
         Contents
Index 489
vi
                                                                          Foreword
Scientists strive to explain the relationship between cause and effect;   two decades, science has developed the technology on which our
in the context of locomotion, structure and function. Those in            understanding has expanded enormously, not only of the mechani-
practice, such as clinicians and horse trainers, are concerned with       cal attributes of the horse’s musculoskeletal system, but also of the
the application of scientific findings, but this requires monitoring      biological and pathological processes involved in the structures on
in the spirit of evidence-based medicine (EBM).                           which equine ‘athleticism’ is based. This is a never-ending progres-
   In the foreword to the first edition of this book, Professor McNeill   sion in keeping with scientific method and is likely to continue
Alexander FRS drew attention to early studies initiated by the pho-       indefinitely in the future. The content of the present edition of
tography of Muybridge (1899) and of digital ligaments by Camp             Equine Locomotion represents a significant step in this pathway.
and Smith (1942). James Gray (1936) proposed the paradox as to               Consultation with two colleagues active in practice led to the
how dolphins obtain high speeds and acceleration with such small          following personal communications:
muscle mass against the drag forces of water. He hypothesized that
their skin must have special anti-drag properties.                           The study of locomotion should be applied to the young
   This was subsequently discredited as summarized by Wei (2008),            racehorse to help circumvent injury or lameness developing as,
but serves to illustrate the biological need to elucidate the features       for example, in the specific condition of plantar osteochondral
of structure and function. From the viewpoint of a veterinary clini-         disease (POD) or more simply a stress-related bone injury to
cian, this is the essential contribution of locomotory science with          the lower cannon. Science might guide us towards different
the objective of improving performance and reducing the likeli-              training methods and programmes, shoeing, surfaces, tack or
hood of injury, or improving the chances of successful treatment if          other unknowns to improve the soundness and welfare of the
injury occurs; thereby offering overall benefits in the welfare of           horse and reduce wastage and days lost from training.
horses.
                                                                                                               M.C. Shepherd BVSc Massey, MRCVS
   The introduction of techniques applied to elucidate the mysteries
of movement illustrates the advances reported in the present book.
There is, for example, very substantial potential for telemetry involv-
ing inertial motion sensors which, especially when combined with             Breeders of modern sport horses are currently selecting for
global positioning system (GPS) technology, make possible the                traits that adapt the individual to the needs for a chosen
collection of a great deal of data about movement and limb kine-             discipline. With this, biomechanically specific pathologies
matics, such as reported in the study of Pfau et al. (2006).                 typical of a discipline, its training and competition conditions
   Viewpoints differ according to the circumstances of those involved        are challenging and taxing the mental and physical limits of
in exercise physiology and locomotion: the scientist pursues the             the animal in its artificial environment. The understanding
essential elements of knowledge. Veterinary clinicians require the           of the changing demands each discipline exerts on the
means to the end of diagnosis, prophylaxis, therapy and prognosis;           phenotypical development of the more slowly changing genotype
the owner uses knowledge to improve the return on investment;                is essential to the welfare of the horses and sustained sporting
and the trainer of horses, be they for racing, competition or riding,        and economic success of a discipline. Learning about ground
needs to improve on methods to achieve the purpose for which the             and force interaction, evolving equitation and training ideas
horse is kept.                                                               on repetitive biomechanical stresses and their effects on
   The questions of practice include, why do individuals differ as to        skeletal, articular and muscular sustainable long term athletic
their performance or susceptibility to injury on differing track sur-        health is essential for the sporting success of the current and
faces, and what in the structure or body function of the individual          future generations of show jumpers, eventers, dressage as well
determines sprinting or stamina as a feature?                                as endurance, driving, reining horses and polo ponies.
   The modern horse is, somewhat paradoxically, the product of                                                F.E. Barrelet DrVetMed Berne, MRCVS
man’s interference with the evolutionary process due to our selec-
tion for various roles, ranging from the drawing and carrying of             The history of scientific progress is described eloquently in the
loads to the participation in war and war-like activities, including      first chapter by René van Weeren. There are then nineteen chapters
chariot racing, and, more recently, on the racecourse, in endurance       devoted to the application of scientific methods and measurement
and in eventing competitions. But the relationship between the            techniques regarding limb and bodily function in motion. The list
biological composition of the individual and the stresses and strains     of 45 contributors from twelve different countries and three conti-
of functional challenge imposed must, in large measure, be consid-        nents is evidence of the substantial weight of scientific input into
ered unnatural as far as outcome of performance and susceptibility        the subject of equine locomotion; and lends emphasis to the impor-
to injury are concerned.                                                  tance of the book and the successful endeavours of the two co-
   Up until about the 1970s, the disciplines of locomotion and            editors, Wim Back and Hilary Clayton, who deserve congratulations
exercise physiology were largely in the hands of clinicians and           from all concerned, contributors and readers alike.
horsemen, who based their diagnostic and therapeutic measures
upon experience and trial and error associated with outcome. The
                                                                                                                              Peter D. Rossdale
introduction of scientific methods has not only solved problems,
but also challenged those responsible for the care and well-being                                  Emeritus Editor Equine Veterinary Journal
of horses for whatever purpose they are used. Particularly in the past                                Rossdale and Partners, Newmarket, UK
                                                                                                                                                    vii
        Foreword
       References
       Camp, C.L., Smith, N., 1942. Phylogeny and     Muybridge, E., 1899. Animals in motion.      Wei, T., 2008. Gray’s paradox solved:
          function of the digital ligaments of the       Chapman & Hall, London.                     researchers discover secret of speedy
          horse. University of California Memoirs     Pfau, T., Witte, T.H., Wilson, A.M., 2006.     dolphins.
          Zoology 13, 69–124.                            Centre of mass movement and mechanical Science Daily. Available at: http://www.
       Gray, J., 1936. Studies in animal locomotion      energy fluctuation during gallop            sciencedaily.com/releases/2008/11/
          V1: The propulsive powers of the dolphin.      locomotion in the Thoroughbred racehorse.   081124131334.htm. Accessed 11 November
          J. Expt. Biol. 13, 192–199.                    J. Exp. Biol. 209, 3742–3757.               2009.
viii
                                                                          Foreword
                                                                to the first edition
Horse locomotion has lost most of the practical importance it had            valuable insight into the stresses that bones have to withstand when
in past centuries, but a great many people remain passionately               surgically implanted strain gauges were used to record strains in the
interested in horses for leisure, racing or other purposes. This, and        lower leg bones of running and jumping horses (Biewener et al.,
the high value of horses, sustain veterinary interest in the species.        1983). It was in a study of horses that Rome et al., (1990) showed
   Horses have also attracted the interest of many research scientists.      us the remarkable range of properties that can be found within a
Muybridge’s (1899) sequences of photographs of horses in motion,             single muscle. Some fibers in the soleus muscle of horses are capable
taken with multiple cameras before the cine camera had been                  of contracting ten times faster than others. And observations on
invented, have an honored place in the history of motion pictures.           horses were the first to show that tendons can be damaged by
Camp and Smith’s (1942) study of the digital ligaments of horses             overheating, by heat liberated by the repeated stretching and recoil,
was an early recognition of the importance of tendon and ligament            that occurs in running (Wilson & Goodship, 1994).
elasticity in running; horses, people, dogs, kangaroos and many                 Besides these studies that have wide significance, there have been
other animals save energy by bouncing along, using their tendons             others, equally fascinating, that concern horses alone. The recipro-
like the spring of a child’s pogo stick. Horses were particularly good       cal apparatus in the hind limb makes movements of the stifle joint
material for this study because their adaptations for elastic energy         drive those of the hock (van Weeren et al., 1992). The hooves of
savings are surpassed only by the camel (Dimery et al., 1986).               horses have been shown to be designed in a remarkably sophisti-
Recent research provides many examples of research on horses                 cated way, to withstand impact on the ground (Thomason et al.,
that has wide significance for the understanding of animal and               1992). The hock joint of horses has bistable properties that make
human movement. I will cite just a few of my favourites.                     it click like an electric switch from one extreme position to the
   Most quadrupedal mammals walk, trot and gallop, but the sig-              other, a property which, curiously, is much more marked in domes-
nificance of changing gaits became apparent only when Hoyt and               tic horses than in zebra or Przewalsky’s horse (Alexander & Trestik,
Taylor (1981) trained ponies to change gait on command, so that              1989).
they could be made (for example) to trot at speeds at which they                These examples make it clear that horse locomotion has inspired
would have preferred to walk, and vice versa. By measurements of             a great deal of excellent and interesting science, much of which
oxygen consumption they showed that walking is the gait that needs           throws light on the biology of other animals, as well as of horses.
least energy at low speeds, trotting at intermediate speeds, and gal-        That is one reason why this book will be so welcome. Another is
loping at high speeds, and that each gait is used in the range of            that it has been written by a carefully chosen team of scientists
speeds in which it is most economical. Bramble and Carrier (1983)            whose research has added substantially to our knowledge of horse
depended largely on observations of horses for their demonstration           locomotion.
that galloping mammals take one breath per stride, their breathing              Sadly, the team has been depleted by the death of Henk
apparently driven by the movements of locomotion. They specu-                Schamhardt, co-author of one of our chapters, who was pre-
lated that this might depend on the viscera functioning as an iner-          eminent among researchers in the field of equine biomechanics.
tial piston, shifting forward and back in the trunk as the animal
accelerated and decelerated in the course of each stride. Disappoint-                                                     R. McNeill Alexander FRS
ingly, this seems not to be the case; the breathing of a galloping
horse seems to be driven by the bending and extension of the back,                                                   Emeritus Professor of Zoology
functioning like a bellows (Young et al., 1992). Horses gave us                                                             University of Leeds, UK
References
Alexander, R.McN., Trestik, C.L., 1989. Bistable     the locomotion of horses (Equus caballus).       van Weeren, P.R., Jansen, M.O., van den
   properties of the hock joint of horses. J.        J. Zool. 210, 415–425.                              Bogert, A.J., Barneveld, A., 1992. A
   Zool. 218, 383–391.                             Hoyt, D.F., Taylor, C.R., 1981. Gait and the          kinematic and strain gauge study of the
Biewener, A.A., Thomason, J., Lanyon, L.E.,           energetics of locomotion in horses.                reciprocal apparatus in the equine hind
   1983. Mechanics of locomotion and                  Nature 292, 239–240.                               limb. J. Biomech. 25, 1291–1301.
   jumping in the forelimb of the horse            Muybridge, E., 1899. Animals in Motion.            Wilson, A.M., Goodship, A.E., 1994.
   (Equus): In vivo stress developed in the           Chapman and Hall, London.                          Exercise-induced hyperthermia as a
   radius and metacarpus. J. Zool. 201, 67–82.     Rome, L.C., Sosnicki, A.A., Goble, D.O., 1990.        possible mechanism for tendon
Bramble, D.M., Carrier, D.R., 1983. Running           Maximum velocity of shortening of three            degeneration. J. Biomech. 27, 899–905.
   and breathing in mammals. Science 219,             fibre types from horse soleus muscle:           Young, I.S., Alexander, R.McN., Woakes, A.J.,
   251–256.                                           implications for scaling with body size. J.        Butler, P.J., Anderson, L., 1992. The
Camp, C.L., Smith, N., 1942. Phylogeny and            Physiol. 431, 173–185.                             synchronisation of ventilation and
   function of the digital ligaments of the        Thomason, J.J., Biewener, A.A., Bertram, J.E.A.,      locomotion in horses (Equus caballus).
   horse. University of California Memoirs            1992. Surface strain on the equine hoof            J. Exp. Biol. 166, 19–31.
   in Zoology 13, 69–124.                             wall in vivo: implications for the material
Dimery, N.J., Alexander, R.McN., Ker, R.F.,          design and functional morphology of the
   1986. Elastic extensions of leg tendons in        wall. J. Exp. Biol. 166, 145–168.
                                                                                                                                                      ix
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                                                                            Preface
The repercussions of societal revolutions are felt far and wide, and     and gamers. The new chapter on modeling, simulation and anima-
the equine industry is certainly not immune. The industrial revolu-      tion draws on the expertise of multiple authors to adequately re
tion brought major changes in agriculture and transportation that        present this exciting area.
were the impetus for a change in the predominant use of horses              Considerable new information has been added to the chapters
from work to sport and recreation. The baby boomer generation            on signals from materials, genetic contributions to exercise and
adopted a fitness craze that ultimately resulted in an increase in       performance, the horse–rider interaction, locomotion ethology and
sport-related injuries and a growing need for sports medicine prac-      welfare, and rehabilitation. These chapters present state-of-the-art
titioners. Equestrian sports were also growing in popularity and         information from the researchers who are at the forefront in these
there was a demand for scientific information about the structure,       areas.
function and diseases of sport horses.                                      Production of this text was timed so that the chapter authors
   Gait analysis has always been recognized as a key element in          could include new information presented at the International Con-
understanding equine athletic performance but it was not until the       ference on Equine Exercise Physiology in November 2010. At this
technological revolution that the tools became available to make         conference, biomechanics was the strongest subject area; there were
rapid progress in this area. Biomechanists now have at their disposal    numerous excellent presentations made at the conference and
a dazzling array of equipment and techniques to analyze equine           published in the proceedings book. This second edition of Equine
locomotion. Consequently the past decade has seen tremendous             Locomotion truly represents the current state of knowledge about
growth in the body of literature in this area. Since the first edition   equine locomotion and the multitude of factors that can influence
of Equine Locomotion was published in 2001, the knowledge base           locomotor performance in the horse.
has expanded in the traditional areas and many new foci of inves-           As the editors of this edition we thank all our contributors for
tigation have emerged. Therefore, there was no shortage of new           their expertise and dedication in making the information so readily
information for the second edition.                                      available to all those who have an interest in this fascinating subject.
   In this edition, almost every chapter has undergone substantial
revision to include new information. Notable among these is the                                      Willem Back (Utrecht, The Netherlands)
chapter on modeling of locomotion, an area that was in its infancy
a decade ago but has now become much more mainstream and                                   Hilary M. Clayton (East Lansing, Michigan, USA)
accessible to researchers rather than being the domain of animators                                                                        2013
                                                                                                                                                    xi
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                                                                            Preface
                                                             to the first edition
As a result of their diverse athletic abilities, horses have been used   reader a complete picture of the horse in motion, as we now know
as beasts of burden, as vehicles of war and as partners in sports and    it. The book begins with a history of man’s association with the
recreation. The past century has seen an explosion in the popularity     horse both in sports and in veterinary medicine, which sets the stage
of equestrian sports with a concomitant increase in competition          for a comprehensive description of the present state of knowledge
standards. The expectations for performance in today’s competition       beginning with the initiation of gait and ending with the more
horse require a high level of care and training, which can be            futuristic area of computer modeling. In areas where studies of
achieved only through a comprehensive understanding of the               horses are lacking, ideas from other species have been introduced.
anatomy and physiology of the elite equine athlete. The scientific       The list of authors comprises individuals who are acknowledged
community responded to this need for information by embracing            experts in their subject areas. We thank them for the enormous time
the discipline of equine sports science, which has developed in          and effort they have invested in producing this book.
parallel with the growth of equestrian sports. Gait analysis, which         Unfortunately, one of our most esteemed authors, Henk C.
is the study of locomotion, is an area of equine sports science that     Schamhardt, PhD, died in an accident on June 26th 1999 during
has made great strides (quite literally) in the last 30 years.           his sabattical leave in Australia. As a leading member of the Utrecht
   By 1991, gait analysis was sufficiently established as a scientific   Equine Biomechanics Research Group, Henk made an enormous
discipline to warrant the establishment of an International Work-        contribution to the development of equine biomechanics across the
shop on Animal Locomotion (IWAL). The idea of IWAL was con-              world. Those who did not know Henk personally are familiar with
ceived and brought to fruition by Henk Schamhardt and Ton van            his work through his excellent conference presentations, numerous
den Bogert at Utrecht University. Subsequent IWALs have been             publications, and his role as co-editor of the proceedings of the first
organized by Hilary Clayton in California in 1993 and by Eric            two IWALs. As a result of his generosity in sharing his skills and
Barrey in Saumur, France in 1996. By the time this book is pub-          knowledge, Henk acted as a mentor to a new generation of research-
lished, Florian Buchner will have organized IWAL4 in Vienna and          ers in equine locomotion and biomechanics. It is a fitting tribute
IWAL5 will be in the planning stages.                                    to dedicate this book to him.
   Each IWAL proceedings contains a collection of manuscripts that          It has been an honour and a pleasure to edit this millennium
reflects the recent and on-going research projects in locomotion         book about the locomotion of our mutual friend, the horse. As our
laboratories around the world. Although these proceedings have           Swedish colleagues would say while standing with one boot on a
proven to be a valuable resource, the information they contain is        chair and the other one on the table ‘To the horse!’
not intended to cover the various aspects of the discipline com-
pletely. The need for a more comprehensive source of information                                    Willem Back (Utrecht, The Netherlands)
on equine locomotion was recognized by Wim Back. W.B. Saunders
supported the concept and Hilary Clayton was enlisted to assist in                            Hilary Clayton (East Lansing, Michigan, USA)
the editorial duties. Our goal in producing this book is to give the                                                                      2000
                                                                                                                                                   xiii
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                                              Acknowledgments
We thank the staff at Elsevier, especially Alison Ashmore, Rita        husband Richard. We appreciate their support and tolerance of the
Demetriou-Swanwick, Robert Edwards, Catherine Jackson, Jennifer        time we spent working on the book, which was usually during off
Jones, Bhargavi Natarajan, Joyce Rodenhuis, Julie Taylor, and Louisa   duty hours.
Talbott for their help in completing this book.
  We must also recognize the important role of our families, Wim’s
wife Tia and their children Niels, Floris and Milou, and Hilary’s
                                                                                                                                           xv
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                                                        Contributors
R. McNeill Alexander CBE, MA, PhD, DSc, Hon DSc                 Antonie J. Van den Bogert PhD
(Aberdeen), Dr.h.c. (Wageningen), FSB, FRS, EAS                 Parker-Hannifin Endowed Chair in Human Motion and
Emeritus Professor of Zoology                                   Control
Faculty of Biological Sciences                                  Department of Mechanical Engineering
School of Biology                                               Cleveland State University
University of Leeds                                             Cleveland, OH, USA
Leeds, UK
                                                                Pieter A.J. Brama DVM, PhD, MBA, Spec. KNMvD (Equine
Fabrice Audigié DVM, PhD, LA-ECVDI                              Surgery), Dipl. ECVS
Professor in Equine Diagnostic Imaging                          Professor of Veterinary Surgery
CIRALE-École Nationale Vétérinaire d’Alfort                     Head Veterinary Clinical Sciences
Maisons-Alfort, France                                          School of Veterinary Medicine
                                                                University College Dublin
Adam Arabian PhD, PE
                                                                Belfield, Dublin, Ireland
Department of Engineering
Seattle Pacific University                                      H.H. Florian Buchner DVM, PhD
Seattle, WA, USA                                                Associate Professor of Orthopaedics in Large Animals
                                                                Equine Surgery Section
Willem Back DVM, Cert. KNMvD (CKRD), Cert. Pract.
                                                                Clinic for Horses
KNMvD (Equine Practice), PhD, Spec. KNMvD (Equine
                                                                Department for Small Animals and Horses
Surgery), Dipl. ECVS, Prof. (U Ghent)
                                                                University of Veterinary Medicine Vienna
Assistant Professor in Equine Surgery
                                                                Vienna, Austria
Department of Equine Sciences, Faculty of Veterinary Medicine
Utrecht University                                              Anna Byström DVM
Utrecht, The Netherlands;                                       Department of Anatomy, Physiology and Biochemistry
Visiting Professor in Equine Orthopaedics                       Swedish University of Agricultural Science
Department of Surgery and Anaesthesiology of Domestic           Uppsala, Sweden
Animals
                                                                Henry Chateau DVM, PhD
Faculty of Veterinary Medicine
                                                                Associate Professor in Anatomy
Ghent University
                                                                INRA-ENVA Biomechanics and Locomotor Pathology of the
Merelbeke, Belgium
                                                                Horse
Albert Barneveld DVM, PhD, Spec. KNMvD (Equine                  Ecole Nationale Vétérinaire d’Alfort
Surgery)                                                        Maisons-Alfort, France
Professor of Equine Surgery
                                                                Hilary M. Clayton BVMS, PhD, Dipl. ACVSMR, MRCVS
Department of Equine Sciences
                                                                McPhail Dressage Chair in Equine Sports Medicine
Faculty of Veterinary Medicine
                                                                Professor of Large Animal Clinical Sciences,
Utrecht University
                                                                College of Veterinary Medicine, Michigan State University
Utrecht, The Netherlands
                                                                East Lansing, MI, USA
Eric Barrey DVM, PhD
                                                                Jean-Marie Denoix DVM, PhD, Agrégation in Anatomy,
Research Director
                                                                Assoc. LA-ECVDI
INRA
                                                                Professor in Equine Anatomy and Locomotor System
Animal Genetics and Integrative Biology
                                                                Pathology
Jouy-en-Josas,
                                                                CIRALE-École Nationale Veterinaire d’Alfort
Inserm, Integrative Biology of Exercise Adaptations,
                                                                Maison-Alfort, France
Evry University,
Genopole, Evry, France                                          Nancy R. (Deuel) Toby MSc, PhD
                                                                Freelance Editor
Helen L. Birch BSc, PhD, FHEA
                                                                St. Michaels, MA, USA
Senior Lecturer in Musculoskeletal Pathobiology
Institute of Orthopaedics and Musculoskeletal Science
University College London,
Stanmore Campus
London, UK
                                                                                                                            xvii
         Contributors
xviii
                                                                                                        Contributors
Frederik Pille DVM, PhD, Dipl. ECVS                     Natalie K. Waran BSc (Hons), PhD
Professor of Orthopaedics in Large Animals              Jeanne Marchig Professor of Animal Welfare Education
Department of Surgery and Anaesthesiology of Domestic   Director of the Jeanne Marchig International Centre for
Animals                                                 Animal Welfare Education Royal (Dick) School of Veterinary
Faculty of Veterinary Medicine                          Studies
Ghent University                                        The University of Edinburgh
Merelbeke, Belgium                                      Easter Bush, Roslin Midlothian, UK
Lars Roepstorff DVM, PhD                                P. René van Weeren DVM, PhD, Spec. KNMvD (Equine
Professor of Equine Functional Anatomy                  Surgery), Dipl. ECVS, Dipl. RNVA
Unit of Equine Studies                                  Professor of Equine Musculoskeletal Biology
Swedish University of Agricultural Science              Department of Equine Sciences
Uppsala, Sweden                                         Faculty of Veterinary Medicine
                                                        Utrecht University
José Luis L. Rivero DVM, PhD
                                                        Utrecht, The Netherlands
Professor of Veterinary Anatomy
Head of the Laboratory of Muscular Biopathology         Michael A. Weishaupt PD, Dr.med.vet., PhD
Faculty of Veterinary Medicine,                         Sports Medicine Section
University of Cordoba,                                  Equine Department
Cordoba, Spain                                          Vetsuisse Faculty
                                                        University of Zürich
Peter D. Rossdale MA, PhD, Dr.h.c. (Berne, Edinburgh,
                                                        Zürich, Switzerland
Sydney), DESM, FRCVS
Founder Rossdale and Partners                           Inge D. Wijnberg DVM, PhD, Spec. KNMvD (Equine
Emeritus Editor Equine Veterinary Journal               Internal Medicine), Dipl. ECEIM
Director Romney Publications Ltd                        Assistant Professor in Equine Medicine
Newmarket, UK                                           Department of Equine Sciences
                                                        Faculty of Veterinary Medicine
Henk C. Schamhardt PhD (deceased)
                                                        Utrecht University
Faculty of Veterinary Medicine
                                                        Utrecht, The Netherlands
Utrecht University
Utrecht, The Netherlands                                Claudia Wolschrijn DVM, PhD
                                                        Associate Professor in Veterinary Anatomy
Narelle Stubbs BAppSc (PT), MAnimSt (Animal
                                                        Department of Pathobiology
Physiotherapy), PhD
                                                        Faculty of Veterinary Medicine
Department of Large Animal Clinical Sciences
                                                        Utrecht University
College of Veterinary Medicine
                                                        Utrecht, The Netherlands
Michigan State University
East Lansing, MI, USA
                                                                                                                       xix
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                                                                          Glossary
Abduct, abductor, abduction:  Pertaining to     Biphasic:  A movement or measurement             Diagonal width:  The lateral distance,
   the movement of a body part away from           with two distinct major amplitudes                measured perpendicular to the direction
   the midsagittal plane.                          per cycle.                                        of motion, between the placements of
Acceleration:  The time rate change of          Canter, rotary:  One of two footfall                 the diagonal fore and hind limbs during
   velocity.                                       sequences of the canter gait in which a           diagonal stance.
Acceleration due to gravity:  The                  lateral pair of limbs move synchronously      Digitize:  Transform analog data, e.g. a
   acceleration of a body freely falling in a      and the leading limbs are on opposite             photographic image, to digital form,  
   vacuum, the magnitude of which varies           sides of the body for the fore and hind           e.g. an electronic file.
   slightly with location. Standardized            limb pairs.                                   Displacement:  Length measured along a
   value at sea level is 9.807 m/s2.            Canter, transverse:  One of two footfall             straight line from starting point to
Accelerometer, accelerometry:  Pertaining          sequences of the canter gait in                   finishing point. A vector quantity.
   to the measurement of accelerations.            which a diagonal pair of limbs move           Distal:  Away from the main mass of the
Adduct, adductors, adduction:  Pertaining          synchronously and the leading limbs are           body; opposite of proximal.
   to the movement of a body part toward           on the same side of the body for the          Distance:  Length measured along the path
   the midsagittal plane.                          fore and hind limb pairs.                         taken by the body from starting point to
Advanced completion/lift-off:  Time             Caudal, caudad:  Toward the tail.                    finishing point. A scalar quantity.
   elapsing between lift-off of two specified   Center of mass:  The point about which the       Dorsal:  Toward the dorsum (back) of the
   limbs.                                          total mass of a body is evenly balanced.          body, opposite of ventral.
Advanced placement:  Time elapsing                 Used to represent the mass of an object       Drag:  Resistance to motion within a fluid.
   between ground contact of two specified         in physical calculations.                     Duration:  The period of time during which
   limbs.                                       Central pattern generators:  Neural                  a given state lasts.
Air resistance:  Drag on a body produced           networks located in the spinal cord           Duty factor:  The duration of the stance
   by the frictional effects of moving             that produce rhythmic limb movements.             phase of a specified limb as a proportion
   through air.                                 Cervical:  The anatomic name for the neck;           of the total limb cycle duration or stride
Allometry:  The study of factors that change       horses have seven cervical vertebrae.             duration.
   the shape and functionality of an animal     Contralateral:  Located on opposite (left or     Dynamics:  The branch of mechanics that
   with increasing size.                           right) sides of the body.                         deals with motion and the way in which
Angular acceleration:  The time rate change     Cost of transport:  The energy expended by           forces produce motion.
   of angular velocity.                            an animal in moving a given distance.         Efficiency:  The ratio of useful energy
Angular displacement:  The change in            Couplet:  When the alternating footfalls of          delivered by a dynamic system to the
   orientation of a line segment, as the           a pair of limbs (diagonal, lateral, fore or       energy supplied to it.
   plane angle between initial and final           hind) are separated by unequal intervals      Elastic energy:  The potential energy stored
   orientation, regardless of the rotational       of time, the two closely-spaced footfalls         by a body as a result of deformation.
   path taken.                                     occur as a couplet.                           Electrogoniometry, electrogoniometer,
Angular velocity:  The time rate change of      Cranial, craniad:  Toward the head.                  electrogoniometric:  Pertaining to
   angular displacement. A vector quantity.     Damping:  A gradual reduction in                     electrical signals generated by devices
Arthromere:  One of the body segments of           the amplitude of an oscillating                   which monitor the change in angle of  
   a jointed animal, somite.                       movement.                                         a joint.
Arthrometry:  The study of joint movement       Density:  The concentration of matter,           Electromyography, electromyographer,
   range and mobility.                             expressed as mass per unit volume.                electromyographic, EMG:  Pertaining to
Articular, articulate, articulated,             Diagonal dissociation:  temporal                     electrical potentials generated in muscle
   articulation:  Pertaining to a structure        dissociation at contact or lift-off of a          cells during contractions.
   constructed of segments united by joints.       diagonal pair of limbs that appear to         Energetics:  The study of energy, force, and
Axis:  A straight line about which rotation        move in synchrony.                                efficiency.
   occurs.                                      Diagonal limb (pair):  A forelimb of one         Extend, extension, extensor (joint): 
Biokinematics:  Kinematics applied to              side and the hind limb of the opposite            Pertaining to factors that cause an
   biological systems or entities.                 side. Customarily, the ‘right diagonal’           increase in joint angle.
Biokinetics:  The study of the forces              is right fore and left hind; the ‘left        Fatigue:  A reduction in power output,
   responsible for the movements of                diagonal’ is left fore and right hind.            comfort, and/or efficiency associated
   living organisms.                            Diagonal stance, left/right:  A stride phase         with prolonged or excessive exertion.
Biomechanics:  The application of                  in which the body is supported by a           Flex, flexion, flexor (joint):  Pertaining to
   mechanical laws to living structures.           diagonal pair of limbs.                           factors that cause a reduction in joint
Biped, bipedal:  Having, utilizing, or          Diagonal step length, left/right:  The               angle.
   supported by two feet.                          distance along the direction of motion        Flexion/extension:  The movement of a
Bipedal:  A portion of the stride in which         between the diagonal fore and hind                joints around its transverse axis. The
   two limbs support the body.                     hooves during diagonal stance.                    flexor and extensor sides of the joints are
                                                                                                                                                   xxi
        Glossary
          defined according to anatomical                Lateral limb (pair):  A forelimb and hind        Normal:  Perpendicular to a plane, usually
          convention.                                        limb on the same side of the body.              the ground.
       Force:  The mechanical action or effect of        Lateral stance, left/right:  A stride phase in   Normalize:  Mathematically convert
          one body on another, which causes the              which the body is supported by a lateral        measurements to a common frame of
          bodies to accelerate relative to an inertial       pair of limbs.                                  reference to facilitate comparisons
          reference frame.                               Lateral step length, left/right:  The distance      between individuals or groups.
       Force plate:  A device that measures ground           along the direction of motion between        Ontogeny:  The sequential development of
          reaction forces.                                   the placements of the ipsilateral hind          the individual organism.
       Frequency:  The number of repetitions of a            and forelimbs.                               Outliers:  Values of data that are in excess of
          periodic event that occur within a given       Laterality:  Asymmetry between the                  a certain cut-off point.
          time interval, usually expressed in Hz             left and right sides of the body in          Overlap:  Stride phase in which two or
          (cycles per second).                               motion or limb usage that occurs                more specified limbs are simultaneously
       Gait:  Cyclic pattern of limb movements.              naturally and is not accounted for by           in stance.
          Each complete cycle is one stride.                 pathology or injury, as in handedness in     Pedobarograph:  Device for measuring the
       Gallop, rotary:  One of two footfall                  humans.                                         pressure distribution beneath the foot.
          sequences of the gallop gait in which          Levator, elevate, elevation:  Pertaining to      Phylogeny:  The complete developmental
          the footfall of the leading hind limb is           lifting a body part vertically.                 history through evolution of a group of
          followed by the footfall of the ipsilateral    Lift-off:  The moment when the hoof leaves          animals.
          forelimb and the leading forelimb and              the ground. Marks the transition from        Pitch:  Body rotation about the transverse
          leading hind limb are on opposite sides            stance to swing phase.                          (mediolateral) axis.
          of the body.                                   Limb, lead/leading:  The second of the two       Placement interval:  Elapsed time between
       Gallop, transverse:  One of two footfall              hind limbs or two forelimbs to contact          the contacts of two specified limbs
          sequences of the gallop gait in which              the ground in each stride of an                 within a stride.
          the footfall of the leading hind limb is           asymmetrical gait.
                                                                                                          Potential energy:  Energy of a body
          followed by the footfall of the diagonal       Limb, trail/trailing:  The first of the two         associated with position or
          forelimb and the leading forelimb and              hind limbs or two forelimbs to contact          configuration.
          leading hind limb are on the same side             the ground in each stride of an
                                                                                                          Power:  The rate at which work is done or
          of the body.                                       asymmetrical gait.
                                                                                                             energy is expended.
       Ground reaction force:  force exerted by the      Longitudinal axis:  A line in the median
                                                                                                          Pressure:  The force applied per unit area.
          ground against a limb that is in contact           sagittal plane extending from head to
          with the ground. Acts in opposition to                                                          Pronate, pronator, pronation:  Pertaining
                                                             tail; craniocaudal axis.
          the force exerted by the limb against                                                              to axial rotation of a limb in which the
                                                         Lumbar:  The anatomic name for the loin
          the ground.                                                                                        lateral aspect rotates in a cranial
                                                             of the horse; there are usually 6 lumbar
                                                                                                             direction.
       Horsepower:  A quantity of power equal to             vertebrae.
          735.5 watts (or joules per second)                                                              Protract, protraction, protractor: 
                                                         Mass:  The quantity of matter contained
          (metric unit), or 745.7 watts (imperial                                                            Pertaining to moving a body part
                                                             by a body, with standardized
          unit).                                                                                             forward (cranially).
                                                             international measurement units  
       Hyperextension:  Excessive or extreme                                                              Proximal:  Toward the main mass of the
                                                             of kilograms.
          extension of a joint; in a range that may                                                          body; opposite of distal.
                                                         Mass moment of inertia:  The measure of a
          cause injury.                                                                                   Quadruped, quadrupedal:  Having,
                                                             body’s resistance to accelerated angular
       Hyperflexion:  Excessive or extreme flexion                                                           utilizing, or supported by four feet.
                                                             motion about an axis.
          of a joint; in a range that may cause                                                           Quadruple or quadrupedal support:  A
                                                         Mechanical energy:  The capacity to do
          injury.                                                                                            portion of the stride in which four limbs
                                                             work, equal to the sum of potential
       Ipsilateral:  Located on the same (left or                                                            support the body.
                                                             energy and kinetic energy.
          right) side of the body.                                                                        Retract, retraction, retractor:  Pertaining to
                                                         Mechanics:  The branch of physics
       Jump suspension:  The phase during                                                                    moving a body part backward
                                                             concerned with the behavior of  
          jumping when the horse has no                                                                      (caudally).
                                                             physical bodies when subjected to  
          contact with the ground.                           forces or displacements, and the             Retrograde motion:  Movement opposite to
       Kinematics:  The branch of mechanics that             subsequent effects of the bodies                the accustomed direction, i.e. in the
          is concerned with the description of               on their environment.                           caudal direction.
          movements.                                     Modeling:  A theoretical, simplified             Roll:  Body rotation about the longitudinal
       Kinetic energy:  Energy of a body associated          mathematical construct of a physical            (craniocaudal) axis.
          with translational and rotational                  phenomenon.                                  ROM:  Range of motion is the total angular
          motion.                                        Moment of a couple:  The resultant                  change during one stride.
       Kinesiology:  The study of the mechanics of           moment of two equal but oppositely           Sagittal plane:  Plane parallel to the
          motion. Usually described with reference           directed, non-collinear parallel forces         median plane.
          to human anatomy.                                  (the couple).                                Scalar quantity:  A quantity that is
       Kinesthesia:  The perception or sensing of        Moment of a force:  The turning effect              completely expressed in terms of  
          the motion, weight, or position of the             (torque) of a force about a point.              its magnitude.
          body.                                          Morphometry, morphometric:  The study            Single support:  A portion of the stride in
       Kinetics:  The study of internal and external         of the form and dimensions of a body.           which only one limb is in the stance
          forces, energy, power, and efficiency          Newton:  The standard unit of force,                phase.
          involved in the movement of a body.                equivalent to that which will cause a        Somite:  Body segment.
       Lateral:  Pertaining to the sides, left and           mass of one kilogram to accelerate           Speed:  The rate of change of distance;
          right.                                             1 m/s2.                                         a scalar quantity.
xxii
                                                                                                                                   Glossary
Stance phase of a limb:  The period of         Support, bipedal or double:  Ground              Time:  Measurable quantity in the temporal
   ground contact of an individual limb           contact and/or weight bearing by two             domain, with standardized international
   within a stride beginning at ground            limbs.                                           units of seconds.
   contact and ending at lift-off.             Support phase:  phase of the stride when         Toe-off:  The instant at the end of the
Stance phase of the stride:  Summation of         one or more limbs are in contact with            stance phase at which the toe is no
   time periods during a stride when one          the ground.                                      longer contacting the ground. Marks  
   or more limbs are in contact with the       Support, quadrupedal or quadruple:                  the transition between stance and swing
   ground.                                        Ground contact and/or weight bearing             phases.
Statics:  The branch of mechanics                 by four limbs.                                Torque:  A turning or twisting force; also
   concerned with the analysis of loads        Support, single:  Ground contact and/or             referred to as moment of force.
   (force, torque/moment) on physical             weight bearing by one limb.                   Transverse axis:  A mediolateral line
   systems in static equilibrium.              Support, tripedal or triple:  Ground contact        that is mutually perpendicular to the
Step:  The movement pattern in normal             and/or weight bearing by three limbs.            longitudinal and vertical axes;
   locomotion in transitioning from            Suspension:  An aerial or airborne phase            mediolateral axis.
   weight-bearing by one limb to another.         of the stride in which all four limbs are     Triped, tripedal:  Having, utilizing, or
Step duration:  The time between ground           simultaneously in the swing phase and            supported by three feet.
   contacts of two specified limbs.               free from weight bearing.                     Tripedal support:  A portion of the
Step height:  The height to which a            Suspension, extended:  Aerial phase of the          stride in which three limbs support  
   specified location on a limb is raised         stride that occurs with between lift-off of      the body.
   from the ground during locomotion.             the leading hind limb and contact of the      Ungulate:  Hoofed mammal.
Step length:  The horizontal distance in          trailing forelimb when the vertebral          Uniped, unipedal:  Having, utilizing, or
   the direction of motion between the            column is extended.                              supported by one foot.
   footfalls of two specified limbs.           Suspension, gathered:  Aerial phase of the       Unipedal support:  A portion of the
Strain:  Deformation resulting from the           stride that occurs between lift-off of the       stride in which one limb supports the
   application of stress.                         leading forelimb and contact of the              body.
Strain rate:  The rate of strain generation.      trailing hind limb when the vertebral         Units, SI:  Standard international units (or
Strength:  The maximal force produced by          column is flexed.                                their standard multiples) accepted by the
   muscular contraction.                       Swing phase:  The portion of the stride             International Society of Biomechanics
Stress:  An external force that acts on a         cycle or limb motion cycle in which              for scientific measurement, including
   body.                                          a designated limb is free from contact           length in meters, mass in kilograms,
Stride:  A complete cycle of the repetitive       with the ground.                                 time in seconds and plane angle in
   series of limb movements that               Symmetrical:  A movement or morphology              radians.
   characterize a particular gait.                that is substantially similar in being a      Vector quantity:  A quantity that has both
Stride duration:  The time required to            mirror image on left and right sides of          magnitude and direction.
   complete one stride.                           the body.                                     Velocity:  The time rate change of
Stride frequency:  The number of               Symmetrical gait:  A gait in which the              displacement. A vector quantity.
   repetitions of the stride per unit             limb coordination pattern of one side         Ventral:  Toward the ventrum (belly,
   time.                                          repeats that of the other side, half a           underside) of the body; opposite  
                                                  stride later.                                    of dorsal.
Stride length:  The horizontal distance
   traveled in the direction of motion         Temporal:  Concerning time, duration.            Weight:  The force of gravity acting
   during a single stride, or between          Tension:  The application of forces acting to       on a body, equal to the product  
   consecutive hoof prints of the same            stretch an object.                               of mass and the acceleration due  
   hoof.                                       Tetrapod, tetrapodal:  Having, utilizing, or        to gravity.
Supinate, supinator, supination:  Pertaining      supported by four feet.                       Work:  The result of a force acting to
   to axial rotation of a limb in which the    Thoracic:  The anatomic name for the chest          displace a body in a given direction.
   lateral aspect rotates in a caudal             of the horse; there are usually 18            Yaw:  Body rotation about the vertical
   direction.                                     thoracic vertebrae.                              (dorsoventral) axis.
                                                                                                                                               xxiii
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                                                                                                                    C H A PTER            1 
                                              History
                                              P. René van Weeren
                                                                                                                                                  1
      1      History
    wildebeest are abundant together with equids (zebras), while other           These changes in human society were to a large extent possible
    species such as rhinoceros and the large cats occur in significantly      thanks to a new phenomenon: the domestication of animal
    smaller numbers.                                                          species. It is widely believed that the dog was the first animal to be
       Man was still a hunter-gatherer in those days and, for this reason,    domesticated about 12 000 years ago. Like most early domestica-
    the wild animals comprised an essential part of his diet. Remains         tions, this event took place in Western Asia’s Fertile Crescent (the
    of large mammals eaten by man, including horses, have been found          area of fertile land from the Mediterranean coast around the
    at many sites. It is interesting to note that the vast majority of rock   Syrian Desert to Iraq), which was the cradle of human civilization.
    paintings concerned animals, most of them large mammals, whereas          There also the next domestication took place: small ruminants
    man himself was depicted rarely and other parts of the environment        were domesticated approximately 10 000 years ago, sheep and
    such as the vegetation or topographical peculiarities were never          goats in about the same period. Cattle were domesticated 2000
    shown. Also non-mammalian species such as birds, reptiles, fish or        years later in Anatolia (Western Turkey). Cats were domesticated
    insects were virtually unrepresented. The rock art found in various       (or adopted man as some people state) as early as 9000 years ago.
    parts of Zimbabwe and other parts of Southern Africa was some-            The first camelids to be domesticated were llamas in South
    what different. These paintings were made by the Bushmen from             America, perhaps as early as 7500 years ago. The horse arrived
    13 000–2000 years ago. Here again, the large mammalian species            rather late on the scene. There is evidence that the first horses were
    prevailed, with the zebra representing the equids, but man was            domesticated in what is now Southern Russia approximately 5000
    depicted more often and there were some paintings of fish and             years ago. However, the domestication of the horse dramatically
    reptiles (Adams & Handiseni, 1991). The Bushmen culture has               influenced the history of mankind, mainly because of its enor-
    survived until the present day, though in a much diminished and           mous potency in warfare.
    nowadays heavily endangered form, and it is known that these                 The horse was definitely the most revolutionary innovation in
    people, who were hunter-gatherers, lived in a very close relationship     warfare before the invention of gunpowder. First, the animals were
    with their environment, forming an integral part of the entire eco-       used to draw heavy war chariots which, used against traditional
    system. It is easy to imagine that under such circumstances the large     infantry, could provoke enormous massacres while being them-
    mammals, which were the most impressive fellow-creatures giving           selves rather invulnerable. Later, with the development of the skill
    rise to mixed feelings of awe, admiration and a certain form of soli-     of horse riding and increasing horsemanship, a real cavalry of
    darity, inspired the creation of works of art.                            mounted soldiers was developed which, with their greater agility,
       The world changed dramatically when, at the beginning of the           replaced the chariots. This development enabled rapid conquests of
    Neolithic period about 10 000–12 000 years ago, man changed from          vast territories. The Hittites conquered Asia Minor (present-day
    being a hunter-gatherer to primitive forms of agriculture and pas-        Turkey) in 2000 BC with their horse drawn chariots. A thousand
    toralism. The capacity of most natural savanna habitats to support        years later the Scythians, originally a Eurasian nomadic tribe settled
    fixed human nutritional requirements is estimated at only one or          in the area north of the Black Sea. The Scythians were excellent
    two persons per square mile (Dunlop & Williams, 1996). The                horse riders and they became masters in the tactics of cavalry-based
    advent of agriculture and pastoralism meant that the nutritional          steppe warfare, enslaving agricultural peoples and plundering what
    constraints on population growth were lifted and an unprecedented         came in their way. Later, other tribes that were mostly of Eastern
    population growth followed. It also meant that man definitively           origin, succeeded. The Huns overran the Roman Empire from the
    and irreversibly placed himself apart from his fellow-creatures           4th to the 6th century AD, and in the 13th century AD, Genghis Khan
    and outside the existing ecosystems where the numbers of species          reached the gates of Western Europe. For those peoples the horse
    were determined by the unmanipulated carrying capacity of the             was more than just a domesticated animal; it was central in their
    environment.                                                              culture, as a weapon, food, drink, a friend and a god. The warriors
2
                                                                                                                            The Antique world
were capable of staying in the saddle for an entire day. They ate        alluded to earlier (Simpson, 1951), the oldest reports of domesti-
horsemeat, drank mare’s milk and intoxicated themselves during           cated horses are from the Shung dynasty (1766–1027 BC). Like
their feasts with the fermented form of it. It is even said that sol-    everywhere else, the horse was used first to draw chariots, then for
diers, traveling without rations, opened the veins of their horses,      a mounted cavalry. From the latter period dates the famous ‘army’
drank the blood, closed the wounds, and remounted (Simpson,              of terra cotta figures (including large numbers of horses) that was
1951).                                                                   excavated at the burial site of Shih Hunagdi (259–210 BC). He is
   The changes in attitude towards animals by man, including             also called the first emperor as the formerly divided China was
domestication and changes in the use of domestic animals that were       united by then. The horse gained great importance in China during
partly dictated by changing environmental conditions are magnifi-        the Han dynasty when emperor Wu sent out a military expedition
cently demonstrated by the North African rock art found, for             to capture 3000 horses of a heavier and sturdier breed, which he
instance, in the Hoggar and Air mountain ranges in what is now           called the ‘Horses of Heaven’. They were probably related to the
the central Sahara Desert. Several thousands of years ago, North         Tarpan breed that still roamed the steppes of Southern Russia.
Africa was not covered to such a large extent by the extremely arid      Only 50 of them survived the 2000-mile journey home. By the
and inhospitable Sahara Desert as it is now. The oldest art dates to     middle of the 7th century AD, during the Tang dynasty, horse
about 7000 years ago and depicts wild animals such as buffalo,           breeding in China reached unprecedented heights when numbers
giraffe, elephant, ostriches, etc., suggesting that the area must have   increased from 5000 to over 700 000. The Chinese were excellent
looked like large parts of Eastern Africa do now. About 4000 BC          in designing saddlery and harnesses. They invented the trace
cattle and fat-tailed sheep appeared as first representations of         harness, in which the power of the horse is transmitted by a belt
domestic species. Horses appeared around 1200 BC, first drawing          around the chest, long before it was used in Europe where a collar-
chariots. These chariots are believed to have belonged to Cretan         type of harness was common. This latter type of harness com-
invaders because they are similar to pictures of chariots from this      presses the trachea and jugular veins when force is applied and
island (Lhote, 1988). In those days there was a Trans-saharan route      therefore permits the exertion of a force only one sixth that of
running from Tripoli and probably also Egypt to Gao on the Niger         using a trace harness. Also stirrups are a Chinese invention, dating
River, thus connecting the Mediterranean, Egyptian and Nubian            from the 3rd century AD.
cultures to the Bantu cultures of the Niger River valley. More recent       A few reports on equine veterinary medicine have survived from
rock art shows riders instead of chariots. With the increasing aridity   these cultures, some of which are quite extensive and methodical,
of the Sahara, the horse became unsuitable for traveling large dis-      like some Egyptian works. However, no specific studies on equine
tances with ever diminishing water resources, and was supple-            locomotion are known. Horses in general were depicted as they had
mented by camels around 100 BC.                                          been in prehistoric times and would remain until quite recently:
                                                                         either in a rather natural pose at a slow gait or in the characteristic
                                                                         unnatural pose that was used to indicate the gallop: forelimbs
                                                                         extended forward and hind limbs backward.
The ancient cultures
                                                                                                                                                   3
      1      History
    after him: Alexandria. This city on the mouth of the Nile would          Greece, Asia Minor and, of course, Alexandria. However, the Romans
    remain the intellectual center of the world from 300 BC to 500 AD.       were excellent in organizing and implementing the scientific and
    In the vast library 700 000 scrolls were housed compiling all knowl-     technical advances of others. Consequently, they created one of the
    edge that had been gained in the preceding millennium. The burning       vastest empires the world has ever known and which still influences
    of the library on the orders of Caliph Omar in AD 642 was an act of      many aspects of daily life.
    barbarism, narrow-mindedness and, in its deepest meaning, of fear           Horses played a pivotal role in the Roman army, which employed
    for the unknown. It resembles the burning of books that took place       large numbers of veterinarians to care for them. These were first
    in more recent history and is still taking place on the instigation of   called ‘mulomedici’, but after an overhaul of the military regula-
    totalitarian regimes and intolerant sectarian cults.                     tions under Commodus (180–192 AD) the term ‘veterinarii’ appears.
       The first extensive work on equine conformation was performed         Thanks to the enormous popularity of horse racing (chariots drawn
    by Xenophon (430–354 BC). Apparently a man of great experience,          by 2 or 4 horses), there was also employment for a category of
    he described in full detail the desirable and undesirable traits of      veterinary specialists not unknown today: the racetrack veterinarian
    horses. Many of his criteria were equal to those used today. Though      of which Pelagonius in the 4th century was a famous example.
    his work was more of a hippiatric caliber than a scientific work, he     However, these veterinarians were mainly engaged in the treatment
    already recognized the role of the hindquarters as the motor of          of diseases and healing of the many wounds. Empiricists, they relied
    locomotion.                                                              heavily on their Greek and Hellenistic counterparts for some theo-
       It is not surprising that the first documented study on animal        retical basis. A noteworthy exception was the physician Galenus.
    locomotion originated from one of the great Greek philosophers,          Galenus was born in Pergamon, Asia Minor, in 130 AD, but he
    Aristotle (384–322 BC). In his youth, Aristotle was intrigued by         worked for decades in Rome. He conducted large numbers of experi-
    natural history, and he wrote various volumes on biological and          ments on animals to advance medical knowledge and can be seen
    medical matters. In his works De motu animalium and De incessu           as the founder of the experimental basis of comparative medicine.
    animalium (On the movements of animals and On the progression of         He produced vast numbers of treatises of which about 20% have
    animals) he accurately described quadrupedal locomotion, at least        survived the ages. None of those is dedicated to the study of animal
    in the slower gaits. In De incessu animalium (Aristotle, 1961) he        or human locomotion.
    states that:                                                                Emperor Diocletianus (284–306 AD) had divided the Roman
                                                                             Empire into an eastern and a western half. Constantine the Great
                                                                             reunited the empire in 324, but it was divided again in 395. The
                                                                             western part fell with the abdication of Romulus Augustus in 476;
                                                                             the eastern part was to survive for an additional 1000 years as the
                                                                             Byzantine Empire with Constantinople (Istanbul) as capital. The
                                                                             veterinary profession was at a high level as can be judged from
       (The bendings, then, of the limbs take place in this manner           the compilation of all that was known in this field under the
       and for the reasons stated. But the hind limbs move diagonally        name Corpus Hippiatricorum Graecorum or Hippiatrika. Though
       in relation to the forelimbs; for after the right forelimb            published in the 9th or 10th century, most of the contents date
       animals move the left hind limb, then the left forelimb, and          back to the 4th century. The contributions of Apsyrtos (300–360),
       after it the right hind limb.)                                        the chief military veterinarian in the army of Constantine the
                                                                             Great, are of outstanding quality. Though the care and treatment
       The Romans were more doers than thinkers and lacked the intel-        of the locomotor system have a prominent position in this
    lectual drive that characterized the Greeks. Throughout the whole        work, no specific comments on locomotion itself or gait analysis
    period of the Roman Empire, the intellectual center remained in          are made.
4
                                                                                                              From the Renaissance to the 18th century
Through the Dark Ages to the Renaissance                                mystical powers towards a more rational, naturalistic approach.
                                                                        Perhaps no one was as closely associated with this revolutionary
                                                                        process as the genial artist and scientist Leonardo da Vinci (1452–
After the fall of the Western Roman Empire, the existing administra-    1519). Leonardo himself is known to have been interested in the
tive structures collapsed and much of the knowledge that had been       movements of animals and he even projected to:
gained over the centuries was lost. For centuries most of Europe
became an incoherent assembly of tribes and mini-states where               … write a separate treatise describing the movement of
insecurity and ignorance reigned. During this period the impressive         animals with four feet, among which is man, who likewise in
Arab conquest started from Mecca in the Arabian Peninsula where             its infancy crawls on all fours.
the prophet Muhammad had died in 632. Within a century, the                                                                                         Clayton, 1996
Arabs conquered millions of square miles of land from Northern
India to Spain. This could be accomplished thanks to their aggres-
                                                                           Da Vinci was intrigued by the flexibility of the equine spine and
sive light cavalry, which was based on the swift and enduring Arab
                                                                        produced a series of fine drawings, now in the British Royal Collec-
horses, and their great horsemanship. They were halted by the
                                                                        tion at Windsor Castle, with horses in a number of exceptional, but
troops of the Frankish king Charles Martel at Poitiers in 752. The
                                                                        not impossible poses.
Franks were only able to withstand them because they employed a
                                                                           It has been stated that the renaissance in veterinary medicine
heavily armored cavalry, which was rather invulnerable to the light
                                                                        started with the publication of the first great textbook on veterinary
cavalry of the Arabs, not unlike the use of the first tanks in World
                                                                        anatomy Dell Anatomia et dell’Infirmita del Cavallo (On the Anatomy
War I.
                                                                        and Diseases of the Horse) by Carlo Ruini in 1598. The anatomical
   While Europe was in cultural decline, the Arab culture flourished.
                                                                        part presented the first real new work since Antiquity. However,
It is thanks to many Arab scientists that at least a part of what had
                                                                        the part on diseases did not pass the standards of Jordanus Ruffus,
been written in Antiquity has survived to the present day. They
                                                                        De Medicina Equorum that had been published 350 years earlier.
translated the works into Arabic and in the later Middle Ages these
                                                                           It may not be surprising that this ambiance of emerging science
Arabic versions were translated again into Latin to lay the founda-
                                                                        fostered the first contribution to the science of equine locomotion
tion for the scientific revival in the Renaissance. The Arabs also
                                                                        since Aristotle. Giovanni Alphonso Borelli (1608–1679) was a pro-
contributed to veterinary medicine with original works. Akhi Hizam
                                                                        fessor of mathematics at Pisa University and applied physical theory
al-Furusiyah wa al-Khayl wrote the first book on the characteristics,
                                                                        to the study of animal locomotion. He calculated the force of
behavior and diseases of horses in 860. Abu Bakr ibn el-bedr al
                                                                        muscle action and recognized that the muscles were under nervous
Baytar (1309–1340) wrote an excellent work on veterinary medi-
                                                                        control (Fig. 1.3). In his book De motu Animalium (On the movement
cine, the Kamil as Sina’atayn. This book features aspects of equine
                                                                        of animals), he describes the center of gravity and also makes obser-
management and care including the tricks of horse-dealers(!),
                                                                        vations about limb placement in the various gaits (Borelli, 1681).
together with remarks on appearance, conformation and gait
(Dunlop & Williams, 1996). The horse had a very high standing in
the Arab world. Abu Bakr held the opinion that the horse was so
important to an Arab man that it would be reunited with him in
paradise, together with his wives. There is also an Arab maxim
stating that:
   Every grain of barley given to a horse is entered by God in the
   register of Good Works.
                                                       Simpson, 1951
   In the first part of the Middle Ages the medical and veterinary
professions stood at a low level in most of Europe. The link with
Antiquity had been broken and the Christian church, which saw
diseases as a divine punishment to be cured with the help of
supernatural power, had a hostile attitude towards the few rational
natural scientists. In medieval matters mystics and superstition
played an important role. It was not until the late Middle Ages that,
mainly through the translation of Arab texts (originals and transla-
tions of classical works), the tide changed. The emperor Frederick
II was a man ahead of his time. He formed a bridge between the
Christian Western world and the Islamic East. He was a great pro-
ponent of science and had a special interest in animals. It was his
chief marshal, Jordanus Ruffus, who, supported by the emperor,
published the first new work on equine medicine De Medicina
Equorum in 1250. Fredrick II was a great, but ruthless, innovator. At
first supported by Pope Innocent III, he fell into disgrace with his
successors who deprived him of his kingdoms in 1245. This enlight-
ened man can be seen as a very early protagonist of the wave of
renewal that was to blow over Europe and which would mean an
end to the Middle Ages: the Renaissance.
From the Renaissance to the 18th century                                Fig 1.3  Page from De motu animalium by Giovanni Borelli comparing equine
                                                                        and human locomotion.
In Italy a change in scientific attitude developed; this involved a     Reproduced from Dunlop, R.H., Williams, D.J. (Eds.), 1996. Veterinary Medicine. An illustrated
change from the concept of life as the product of supernatural and      history. Mosby, St. Louis, with permission from Elsevier.
                                                                                                                                                                         5
      1      History
    He was obviously ahead of his time; this line of investigation would        interesting for everybody dedicated to the art of horse-riding. The
    not be further pursued until the end of the 18th century.                   work is of extreme importance in the history of equine gait analysis.
      The 17th century was the age of the great horse marshals. One of          Though not entirely correct with respect to limb placement in the
    these was William Cavendysh, the first Duke of Newcastle (1592–             faster gaits, the study is well done and enters into great detail. Gaits
    1676). He was one of the most famous horse trainers of his days             of horses are represented by a ‘piste’ (a graphical representation of
    but was, as a royalist, forced to leave Britain when Charles I’s army       the footfall pattern), a kind of schematic stick diagram, an elaborate
    was defeated by Cromwell’s troops. In exile in Antwerp he wrote an          table, and by what we now call a gait diagram (Fig. 1.4). This latter
    extensive work on all aspects of the horse, which first appeared in         representation of equine gait was invented by Goiffon and Vincent
    French. It includes a chapter on the gaits, which he studied with           and has proved so useful that it is used in many present-day
    help of the sounds that the hooves make when they strike the                publications in an essentially unaltered form. Goiffon and Vincent
    ground (Cavendysh, 1674). Another great marshal of this era was             called it an ‘échelle odochronométrique’. Regarding the origin of the
    Jacques de Solleysel from France. His great work Le Parfait Maréschal       word, they state:
    qui enseigne a connoistre la beauté, la bonté, et les défauts des chevaux
                                                                                   Cette denomination est composée de trois mots grecs, dont l’un
    (The perfect marshal who teaches how to know the beauty, the virtue and
                                                                                   signifie chemin, l’autre temps & le troisieme mesure. C’est la
    the defects of horses) consists of two volumes. The first one is dedi-
                                                                                   définition exacte de notre échelle; elle est la mesure du temps
    cated to horse management, the second to equine diseases. De
                                                                                   & du chemin fait pendant ce temps.
    Solleysel makes some remarks on limb placement in various gaits,
                                                                                       (This name is composed of three Greek words: one means
    but appears not to really have made a study of the subject (De
                                                                                   distance, one means time and the third means measurement.
    Solleysel, 1733).
                                                                                   This is the exact definition of our scale, which in fact measures
                                                                                   time and the distance covered in that time.)
    The start of veterinary education                                                                                            Goiffon & Vincent, 1779
6
                                                                                                                                                                              The 19th century
   In the field of locomotion analysis some progress was made in                                     cycle of a limb into six periods. This was a simplification of the
the first three quarters of the 19th century. In Switzerland, Conrad                                 system used by Goiffon and Vincent who had used 12 time inter-
von Hochstätter published, from 1821–1824, his Theoretisch-                                          vals. Raabe’s division was also used by Lenoble du Teil (1873). In
praktisches Handbuch der äussern Pferdekenntniß, und der Wartung und                                 his 1893 publication, when he had a leading position at the famous
Pflege der Pferde (Theoretical and practical handbook of the conformation                            national stud Haras du Pin, Lenoble du Teil used his studies and
of the horse and of horse grooming and care), which includes the first                               similar works of others to take a strong stand against the classical
considerations of the mechanisms underlying equine gait, based on                                    Italian school of riding.
his own observations. He also discusses the consequences of a                                           In the Anglo-Saxon world there was not much research on the
number of faulty conformations for performance. Unfortunately,                                       topic. However, the problem of gait analysis was a point of discus-
this work remained largely unnoticed by the veterinary profession                                    sion from time to time as exemplified by a scientific quarrel between
(Schauder, 1923a). In Germany, there was an increasing interest in                                   Joseph Gamgee (Edinburgh) and Neville Goodman (Cambridge)
the explanation of locomotion by specific muscle action. This cul-                                   in the Journal of Anatomy and Physiology in the early 1870s. Discuss-
minated in the classical work Die topographische Myologie des Pferdes                                ing the canter, Gamgee stated that:
mit besonderer Berücksichtigung der lokomotorischen Wirkung der
                                                                                                          The horse in the fast paces, as in the slowest movement, has
Muskeln (Topographical myology of the horse with special attention to the
                                                                                                          never less than two of his feet acting on the ground.
locomotor effect of muscles) by Karl Günther in 1866. In Austria, Bayer
(1882) did some experimental work on the hoof mechanism using
an electrical device (Fig. 1.5) while in Germany Peters (1879) also                                  This statement was (correctly) attacked by Goodman. However,
dedicated himself to the hoof.                                                                       there was, as yet, no means to prove this (Gamgee, 1869, 1870;
   In the meantime, in France, attention remained focused on gait                                    Goodman, 1870, 1871). In 1873, Pettigrew published a book on
analysis as initiated by Goiffon and Vincent. In his book on the                                     animal locomotion in which he put forward some ideas that were
conformation of the horse, Lecoq (1843) introduced a different gait                                  later taken by Marey from France, who was to become much more
diagram from that of Goiffon and Vincent (Fig. 1.6). It did not find                                 famous.
general acceptance because, although it was unequivocal regarding
limb placement, it did not give temporal information.
   In his book Locomotion du cheval (Locomotion of the horse, 1883),                                 Muybridge and Marey: revolution
Captain Raabe presented an ingenious system consisting of two
discs, a fixed one and a rotating one, with which the sequence of
                                                                                                     in gait analysis
limb placement in all symmetrical gaits can be determined (Fig.                                      About a century after the French Revolution, which meant the end
1.7). Raabe, who first published his work in 1857, divided the stride                                of an era and changed world politics forever, a revolution took place
                                                                   
                                             
                                                                                                                                                                         
                                                                                                                                                                
                                                                                                                                                         
                                                                                                                                         
                    
                                                                                                                                
                                                                                                                
Fig 1.4  Forms in which equine gait was represented by Goiffon and Vincent in the first work that was entirely dedicated to the subject: (A) stick diagram;
(B) table; (C) footfall pattern; (D) ‘échelle odochronométrique’ or the precursor of the present day gait diagram.
Reproduced from Goiffon & Vincent, 1779. Mémoire artificielle des principes relatifs à la fidelle répresentation des animaux tant en peinture, qu’en sculpture. Ecole Royale Vétérinaire, Alfort.
                                                                                                                                                                                                    7
         1   History
8
                                                                                                                                                                The 19th century
in the field of equine gait analysis. So far, treatises on gait analysis                        It has been argued that ‘the invention of motion pictures can be
had largely consisted of theoretical considerations while conclu-                            traced to an argument among the ancient Egyptians whether a trot-
sions based on experimental data were scarce. This was mainly due                            ting horse ever had all four feet off the ground at once’ (Simpson,
to the limitations of the human eye when observing the faster gaits.                         1951). Though this certainly is a bit of an overstatement, it was this
In the middle of the 19th century it was still contentious whether                           still unresolved question that led to Muybridge’s first photographic
the faster gaits had moments when all limbs were in suspension or
not, as illustrated by the dispute between Gamgee and Goodman
alluded to above.
   It is thanks to the efforts of two men that decisive breakthroughs
were made. The English-born American photographer Eadweard
Muybridge and the French physiologist Etienne Jules Marey used
the technology of their time to study equine gait.
                                                                                             Fig 1.6  Gait diagram as introduced by Lecoq (trot). Though later used by
                                                                                             celebrities such as Muybridge, it did not find general acceptance because it
                                                                                             provided information about the spatial position of the limbs only, but not
                                                                                             about temporal aspects. This in contrast to the original ‘échelle odochronomé-
Fig 1.5  Electrical device as developed by Bayer to measure the movement                     trique’ invented by Goiffon and Vincent which, after modification by Marey,
of the lateral hoof wall. St, needle; B, wire to battery; SA, wire to electric bell.         became the world standard.
Reproduced from Bayer, J., 1882. Experimentelles über Hufmechanismus. Oesterr. Monatsschr.   Reproduced from Lecoq, F., 1843. Traité de l’extérieur du cheval, et des principaux animaux
Thierheilk. 7, 72–74.                                                                        domestiques. Savy, Lyon.
                                                                                                                                                                                           9
        1        History
     Fig 1.9  Position of cameras and track as used in the studies conducted by Muybridge during his period at the University of Pennsylvania. B, lateral background;
     C, transverse backgrounds; F, R, batteries of 12 automatic photo-electric cameras; L, lateral battery of 24 automatic photo-electric cameras; O, position of opera-
     tor; T, track.
     Reproduced from Muybridge, E., 1957. Animals in motion. Original edition 1899. Republished: Brown, L.S. (Ed.), Dover Publications, New York.
     experiments. The railroad magnate Leland Stanford, the founder of                                 The thrust against each thread completed an electric circuit and
     Stanford University, was intrigued by this question with respect to                               effectuated a photographic exposure. He managed to get pictures
     his trotter ‘Occident’ and it was at his farm in Palo Alto, California,                           of an excellent quality as, through an ingenious combination of
     that Muybridge commenced his experiments in 1872 (Fig. 1.8).                                      clockworks and electro-magnetic circuits, he had finally succeeded
        His first efforts were unsuccessful because his camera lacked a                                in bringing exposure time down to one six-thousandth second (in
     fast shutter. Then the project was interrupted because Muybridge                                  a time when an exposure of half a second was considered
     was being tried for the murder of his wife’s lover. Though acquit-                                instantaneous!).
     ted, he found it expedient to travel for a number of years in                                        Muybridge did not only study equine locomotion, though it
     Mexico and Central America taking publicity photographs for the                                   formed the major part of his work. He also focused on other domes-
     Union Pacific railroad, owned by Stanford. In 1877, he returned                                   ticated species, wild animals and man. His book Animal Locomotion,
     to California and later pursued his work at the University of                                     first published in 1887, has been republished several times. Muy-
     Pennsylvania (Fig. 1.9). Muybridge placed 24 single-lens cameras                                  bridge also invented the ‘zoöpraxiscope’, a device that consisted of
     on a row. The cameras were triggered in sequence by a series of                                   a large glass disc on which successive pictures were printed. By
     thin threads that were stretched across the path of the animal.                                   projecting these in rapid succession on a screen, it gave an
10
                                                                                                                                                      The 19th century
A B C
Fig 1.10  Devices developed by Marey to quantify equine locomotion. (A) ‘Chaussure exploratrice’ or exploratory shoe; (B) the recorder indicating limb placement
of the horse; (C) air-filled bracelet for the discrimination between stance and swing phase on hard surfaces where the ‘chaussure exploratrice’ could not be used.
Reproduced from Marey, E.J., 1882. La machine animale. Locomotion terestre et aérienne. Germer Baillière et Cie, Paris.
impression of a moving picture. In fact, this was a forerunner of                                      have to for ever envy the birds and insects for their wings or
present-day cine film, the invention of which is usually credited to                                   whether it would be possible some day for him to travel
Thomas Edison, though it is known that Edison derived some of                                          through the skies as he travels the oceans? At various times
his basic ideas from Muybridge. Early in 1888 Muybridge even                                           scientific authorities have declared, after having made
discussed with Edison the possibility of producing talking pictures                                    elaborate calculations, that this was an idle dream. But how
by synchronizing a zoöpraxiscope with a phonograph. As the pho-                                        many inventions did we not see that had been declared equally
nograph at the time was not loud enough to be heard by an audi-                                        impossible beforehand?)
ence, the idea was abandoned (Muybridge, 1957). It would take
another 40 years before the talking picture would conquer the                                     Twenty years later the Wright brothers would make their first flight
world.                                                                                            and 80 years later long-distance maritime passenger transport
   Though originally a photographer, Muybridge was also some-                                     would have been almost totally replaced by air travel.
thing of a scientist. His book Animals in motion has a better scientific                             In his book, Marey studied both terrestrial and aerial locomotion.
base than the book The horse in motion as shown by instantaneous                                  The studies on terrestrial gait focused on the horse. Three ingenious
photography with a study on animal mechanisms founded on anatomy                                  devices were used to study the equine gaits in a relatively accurate
and the revelation of the camera in which is demonstrated the theory of                           way. To discriminate between stance and swing phase Marey used
quadrupedal locomotion by the physician J.D.B. Stillman (1882).                                   a ‘chaussure exploratrice’ or ‘exploratory shoe’ (Fig. 1.10A). This was
Stanford provided many of Muybridge’s photographs to Stillman                                     essentially an India rubber ball filled with horsehair that was
without giving credit to the original photographer. Muybridge also                                attached to the horse’s foot. At hoof placement the ball was com-
suggested in a letter to Nature in 1883 that the photographic tech-                               pressed. The increase in pressure, transmitted by airtight rubber
nique could be used to identify the winner of horse races when the                                tubing, was registered by a recorder in the rider’s hand (Fig. 1.10B).
finish was very close (Leach & Dagg, 1983). Indeed, in 1888, the                                  The recorder consisted of a charcoal-blackened rotating cylinder on
world’s first photo finish was made in New Jersey.                                                which traces were made by a needle that reacted to changes in air
   In the meantime, in France, the physiologist and university pro-                               pressure. As this device wore rapidly on hard surfaces, a second
fessor E.J. Marey investigated equine gait with equally inventive, but                            instrument was made (Fig. 1.10C). It consisted of a kind of bracelet
somewhat different techniques. Marey was intrigued by the similar-                                that was fastened to the distal limb just above the fetlock joint and
ity of natural mechanisms and mechanical machinery and was                                        that functioned according to the same principle. A third device
convinced that a more profound study of the former, especially in                                 consisted of two collapsible drums that were fastened to the withers
the area of locomotion, would lead to substantial progress in                                     and the croup, with levers attached to record vertical movements in
mechanical engineering. In the preface of his book La machine                                     the gaits.
animale, locomotion terrestre et aérienne (Marey, 1882a) he writes:                                  Marey discussed various notations of gaits and concluded that
                                                                                                  the notation by Goiffon and Vincent was by far superior. He adapted
     Quant à la locomotion aérienne, elle a toujours eu le privilège                              this method somewhat and his notation, depicting limb placement
     d’exciter vivement la curiosité chez l’homme. Que de fois ne                                 by sequential open and filled bars, is still in common use today.
     s’est-il pas demandé s’il devrait toujours envier à l’oiseau et à                            Marey worked out the exact sequence of foot contacts, but his cal-
     l’insecte leurs ailes, et s’il ne pourrait aussi voyager à travers                           culation of how long each foot remained on the ground was too
     les airs, comme il voyage à travers les océans? A différentes                                short. Like Muybridge, he demonstrated the short suspension phase
     époques, des hommes qui faisaient autorité dans la science ont                               of the trot and he also correctly deduced that the hindquarters gave
     proclamé, à la suite de longs calculs, que c’était là un rêve                                the main propulsion whereas the forequarters provided support
     chimérique. Mais que d’inventions n’avons-nous pas vu réaliser                               (Leach & Dagg, 1983).
     qui avaient été pareillement déclarées impossibles?                                             Though the techniques used in La machine animale are mainly of
         (Aerial locomotion has always provoked a vivid curiosity in                              a mechanical nature and not photographic, Marey in fact is also
     man. How many times did man wonder whether he would                                          one of the pioneers in photography (Marey, 1882b, 1883). At first
                                                                                                                                                                            11
       1      History
     he used multiple exposures on the same photographic plate, later          photographer Otoman Anschütz for his largely theoretical treatise
     he made a rotating plate not unlike Muybridge’s ‘zoöpraxiscope’. He       on the jumping horse (1912). In the proceedings of the Kaiserlich-
     also produced flight arcs of several segments of the body by repeated     Königliche Botanische Gesellschaft in Vienna in early 1917 professor
     exposure of black objects with reflecting markers at anatomically         Keller showed the results of own kinematic experiments. Keller had
     defined points moving against a black background. Most of these           constructed a turntable, which was moved by the horse itself, in the
     techniques were applied to study human locomotion, but photo-             center of which was a camera. This system ensured a strictly lateral
     graphs of horses were also made. In the latter the superposition of       view although the horse was not walking along a straight line. Keller
     hind limb markers over forelimb markers using the repeated expo-          filmed at a rate of 32–50 fps (frames per second), and showed the
     sure technique made interpretation of the data a difficult job. He        film at the standard rate of 16 fps, thus creating a slow motion
     and his coworkers, Pagès and Le Hello, published a fine series of         effect. Schmaltz (1922a,b) used essentially the same technique, but
     articles on the subject in the Comptes Rendus Hebdomodaires des           used the film mainly to produce a photographic series that shows
     Séances de l’Academie des Sciences (Le Hello, 1896, 1897, 1899;           the characteristics of each gait. It is Walter (1925) who, under the
     Marey & Pagès, 1886, 1887; Pagès, 1885, 1889).                            guidance of Schmaltz, extensively used the turntable in his study of
        Coincidentally, these two great men of equine gait analysis, Muy-      limb placement sequence and changes in joint angles during walk,
     bridge and Marey, were born 1 month apart in 1830 and died                trot and gallop. Walter admits the disadvantage of the circular
     within 1 week from each other in 1904. They met in Marey’s labora-        movement and indicates that the clinical department of the Berlin
     tory, in the presence of a large number of scientists from all over       Veterinary High School made use of a linear rail over which a
     the world who attended the Electrical Congress in Paris in 1881.          camera could be moved by mechanical power in order to keep up
     This was when Muybridge gave the first demonstration of his               with a horse moving on a parallel path.
     ‘zoöpraxiscope’ in Europe (Muybridge, 1957).                                 In a publication from 1923, A.O. Stoss from Munich used pho-
                                                                               tographic methods to study the anatomy and kinematics of the
                                                                               equine limbs. In the section on the shoulder he remarked that it
     German supremacy until World War II                                       was a pity he could not use Muybridge’s pictures as for the exact
                                                                               location of the skeletal parts that make up the shoulder, because
     A nice synopsis of late 19th century state of the art in the field of     only skinny horses could be used for this purpose. Apparently,
     equine gait analysis is given in the book by Goubaux and Barrier          Muybridge’s horses were too fat!
     De l’extérieur du cheval (On the conformation of the horse, 1884). They      Also, studies using techniques other than photography were
     describe both Marey’s techniques and Muybridge’s work. They cite          being performed, again mainly by anatomists. Dörrer (1911),
     Marey as saying that, if he had to do his experiments again, he           working at the Königliche Tierärztliche Hochschule in Dresden,
     would use an electric circuit instead of a pneumatic system. In fact,     wrote a thesis on the tension in the flexor tendons and the suspen-
     it appears that Barrier repeated his measurements in 1899 using an        sory ligament during various phases of the stride cycle. For his in
     electrical device to improve accuracy (Schauder, 1923b). Goubaux          vitro work he used a device that had originally been designed by
     and Barrier also described some other means to represent equine           Moser (Fig. 1.12). Strubelt (1928), who worked in Hanover, found
     gait such as a kind of adjustable rattle that would reproduce the         that transecting either the lacertus fibrosus or the peroneus tertius
     sounds made by the hoof beats in the various gaits, and a wooden          muscle did not affect locomotion in the living animal, or the ana-
     table that was over 8 feet high through which limb placement in           tomical relations in a specimen of the hind limb that was brought
     various gaits could be visualized (Fig. 1.11).                            under tension.
        Following Goubaux and Barrier, the period of French supremacy             Bethcke (1930) focused on the relationship between morpho-
     in gait analysis ended. The French were very ingenious inventors,         metric data and performance in the trotter. Earlier studies on the
     but there is little work by French authors on gait analysis dating        subject had been performed by Bantoiu (1922) in Berlin and Birger
     from after 1900 and it was essentially the Germans who chose to           Rösiö (1927) who performed measurements on Standardbreds in
     follow the path indicated by Marey and Muybridge. It was only             Sweden, Germany and the United States. Bantoiu was one of a series
     through sequential photography, soon followed by cine film, which         of Rumanian vets who, under the guidance of professor Schöttler
     is essentially the same, that the faster equine gaits could be fully      in Berlin studied the relationship between conformation and per-
     explored.                                                                 formance in various breeds. His colleagues Stratul (1922), Nico-
        After laying the foundations in the late 19th century, German          lescu (1923) and Radescu (1923) studied this relationship in
     veterinary science had its golden age in the first half of the 20th       Thoroughbreds and Hanoverian horses. Though Bethcke is able to
     century. Many disciplines flourished, but perhaps none so abun-           give some data on anatomical differences between various breeds
     dantly as the discipline of veterinary anatomy. Wilhelm Ellenberger       of horses, he has to conclude that he could not predict performance,
     (1848–1928) and Hermann Baum (1864–1932) published many                   stating that:
     editions of their Handbuch der vergleichenden Anatomie der Haustiere
     (Handbook of comparative anatomy of domestic animals). This work was         Wenn uns so auch die Maße für die Beurteilung eines
     so complete that a facsimile version of the 1943 edition was still in        Trabers gewisse Anhaltspunkte geben, so sind für seine
     print in the 1970s. Another excellent anatomist was Paul Martin              Leistungsfähigkeit letzten Endes doch noch andere Faktoren
     who moved from Zurich to Giessen in the first years of the 20th              wie Training, Temperament, Abstammung, Ausdauer,
     century. Two of his pupils were to become famous anatomists them-            Beschaffenheit der inneren Organe usw. mit ausschlaggebend.
     selves: Wilhelm Schauder at Giessen University and Reinhold                     (Though the measurements may give us some clues for the
     Schmaltz in Berlin. In Germany, the study of muscle function and             judgement of a trotter, performance is in the end more
     locomotion was in the hands of the anatomists. It is therefore not           determined by other factors such as training, character,
     surprising that many of these individuals became involved in                 descent, endurance and condition of the internal organs.)
     equine gait analysis and/or biomechanical studies. It has been
     reported that Ellenberger studied the gallop by attaching 4 different-    This conclusion has not changed in the past 80 years.
     sounding bells to the feet of the horses (Schauder, 1923b). Schmaltz         The relationship of conformation and locomotion was heavily
     was among the first to extensively use cine film for equine gait          studied in pre-war Germany. Wiechert (1927) studied East-Prussian
     analysis, and Schauder published on equine gait and related topics        cavalry horses to find morphometric criteria for performance poten-
     throughout a long career that extended until after World War II.          tial. Though he finds some biometric differences between horses
        Chief veterinary officer in the first Dragoon Regiment at Berlin,      selected for specific purposes, the study lacks any statistical elabora-
     Werner Borcherdt, used the pictures by Muybridge and the German           tion of the data. Buchmann (1929) focused mainly on stride length
12
                                                                                                                                       The 19th century
in various breeds. Kronacher and Ogrizek (1931) published a com-        conformational indications could be found. Therefore, it was better
prehensive study using 60 Brandenburger mares. A follow-up to this      to accurately measure the actual stride length when buying cavalry
study was performed by Horst Franke (1935) who studied 186              horses! In 1934 Wagener published a comprehensive study on
mares from the famous stud in Trakehnen (East-Prussia). A positive      jumping horses and in 1944 Wehner wrote on the relation of bone
relationship between the length of some limb segments and stride        axes and joint angles and stride length in the German Coldblood.
length was found, but results on the influence of joint angulation         In Munich research was more biomechanically oriented. Moskov-
were not consistent. While Kronacher and Ogrizek report a clear         its (1930) studied statical-mechanical aspects of the equine meta-
positive relationship between stride length and shoulder and elbow      carpus. Max Kadletz studied the biomechanical behavior of the
angles, Franke is more cautious stating that joint angles are much      small tarsal joints in detail in relation to the pathogenesis of bone
less important in determining stride length than the dimensions of      spavin (Kadletz, 1937). He also paid attention to the movements
limb segments. The study of Schmidt (1939) is even less conclusive.     of fore and hind limbs, and addressed the age-old problem of how
He studied 100 cavalry horses with the aim of determining confor-       artists should depict horses, inventing some makeshifts for this
mational characteristics that were indicative of a long stride, which   purpose (Kadletz, 1926, 1932, 1933).
was a desirable trait of cavalry horses that often had to cover more       Possibly the most prolific of the pre-war German scientists was
than 30 miles a day, and concluded that no unequivocal                  Wilhelm Krüger from Berlin. He published a very elaborate and
                                                                                                                                                                  13
        1       History
                                                                                             Fig 1.13  The so-called ‘Balance of Borelli’ as used by Krüger to determine the
                                                                                             center of gravity of the horse.
                                                                                             Reproduced from Krüger, W., 1939. Die Fortbewegung des Pferdes. Paul Parey, Berlin.
     Fig 1.12  Device to (semi-quantitatively) determine the tension in the flexor           on the gaits of the horse, Magne de la Croix from Argentina started
     tendons and the suspensory ligament in various positions of the limb as                 to study photographic material, including the series made by Muy-
     designed by Moser and used by Dörrer.                                                   bridge, and became so interested in the subject that he wrote an
     Reproduced from Dörrer, H., 1911. Über die Anspannung der Beugesehnen des Pferdefußes   article on the evolution of the gallop in which he stated that, in
     während der verschiedenen Bewegungsstadien derselben. Inauguraldissertation, Dresden.   evolutionary terms, the rotatory gallop was more advanced than the
                                                                                             transverse gallop (Magne de la Croix, 1928). He can be seen as a
                                                                                             forerunner of the great American zoologist Milton Hildebrand, who
     authoritative study on the kinematics of both fore- and hind limbs                      four decades later stated that the various gaits are not that distinct
     (Krüger, 1937, 1938). Krüger did not use a turntable like his prede-                    as hitherto presumed but in fact form a continuum that may gradu-
     cessors Schmaltz and Walter, but made use of a vehicle that moved                       ally change into each other, when he writes:
     alongside and at the same speed as the horse, probably the same
     installation that had already been described by Walter. He was well                         Un hecho en el cual nunca me había fijado, resaltó de repente
     aware of the artifact introduced by the use of skin markers, which                          a mis ojos, y es que el galope de carrera de los varios animales,
     had already been noted by Fick (1910) who had stated:                                       en vez de presentarse sólo bajo dos formas: transverse gallop y
                                                                                                 rotatory gallop, como los llama Muybridge, ofrece, en realidad,
        Vor allem ist es schwierig, an den bewegten Gliedern                                     una infinidad de variantes que constituyen una cadena
        bestimmte Punkte sicher zu markieren die ihre Lage auf der                               insensible y continua.
        Körperoberfläche während der Bewegung nicht ändern, da sich                                  (A fact that so far had never occurred to me became
        ja auch die Haut in der Nähe der Gelenke beträchtlich                                    suddenly clear. This is that the racing gallop of the various
        verschiebt.                                                                              species, instead of presenting in only two forms: transverse and
           (In the first place it is difficult on the moving limbs to                            rotatory gallop as Muybridge calls them, in fact presents as an
        mark sites that do not alter their positions on the body surface                         infinite number of variations that form a continuous,
        during movement, as the skin near the joints shifts                                      imperceptibly changing chain.)
        considerably.)
                                                                                                He developed the idea further and included all gaits and many
     Krüger avoided the problem by oiling the skin and using oblique                         different animals in his extensive paper on the phylogeny of qua-
     lighting, thus visualizing the position of the bones directly. Though                   drupedal and bipedal locomotion in vertebrates (Magne de la
     the skin displacement artifact is taken into account in most pre-war                    Croix, 1929) (Fig. 1.14). He continued publishing on the subject
     research (in contrast to many much more recent studies), this was                       until the mid-1930s (Magne de la Croix, 1932, 1936). Armando
     not always the case and Krüger does not hesitate to blame this                          Chieffi in Brazil started his investigations of locomotion with a large
     artifact for the discrepancies of his findings with those by Aepli                      study of the position of the center of gravity (Chieffi & de Mello,
     (1937) who, in his cinematographic measurements of joint angles                         1939). He continued with papers on the ‘marcha’ (an artificial gait)
     during locomotion, failed to correct for the artifact (Krüger, 1938).                   in the Mangalarga horse (1943) and with studies comparing the
     Krüger was a dedicated scientist and a prolific writer. Apart from his                  stance phases of different gaits and the change of gallop (Chieffi,
     cinematographic work on gait analysis, which he summarized in a                         1945, 1946). Finally he wrote a thesis (1949) on the subject of the
     treatise on the movement of the horse (1939a) (Fig. 1.13), he wrote                     transition of gaits, a subject on which little scientific work had been
     on the oscillations of the vertebral column (1939b), specific limb                      done as he concluded from his review of the literature:
     placement during the gallop and while jumping (1939c,d), the
     position of the center of gravity during locomotion (1941a), and                            O exame de literatura a respeito…… revelou que pouco ou
     the effect of hauling heavy loads on the tendons in the forelimb                            nade existe sôbre transição de andamentos.
     (1941b).                                                                                       (The literature search showed that there was very little if
        Though German scientists were dominant in the era between the                            anything on the subject of changes of gait.)
     turn of the century and World War II, this was not the only site of
     activity. The work of Aepli (1937), which has been referred to                          It still is a relatively unexplored area.
     already, was performed in Zurich. Before World War II, there were                          In Belgium, Zwaenepoel published the same study on the impulse
     also scientists in South America who focused on equine gait analy-                      of gait in the horse twice in different journals (Zwaenepoel, 1910a,b,
     sis. When asked to write a series of articles for a sports magazine                     1911a,b). In Holland, Kroon (1922, 1929) and van der Plank
14
                                                                                                                                                                   The horse in decline
Fig 1.14  Depiction of various gaits by Magne de la Croix. (A) Trotting horse; (B) pacing camel; (C) 3-beat gallop; (D) horse featuring 4-beat racing gallop.
Reproduced from Magne de la Croix, P., 1929. Filogenia de las locomociones cuadripedal y bipedal en los vertebrados y evolución de la forma consecutiva de la evolución de la locomoción. Anal.
Soc. Argent. 108, 383–406.
                                                                                                                                                                                                  15
       1      History
     equine gait analysis and biomechanics had flourished as nowhere           Giessen University, continued publishing. He was principally inter-
     else, Bernhard Grzimek was still performing research on handed-           ested in the functional development of the musculoskeletal system.
     ness in horses, parrots and monkeys in Frankfurt Zoo in the summer        In his pre-war publications he had focused on the development of
     of 1944 when the Allied Forces already were fighting their way to         various parts of the equine musculoskeletal system (Schauder,
     Paris through the heavily defended French province of Normandy.           1924a, 1924b, 1932). After the war he continued with this subject
     He submitted the paper on October 5th 1944, about at the time             when quoting Goethe to express his basic presumption: ‘Gestalten-
     Montgomery’s troops were defeated in the Battle of Arnhem, which          lehre ist Verwandlungslehre’ (Morphology is the science of change,
     would prolong the war for about half a year. However, after the           Schauder, 1949). In the early 1950s, he concentrated on shock-
     capitulation of the Third Reich in May 1945, science in Germany,          absorbing structures in the equine limbs and rump (Schauder, 1951,
     like practically all aspects of public life, came to a grinding halt.     1952, 1954), which he discussed on a theoretical basis.
     Grzimek’s paper finally was published in 1949.                               The tradition at Giessen was continued by L. Krüger (not to be
        Although public life regained its vitality earlier in the formerly     confused with Wilhelm Krüger from Berlin), who published on the
     occupied and now liberated parts of Europe, the situation was not         hauling capacity of horses (and cattle) in order to determine per-
     essentially different. Attention was focused on repairing the enor-       formance capacity (Krüger, 1957). At the Institute of Animal Physi-
     mous damage caused by the war, rather than on developing new              ology of the University of Bonn (which features no veterinary
     scientific approaches.                                                    faculty), Kaemmerer (1960) used photography to study the flight
        Apart from the direct consequences of the war, there were other        arcs of various parts of the equine limbs. He concluded that these
     developments that failed to stimulate new research in the field of        flight arcs cannot be seen as parts of a circle, as had been stated
     equine locomotion. In World War I horses had been used exten-             before, but in fact are complicated cycloids which change their form
     sively. The British expeditionary force in France in 1914 began with      when the horse is more heavily loaded. He stated, not without
     53 000 horses, but it is estimated that in 1917 the army had more         surprise, that the work by Walter (1925) had not received the rec-
     than 1 000 000 horses in active service over all fronts (Dunlop &         ognition it merited. He had come across Walter’s work only after
     Williams, 1996). On the German side the number of horses was              finishing his own experiments, and concluded that both investiga-
     reported to be 1 236 000 in the same year, not counting those             tions, performed using different techniques, generally confirmed
     belonging to the army contingents employed at home or in the              each other.
     occupied territories (von den Driesch, 1989). In German East Africa          Equine gait analysis still formed a topic for a few of the many
     (Tanzania), the commander of the relatively weak forces, First Lieu-      veterinary doctorate theses at the German universities. Richter
     tenant von Lettow-Vorbeck, developed a ‘veterinary strategy’ to           (1953) in Berlin, continued the tradition of the Rumanian veteri-
     combat an overwhelmingly more numerous army, consisting of                narians from the early 1920s when he studied the American-bred
     British, South African, Belgian and Portuguese forces. Using his          trotter in order to correlate morphometric data with performance.
     superior knowledge of the local situation of tropical diseases, espe-     In Giessen, Maennicke (1961) and Genieser (1962) were among the
     cially trypanosomiasis, and giving better prophylactic care to his        first to work with (Shetland) ponies and not with horses. The
     own animals, he consistently retreated through the tsetse infested        Turkish veterinarian, Ihsan Aysan (1964), analyzed the gait of lame
     areas, inflicting heavy losses in animals on the Imperial Forces. On      horses during his years in Giessen in which he prepared his thesis.
     Armistice Day in 1918, he still was at large with his last 1323 troops,   He worked with a 3-m long track and with a fixed camera using a
     pursued by an army of 120 000.                                            film speed of 132 fps. As the distance of the horse to the camera
        At the start of World War II, in September 1939, Polish lancers        was not constant, complicated mathematical procedures were nec-
     tried to stop the invading German tanks. Not surprisingly, they suf-      essary to calculate the exact locations of certain anatomical sites.
     fered heavy losses and were not able to slacken the advance of the        Though the principle of this mathematical data processing is the
     enemy. Though the German army still used horses extensively for           same in the modern video-based systems, one should be aware of
     transportation (a mean population of about 1 350 000 has been             the fact that this study was undertaken before the advent of the
     estimated of which an average of 59% was lost), it became clear           computer. As Aysan could not statistically process the data, his work
     that the role of the horse in warfare finally had come to an end after    basically consists of extended case reports of various types of
     5000 years. There is no modern army in which the horse plays a            lameness.
     prominent role, except perhaps for some ceremonial duties.                   Though the interest in equine locomotion certainly was at a low
        The increasing mechanization not only influenced the military          in the period between the end of World War II and the early 1970s,
     role of the horse. Numbers of horses in the United States reached         some seeds were sown of what in later decades would become rich
     their peak in 1918 at 21 000 000. After that year, which is also the      fruit-bearing trees. In Sweden, Björck (1958) was the first to use a
     year that automobile production first passed the 1 million mark,          force-shoe to analyze the ground reaction forces exerted by the
     the population more than halved to an estimated 8 million horses          horse. In Vienna, the opening of the reconstructed lecture hall of
     and 2 million mules in 1947 (Simpson, 1951). In Britain, the agri-        the anatomy department in 1950 was celebrated with a lecture by
     cultural horse population in 1913 was 1 324 400; in 1956 it was           Schreiber on the old theme of the anatomically (in)correct depic-
     only 233 500 (Brayley Reynolds, 1957). It was to be expected that         tion of horses in art.
     the day would not be far away that the last commercially used horse          The then young assistant Peter Knezevic used strain gauges and
     could be turned out to pasture after retirement. Of course, this trend    cinematography to study the hoof mechanism. With a 4-channel
     affected the numbers of patients presented for treatment to the           recorder he was able to make synchronous ungulographic record-
     veterinary schools. In the pre-war period, the Utrecht Clinic of Large    ings at walk, trot and gallop (Knezevic, 1962). In Holland, Slijper
     Animal Surgery received more equine than bovine patients. This            had already published an extensive study on the vertebral column
     ratio changed to 1 : 1 in the early post-war period and remained so       and spinal musculature of mammals in 1946. However, the tradi-
     through the early 1960s, followed by an increase in equine patients       tion of biomechanical research and gait analysis at Utrecht Univer-
     again from 1964 onwards, now in the form of sports and leisure            sity, which is maintained to the present day, can be said to have
     animals (Offringa, 1981).                                                 started with the publication by Dick Badoux in Nature on the fric-
        In view of the declining role of the horse in society, it is not       tion between feet and ground (1964). Many publications were to
     surprising that research on equine locomotion received less priority      follow, all focusing on the biomechanics of specific parts of the
     than in the years before the war. Nevertheless, some activity             musculoskeletal system (Badoux, 1966, 1970a, 1970b). There was
     remained. In Germany the old tradition had not completely been            also a start of the input of biomechanics in essentially clinical work,
     broken by the war, though the relative number of publications             as shown by the thesis of Rathor (1968) on disorders of the equine
     decreased considerably. Of the pre-war scientists, Schauder, at           and bovine femoropatellar articulation.
16
                                                                                               Equine locomotion research centers and activities
   Elsewhere, activity was very limited in this field of research. In     competition. The official history of horse racing tells us that this
France, a thesis was published by Marcel André (1949) on static,          sport started in 648 BC in Olympia in Greece (Simpson, 1951), but
dynamic and cinematic aspects of equine locomotion. In Switzer-           it is highly improbable that horse races were not common in the
land some work was performed on the biomechanics of the equine            few thousand years between domestication of the horse and that
elbow joint in the late 1960s (Mosimann & Micheluzzi, 1969). In           date. Apart from its role in competition, the horse, unlike any other
Eastern Europe, there was some interest in the relation between           animal with the possible exception of the dog, has always had man’s
conformation and performance. Fehér focused principally on bio-           affection. This special bond between man and the horse is already
metric data concerning the horse with a normal configuration              evident in the earliest human writings on the species in Antiquity
(Fehér, 1957, 1958). From the early 1960s, Dušek from Czechoslo-          and remains so, through the great horse marshals of the 17th
vakia started a series of publications on the relation of a number of     century and many others in the course of time, to the present day.
conformational parameters and performance like jumping ability               With the booming economy in the 1960s, popular interest in the
and how to correctly evaluate these parameters. Unfortunately,            horse could be materialized. Equestrian sports had existed for thou-
some of this work was published in the Czech language, which is           sands of years, but had always been restricted to the lucky few. Now
not accessible to many scientists (Dušek & Dušek, 1963, Dušek             they became within reach of the general public. From the end of
et al., 1970). In the German Democratic Republic, some work was           the 1960s and beginning of the 1970s equestrian sports flourished
done on the conformation of trotters by von Lengerken and Werner          as never before. This was evident in very old and well-known
(1969). However, the breed was not very important in socialist days       branches of the equestrian sports such as flat racing and harness
as there was no more than one racetrack in the whole country. In          racing all over the world, the Western style activities in the United
the Soviet Union, Sukhanov (1963) focused in a more general sense         States, and dressage and jumping in Europe. Popular interest also
on the evolution of gait. In Japan Nomura published a series of           increased in other, less-known, areas such as three-day-eventing,
reports on the mechanics of a number of equine joints in the early        vaulting, four-in-hand driving and endurance competitions. New
1950s (Nomura, 1953a,b,c).                                                competitions were created in several of these disciplines and the
   In the Anglo-Saxon world, the interest in equine gait analysis and     time was ripe for the organization of large events like the World
biomechanics was still limited. In 1951 Grogan published a general        Equestrian Games, the first of which was held in Stockholm
descriptive article about gaits in horses which ominously opens           in 1990.
with the words: ‘With the drop in the number of working horses,              The increased interest in the horse was the trigger for the revival
the study of the horse has held less interest for most veterinarians      in equine locomotion research that started in the early 1970s.
and received less attention in the schools’. In England, H.W. Dawes       Though the economic role of the horse had disappeared (except for
(1957) published a paper on the relationship between conforma-            the increasing economic significance of the horse industry itself),
tion and soundness, giving detailed descriptions of some more or          the need for research into equine locomotion was now even greater
less desirable traits. The same topic is discussed by Pritchard in the    than before. While in earlier times the horse had to be able to do
United States nearly a decade later (1965). Though interesting, both      its job properly which required a functional, but not necessarily
papers are based on clinical impressions rather than scientific           superior, locomotor system, the horse now had become an athlete
research. This is different with the work of the great American zoolo-    upon which high demands were made. This prompted the need for
gist Milton Hildebrand who studied, using film among other tech-          a highly accurate analysis of normal and abnormal gait and of the
niques, the gaits of tetrapods. Though he used the horse frequently       ways in which equine locomotion could be influenced or improved.
as a study object, his interests were broader. The analysis and inter-    Rapid developments in computer technology enabled the produc-
pretation of the gaits of tetrapods, including the energetics of oscil-   tion of both hardware and software that facilitated capture and
lating legs in relation to conformation and gait were his main            analysis of the faster movements of the horse in intricate detail.
targets, not the horse itself (Hildebrand, 1959, 1960, 1965, 1966).       These were the main factors that determined the explosion in
However, in the late 1960s some horse-specific research was pub-          equine locomotion research that started in the late 1970s and con-
lished in the United States (Taylor et al., 1966; Rooney, 1968, 1969;     tinues today.
Solá, 1969; Cheney et al., 1970), indicating that we are in the wake         Thus far, an attempt has been made in this chapter to provide a
of what may be called revolutionary changes in the science of             comprehensive and, to the author’s knowledge, as complete as pos-
equine biomechanical research and gait analysis.                          sible overview of the literature on equine gait analysis because many
                                                                          of the older works can not be found with help of the currently used
                                                                          electronic databases. However, from this point on this is no longer
The revival in equine locomotion research                                 the case. It is far beyond the scope of this chapter to provide an
                                                                          exhaustive bibliography of the vast amount of work that has been
In most countries in the world the era directly after World War II        done in recent decades. These references can easily be found in
had been a period of hardship in which the damage caused by the           modern databases and most of them will be mentioned in the other
war, either materially or economically, had to be repaired. In large      chapters of this book, which are dedicated to virtually all aspects of
parts of the world it was a period of lack of resources in which          equine locomotion. In the following section a brief overview will
people were forced to work hard while leading a life deprived of          be given of the development of the main centers of equine locomo-
any luxury. Gradually this picture changed since, from the late           tion research in order to provide a link from the rich history of this
1950s and early 1960s, economies began to boom. The mid 1960s             area of research to the practice of today. References will be restricted
onwards marked the start of a period of unprecedented economic            to some key publications, but make no pretense of completeness.
growth and increasing prosperity in the developed world. While old
sources of richness, such as the former colonial empires, disap-
peared new technological developments enabled manifold increases          Equine locomotion research centers
in human production capacity, leading to a large increase in cheap        and activities
consumer goods. This development led to a period of wealth and
prosperity in the industrial world.
  The horse had lost its role in the military completely and in           Europe
agriculture and transport to a large extent. However, it had, after
5000 years of close alliance, not lost its appeal to man. The horse       Stockholm/Uppsala
had always been a very useful instrument for the satisfaction of one      Ingvar Fredricson and coworkers may be credited for the initiation
of the most fundamental drives of mankind, the need for                   of the revival of research on equine locomotion. In 1970, they
                                                                                                                                                     17
        1         History
     published a report about the quantitative analysis of hoof motion                                      Gunnar Hjertén, focused on kinematic analysis of the Swedish Stan-
     patterns of harness horses using high-speed film in the proceedings                                    dardbred. In Sweden, harness racing had always been a popular
     of a congress on high-speed photography (Fredricson et al., 1970).                                     sport, but the industry boomed in the 1970s and 1980s with
     Shortly after that, the new method of investigating equine locomo-                                     Sweden and France becoming the most important countries for
     tion was published in the then recently founded Equine Veterinary                                      harness racing in Europe. This increase in popularity of the sport
     Journal (Fredricson & Drevemo, 1971). Fredricson used high-speed                                       was partly due to the very generous fiscal legislation for horse
     film (with frame rates up to 500 fps) and analysis methods derived                                     owners. The interest in harness racing was also evident in the exten-
     from the aviation industry to process his data. This approach                                          sive research this group has performed on the design of racetracks,
     enabled him to analyze in 3 dimensions the very fast movements                                         signaling deleterious effects of poor racetrack design and giving
     of the distal limbs of Standardbreds trotting at high speed (Fig.                                      possible solutions for improvement (Fredricson et al., 1975a, b).
     1.16). These investigations resulted in his thesis, which may be seen                                  Indeed, their work resulted in considerable improvements with
     as the starting point of the modern era of equine locomotion                                           respect to banking and curve geometry of many racetracks. The
     research (Fredricson, 1972).                                                                           Swedish group may also be credited for being the first to use a
        The Swedish group, the nucleus of which was formed by Ingvar                                        treadmill for equine locomotion analysis (Fredricson et al., 1983),
     Fredricson and Stig Drevemo, later joined by Gøran Dalín and                                           an example that was soon to be followed by many research centers
                                                                                                            all over the world.
                                                                                                               After Fredricson left the group to head the national stud at
                                                                                                            Flyinge, Stig Drevemo took the helm. He became a professor of
                                                                                                            Anatomy at the Faculty of Veterinary Medicine of the Uppsala Uni-
                                                                                                            versity of Agricultural Sciences into which the formerly independent
                                                                                                            Royal Veterinary College had been converted. His series of papers
                                                                                                            on equine locomotion that appeared in the Equine Veterinary
                                                                                                            Journal in 1980 can be considered as classic (Drevemo et al.,
                                                                                                            1980a–c). Drevemo was a strong protagonist of international coop-
                                                                                                            eration in the field of equine locomotion research. Together with
                                                                                                            Doug Leach from Saskatoon, Canada, he published the first (and
                                                                                                            last) edition of a Bibliography of research in equine locomotion and
                                                                                                            biomechanics in 1988.
                                                                                                               The almost exclusive emphasis on kinematics of the Standard-
                                                                                                            bred was broken by the arrival in Uppsala of the English-born
                                                                                                            globetrotter Leo Jeffcott. His broad interest in the field of equine
                                                                                                            orthopedics included problems related to the back. With the excep-
                                                                                                            tion of the 1939 paper by Wilhem Krüger, little attention had been
                                                                                                            paid so far to the equine back. There is little doubt that this appar-
                                                                                                            ent lack in interest was partly caused by the inaccessibility of this
                                                                                                            structure. Jeffcott worked with Dalín and other members of the
                                                                                                            Swedish team on normal biomechanics of the back and on various
                                                                                                            back-related disorders (Jeffcott & Dalín, 1980; Jeffcott et al., 1982,
                                                                                                            1985).
                                                                                                               After Jeffcott left for Australia, the Swedish group continued to
                                                                                                            perform equine locomotion research using high-speed cinematog-
                                                                                                            raphy. Though very reliable and accurate, the technique has a major
                                                                                                            drawback in that data analysis is extremely labor-intensive. The
                                                                                                            Swedes tried to overcome this problem by automating as far as pos-
                                                                                                            sible this analysis using advanced and expensive techniques such as
                                                                                                            the Trackeye® system (Drevemo et al., 1993). In the 1990s they
                                                                                                            finally opted for the video-based Proreflex® system. Though older
                                                                                                            members of the group left or became absorbed in administrative
                                                                                                            functions, the Swedish group succeeded in maintaining momentum
                                                                                                            by attracting young researchers such as Holmström, Johnston and
                                                                                                            Roepstorff. Of these, Holmström focused on the kinematic analysis
                                                                                                            of top-level dressage horses (Holmström, et al. 1995), while Roep-
                                                                                                            storff and Johnston were engaged in the development of a force
                                                                                                            shoe suitable for use on the treadmill, in fact continuing the tradi-
                                                                                                            tion begun by Björck in the late 1950s (Roepstorff & Drevemo,
                                                                                                            1993).
                                                                                                               In 1990, Uppsala housed the International Conference on Equine
                                                                                                            Exercise Physiology (ICEEP), a four-yearly conference that had
                                                                                                            started in 1982. Although the major part of this conference is dedi-
                                                                                                            cated to exercise physiology in a more strict sense, and thus is more
                                                                                                            cardiovascular and respiratory system oriented, the conference has
                                                                                                            always featured a part on biomechanical musculoskeletal system
     Fig 1.16  Diagrammatic representation of the data capture and data analysis                            oriented research.
     procedure as used by the Swedish group in the 1970s when they worked with                                 Energetically directed by Chris Johnston and Lars Roepstorff
     high-speed film.                                                                                       (with Stig Drevemo still in the background as Head of Department)
     Reproduced Fredricson, I., Drevemo, S., Dalín, G., Hjertén, G., Björne, K., 1980. The application of   locomotion research in Uppsala has remained strong. Around the
     high-speed cinematography for the quantitative analysis of equine locomotion. Equine vet. J.           turn of the century collaboration with the group from Utrecht was
     12 (2), 54–59.                                                                                         intensified in a project focusing at the kinematics of the equine
18
                                                                                                Equine locomotion research centers and activities
back. With the results of that study it became possible to develop,        2004; Peham et al., 2004). However, more fundamental work on
together with the manufacturer of the Proreflex® system Qualisys           modeling was performed as well (Peham & Schobesberger, 2004).
AB, a reliable and accurate program (Backin®) for the analysis of
non-invasively captured kinematic data from the equine thoraco-
lumbar spine. Back motion had always been a very difficult area            Utrecht
because of the difficult accessibility of the back, the relatively small   In Holland, the foundation for the line on biomechanical research
ranges of motion of the components of the back and the fact that,          had been laid in the 1960s by Dick Badoux from the Department
unlike the limbs, movements out of the sagittal plane contribute           of Anatomy at the University of Utrecht. One of the products of this
significantly to overall motion. Work from Uppsala has made a              line was the still authoritative study by Wentink on the biomechan-
substantial contribution to the knowledge about equine back                ics of the hind limb of horse and dog (Wentink, 1978a,b). However,
motion in normal and clinically affected horses (Johnston et al.,          it was the strategic alliance between the Departments of Anatomy
2004; Roethlisberger-Holm et al., 2006; Rhodin et al., 2005;               and of General and Large Animal Surgery that really boosted this
Wennerstrand et al., 2004). Other lines pursued in Uppsala included        kind of research from the end of the 1970s onwards. For this stra-
work on shoeing (Roepstorff et al., 2001; Johnston & Back, 2006)           tegic alliance, the vision of the department heads, Professors W.
and on modeling and the more technical analytical aspects of               Hartman and A.W. Kersjes respectively, should be given full credit.
equine motion (Halvorsen et al., 2008). The Uppsala group was,                First, Schamhardt and Merkens focused on the analysis of the
together with researchers from Zurich and Utrecht, one of the              ground reaction forces in sound and lame horses using a force plate
founders of the so-called SDS (Swiss-Dutch-Swedish) consortium             (Merkens et al., 1986; Schamhardt & Merkens, 1987). Later, kine-
that initiated a groundbreaking research project on the influence of       matic analysis was added. The Dutch group did not opt for high-
head and neck position on dressage horses that managed to bring            speed film or the then recently introduced first video-based systems
science closer to the equestrian sports than it ever had been (see the     such as Selspot® or Vicon®, but chose a new invention from England:
paragraph about the Zurich group) and later on started an FEI-             the CODA-3® system. This optoelectronic system used a concept
backed project on the influence of the surface on the orthopedic           that was basically different from any video-based system and thus
health of the distal limb (Hernlund et al., 2010).                         avoided a number of disadvantages inherent to these systems.
                                                                           However, when the prototype with serial number 007 was delivered,
                                                                           it proved to be not exactly ready-to-use. In fact, it took about 4 years
Vienna                                                                     and a considerable amount of manpower before the machine was
Another center where research on equine locomotion was initiated           working well under the conditions encountered when performing
in the 1970s was Vienna. Peter Knezevic had written a thesis on the        gait analysis in the horse. It proved to have a high spatial and tem-
biomechanics of the hoof using strain gauges when he was an                poral (300 fps) resolution. Van Weeren, who was intended to be
assistant at the Veterinary High School. After he became head of           the first user of the newly purchased system, was forced to redirect
the Department of Orthopaedics of Even and Uneven-hoofed                   his line of research. He started an investigation into a topic in
Animals of the Faculty of Veterinary Medicine of the University of         equine kinematic gait analysis that had been correctly identified by
Vienna, he strongly promoted further research in this field. From          most pre-war researchers, but which had been largely ignored so far
the late 1970s, the Vienna group started to publish regularly on           in more recent research: the problem of skin displacement. Together
both kinematic (using high-speed cinematography and later also             with van den Bogert, Schamhardt and Barneveld, he developed
the Selspot® system) and kinetic studies (using force plates) in the       techniques using intra-osseous LEDs, which shone through the
horse (Knezevic et al., 1978; Knezevic & Floss, 1984). The histori-        skin, and transcutaneous pins to produce correction factors for skin
cal interest of Knezevic is shown by his 1985 paper in the Wiener          displacement (Van Weeren & Barneveld, 1986; Van Weeren et al.,
Tierärztliche Monatsschrift (where many of the papers from the first       1992). In his study on the coupling between stifle and hock joint
Golden Age of equine locomotion research had been published).              by the reciprocal apparatus, he was finally able to use the CODA-3®
However, this paper is principally a German copy of the Equine             system for the first time (van Weeren et al., 1990). The first person
Veterinary Journal paper published on the same topic by Leach and          using the CODA-3® system extensively was Willem Back who, in a
Dagg in 1983. Knezevic’s coworker Girtler wrote an excellent and           long-term project, studied the longitudinal development of gait
elaborate thesis on the temporal stride characteristics of lame            from 4-month-old foal to adult horse (Back et al., 1994a), conclud-
horses at the walk and trot which, again, appeared in the Wiener           ing that the gait pattern of the individual horse does not essentially
Tierärztliche Monatsschrift (Girtler, 1988). Also after the retirement     alter during this development. He also made comparisons between
of Knezevic locomotion research remained a priority topic in               hard data from kinematic gait analysis and the subjective evaluation
Vienna. The research facilities greatly improved when the Faculty          of horses as is done at horseshows and during sire selection proce-
was moved to the vast new premises at the end of the 1990s. The            dures, identifying kinematic parameters that determine the judg-
group was substantially reinforced by the arrival of Florian Buchner       ment of quality of equine gait (Back et al., 1994b). The German
in 1996, who had spent 4 years with the Utrecht Equine Biome-              veterinarian Florian Buchner used his time in Utrecht to study the
chanics Research group working on his PhD thesis. The growing              kinematics of lame horses, and the symmetry of gait (Buchner et al.,
importance of the Austrian group was recognized and in 2000 the            1996). Besides, he performed some important work on determining
4th International Workshop on Animal Locomotion (IWAL-4) was               the centers of gravity of various body segments (Buchner et al.,
organized in Vienna.                                                       1997). Van den Bogert mathematically modeled equine gait (Van
   The new facilities, which included a treadmill and a Motion             den Bogert et al., 1989). This excellent scientist included a floppy
Analysis® kinematic gait analysis system, were not left unused. The        disc in his thesis with an animation of equine gait, which was a
research effort was boosted by the arrival of the vet Theresia Licka,      novelty at the end of the 1980s.
who had graduated in Vienna but had spent a couple of years after-            Apart from the kinematic and kinetic studies, other lines of
wards in Scotland, and the engineer Christian Peham, who became            research were followed as well. Some work on bone strain in the
the technical figure of the group. Here too, equine back motion was        tibia was performed (Hartman et al., 1984; Schamhardt et al.,
studied extensively using a variety of techniques including electro-       1984). Riemersma started a line on tendon research using many
myography (Licka et al., 2001). The Vienna group focused on a              techniques, including kinetic and kinematic analyses (Riemersma
number of practical applications of clinical research, such as studies     et al., 1988a,b). This line was continued by Jansen who made use
into saddle pressure under various circumstances (Fruehwirth et al.,       of mercury in-silastic strain gauges (Jansen et al., 1993) and by
2004), the influence of other tack (Kicker et al., 2004), and the          Becker who focused on the inferior check ligament (Becker et al.,
effect of skill of the rider on the way a horse moves (Licka et al.,       1994).
                                                                                                                                                      19
       1      History
        In 1992, a specially constructed equine biomechanics research          foals tend to continually protract the same limb when they spread
     lab was opened in Utrecht, featuring a treadmill and a force plate        their front limbs in order to reach the ground for grazing, which
     track. This building greatly facilitated research. In the late 1990s,     leads to the development of uneven feet with possible clinical con-
     the CODA-3® system was replaced by a ProReflex® system (Fig.              sequences in the long term (van Heel et al., 2006b). Maarten
     1.17). By the early 1990s, the Utrecht Equine Biomechanics research       Bobbert of the Department of Human Movement Sciences of the
     group had become one of the world’s leading centers for equine            Free University of Amsterdam, filled the vacuum caused by the
     locomotion research. This had been possible in somewhat more              death of Henk Schamhardt, providing invaluable scientific input.
     than a decade because of the vision of the heads of department            The extensive reconstruction of the entire Equine Clinic, which had
     (after the retirement of Kersjes as head of the Department of General     been concluded in 2008, enabled the incorporation of the formerly
     and Large Animal Surgery, he had been succeeded by Ab Barneveld           separately housed biomechanics lab in the clinic, opening possibili-
     who strongly supported this line of research and, in fact, was the        ties for a better integration of the lab with clinical work. A new
     driving force behind many of the research projects), and the willing-     player in the field in the Netherlands is Wageningen University,
     ness to cooperate. This involved collaboration between depart-            where the Department of Experimental Zoology has expanded into
     ments, and between people with different scientific backgrounds.          equine biomechanical research, focusing on the interaction of horse
     Henk Schamhardt, a driving force behind a large number of the             and rider (De Cocq et al., 2009).
     research projects who unfortunately died as a consequence of a
     tragic accident in 1999, was a physicist not a veterinarian; as is Ton
     van den Bogert, who later left for Canada and the United States,          Alfort
     changing horses for humans.                                               In France, the cradle of modern equine locomotion research, work
        Just before the turn of the century, the Dutch group initiated a       on the topic had been extremely limited after the turn of the
     research project on the quantification of back kinematics that            century. However, here too interest in this kind of research regained
     would, to a large extent, be carried out together with the group from     momentum at the end of the 1970s, which led to the re-emergence
     Uppsala. An invasive experiment in which Steinmann pins were              of France as one of the leading nations in equine locomotion
     implanted in the spinous processes of various thoracic and lumbar         research from the mid-1980s onwards. The new work originated in
     vertebrae was performed that enabled the accurate quantification of       part from the veterinary faculties of the French universities, but also
     back motion (Faber et al., 1999, 2001, 2002), but also served as the      from institutions such as the Institut National de Recherches
     basis from which the skin marker-based, hence non-invasive,               Agronomiques (INRA, National Institute for Agronomic Research)
     Backin® program was developed. Once established and validated,            and the national Stud Services (Haras Nationaux) as is the case
     this technique was extensively used, among other things to study          with the work by Langlois and co-workers (1978) relating confor-
     the effects of induced lameness on back motion (Gómez Álvarez             mation with ability in trotting, galloping and jumping. In these
     et al., 2007), the effect of manual manipulation or chiropractic          institutions research work of a more applied rather than fundamen-
     treatment of the equine spine (Faber et al., 2003; Gómez Álvarez          tal character has been carried out in various fields of equestrian
     et al. 2008), and the influence of various head and neck positions        sports, including jumping and harness racing, which is an impor-
     on equine kinematics in the SDS collaborative project alluded to          tant discipline in France.
     earlier (Gómez Álvarez et al., 2006). Other topics of research               Alfort took the lead among the veterinary schools. Eric Barrey
     included a five-year study into the effect of early training on jumping   studied the biomechanics of the equine foot extensively (Barrey,
     capacity and the predictive value of foal jumping technique for later     1987), while Jean-Marie Denoix started his very active career by
     athletic performance (Santamaría et al., 2005; Bobbert et al., 2005),     studying contact areas in the fetlock joint (Denoix, 1987a) and the
     saddle – related studies (De Cocq et al., 2004) and various studies       kinematics of the thoracolumbar spine (Denoix, 1987b). Originally
     on the effects of shoeing techniques and shoe types on equine             an anatomist, Denoix’s interest in clinical orthopedic disorders
     locomotion (van Heel et al., 2006a). An interesting observation in        would later broaden considerably. His special interest in the bio-
     the last project was that many of today’s long-legged Warmblood           mechanics of the back, however, remained.
20
                                                                                                                 Equine locomotion research centers and activities
A B
Fig 1.18  Trotter performing at high speed, equipped with force shoe and device for the non-invasive measurement of tendon force (A). The metal case on
the sulky contains equipment for data storage. (B): non-invasive tendon force measuring device.
Photographs courtesy of Unité Mixte de Recherche Biomécanique et Pathologie Locomotrice du Cheval.
   The Alfort crew aligned with INRA to form the Unité Mixte de                             ground reaction force) with a Mustang® treadmill, thus avoiding the
Recherche Biomécanique et Pathologie Locomotrice du Cheval,                                 great nuisance of conventional force plates that require many runs
which has been proven to be extremely productive and innovative                             to be made, especially at faster gaits, to get sufficient good hits
in the past decade, led by Nathalie Crevier-Denoix. Henry Chateau                           (Weishaupt et al., 2002, 2004). The instrument proved crucial in
made a very detailed and well-performed study into the three-                               the collaborative study that was performed by the SDS consortium
dimensional motion of the equine distal limb using an invasive                              in February 2005, which looked into the effect of various head and
technique and sound-based system to capture motion (Chateau                                 neck positions on equine biomechanics (Fig. 1.19). In that study,
et al., 2004). Philippe Pourcelot, an engineer, was instrumental to                         hardware from all three research groups was combined, and mea-
the development of a device that could non-invasively quantify                              surements were performed using the instrumented treadmill, a
tendon force in the living and moving animal through the measure-                           12-camera ProReflex® system and a Novel® saddle pressure mat,
ment of (changes in) speed of transmission of ultrasound signals                            simultaneously. This research project turned out to have been very
through the tissue (Pourcelot et al., 2005) (Fig. 1.18). The group                          timely, as shortly afterwards a fierce debate started in the equestrian
introduced more innovative technology such as a new lightweight                             lay press about the use of the so-called Rollkur (Meyer, 1992) or
force shoe and miniaturized accelerometers, both to be used at high                         hyperflexion (an extremely low and flexed position of head and
speed in the performance horse (Chateau et al., 2009, Robin et al.,                         neck that used to be practiced by some (obviously successful) train-
2009). Another example of the innovative technology produced by                             ers and riders). The debate was highly emotional and the Zurich
the group from Alfort is the video-based analysis system for the                            project provided some of the very little hard data of the effects of
quantification of conformation that can easily be used at various                           head and neck position. This made the outcome of the project
horse events, such as stallion selection shows, as it requires only a                       (Gómez Álvarez et al., 2006; Weishaupt et al., 2006) play an impor-
single run of a horse over a defined track without any need for                             tant role in the eventual decision of the FEI (Fédération Equestre
markers (Pourcelot et al., 2002; Crevier-Denoix et al., 2004). In                           Internatonale) not to ban the practice after round table meetings
2008, the French group hosted the 6th International Conference on                           held in Lausanne in 2006 and 2010, although admittedly the evi-
Equine Locomotion (ICEL-6). The French group focuses on funda-                              dence was not conclusive, as the experiment concerned biome-
mental (technological) research, as well as on more applied inves-                          chanical effects only and did not look into possible behavioral
tigations (Vergari et al., 2012).                                                           consequences of the method.
                                                                                                                                                                      21
        1        History
                                                                                     North America
                                                                                     In North America work on equine biomechanics and gait analysis
                                                                                     had been very limited after the great advances brought to this area
                                                                                     of science by Eadweard Muybridge. Publications from the period
                                                                                     that in Europe can be designated as the first Golden Age of equine
                                                                                     locomotion research, the period between World Wars I and II, are
                                                                                     virtually non-existent. After World War II this did not really change
                                                                                     with only a few isolated publications on rather heterogeneous
     Fig 1.19  Horse and rider on the instrumented treadmill at the Zurich lab       topics. However, the scene changed dramatically after the revolution
     during the investigations into the effect of head and neck position on equine   started by the Swedes. In just a few years a number of research
     biomechanics. Both rider and horse are equipped with reflective markers; two    groups were founded which would become very prolific.
     ProReflex® cameras can be seen in the background. The small threads running
     to the hooves of the horses serve to determine the exact position of each
     limb, which is necessary input for the analysis of the force plate data.        Saskatoon
     Photograph courtesy of Equine Hospital, University of Zurich.
                                                                                     At the Western College of Veterinary Medicine in Saskatoon, Canada,
                                                                                     Doug Leach founded a school of equine biomechanical research
     documented in the first Supplement of the Equine Veterinary                     that was to foster a number of excellent scientists. Leach himself
     Journal, the famous Silver report (Silver et al., 1983). Also from              published on a variety of topics including the effects of fatigue
     Britain, R. McNeill Alexander should be mentioned as the author                 (Leach & Sprigings, 1979) and temporal stride characteristics (Leach
     of several studies on quadrupedal gait. Like the American zoologist             et al., 1987). He was also interested in the history of equine loco-
     Milton Hildebrand, Alexander regarded the horse as an example                   motion research (Leach & Dagg, 1983) and was heavily involved in
     rather than a goal in itself (Alexander, 1980; Alexander & Jayes,               the definition of correct terminology (Leach et al., 1984). Another
     1983). At the Royal Veterinary College, Alan Wilson followed in his             researcher from Saskatoon was Hugh Townsend who dedicated his
     foot steps. Whereas his earlier work concerned specific equine items            thesis to thoracolumbar kinematics and the relationships between
     (Wilson et al., 1998), he later focused more on general mechanisms              vertebral morphology and pathologic changes, which led to some
     in equine locomotion (Wilson et al., 2001) and developed a more                 important papers on this difficult subject (Townsend et al., 1983,
     comparative approach (Wilson et al., 2003; Williams et al., 2007),              1986; Townsend & Leach, 1984).
     a strategy that reduced clinical applicability, but certainly was better
     appreciated by the scientific community at large. Thilo Pfau has
     taken the lead in pursuing the clinical applications of gait analysis.          Michigan
     His work has focused on the use of inertial measurement units to                Leach’s coworker and later chair of the Department of Veterinary
     characterize movement asymmetries of the axial skeleton associated              Anatomy in Saskatoon, Hilary Clayton, was to become an even
     with lameness when horses move on the straight and on circles                   greater authority in the field. At first she focused on the kinematic
     (Pfau et al., 2012). Whereas locomotion research in the UK does                 analysis of various causes of lameness using high-speed film
     not have a strong historical basis, as stated before, the increase in           (Clayton, 1986, 1987). Later her research developed a more funda-
     this type of research in the past decade is remarkable, as is the               mental character when it was directed towards the kinematic analy-
     diversity of institutions involved. Equine locomotion research is               sis of elite sport horses (Clayton, 1993, 1994, 1997). Collaboration
     performed at vet schools, with the Royal Veterinary College and                 between Clayton and Bob Colborne, a human kinesiologist, and
     Bristol (Burn 2006; Parsons et al., 2008; Pfau et al., 2007; Thorpe             Joel Lanovaz, a mechanical engineer, broadened the scope of the
     et al., 2009) as the best examples, but certainly not limited to them.          work in Saskatoon to the calculation of net joint moments and joint
     Work is done at engineering departments of universities not featur-             powers at all joints of the equine limbs during both the stance and
     ing a vet school, such as the University of Central Lancashire                  swing phases of the stride (Colborne et al., 1998; Clayton et al.,
     (Hobbs et al., 2006) and Newcastle University (Lawson et al.,                   1998). In 1997, Clayton left Canada to become the first incumbent
     2007), but is also commonplace in polytechnic type institutions                 of the Mary Anne McPhail Dressage Chair in Equine Sports Medi-
     such as Hartpury College (Lovett et al., 2005) and Myerscough                   cine at Michigan State University in East Lansing (Fig. 1.20). The
     College (Forsyth et al., 2006).                                                 large research endowment that founded this unique chair and the
                                                                                     construction of the new Mary Anne McPhail Equine Performance
                                                                                     Center made equine locomotion research at Michigan State Univer-
     Belgium                                                                         sity flourish over the past decade. The excellent facilities have
     In Belgium two main centers have been developed: in Liege the                   enabled research into a great many areas of fundamental, clinical
     exercise physiology group (Art & Lekeux, 1988) and in Ghent                     and sport-related research (Clayton & Sha, 2006; Clayton et al.,
     (Oosterlinck et al., 2010) the focus was put on the use of pressure             2008; Geutjens et al., 2008), offering the possibility to many young
     plate in the orthopedic examination of the horse.                               researchers to become acquainted with equine locomotion research.
22
                                                                                             Equine locomotion research centers and activities
In 2004 the Center hosted the 5th International Conference on           et al., 1979). The gallop was the gait most intensively studied by
Equine Locomotion (succeeding the 4th International Workshop            this group (Ratzlaff et al., 1995). The start of the work by George
on Animal Locomotion, the name change indicating that from then         Pratt Jr. dates from about the same period. He used the force plate
on it was a single-species conference). A selection of the papers       and concentrated on the Thoroughbred and the interaction with the
describing the research presented at the conference was published       racetrack (Pratt & O’Connor, 1976; Pratt, 1984).
in a special issue of Equine Veterinary Journal in December 2004.          Nancy Deuel, who spent part of her career at the University of
In 2009 the facilities were improved by the installation of an array    Maryland in College Park, wrote her thesis on the kinematic analy-
of six force plates designed to provide data simultaneously from all    sis of the gallop in Quarter Horses (Deuel, 1985). She later became
supporting limbs during locomotion on the straight and on circles       interested in top-level performance horses and obtained permission
and to facilitate postural sway analysis with each hoof positioned      to make recordings during the World Equestrian Games in 1990
on a separate force plate (Clayton & Nauwelaerts, 2012).                and the Olympic Games in 1988, 1992 and 1996 (Deuel & Park,
                                                                        1990, 1991). Calvin Kobluk performed equine kinematic research,
                                                                        first using cinematography at Guelph University, then the video-
Missouri                                                                based Motion Analysis® system at the University of Minnesota
At Missouri State University, an endowed chair was installed for        (Kobluk et al., 1989).
locomotor research related to lameness. It was Kevin Keegan who            Apart from the fundamental research, more applied investiga-
took the lead there and produced many lameness-related studies          tions were also being carried out. At Texas A&M University,
(Keegan, 2007; Keegan et al., 2008). His mathematical background        Gingerich et al. (1979) used the force plate to study the effect of
drove him into new approaches, such as the fuzzy clustering tech-       pharmaceuticals on joint function. In the same university, Swiss-
nique to describe the motion of horses suspected of ataxia (Keegan      born Jörg Auer experimented with the so-called Kaegi-Straße, a
et al., 2004). This research led to the development of a commer-        5-m long track of rubber matting consisting of a large number of
cially marketed lameness detection system, the Lameness Locator™        tiny liquid-filled chambers, which in fact were electrical circuits.
(Equinosis® LLC, Columbia, Missouri, USA).                              The pressure of the hoof changed the electric resistance and thus
                                                                        resulted in a change in the shape of the signal (Auer & Butler,
                                                                        1985). This ‘diagnostic street’ was intended to aid in diagnosing
Other places in North America                                           specific lameness causes. After the first enthusiastic reports, it died
There have been several places in the United States where work on       a silent death as things turned out not to be as simple as that. At
equine locomotion has been or is performed, but thus far, apart         Tufts University, Howard Seeherman constructed his Equine Per-
from the groups in Michigan and Missouri mentioned above, no            formance Lab, which, among many other tests for equine perfor-
lasting research lines with a strong tradition have developed.          mance, featured gait analysis techniques. Apart from the detection
   As an early researcher in equine biomechanics Jim Rooney, a          of gait irregularities, these were mainly used to correctly balance
pathologist in the Mecca of the American Thoroughbred industry,         the hooves of the patients (Seeherman et al., 1987; Seeherman
Kentucky, should be mentioned. In 1969 he published a book on           et al., 1996).
the Biomechanics of Lameness in horses. After that, a long series of       At Cornell University, Kevin Haussler, a vet and qualified chiro-
papers on a wide variety of biomechanical subjects followed.            practor, conducted research on the effects of chiropractic treatment
Rooney can to a certain extent be compared with the old scientists      on spinal kinematics (Haussler et al., 2001, 2007), but later moved
of the pre-World War II generation. The vast majority of his papers     to the orthopedic research center of Colorado State University in
are single-authored and it sometimes is hard to tell which of his       Fort Collins, where the research climate was more welcoming for
statements are personal opinions based on deductions from obser-        this type of investigations. For several years the team of Don Hoyt,
vations, and which are real facts based on hard, statistically sound,   Steve Wickler, Ed Cogger and Darren Dutto had an active equine
scientific data.                                                        biomechanics and exercise physiology lab at the California State
   From the mid 1970s, Marc Ratzlaff and his group at Washington        Polytechnic University Pomona. This group performed a number of
State University in Pullman were one of the few who extensively         fundamental studies on the relationships between gait and energet-
used electrogoniometry for gait analysis in the horse, in addition to   ics and the effects of moving at different speeds and on an incline
other techniques such as cinematography (Ratzlaff, 1974; Ratzlaff       or decline (Hoyt et al., 2006).
                                                                                                                                                           23
       1      History
     Elsewhere in the world                                                      was the latter two aspects that ensured the horse’s survival when
                                                                                 mechanization relieved the horse of its former strongholds of mili-
     Elsewhere in the world, research remained limited. In Australia, Leo        tary and economic importance and, at the end of the 1940s, a total
     Jeffcott began investigations into the non-invasive measurement of          eclipse of the species threatened. Despite its retreat from many areas
     bone quality and the influence of exercise thereon (Jeffcott et al.,        in society, the horse has remained within the public domain and is
     1987), while Wilson et al. (1988a,b) did some work on the kine-             now more popular than ever.
     matics of trotters. However, the only long-lasting research line was           The interest in the species from the veterinary perspective has kept
     set up by Helen Davies at the University of Melbourne, where she            pace with public appreciation of the horse. The same applies to
     focused on bone strain in Thoroughbred racehorses, both under in            equine locomotion research, though another factor should be men-
     vivo and ex vivo conditions (Davies, 2006; Davies et al., 1993). In         tioned too: the state of technology. The development of technology
     New Zealand, Chris Rogers introduced kinematic research at Massey           in general, and photography in particular, made possible the great
     University. He did a lot of work in collaboration with the group in         breakthroughs accomplished by Muybridge and Marey at the end
     Utrecht (Rogers & Back, 2007) and aims, as is the case with the SDS         of the 19th century, which were the prelude to the first Golden Age
     consortium mentioned earlier, to bridge the gap between the scien-          of equine locomotion research. It was also the combination of the
     tist and the end-user in the equestrian sports (Rogers et al., 1999).       renewed interest in the horse and the rapidly developing computer
     In Japan, Tokuriki and coworkers made advances in electromyogra-            technology, which led to the second Golden Age of this branch of
     phy in the horse (Aoki et al., 1984), while Niki and colleagues used        research.
     the force plate for the study of equine biomechanics (Niki et al.,             What about the future? The bond between man and the horse
     1982).                                                                      has proved to be strong enough to survive the disappearance of
        In the second decade of the 21st century, the second Golden Age          what seemingly was the raison d’être of the alliance between the two
     of equine biomechanical and locomotion research has certainly               species. There is no reason to suppose that interest in the horse will
     surpassed the first in researchers involved and in what had been            diminish as long as economic conditions do not become too harsh.
     accomplished. This type of research is now well established with            As for technology, developments in this area seem to happen at ever
     various centers where high-quality research is being performed in           increasing speed. It can be anticipated that the increasing availabil-
     North Western Europe and North America. Besides these major                 ity of high-performance micronized equipment that uses telemetry
     research groups, smaller scale projects are undertaken in many other        for data transfer, or is equipped with sophisticated lightweight data
     places, the number of which is growing and starts to include places         logging tools, will be increasingly used in real-life training and
     where no real tradition existed.                                            competition conditions. The day may even be not too far off that
                                                                                 equipment of this kind becomes a compulsory feature of competi-
                                                                                 tion in some kinds of equestrian activities (think of rein strain
     Concluding remarks                                                          gauges for dressage or heart rate equipment for endurance horses).
                                                                                 Another branch of equine biomechanical research that is likely to
     After its domestication 5000 years ago, the horse has had a close           flourish in the next decade is advanced modeling of various parts
     relationship with man. There is no doubt that, from a historical            of the equine locomotor system with the aim to assess the effect of
     viewpoint, the horse’s most important role has been that of a               certain equestrian activities or environmental conditions (such as
     machine of war, followed by its economic significance as a draft            surface type) on lesion-prone structures of the horse. Research of
     animal. However, from the very early days after domestication, the          this type will be driven, as always, by scientific curiosity, but also
     horse has had other roles also: as a sports and competition animal          may become badly needed because of considerations of animal
     and as an animal with which man formed a bond of affection. It              welfare that become of increasing concern to the general public.
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30
                                                                                                                      C H A PTER              2 
Introduction                                                             of correct hits usually has a lower SEM. Are data from that limb
                                                                         more ‘correct’ than those from the other limb? Obviously not, but
                                                                         it is not easy to define a universal, statistically correct recipe to deal
In a qualitative evaluation of a horse’s gaits or movements, the         with this problem. In practice, most laboratories collect data until
human eye captures the image and the brain processes the informa-        a certain minimum number of correct hits have been recorded from
tion to form an opinion based on evaluating the observed motion          each limb. In sound horses, both the kinematic and force variables
in the context of previous experience. Even though some judges of        are quite stable, and analysis of three to five strides is sufficient to
horses and equestrian sports are very astute observers, subjectivity     give a representative value for kinematic (Drevemo et al., 1980a) or
is inherent in this type of judgment. In assigning a lameness grade,     GRF (Schamhardt, 1996) analysis. The mean value is then used in
clinicians draw on their powers of observation and previous experi-      further stages of the analysis as being representative of that variable
ence to assign a lameness score in a semi-quantitative analysis.         for a particular limb in one horse. Most of the stride variables show
Experienced clinicians may be consistent in their scores (Back et al.,   good repeatability over the short and long term (Drevemo et al.,
1993), but there is considerable variation between clinicians            1980b; van Weeren et al., 1993; Ishihara et al., 2005; Lynch et al.,
(Keegan et al., 1998).                                                   2005), and the stride kinematics of a young horse have already
   Scientific analysis requires accurate quantitative data describing    assumed the characteristics that they will have at maturity by the
the movements and the associated forces. Kinematic analysis mea-         time the foal is 4 months of age (Back et al., 1994).
sures the geometry of movement without considering the forces that          When planning an experiment, knowledge of the reliability of a
cause the movement. At the present time, the majority of kinematic       variable should be combined with estimates of the sample size
evaluations are performed using optoelectronic systems consisting        required to detect significant differences. Thus, knowledge of vari-
of integrated hardware and software components. Kinetics is the          ability within and between recording sessions is helpful in selecting
study of the internal and external forces that are associated with the   variables for analysis and in calculating the number of trials and
movements. A variety of transducers, including strain gauges, piezo-     subjects needed to obtain meaningful results in research studies.
electric and piezoresistive transducers, accelerometers, gyroscopes         Some horses may, inherently, show more variability than others
and magnetometers are used in kinetic studies. Several transducers       (Lynch et al., 2005) and variability may be affected by many of the
can be combined into force plates and force shoes for measuring          conditions that are being studied, such as lameness, the presence
ground reaction forces (GRFs) or into mats for mapping pressure          of a rider and the fit of the saddle. Horses with more severe lame-
distribution. Electromyography (EMG) detects the electrical activity     ness tend to have larger coefficients of variation for kinetic variables,
associated with muscular contraction as a means of determining           both within and between horses (Ishihara et al., 2005). On the
muscular activation patterns during different activities. Variables      other hand, variability in stride length increased significantly when
that are not or cannot be measured directly may be calculated from       lameness was reduced by intra-articular or perineural anesthesia
the data by computer modeling.                                           (Peham et al., 2001). It was suggested that variations from the
                                                                         optimal motion pattern are associated with pain, so lame horses
                                                                         maintain a highly consistent kinematic pattern, whereas sound
Interpreting the effects of biological variability                       horses are not constrained by the association between kinematic
                                                                         variation and pain, so other influences on motion, such as external
Variability is inherent to data obtained from repeated measure-          stimuli become more influential. In horses moving on a treadmill,
ments on biological material. For example, when the horse is             variability in forward velocity and acceleration decreased when the
guided over the force plate, the chance for a correct hit by one fore    horses were ridden but the same variables had higher variability
hoof is about 50%, with the number of hits being approximately           when the rider used a poorly fitting saddle compared with a well
evenly distributed between the right and left limbs. After several       fitting saddle (Peham et al., 2004).
runs, it is likely that a different number of correct hits will have        Variability between individual horses affects the response to
been recorded from the right and left limbs. When calculating the        certain interferences, such as drug treatment and shoeing, which
mean and the standard error of the mean (SEM) for a force variable       differ qualitatively and quantitatively in different animals. Impres-
(e.g. peak vertical force) by averaging the data of these runs, the      sive libraries of statistical routines have been developed to extract
mean of the data obtained from the limb with the higher number           trends in the data, to detect differences between groups, or to
                                                                                                                                                      31
       2      Measurement techniques for gait analysis
                                                                                 Percent stride
                                                                                                    10
     experimental design and statistical model are determined to test
     that hypothesis. After collection of data, it is not unusual to find
     dependency between variables within series of data, which disquali-                             5
     fies a particular statistical test. A detailed discussion of the pitfalls
     and problems associated with statistical testing is beyond the scope                            0
     this text. Readers are advised to consult a suitable statistical text or
     a statistician to avoid perpetuating the use of incorrect analyses,                             -5
     which have appeared frequently in the literature.                                                    012       5 012        5   0         5   0       5   0         5   0        5
        A statistical test determines the likelihood that a certain hypoth-                                     I           II           III           V           VII           IX
     esis can be accepted, or has to be rejected. However, the answer is
     not absolute: for example, having selected an uncertainty level of                                     I–IX sessions                          0–5 minutes training
     p < 0.05, the correct decision to accept or reject the hypothesis will
     be made in 95% of cases but has a 5% chance of being wrong, and
     one observation out of 20 will differ significantly due to chance.                           0.05
     Therefore, statistical tests are not proof that a certain hypothesis is
     true or false. The majority of equine locomotion studies are based                           0.00
     on a rather small number of subjects, which may be insufficient to
                                                                                                  -0.05
     give the required power for a statistical analysis. In these cases,
                                                                                 Seconds
     trends in the data may suggest a biologically significant effect that
                                                                                                  -0.10
     cannot be proven statistically but is, nevertheless, important.
                                                                                                  -0.15
                                                                                                  -0.25
     The treadmill is extremely useful for equine gait analysis due to the                                012       5 012        5   0         5   0       5   0         5   0        5
     ability to control the speed of movement and the environment                                               I           II           III           V           VII           IX
     around the horse. It must be recognized, however, that stride kine-
                                                                                                            I–IX sessions                          0–5 minutes training
     matics on the treadmill differ in some respects from over ground
     locomotion (Fredricson et al., 1983; Barrey et al., 1993; Buchner           Fig 2.1  Habituation to treadmill locomotion in 10 horses determined by
     et al., 1994b). Horses trotting at the same speed under both condi-         changes in hind limb stance duration, expressed as a percentage of stride
     tions use a higher stride frequency and a longer stride length on the       duration (above) and in seconds (below). The horizontal axis shows the
     treadmill (Barrey et al., 1993). The treadmill is also associated with      number of training sessions, each of 5 min duration. The vertical axis shows
     longer stance durations, earlier placement of the forelimbs, greater        the relative stance duration. Reductions in relative stance duration are
     retraction of both fore and hind limbs and reduced vertical excur-          regarded as a sign of habituation. The horizontal line indicates the
     sions of the hooves and the withers (Buchner et al., 1994b).                ‘habituation limit’ based on data of the final recording session. Vertical bars
        A period of habituation is required before horses move consis-           indicate standard deviations within 10 horses.
     tently on the treadmill, with habituation occurring more rapidly at         Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M., Scharmhardt, H.C., et al., 1994.
     faster gaits. Rapid adaptation is seen during the first few training        Kinematics of treadmill versus overground locomotion in horses, Veterinary Quarterly, Vol 16,
     sessions, and by the end of the third 5-min session, the kinematics         supp2, S87–S90, with permission of Taylor & Francis Ltd, http://www.tandf.co.uk/journals.
     of the trot have stabilized (Fig. 2.1), whereas walk kinematics are
     not fully adapted even at the tenth session (Buchner et al., 1994a).
     During the first session and, to a lesser extent at the start of subse-
     quent sessions, the horse takes short, quick steps, with the withers        diminish its value for clinical and research studies involving com-
     and hindquarters lowered, and the feet splayed to the side to widen         parisons between locomotion on the treadmill under different con-
     the base of support. Even experienced horses take at least one              ditions, for example in evaluating hoof balance and the flight arc
     minute for their gait pattern to stabilize each time the treadmill belt     of the hoof.
     starts moving (Buchner et al., 1994a). When measurements are                   Kinematic analysis of horses moving on a treadmill has been used
     made during treadmill locomotion, it is recommended that horses             to study many aspects of equine locomotion, including movements
     habituate for one minute after a change of gait or speed before             of the limbs (Back et al., 1995a, 1995b), ontogeny of the trot (Back
     making steady state measurements (Buchner et al., 1994a).                   et al., 1994), response to training (van Weeren et al., 1993; Corley
        Horses moving on a treadmill use less energy than horses moving          & Goodship, 1994), development of gait asymmetries (Drevemo
     over ground at the same speed (Sloet & Barneveld, 1995), which              et al., 1987) and kinematic adaptations used by the horse to manage
     may be partly due to a power transfer from the treadmill to                 lameness (Peloso et al., 1993; Buchner et al., 1995, 1996a, 1996b).
     the horse. Although the speed of the treadmill belt is assumed              The ability to incline the treadmill belt allows studies of stride
     to be constant, in fact it is decreased by about 9% in early stance         kinematics when horses move on an incline or decline (Sloet et al.,
     due to the frictional effect of the vertical force component and the        1997; Hoyt et al., 2000; Dutto et al., 2004b; Hodson-Tole 2006).
     decelerating effect of the longitudinal force component exerted by             Mounted studies have also been performed on the treadmill,
     the horse’s hoof. Towards the end of the stance phase the frictional        which provides a consistent speed and environment for assessing
     effect of the vertical force declines while the propulsive longitudinal     the influence of a rider (Barrey et al., 1993; Peham et al., 2004), the
     force tends to accelerate the belt (Schamhardt et al., 1994).               effects of different training techniques or riding styles (Gomez
        Although the kinematics and energetics of treadmill locomotion           Alvarez et al., 2006; Weishaupt et al., 2006b) and the role of saddle
     are not exactly equivalent to over ground locomotion, this does not         fit (Peham et al. 2004; Meschan et al., 2007).
32
                                                                                                                                Kinematic analysis
                                                                                                                                                       33
       2      Measurement techniques for gait analysis
     Fig 2.3  The black dots represent locations that are commonly used for skin marker placement for two-dimensional kinematic analysis. Limb markers are
     placed over the centers of joint rotation.
     asymmetries associated with lameness (Buchner et al. 1996a;                    to the cameras during locomotion and at locations for which the
     Keegan et al., 2004).                                                          skin displacement is known. A stationary file is recorded with
        Three-dimensional analysis requires a minimum of three non-                 both the virtual and tracking markers in place, after which the
     colinear markers per segment. Ideally, the markers should be widely            virtual markers are removed. Trials are recorded with only the track-
     distributed over the segment and, as for two-dimensional analysis,             ing markers in place.
     placed in locations that show minimal skin displacement or for                    In the sagittal plane, skin displacement relative to the underlying
     which correction algorithms for skin displacement are available.               bones has been quantified and correction algorithms have been
     Each marker must be visible to at least two cameras throughout the             developed to calculate skin motion relative to specific bony land-
     movement and accuracy improves with an increase in the number                  marks from the scapula to the metacarpus and from the pelvis to
     of cameras tracking a marker. When markers are required in loca-               the metatarsus of walking and trotting Dutch Warmblood horses
     tions where they are difficult to track, it is possible to use a virtual       (van Weeren et al., 1990a, 1990b, 1992). However, these algorithms
     targeting system (Nicodemus et al., 1999). This method relies on               are only valid for horses of similar conformation, moving at the
     the fact that, for rigid body motion, the location of any point on a           same gaits and at similar speeds. For three-dimensional analysis,
     body does not change with respect to that body. Therefore, if the              correction algorithms are available for sites on the crural and meta-
     location of a point on a segment is known with respect to the posi-            tarsal segments (Lanovaz et al., 2004) and on the forearm segment
     tion of the markers on that segment and the orientation of                     (Sha et al., 2004) of trotting horses.
     the segment is known in a GCS, then the location of that point
     on that segment can be calculated in the GCS. The virtual targeting
     method employs two sets of markers: tracking markers and virtual
                                                                                    Calibration
     markers. Three (virtual or tracking) markers attached to each                  The recording area or volume must be calibrated in order to scale
     segment are used to define the segmental coordinate system: two                the linear measurements. The accuracy of the calibration directly
     are oriented along the long axis of the segment and the third is               determines the accuracy of the final three-dimensional data
     perpendicular to that axis. Three non-collinear tracking markers are           (DeLuzio et al., 1993), which emphasizes the importance of invest-
     placed on the segment in appropriate positions to track the motion             ing the necessary effort into calibration of the volume space in
     of the segment in the GCS, i.e. at locations that are readily visible          which the measurements are made.
34
                                                                                                                                     Kinematic analysis
                                                                                 movement angle is less than about 15°, this error is smaller than
                                                                                 5%. If the analysis involves measuring a transverse distance, such
                                                                                 as step width between the left and right limbs, the error is larger
                                                                                 and increases in proportion to the sine of the oblique movement
                                                                                 angle. If the horse moves at an angle of 15°, the error in the trans-
                                                                                 verse direction can be as large as 26%.
                                                                                    For three-dimensional studies a calibration frame with non-
                                                                                 coplanar control points can be used. A larger frame with more
                                                                                 numerous control points gives a more accurate reconstruction. The
                                                                                 accuracy of the data is markedly reduced outside the calibrated
                                                                                 volume, so a large, custom-designed frame is required for equine
                                                                                 studies.
                                                                                    Modern motion analysis systems are calibrated using a dynamic
                                                                                 linearization technique. First, the x, y and z axes of the GCS are
                                                                                 defined, then a wand of appropriate length for the size of the
                                                                                 capture volume and with markers at known locations is waved in
                                                                                 three planes throughout the capture volume to establish camera
                                                                                 linearization parameters. Software locates the cameras, calibrates
                                                                                 the volume, corrects for camera lens distortions and calculates the
                                                                                 error in linear measurements.
                                                                                 Sampling frequency
                                                                                 In order to reconstruct (interpolate) a signal from a sequence of
                                                                                 samples, sufficient samples must be recorded to capture the peaks
                                                                                 and troughs of the original waveform. If a waveform is sampled at
                                                                                 less than twice its frequency the reconstructed waveform will effec-
                                                                                 tively contribute only noise. This phenomenon is called ‘aliasing’.
                                                                                 For most equine kinematic studies, a sampling frequency of 120 Hz
                                                                                 is adequate, unless the objective is to study short duration events
                                                                                 such as impact, which require a much higher sampling frequency.
                                                                                 Digitization
                                                                                 Digitization determines the coordinates of the markers in two-
                                                                                 dimensional or three-dimensional space within the GCS. Markers
                                                                                 may be tracked manually, for example when there is too much
                                                                                 ambient light for automated tracking or when markers cannot be
                                                                                 used as in a competition. In addition to the time required, this
                                                                                 tedious process creates more digitizing noise than automated
                                                                                 marker tracking. With automated tracking, the system locates each
                                                                                 marker and then calculates its centroid. Many automated systems
                                                                                 can track complex marker sets in real time. However, the operator
                                                                                 should check each digitized field during post-processing to make
                                                                                 adjustments for digitizing errors, such as marker misidentification,
Fig 2.4  Dorsal view of horse trotting through data collection volume            before accepting the data for further analysis.
recorded using Motion Analysis System. The grid pattern shows the
alignment of the horizontal axes of the global coordinate system (GCS). The
position of the markers distributed along the horse’s dorsal midline and on      Smoothing
the left and right sides of the head and neck indicates that the craniocaudal
axis of the horse’s body is aligned with the longitudinal axis of the GCS. The   During digitization small errors are introduced that constitute
shoulders are slightly turned to the right due to the retraction of the right    ‘noise’ in the signal. The effect of noise is not too great in the dis-
forelimb.                                                                        placement data, but it becomes increasingly apparent in the time
                                                                                 derivatives, i.e. the velocity and acceleration data (Fioretti & Jetto,
                                                                                 1989) as shown in Figure 2.5. Smoothing removes high-frequency
                                                                                 noise introduced during the digitization process using one of two
                                                                                 general approaches: a digital filter followed by finite difference tech-
   For two-dimensional analysis, a rectangular frame or a linear ruler           nique or a curve-fitting technique (e.g. polynomial or spline curve
is recorded in the plane of movement in different areas of the move-             fitting). Selection of an appropriate smoothing algorithm and
ment space. If the horse deviates from the plane of calibration                  smoothing parameter for a specific purpose requires some expertise
during data collection, errors are introduced in the linear data,                and is discussed further in Chapter 3. As a guideline, a low-pass
though the timing data are not affected. Correction algorithms can               digital filter with a cut-off frequency of 10–15 Hz is adequate for
be used to adjust the linear data if the horse moves along a line                most kinematic studies of equine gait. However, if the movement
parallel to the intended plane of motion, but if the horse travels at            of a marker has an oscillatory component, as occurs when loose
an oblique angle to the camera, it introduces image distortion.                  connective tissue is interposed between the skin and the underlying
Linear measurements in the longitudinal direction (e.g. stride                   bones, these oscillations are essentially tied to the movements
length) are proportional to the cosine of the angle at which the                 themselves and cannot be removed by smoothing (Schamhardt,
horse moves relative to the desired direction. As long as the oblique            1996).
                                                                                                                                                            35
       2       Measurement techniques for gait analysis
36
                                                                                                                           Kinematic analysis
and then expressed as stride duration in dimensionless units (strid-     Multi-planar analysis
eDU), stance time in dimensionless units (stanceDU) and swing
duration in dimensionless units (swingDU).12                             An approach that has been used in some equine studies is to project
                                                                         the three-dimensional coordinate data onto three orthogonal
                                     stride duration                     planes that are tied to the GCS (Fredricson & Drevemo, 1972).
                  strideDU (s/s) =                                       Provided the horse moves in a direction parallel to a global coor-
                                          height/g
                                                                         dinate axis, the analytic planes become the sagittal (side view),
                                     stance duration                     frontal (front or rear view) and dorsal (dorsal or ventral view)
                 stanceDU (s/s) =
                                         height/g                        planes. In effect, this method degrades the three-dimensional analy-
                                                                         sis into a series of quasi-two-dimensional analyses. Joint motion
                                     swing duration                      that is not parallel to one of the projection planes cannot be accu-
                  swingDU (s/s) =
                                         height/g                        rately measured and, since the segments are defined as simple lines
                                                                         between landmarks, rotations along the long axis of a segment are
Similarly, subject velocities are standardized by dividing measured      impossible to measure.
velocity by adjusted velocity and expressed as velocity in dimension-
less units (VDU).
                                                                         Three-dimensional analysis
                                        velocity
                    VDU (ms/ms) =                                        A true three-dimensional analysis requires multiple cameras that
                                        height ∗ g
                                                                         are synchronized precisely and with each marker visible to at
An objective method of predetermining an equivalent velocity for         least two cameras at all times. Each length measurement has
horses of different sizes is to adjust the velocity on an individual     three components in space and a segment requires three angle
basis by taking into account height at the withers and the effects of    measurements to define its orientation. A three-dimensional joint
gravitational acceleration as described above (Alexander, 1977).         coordinate system (JCS) is established for the joint based on embed-
After setting the VDU, the target velocity for each horse is             ding an anatomically meaningful coordinate system within each
calculated.                                                              limb segment comprising the joint. Flexion/extension, adduction/
                                                                         abduction, and internal/external rotation are usually expressed as
           target velocity = VDU (ms/ms) ∗    (   height ∗ g   )         motions of the distal segment relative to the fixed proximal segment
                                                                         (Fig. 2.6). The angles can be described independently of each other,
GRFs are standardized to the subject’s body mass and expressed as        which allows for examination of complex coupled motion in a
force per kg body mass (N/kg). Impulses are affected by both mass        joint. Angles measured with the JCS are independent of the joint
and height at the withers. The measured impulse (force*stance            centers of rotation.
duration) is divided by the force due to body mass (weight*g)               One method of expressing three-dimensional joint motions is
multiplied by the adjusted time, and expressed as the impulse in         based on a strictly ordered sequence of three rotations, known as
dimensionless units (IDU). The equation to obtain IDU is:                Euler angles. In aeronautical terminology these are referred to as
                                force ∗ stance time                      pitch, yaw and roll. The drawback to the use of Euler angles is the
               IDU (Ns/Ns) =                                             need to specify the order of rotations. In an effort to express joint
                               weight ∗ g ∗ height/g
                                                                         motion in a context that is more meaningful to clinicians, Grood
                                                                         and Suntay (1983) proposed the use of a JCS for the human knee
                                                                         joint in which the rotations are consistent with the clinical defini-
Kinematic data                                                           tions of flexion/extension, abduction/adduction and internal/
Kinematic data include temporal, linear and angular variables. Tem-      external rotation. The first axis of rotation (flexion/extension) was
poral data, which describe the stride duration and the limb coordi-      attached to the segment proximal to the joint, the third (internal/
nation patterns, are calculated from the frame numbers and the           external rotation) axis was attached to the distal segment and the
sampling frequency. Linear variables, which describe stride length,      second (adduction/abduction) axis was a floating axis that was
the distances between limb placements, and the flight paths of the       mutually perpendicular to the other two axes and was not aligned
body parts, are calculated from the coordinates of the markers           with the planes of either segment (Fig. 2.6). For each axis, there is
combined with the calibration information. Angular variables             a rotation around the axis and a translation along the axis. All three
describing the rotational motion of the body segments and joints         rotations take place at the same time, as in a mechanical linkage,
are calculated from the coordinate data.                                 thus eliminating the need to specify the order of rotations. The
   Analyses may be performed in two or three dimensions. Since the       method of Grood and Suntay (1983) brought a wider acceptance
horse’s limbs have evolved to move primarily in a sagittal plane,        of the value of the JCS in a clinical setting, though it is now under-
most of the useful information is captured by the two-dimensional        stood that their method is actually identical to the Euler angle
lateral view, and in many situations the extra effort involved in        method.
extracting three-dimensional data is not warranted. However, there          When using the JCS method, kinematic analysis is typically per-
are times when knowledge of abduction/adduction or internal/             formed in three steps. The first step is to define a coordinate system
external rotations would be useful, especially during sporting activi-   on each bone. Second, the rotation matrix and translation vector
ties and in relation to lameness.                                        relating the GCS with the JCS is obtained from three-dimensional
                                                                         marker coordinates during motion using a singular value decom-
                                                                         position method (Soderkvist & Wedin, 1993). This algorithm pro-
                                                                         duces a rotation matrix and a translation vector that describe the
Sagittal plane analysis                                                  rotation and translation of the segmental coordinate system from
Data are collected in a global (or laboratory) coordinate system         its neutral position in the stationary file to the orientation in each
(GCS). A common convention is for the z-axis to be vertical and to       frame of tracked data. In the final step, matrix equations are used
align the two horizontal axes (y: longitudinal; x: transverse) with      to extract the three rotation angles and three translations (Grood &
the force plate axes or with the longitudinal and transverse axes of     Suntay, 1983). Relative angular motions (helical angle changes)
the runway. If the horse moves straight along the length of the          between the segments may be calculated using a spatial attitude
runway, the y-z plane of the GCS corresponds with the horse’s            method (Spoor & Veldpaus, 1980; Woltring, 1994) or Euler angles
sagittal plane.                                                          may be calculated (Ramakrishnan & Kadaba, 1991). Software is
                                                                                                                                                  37
       2       Measurement techniques for gait analysis
20
10
-10
-20
                              Adduction/abduction
                                                                                     mathematically valid, differences in output affect interpretation of
                                                                                     the results. Clinical conclusions can be upheld or refuted, based on
                                                                                     the same data set, subject to coordinate system definitions (Beard-
                                                                                     sley et al., 2007). Choice of the coordinate system is, therefore,
                                                                                     critical to the outcome of a study.
                                                                                        In equine studies, limb segment axes have been based on ana-
                                                                                     tomical landmarks identified by palpation and/or fluoroscopy
                                                                                     (Khumsap et al., 2004; Clayton et al., 2004, 2007a, 2007b) or using
                                                                                     a template attached to the bones (Chateau et al., 2004, 2006). A
                                                          Flexion/extension          right-handed coordinate system is used to establish the three axes
                                                                                     around which flexion/extension, abduction/adduction and internal/
                                                                                     external rotation occur. Errors are reduced if the axis aligned with
                                                                                     the longest dimension of the bone is established first.
                                                                                        Kinematic crosstalk is a common problem in using the JCS
                                                                                     method. Flexion/extension angles are robust due to their large
                                                                                     signal to noise ratio and misalignments between the horse or the
                                                                                     plane of motion and the GCS tend to have little effect on flexion/
                                                                                     extension measurements where this is the predominant type of
                                                                                     motion (Ramakrishnan & Kadaba, 1991). However, these misalign-
                                                                                     ments will cause some of the flexion movement to be misinter-
                                                                                     preted as abduction. Figure 2.7 shows the effect of a small (±10°)
                                                                                     change in alignment of the flexion/extension axis on the amount
                                                                                     of motion ascribed to abduction/adduction at the fetlock joint
                                                                                     (Clayton et al., 2007a). Another problem with the JCS methodol-
                                                                                     ogy is gimbal lock, which causes the rotation angles to become
                                                                                     increasingly sensitive to measuring errors when the second rotation
                            Internal/external                                        approaches ±90° (Woltring, 1994).
38
                                                                                                                   Methods of kinematic analysis
                                                                                                                                                     39
       2      Measurement techniques for gait analysis
     dynamometers, foot switches, event recorders, etc., can be synchro-       an electronic shutter synchronized with the strobed lights will
     nized with the system. Kinematic data may be recorded using active        remove motion blur.
     markers (markers that emit a signal) or passive markers (markers             Software packages for kinematic analysis offer a simple and pow-
     that detect or reflect a signal). Most of the equine gait laboratories    erful interface that facilitates set up, calibration, motion capture
     currently use optoelectronic systems based on passive markers, such       (real-time and for post processing), editing and saving data in a
     as the Motion Analysis System (Motion Analysis Corp., Santa Rosa,         chosen format. The software delivers six-degrees-of-freedom data
     CA), Vicon MX (Vicon, Oxford, UK) or ProReflex MCU (Qualysis              for the full range of targets using reflective markers and high speed,
     Inc., Glastonbury, CT). Figure 2.10 shows data collection in progress     high-resolution cameras. In this way, the system can provide the
     using a Motion Analysis System in the Mary Anne McPhail Equine            highest order positional and angular accuracy. The interface syn-
     Performance Center at Michigan State University.                          chronizes with other analog and digital devices, such as video
        In choosing cameras for an optoelectronic system, there is a           cameras, force plate, pressure mat and EMG. The on-screen display
     balance between range, speed, size, performance and cost. The             may allow simultaneous display of several panels showing video, a
     current industry standard is to use digital camera systems that have      three-dimensional stick figure viewed from any perspective, together
     a ring of strobed lights (visible red, infra-red) surrounding the lens;   with graphical outputs of the data. A considerable volume of litera-
     the strobe frequency corresponds with the sampling rate. Desirable        ture in the field of equine locomotion has been based on the use
     features include a combination of high resolution (high pixel             of optoelectronic systems with passive markers.
     count) and a high frame rate, though at higher sampling rates the            Motion analysis systems based on active strobed markers offer
     resolution may be reduced or the image may be displayed in split-         automated marker identification by sequencing the temporal output
     screen mode. Cameras with more pixels allow the use of larger             of different markers, which avoids marker confusion or swapped
     capture volumes, smaller markers and more complex marker sets,            trajectories. These systems include Optotrak Certus (NDI, Waterloo,
     all of which are advantageous when working with horses. The               ON) and Codamotion (Charnwood Dynamics Ltd., Rothley, UK).
     advantages of digital technology over its analog predecessors are         An advantage to Codamotion is that its precalibrated sensor units
     that there is no degradation of the signal over distance, less noise,     are portable and can be set up in any location to measure three-
     and no re-sampling of data on another piece of electronics. The           dimensional coordinates without the need for a calibration process.
     signal processing is embedded in the camera and the signal goes
     directly to the tracking computer via an ethernet connection. By
     streamlining the system of motion capture from camera to com-
     puter, the amount of hardware is reduced and there is less potential
                                                                               Electromagnetic systems
     for equipment problems. Regardless of the type of camera used, a          Electromagnetic systems, such as Flock of Birds (Ascension Tech-
     high-quality lens will improve the accuracy of the entire system and      nologies, Burlington, VT) are used as three-dimensional tracking
40
                                                                                                                                               Kinetic analysis
A B
Fig 2.11  Zebris system in use at the National Veterinary School of Alfort, France. Triads of ultrasound microphones fixed rigidly to the limb segments (left)
are located relative to a fixed system of three ultrasound transmitters as data are collected from a horse moving over ground (right).
Photograph courtesy of Dr. H. Chateau.
devices for applications that include real-time visualization, and                walking and trotting over ground and in analysis of the stance and
target acquisition. The magnetic tracking has accuracy comparable                 swing phases of horses walking and trotting on a treadmill (Chateau
with an optical motion system (Hassan et al., 2007). Drawbacks to                 et al., 2004, 2006).
the use of an electromagnetic system include the problem of metal
interference, the relative heaviness of the receivers, the presence of
wires and the small data capture volume.                                          Kinetic analysis
                                                                                                                                                                  41
                    2           Measurement techniques for gait analysis
12 12
10 10
                        8                                                                   8
     Force (N/kg)
                                                                           Force (N/kg)
                        6                                                                   6
4 4
2 2
                        0                                                                   0
                            0        20      40        60     80   100                           0   20         40        60     80     100
                                          Percent of stance                                                  Percent of stance
                    1.5                                                                   1.5
                    1.0                                                                   1.0
                    0.5                                                                   0.5
                    0.0                                                                   0.0
     Force (N/kg)
                                                                           Force (N/kg)
                    -0.5                                                                  -0.5
                    -1.0                                                                  -1.0
                    -1.5                                                                  -1.5
                    -2.0                                                                  -2.0
                    -2.5                                                                  -2.5
                            0        20      40        60     80   100                           0   20         40        60     80     100
                                          Percent of stance                                                  Percent of stance
                    0.6                                                                   0.6
                    0.4                                                                   0.4
                    0.2                                                                   0.2
     Force (N/kg)
Force (N/kg)
                    0.0                                                                   0.0
                    -0.2                                                                  -0.2
                    -0.4                                                                  -0.4
                    -0.6                                                                  -0.6
                    -0.8                                                                  -0.8
                            0        20      40        60     80   100                           0   20         40        60     80     100
                                          Percent of stance                                                  Percent of stance
     Fig 2.12  Vertical (above), longitudinal (center) and transverse (below) components of the ground reaction force for a horse at the walk (left panel) and at
     the trot (right panel). For the longitudinal force the cranial direction is positive and for the transverse force the medial direction is positive. Forelimb (red line);
     hind limb (green line).
     complete three-dimensional data or a more limited range of GRF                                       result of friction that prevents the hoof slipping forward. Later in
     components, so the method of measurement should be chosen in                                         the stance phase, it changes to a propulsive (accelerating) force. The
     accordance with the goals of the study.                                                              direction of the horse’s motion across the force plate determines
        Standard GRF patterns have been developed for Dutch Warm-                                         whether acceleration or deceleration is recorded as positive. Soft-
     bloods at a walk (Merkens et al., 1988), trot (Merkens et al., 1993a)                                ware correction is applied to standardize the sign convention. The
     and canter (Merkens et al., 1993b). Since there are significant dif-                                 transverse force, which increases during sideways or turning move-
     ferences between breeds (Back et al., 2007), the Dutch Warmblood                                     ments, is small in magnitude when moving in a straight line and is
     data must be adapted to other breeds by incorporating appropriate                                    directed medially. The left to right values recorded by the force plate
     parameters and weighting factors into the formulae used to develop                                   can be converted during post-processing to represent medial and
     the standard patterns. For example, when forces are normalized to                                    lateral values for each limb. During turning the transverse force acts
     body weight, Quarter Horses have lower vertical GRFs than Dutch                                      toward the center of the turn or toward the direction of lateral
     Warmbloods trotting at a similar velocity (Back et al., 2007).                                       motion.
        Figure 2.12 shows the three force components (vertical, longitu-                                     For a walking horse, the peak vertical GRF has a magnitude of the
     dinal, transverse) during the stance phase of a forelimb at a walk                                   order of 60% body weight at walk and 90% body weight at a moder-
     and trot. The vertical force, which represents the anti-gravity support                              ate speed trot (Fig. 2.12). At slower walking velocities the vertical
     function of the limb, is always positive. The longitudinal force,                                    force trace tends to be biphasic with the second peak being higher
     which provides acceleration and deceleration, has negative and                                       in the forelimbs and the first peak being higher in the hind limbs.
     positive phases. In the early part of the stance phase, the longitudi-                               During walking, peak values of the vertical and longitudinal forces
     nal force brakes (decelerates) the horse’s forward movement as a                                     in the forelimb increase with velocity, but the corresponding
42
                                                                                                                                                 Kinetic analysis
                                                                          Force (N/kg)
(impact phase). The trace then rises smoothly to peak around the                           8
time the limb is at its midstance position, which is marked by the
cannon segment being vertical, after which it decreases to lift-off                        6
(Fig. 2.12). The peak value of the longitudinal force is 10–15% of
the horse’s body weight at the walk and trot, with marked spiking                          4
occurring during the impact phase at trot. The transverse force is                         2
much smaller in magnitude, around 2% body weight at the trot
(Fig. 2.12). The center of pressure is located under the middle of                         0
the hoof during most of the stance phase, moving rapidly toward                                 0   20        40          60              80            100
the toe at the start of breakover.                                                                            Time (% stance)
   Values representing the peak forces and their times of occurrence
are extracted from the force history. Impulses are determined by                         1.0
time integration of the force curves. A procedure that combined over
90 numbers describing the peak amplitudes, their times of occur-                         0.5
rence, and the impulses has been described as the H(orse) INDEX
(Schamhardt & Merkens, 1987). This method is valid but has some                          0.0
                                                                                                    20         40           60            80            100
                                                                          Force (N/kg)
drawbacks in that the variables used to calculate the index are
selected by the user and are essentially dependent on the shape of                       -0.5
the signal. Moreover, it does not take account of the real pattern of
the curve, which can be accomplished by different techniques that                        -1.0
are more suitable for comparison of curve patterns.
   The stance durations, GRF amplitudes and impulses are sym-                            -1.5
metrical in sound horses at the walk (Merkens et al., 1986, 1988)
and trot (Seeherman et al., 1987; Merkens et al., 1993a; Linford                         -2.0
1994; Weishaupt et al., 2004a). Analysis of ground reaction forces
                                                                                                              Time (% stance)
is a reliable way to quantify lameness, with peak vertical force and
vertical impulse being the variables with highest limb specificity        Fig 2.13  Vertical (above) and longitudinal (below) ground reaction forces
and sensitivity in grading lameness (Weishaupt, 2004b, 2006a). An         of forelimbs in sound condition (mean value of left and right forelimbs in
example of the changes in ground reaction forces in superficial           blue) and after induction of superficial digital flexor tendonitis in one
digital flexor tendonitis is shown in Figure 2.13. Lameness models        forelimb (lame, forelimb in green and compensating forelimbs in red shown
include pressure on the hoof sole (Merkens & Schamhardt, 1988);           separately).
collagenase-induced tendinitis in the flexor tendons (Clayton et al.,     From Clayton et al. (2000) Am. J. Vet. Res. 61, 191–196 with permission of American
2000a) or desmitis of the suspensory ligament (Keg et al., 1992);         Veterinary Medical Association, http://avmajournals.avma.org/loi/ajvr.
and surgical creation of a cartilage defect (Morris & Seeherman,
1987; McIlwraith et al., 2011). In addition to its value for detecting
lameness, the force plate is a sensitive tool for measuring the           a non-slip material (Fig. 2.15). When a horse steps on the plate, the
response of lame horses to diagnostic anesthesia (Keg et al., 1992)       force is detected by transducers at its corners, and is converted to
or to therapeutic intervention (Gingerich et al., 1979).                  an electrical signal that is amplified and recorded. Two types of force
   Ground reaction force has also been used for postural sway analy-      transducers are used: strain gauge and piezoelectric. Strain gauges
sis, which projects movements of the center of pressure onto a            have a linear response, are relatively insensitive to temperature, and
horizontal plane. A stabilogram (Fig. 2.14) is a graphic representa-      can be miniaturized. The disadvantage is their low sensitivity. By
tion of the motion of the center of mass in craniocaudal and medio-       comparison, piezoelectric transducers have high responsiveness and
lateral directions over a period of time. Techniques for postural sway    can be miniaturized but they are sensitive to temperature and
analysis has been described in horses (Clayton et al., 2003a; 2012)       humidity and are not amenable to static calibration. Variables
and disturbances in balance after administration of a sedative have       measured by the force plate include stance duration, magnitude of
been quantified (Bialski et al., 2004). Postural sway analysis also       the vertical, longitudinal (horizontal craniocaudal) and transverse
shows promise as a technique for detection of neurological diseases       (horizontal mediolateral) forces, time when the peak forces occur,
(Clayton et al., 1999).                                                   the impulses (areas under the force–time curves), and point of
                                                                          application of the force (center of pressure or point of zero moment).
                                                                             In selecting a force plate for equine use, it is important to choose
Normalization                                                             one that has a linear response over an appropriate range of forces,
                                                                          taking into account the weight of the horses and the gaits and
GRFs vary with body mass (Barr et al., 1995). Comparisons between
                                                                          speeds to be studied. The dimensions of the plate should maximize
horses are facilitated by normalizing the force traces to the horse’s
                                                                          the chance of getting a good strike from one fore hoof followed by
weight, so they are expressed in Newtons/kilogram body weight (N/
                                                                          the hind hoof on the same side at the selected gait. If two hooves
kg). GRFs may also be standardized to the duration of the stance
                                                                          strike the plate simultaneously, it is not possible to separate their
phase, which allows comparison of the forces occurring at a percent-
                                                                          effects. Shorter force plates (60–90 cm) are ideal for collecting data
age of stance duration in strides with different durations.
                                                                          at the walk, but a length of 90–120 cm is preferable for use at the
                                                                          faster gaits. Width of the plate is not generally a limiting factor:
                                                                          50–60 cm is adequate. Depending on the dimensions of the force
Force plate                                                               plate, it is typical for a good strike to be recorded for every two to six
A force plate is a steel plate that can be mounted in a runway or         passes at the walk, trot and canter (Niki et al., 1982; Merkens et al.,
recessed into the ground. For equine use, it is usually covered with      1986, 1993a, 1993b). During jumping, the obstacle is moved
                                                                                                                                                                    43
                              2        Measurement techniques for gait analysis
                                                                                          tant to the quality of the data collected. The plate should be embed-
                                                                                          ded in a concrete pit to isolate it from surrounding vibrations and
                                                                                          the supporting surface must be absolutely level to avoid cross talk
                                  -3        -2       -1      0           1        2   3   between the vertical and horizontal channels. Before recording data,
                                                                                          the calibration should be checked by placing a known weight,
                                                                                          similar in magnitude to the loads that will be applied during
                                                            -2                            normal use, at different locations on the force plate. The same verti-
                                                                                          cal force should be recorded independent of location, and the
                                                                                          position of the center of pressure should match the actual location
                                                            -4                            of the load.
                                                                                             Simple procedures for checking force plate calibration on a daily
                                                                                          basis have been described (e.g. Lewis et al., 2007). Since GRFs vary
                                                                                          with velocity (McLaughlin et al., 1996; McGuigan & Wilson, 2003),
                                                            -6                            measurement and control of velocity are important in studies of
                                                                                          GRFs. Provided the horse’s velocity over the force plate is main-
                                                      Transverse sway (mm)
                                                                                          tained within a narrow range, the GRFs are consistent and repeat-
      Fig 2.14  The stabilogram is a graphic representation of the motion of the          able between strides, with analysis of five strides being sufficient to
      horse’s center of mass projected onto a horizontal plane. In the graph              provide representative data (Merkens et al., 1986). Methods of mea-
      shown here, the line traces the motion of the center of mass during a 20 s          suring the horse’s average velocity over the plate include the use of
      recording period at 1000 Hz. The 0,0 location, which is the centroid of all         timing lights that record the time taken to cover a known distance
      the points, is located at the intersection of the transverse and longitudinal       or dedicated kinematic software. Sensors for a simple infrared
      axes. The head is toward the top of the figure and the horse’s left is on the       timing device that measures the time elapsing as the horse passes
      left. Note the different scales on the vertical and horizontal axes.                through the data collection volume can be purchased inexpensively.
                                                                                          Alternatively, software can be written to track a position marker (as
                                                                                          described above) on the horse’s torso and calculate average speed
                                                                                          and speed variation during the trial. Depending on the objectives
                                                                                          of the study, data from runs that fall outside a predetermined range
                                                                                          of velocities may be discarded.
                                                                                             Bad trials occur when the horse fails to strike the force plate, when
                                                                                          the hoof contacts the edge of the plate, when more than one hoof
                                                                                          is on the plate simultaneously, and when the horse’s body axis or
                                                                                          direction of movement are not aligned with the axes of the force
                                                                                          plate. These problems may be recognized by the force traces having
                                                                                          an unusual shape or magnitude or failing to return to the baseline
                                                                                          between individual limb contacts. It is helpful to use kinematic data
                                                                                          to verify which hoof is on the force plate and its precise location,
                                                                                          and also to check the alignment of the horse and the direction of
                                                                                          movement.
                                                                                             Variables with low variability require fewer animals, trials and
                                                                                          days to obtain accurate data while maintaining adequate statistical
                                                                                          power. Inter-day reliability of force plate data over three consecutive
                                                                                          days is high for stance duration, peak vertical force and vertical
                                                                                          impulse (<10% variability of the mean), while longitudinal force
                                                                                          peaks and impulses have larger variation (>20% variability of the
                                                                                          mean) (Lynch et al., 2005). In lame horses, peak vertical force and
                                                                                          vertical impulse have the lowest between- and within-horse coeffi-
                                                                                          cients of variation and the highest correlations with subjective lame-
                                                                                          ness grade. Peak vertical force also has high sensitivity and specificity
                                                                                          for lameness classification (Ishihara et al., 2005).
                                                                                             Although force plates for equine use are usually covered with
                                                                                          rubber matting, it is possible to place different surface materials on
                                                                                          top of the force plate. For example, a steel-reinforced concrete top-
                                                                                          plate has been used to simulate the surface of a road in a study of
                                                                                          energy dissipation during hoof slippage at the start of stance
                                                                                          (Wilson & Pardoe, 2001).
                                                                                             At the University of Zurich, a force plate suitable for equine use
                                                                                          has been embedded in a treadmill (Fig. 2.16) to measure the vertical
                                                                                          forces of all four limbs over an unlimited number of steps at any
      Fig 2.15  Horse stepping on force plate during data collection.                     gait (Weishaupt et al., 2002). The force measuring system consists
44
                                                                                                                                                      Kinetic analysis
                     Angular encoders
       X                                                 Rubber string
Y Z
R1 R2 R3 R4 R5 R6 R7 R8 R9
0.5m
                                                                                                                                                                          45
          2       Measurement techniques for gait analysis
                                                                       Ridge around
           Hoof Plate                             z-axis               the hoof wall
Sensor 2
                                                                                            y-axis
      A       Ground Plate
0.5 mm radius
                                                                                                     Fig 2.19  Force shoe attached to hoof and viewed from the solar aspect.
                                                                                                     HL, lateral heel; QL, lateral quarter; QM, medial quarter; HM, medial heel; and
      B                                    Flange for mating with ground plate                       global anatomical frame (Xhoof, Yhoof).
                                                                                                     Reprinted from Rollot, Y., Lecuyer, E., Chateau, H., Crevier-Denoix, N., 2004. Development of a
     Fig 2.18  Above: dynamometric horseshoe viewed from the toe with
     coordinate axes superimposed. The x-axis is perpendicular to the plane of                       3D model of the equine distal forelimb and of a GRF shoe for noninvasive determination of
     the photograph. The elevation of the x–y plane coincides with the bottom                        in vivo tendon and ligament loads and strains. Equine Vet. J. 36, 677–682, with permission
     plane of the ground plate. The location of the y–z plane is palmar from the                     from the Equine Veterinary Journal.
     center of sensor 2, two-thirds of the distance from sensor 2 to a line
     between the other two sensors (not visible). Below: diagram indicating                          15 kN. The total weight of the assembly was around 700 g. When
     strain gage placement on the sensors as viewed from below. Opposite                             compared with data from a force plate, the force shoe represented
     sensor faces have the same gage pattern.                                                        the shape of the GRF curve but the amplitude was reduced, which
     Reprinted from Roland, E.S., Hull, M.L., Stover, S.M., 2005. Design and demonstration of a      was explained by the fact that the screws used to sandwich the
     dynamometric horseshoe for measuring ground reaction loads of horses during racing              sensors were supporting some of the load. Another issue was that
     conditions. J. Biomech. 38 (10), 2102–2112, with permission from Elsevier.                      rotation of the hoof and shoe relative to the ground, especially
                                                                                                     during contact and breakover, resulted in crosstalk between the
                                                                                                     longitudinal and vertical forces. On sand, weight bearing over the
     base plate matched the size and shape of the solar surface of a Thor-                           frog and sole reduced the force recorded by the instrumented shoe
     oughbred hoof. The data were measured in a local coordinate system                              relative to the actual GRF.
     aligned with the hoof, whereas force plate measurements are in a                                   A force shoe with four transducers located on the medial and
     global coordinate system fixed to the ground. When the hoof was                                 lateral sides of the toe and quarters, was integrated into the bottom
     flat on the ground, the three-dimensional GRF patterns and ampli-                               of an easy boot and used to measure the vertical GRF component
     tudes agreed well with previously reported force plate data but there                           at walk and trot (Barrey, 1990). This shoe was used to compare
     were differences at the start and end of stance when the hoof was                               different track surfaces (Barrey et al., 1991).
     not flat on the ground. The entire shoe weighed 860 g, which is                                    Although a force shoe would be an ideal method of measuring
     likely to affect swing phase kinematics due to the added inertia.                               GRFs, there are significant technical difficulties in constructing one
        The first equine force shoe based on piezoelectric sensors was                               that is accurate and reliable throughout the equine stance phase.
     developed by researchers at Washington State University. The first                              Working within these limitations, some useful data have been
     prototype had a single piezoelectric transducer in a housing over                               generated.
     the frog. A later version that had three piezoelectric transducers
     located at the medial heel, the lateral heel and the toe gave a better                          Indirect methods of GRF measurement
     correlation with simultaneous force plate recordings. It was used
     primarily in studies of galloping Thoroughbreds (e.g. Ratzlaff et al.,                          An alternative method of determining GRFs is by calculation rather
     1990), and provided unique data when a horse wearing the shoe                                   than direct measurement. There are different methods of GRF esti-
     sustained a rupture of the distal sesamoidean ligaments while gal-                              mation, each of which has advantages and disadvantages. One
     loping on a training track (Ratzlaff et al., 1994).                                             method of estimating vertical GRF is based on the spring-like prop-
        Another design used four three-axis piezoelectric load cells                                 erties of the distal forelimb, which implies that vertical loading of
     located medially and laterally at the quarters and heels (Fig. 2.19)                            the limb is directly related to the distance from elbow to hoof and
     (Rollot et al., 2004). In this case, the load cells were sandwiched                             also to fetlock angle, which would allow the vertical GRF to be
     between a base plate that was nailed to the hoof and a shoe that                                calculated from limb kinematics (McGuigan & Wilson, 2003). This
     was attached to the base plate using four screws. These screws were                             method likens the limb to a strain gauge; the relationship between
     tightened to preload the load cells with a compressive force of about                           limb force and elbow-hoof distance or fetlock angle is calibrated
46
                                                                                                                                    Tissue strain
using kinematic and force data that are collected synchronously.           Inverse dynamic analysis has been applied in horses to evaluate
Peak vertical force can then be estimated from kinematics. A further     forelimb net joint moments and powers at walk (Clayton et al.,
step involves calibrating the forces indirectly (and without the need    2000b, 2001) and trot (Clayton et al., 1998; Lanovaz et al., 1999)
for force plate analysis) by estimating limb forces from duty factor,    and during jumping (Dutto et al., 2004a; Bobbert & Santamaría,
which is the percentage of stride that a limb spends in the stance       2005). The effects of lameness on net joint moments and powers
phase. A prerequisite of this method is a knowledge of the distribu-     have also been evaluated (e.g. Clayton et al., 2000c; Khumsap et al.,
tion of the total ground reaction force between the individual limbs,    2003).
which is gained through direct force measurements. The results of
a study that used hoof-mounted accelerometers to determine duty
factor and then estimate peak vertical forces yielded an overestima-     Tissue strain
tion of 13% at walk, an underestimation of 3% at trot, an under-
estimation of 16% for the trailing limb at canter and an                 Body tissues deform or strain with respect to their preferred shape
overestimation of 19% for the leading limb at canter (Witte et al.,      as a consequence of applied external forces competing with the
2004). The substantial errors at canter were attributed to the differ-   microscopic internal forces that hold the tissue together. When a
ent functions performed by the trailing and leading limbs in this        tensile force is applied to a solid material, it causes the length to
asymmetrical gait.                                                       increase, whereas a compressive force causes the length to decrease.
   Bobbert et al. (2007) used a slightly different approach to calcu-    A bending force causes both increases and decreases in length in
late force-time histories for the individual limbs based on the          different parts of the tissue. Stress is the force per unit area; strain
assumption that they operated as linear springs. Kinematic data          is the change in length expressed as a percentage of the original
were used to calculate the acceleration of the horse’s center of mass    length.
and the magnitude and direction of the total GRF vector. Angular            In ideally linearly elastic materials, deformation is proportional
momentum of the horse, also calculated from the kinematic data,          to the applied force and the material restores its original shape as
was combined with the GRF vector to determine the moment arms            soon as the deforming force is removed. Deformation of the mate-
of the total GRF relative to the two supporting hooves during            rial, usually expressed in terms of strain (ε), is defined as:
bipedal support (Bobbert & Santamaria, 2005). The moment arm
ratio between fore and hind hooves indicates how the total GRF is                                            l1 − l0
                                                                                                        ε=
distributed between the supporting limbs, so the individual limb                                                l0
forces can be calculated. The forces can be calibrated against distal
                                                                         where l0 is the original (or resting) length, l1 is the length after
limb length or fetlock angle, allowing force–time data for the limb
                                                                         deformation, and l1−l0 represents the change in length. Usually, the
can be estimated based on the time history of distal limb length or
                                                                         resting length is defined as the length at zero loading force. Because
fetlock angle. Compared with values measured by a force plate, peak
                                                                         strain is a relative measure, it has no units. It is expressed as a frac-
vertical GRFs calculated by this method were quite accurate (Bobbert
                                                                         tion or as percentage strain.
et al., 2007).
                                                                         Strain transducers
Inverse dynamic analysis                                                 Strain transducers measure the amount of strain based on electrical
Inverse dynamic analysis (IDA) uses kinematic data, GRF data and         resistance (liquid metal strain gauge, buckle transducer, implant-
knowledge of segmental morphology and inertial properties to cal-        able force transducer and pressure transducer), variation of mag-
culate internal forces within the limb that cannot be measured           netic field (Hall effect transducer), or variation of light flow (optic
directly (Winter, 1990). The net joint moment describes the net          fiber). Ideally, transducers should be reliable, easy to implant,
torque across a joint produced by the soft tissues (muscle, tendon,      induce minimal distortion or length change in the tissue and not
ligament and joint capsule). Net joint power is a measure of the net     cause a significant inflammatory reaction. Implantation requires
mechanical work done across a joint; it is the product of the net        surgery using local or general anesthesia. A drawback is that the
joint moment and joint angular velocity. If the net joint moment         time required to recover from anesthesia delays the start of data
has the same polarity as the joint angular velocity, then the power      collection, which is a relevant concern when using transducers that
is positive (power generation) indicating that the muscles are per-      have a limited lifespan or that induce the development of fibrous
forming positive (concentric) work, in which the muscle fibers           healing reactions (Ravary et al., 2004). Since strain gauges are small
shorten as they generate tension. If the net joint moment has the        devices, they collect data from a limited area that is not necessarily
opposite polarity to the joint angular velocity, the power is negative   representative of the total strain or load of the entire structure.
(power absorption) and the muscles perform negative (eccentric)             The most commonly used type of strain gauge changes its electri-
work, in which the muscle fibers lengthen as they generate tension.      cal resistance in response to deformation in a certain direction; the
Power absorption occurs when muscles act to restrain the rate of         change in resistance is converted to a voltage output that is propor-
joint motion in opposition to gravity or some other force. Net work      tional to the strain. Voltage outputs are stored for later processing
performed over a period of time is calculated by mathematical            by a computer. A combination of three strain gauges stacked at 45°
integration of the power curve with time.                                angles to each other forms a rosette gauge capable of measuring
   Input into the inverse dynamic model comes from synchronized          three-dimensional strains.
kinematic and GRF data, which are combined with morphometric
information (segment mass and center of mass) and segment iner-
tial parameters. A link segment model of the limb is constructed,
                                                                         Measuring strains in hard tissues
with each limb segment represented as a solid bar with its center        Hard tissues, such as bone, deform slightly in multiple directions
of mass located relative to the marker coordinates that define the       as a result of the combined effects of weight bearing, tension in the
segment. An inverse dynamic solution described by Winter (1990)          muscles and tendons, and inertial effects due to acceleration of the
and adapted for use in horses (Colborne et al., 1997) is then used       limb. Rosette (three-dimensional) gauges, bonded to a bone surface
to calculate the sagittal plane net joint moments at each joint. Net     using a thin layer of cyanoacrylate glue, deform with the surface to
joint moment and net joint power can be normalized to horse mass         provide information about the compressive and tensile forces
and expressed per kg body weight (Nm/kg, W/kg, respectively). For        (Lanyon, 1976). The best sites for attaching strain gauges to bones
further details see Chapter 19.                                          are in areas where the bone lies subcutaneously, so soft tissue
                                                                                                                                                     47
        2        Measurement techniques for gait analysis
     Fig 2.20  Strain gage attached to equine third metacarpal with wires
     attached.                                                                  Fig 2.21  Strain gage attached to the hoof wall.
     Photograph courtesy of Dr. H. Davies.                                      Photograph courtesy of Dr. J. Thomason.
     trauma during surgery is minimized. The bone surface is prepared           of loading conditions (e.g. Thomason et al., 1992, 2001) and after
     by removing the periosteum and drying the underlying bone before           application of therapeutic shoes (Hansen et al. 2005).
     bonding the strain gauge to the bone using cyanoacrylate adhesive
     (Fig. 2.20). The wires exit the skin through a separate incision. It is
     important to shield the wires from movement and trauma, since
                                                                                Measuring strains in tendons and ligaments
     damage to or loosening of the wires is the most frequent reason for        The use of strain and force transducers in biomechanical studies of
     failure of the gauges. During data collection, the gauges deform as        tendon and ligament has been reviewed by Ravary et al. (2004).
     if they were part of the bone surface. The resulting electrical signal     Forces can be estimated (e.g. van den Bogert, 1989) or measured
     is amplified and transmitted to a data recorder or computer for            using implanted transducers. Regardless of the type of transducer
     storage.                                                                   used, implantation within a tendon or ligament causes tissue
        A practical problem in quantifying bone strain is that the resting      damage, which may affect the signal output and limit the number
     length of bone is difficult to determine. When the horse is standing       of measurements that can be made.
     quietly with the limb lifted from the ground, the loading may be              The long tendons in the lower limb of the horse can be consid-
     assumed to be small. However, the effects of muscular contraction          ered as more or less elastic, homogeneous cables. When loaded,
     cannot be excluded completely, and the influence of gravity may            their length increases. However, strain in tendons is not as well
     also affect the zero-strain determination. Software has been devel-        defined as in bones. An unloaded tendon shrinks in length and the
     oped to calculate a ‘zero-strain compensation’ for in vivo strain          tendon fibers become wrinkled or crimped. When elongated, the
     gauge data of horses at the walk, using the assumption that                crimp in the fibers is first straightened out, after which the fibers
     strain is minimal in the middle of the swing phase when the limb           are stretched elastically up to a point, beyond which permanent
     is moving forward with an almost constant velocity (Schamhardt &           elongation occurs.
     Hartman, 1982).                                                               The load–elongation curve for a tendon has a ‘toe’ region, which
        Surface strain is a consequence of the forces loading the bone.         is characterized by having a large elongation for a small load. This
     However, the relationship between surface strain and load is com-          region represents straightening of the crimp in the collagen fibers.
     plicated, especially in non-homogeneous, non-linear, viscoelastic          As loading increases beyond the ‘toe’ region, there is a linear rela-
     structures such as bones (Rybicki et al., 1974). Roszek et al. (1993)      tionship between load and elongation in the elastic region until the
     presented an elegant technique to quantify the loading forces from         yield point, which occurs around 10–12% strain. Beyond the yield
     a post-mortem calibration using multiple strain gauges and known           point permanent elongation results as the tendon fibers begin to
     bending and torsional loading forces. Without this kind of calibra-        rupture. A problem in measuring tendon strain lies in defining the
     tion, however, bone strain recordings are a valuable, but qualitative,     initial length of the tendon and the position of zero load, which
     estimate of bone loading.                                                  affects the magnitude of the strains recorded throughout the physi-
        By using three or four strain rosettes around the perimeter of a        ological range. It appears that the resting length, or the length at
     long bone shaft, and combining their output with knowledge of the          zero force, can only be approximated. Studies that rely on different
     bone’s geometry, the distribution of principal strains can be deter-       criteria for defining zero load give very different strain values during
     mined. It has been shown that the loading pattern of each bone is          similar activities and at the yield point. An objective method of
     fairly consistent in different activities, though peak strain and strain   determining the transition between the toe and the elastic region
     rate vary with gait and speed (Rybicki et al., 1974). This informa-        has been described (Riemersma & van den Bogert, 1993).
     tion has been applied in locating the tension surface of various long         In tendons and ligaments, unidirectional strain gauges are ade-
     bones, which is the surface of choice for the application of bone          quate to record tensile strains during loading. The force or strain
     plates. Strain gauges have been bonded to equine long bones to             developed within these structures can be measured directly using
     investigate bone loading under various conditions during exercise          an implanted transducer that should be sufficiently compliant to
     and training (e.g. Hartman et al., 1984; Schamhardt et al., 1985;          measure tissue tension without interfering with its normal use
     Nunamaker et al., 1990; Davies et al., 1993, 2004; Davies 2005).           during locomotion (Ravary et al., 2004).
        Strain gauges are easily bonded to the hoof wall (Fig. 2.21) to            Regardless of the type of transducer used, the electrical signal
     study the functional anatomy of the hoof capsule under a variety           must be converted to strain (relative elongation of the tissue) or
48
                                                                                                                                       Tissue strain
load (internal force within the tissue) by a calibration process in         across the primary loading axis of the tendon then threading a
which the sensor itself or the tissue containing the implanted sensor       sterile fiberoptic sensor through the needle. The needle is then
are stretched. Methods of calibration include traction in a materials       removed leaving the sensor embedded in the tendon. One end of
testing machine, tensile loading with known weights, stretching the         the fiber is connected to the light transmitter unit and the other end
tendons in situ in the limb by manipulation of the isolated limb or         is connected to the light receiver unit. As the tendon stretches lon-
by manually moving the joint, or electrical stimulation of the              gitudinally, its transverse dimension decreases and squeezes the
attached muscle. In animals, direct calibration is often performed          fiberoptic sensor, causing it to lose light, which is quantified by the
post-mortem after anatomical dissection of the tissue. In live              receiver. The amount of light lost varies linearly with the applied
animals, calibration must use an indirect method based on math-             tension in the tendon (Komi & Ishakawa, 2007). Calibration of the
ematical equations of static equilibrium.                                   sensor is similar to the buckle transducer. The fiberoptic transducer
   Several types of strain gauges have been used to study tendon            is relatively unobtrusive (diameter 0.25–0.5 mm), easy to implant
strains in horses. In a buckle transducer, the tendon is wound over         and appears to be well tolerated.
a buckle and preloaded as it passes over the middle support                    An ultrasound probe has been used to measure tendon strain
bar. Tendon damage is reduced by adapting the transducer dimen-             non-invasively (Pourcelot et al., 2005) based on the fact that the
sions and the shape of the crossbar to the width of the tendon.             speed at which acoustic waves travel through a tendon varies with
Tensile loading straightens the tendon and loads the buckle, and            the mechanical properties of the tissue; when the tendon is loaded,
this loading is detected by strain gauges bonded on the transducer          the ultrasound wave travels faster. An ultrasound probe consisting
surface to measure deformation of the buckle. Calibration of a              of an emitter and multiple receivers is placed on the skin with the
buckle strain gauge is achieved by ex vivo transection of the tendon        receivers spaced at regular distances along the skin overlying the
and application of known force or in vivo evaluation of tendon force        superficial digital flexor tendon. The ultrasound wave speed is cal-
from joint moment data. Buckle transducers appear to be poorly              culated from knowledge of the distance between the receivers. The
tolerated and are associated with more postoperative pain than              probe is fixed to the skin of the palmar metacarpal area using an
other types of strain gauges. Another problem with the buckle               adapted boot (Fig. 2.22). It has been used to evaluate the effects of
transducer is that, by forcing the tendon to follow a curved course,        farriery modifications on loading of the superficial digital flexor
its initial strain and tension are altered. The possibility of preload-     tendon at walk and slow trot (Crevier-Denoix et al., 2004).
ing of the tissues is a particular concern when making measure-
ments in short ligaments.
   Liquid metal strain gauges consist of compliant tubes filled,            Sonomicrometry
under slight pressure, with a metal that is liquid at room tempera-
ture (e.g. mercury in silastic). Strain-induced changes in the resis-       Sonomicrometry measures distances using transducers, commonly
tance of the liquid metal are measured, which depend on the length          called ‘crystals’, made from piezoelectric ceramic material that trans-
and cross-sectional area of the column of metal. When the gauge is          mit and receive sound energy. The crystals are implanted in soft
stretched, the liquid column becomes longer and narrower, which             tissue structures where they emit an ultrasonic pulse and detect
is associated with an increase in electrical resistance. Since the gauge    similar pulses from other crystals. The sonomicrometer measures
is part of a circuit with constant current, a change in electrical resis-   the time between transmission of the sound wave from one crystal
tance induces a change in voltage. These gauges are implanted with          to its reception by the other crystals. The time differences are con-
some prestrain to ensure detection of any changes in length. Liquid         verted to distance measurements. Specialized digital circuitry makes
metal strain gauges have the advantage of being calibrated in vivo,         continuous calculations of the distances between transducer crystals
but they have to be custom made, which is a tricky process. Micro-          implanted in or attached to soft tissue structures to quantify the
damage in the area of implantation alters the tensile properties of         active and passive functional properties of moving tissues.
the tendon within a few days, so readings must be taken as soon as             Sonomicrometry is useful in studies of muscle function to deter-
                                                                            mine whether muscles are working concentrically, isometrically or
possible after surgery (Jansen et al., 1998). Longevity is also
                                                                            eccentrically and to relate the type of contraction with the amount
adversely affected when oxygen diffuses through the porous silastic
                                                                            of force produced. This technique has been used in horses to inves-
tubing and oxidizes the mercury. There is also a possibility of break-
                                                                            tigate the relationship between muscle strain and length change of
ing the connecting wires or loss of contact between the wire and
                                                                            the musculotendinous unit (Hoyt et al., 2005)
the liquid metal column. To reduce the risk of problems, readings
should be taken as soon as possible after implantation and it may
be necessary to limit the number of in vivo measurements that are
collected. Liquid metal strain gauges have been used to investigate
                                                                            Calculation of strains
load distribution between the flexor tendons and suspensory liga-           Numerical modeling of the limb allows simultaneous evaluation of
ment (Jansen et al., 1993), to characterize the behavior of the limb        the strain contributions of different ligaments and tendons, even
(Riemersma et al., 1988a, 1988b), to assess the effect of support           those that are deeply placed. The effect of interventions, such as a
bandages (Keegan et al., 1992) and to detect changes in the loading         change in hoof angle can be studied (e.g. Lawson et al., 2007a).
pattern in response to changes in surface type or shoeing adapta-           Bone-fixed markers have been used to calculate three-dimensional
tions (Riemersma et al., 1996a, 1996b).                                     bone segment trajectories, from which geometric displacement of
   A transducer based on the Hall effect, in which the voltage output       tendon and ligament insertions were calculated to determine strain
of a semiconductor is proportional to the strength of a magnetic            of the digital flexor tendons in vitro (Rollot et al., 2004). The estima-
field, was used to measure strain in the superficial digital flexor         tions agreed fairly well with simultaneous measurements of tendon
tendon. Although the strains recorded were higher than would be             length using needles pinned perpendicularly through the superficial
expected, this may have been due to the definition of initial length        digital flexor tendon in the mid-metacarpal and digital regions.
as the length at heel strike (Stephens et al., 1989).                       Differences between calculated and measured strains, which were
   A force transducer that detects strain from a very small part of the     in the range of 12–15%, were due to integration of the length of
tendon has been applied in horses (Platt et al., 1994). A drawback          the proximal scutum (approximately 4 cm), which was not taken
is that the small area sampled is not necessarily representative of         into account in the direct measurement of tendon length.
strain in the entire tendon.                                                   Meershoek et al. (2001a) quantified the parameters for a pulley
   A fiberoptic transducer consists of a plastic optical fiber that loses   model to describe the relationships between force and strain of the
transmitted light under compression. It is implanted into a tendon          flexor tendons and between fetlock joint angle and suspensory liga-
under local anesthesia by passing a 19-gauge needle transversely            ment strain. Evaluation of the sensitivity of the technique indicated
                                                                                                                                                        49
        2        Measurement techniques for gait analysis
                                                                                    Fig 2.23  Telemetered system for measuring rein tension showing strain
                                                                                    gages inserted between rein and bit with battery operated power source
                                                                                    and transmitter-attached to the noseband underneath the horse’s chin.
50
                                                                                                                                                       Tissue strain
                   40
                            Left rein
                            Right rein
                   30
Rein tension (N)
20
10
                    0
                        0         1         2          3              4
                                         Time(s)
 Fig 2.24  Rein tension between the bit and leather side reins for a horse   Fig 2.25  Electronics, accelerometers and power source shown with
 trotting in hand in a straight line.                                        polyurethane housing for mounting on the hoof wall.
                                                                             Reprinted from Ryan, C.T., Dallap Schaer, B.L., Nunamaker, D.L., 2006. A novel wireless data
                                                                             acquisition system for the measurement of hoof accelerations in the exercising horse. Equine
    Accelerometers measure acceleration of the surface to which they         Vet. J. 38, 671–674, with permission from the Equine Veterinary Journal.
 are attached. Sub-miniature accelerometers (mass <1 g) are avail-
 able. They contain silicon beams that deform during acceleration
 causing changes in capacitance that are output as a voltage propor-         mechanical energy fluctuation in galloping Thoroughbreds (Pfau
 tional to the applied acceleration. Tilt relative to the earth’s gravi-     et al., 2006) and in horses moving on an incline (Parsons et al.,
 tational field can also be measured using these accelerometers.             2008), and to compare movements of the left and right tuber coxae
 Gravity deforms the silicon beam, changing the capacitance and              in horses with mild hind limb lameness (Pfau et al., 2007). Inertial
 associated voltage of the sensor.                                           motion tracking has inherently poor resolution and, over time, the
    Since each accelerometer measures acceleration in one direction          readings drift.
 only, two or three accelerometers are often stacked with their axes            A magnetometer measures the strength and/or direction of the
 perpendicular to each other to obtain two-dimensional or three-             magnetic field around it, which can be used to provide an absolute
 dimensional accelerations. Interpretation of the output is subject to       measure of orientation using the earth’s magnetic field, as in a
 errors due to misalignment of the axes of the accelerometers with           compass. A triaxial magnetometer with a tilt sensor can be used to
 the body axes or to rotations of the instrumented body segments             sense absolute three-dimensional orientation.
 during locomotion. Orientation of the accelerations relative to the            In equine studies, accelerometers have most often been applied
 body’s frame of reference can be achieved using optical motion              to the hoof wall, where they are used to detect initial ground contact
 capture or by integration of the angular velocity output of three           and to measure the associated accelerations. In one design (Fig.
 orthogonal gyroscopes.                                                      2.25), three accelerometers, a power source and the associated elec-
    Gyroscopic sensors measure orientation based on the principle            tronics were potted in a shock-attenuating silicon shell inside a
 of conservation of angular momentum. The essence of the instru-             semi-rigid polyurethane housing that was contoured to fit the
 ment is a spinning wheel on an axle that tends to resist changes to         dorsal hoof wall. The total mass of the assembly was only 148 g
 its orientation due to the angular momentum of the wheel. If two            (Ryan et al., 2006).
 gyroscopes with their axles perpendicular to each other are mounted            By mounting accelerometers to the hoof wall and to the bones
 on a platform inside a set of gimbals, the platform will remain             of the digit, Lanovaz et al. (1998) studied the attenuation of impact
 completely rigid as the gimbals rotate. Sensors on the gimbals’ axes        shock in the distal digit in vitro. Willemen et al. (1997) performed
 detect platform rotation. When used in combination with acceler-            similar measurements both in vitro and in vivo. A hoof-mounted
 ometers, the direction of motion and changes in motion can be               accelerometer is an effective tool for measuring certain characteris-
 measured in all three directions. Miniature gyroscopes (mass <1 g)          tics of the footing (Barrey et al., 1991) and the efficiency of shock
 measure angular velocity through the phenomenon of Coriolis                 absorbing shoes and pads (Benoit et al., 1991). Hoof mounted
 force, which is generated when a rotational angular velocity is             accelerometers have also shown that impact accelerations increase
 applied to a vibrating element. It is a by-product of measuring             with speed and are affected by the dynamic properties of the surface
 coordinates relative to a rotating coordinate system.                       the horse moves over (Ratzlaff et al., 2005; Ryan et al., 2006).
    Small, lightweight inertial-based sensors are generally robust and          A different application used two accelerometers secured beneath
 have some useful applications for recording data from a large               the horse’s sternum to measure longitudinal and dorsoventral accel-
 number of consecutive strides, when the use of an optical motion            erations of the trunk segment (Barrey et al., 1994) with data trans-
 analysis system may not be practical. In addition to providing accu-        mitted telemetrically to a receiver connected to a portable computer.
 rate orientation data, inertially based systems can be used to calcu-       Analysis of the symmetry of the trunk acceleration patterns during
 late displacements (Pfau et al., 2005). The large volumes of data           trotting revealed subtle asymmetries in lame horses, though in some
 collected by systems based on inertial sensors necessitate automatic        of these horses the side of hind limb lameness was identified incor-
 processing, especially if the system is to be used in a clinical setting,   rectly (Barrey & Desbrosse, 1996). The same device has been used
 where results are needed rapidly for timely decision-making. One            to study accelerations of the trunk during jumping (Barrey &
 such technique involves the use of a hidden Markov model-based              Galloux, 1997). Accelerometers attached to the saddle have been
 stride segmentation technique based on stochastic pattern recogni-          used to measure the acceleration at different gaits and the findings
 tion. It has been used to evaluate data from trunk-mounted, six             have been applied in the development of a mechanical horse that
 degrees of freedom, inertial sensors in horses (Pfau et al., 2008).         simulates the motions during walking, trotting, cantering and
 Other studies have evaluated center of mass movement and                    jumping (Galloux et al., 1994).
                                                                                                                                                                            51
       2      Measurement techniques for gait analysis
52
                                                                                                                                      Electromyography
Saddle pressure mats                                                             and comparison: left and right sides; front and back halves; quad-
                                                                                 rants, etc. Small changes in position of the horse or saddle relative
Knowledge of pressure beneath the saddle (Fig. 2.27) is potentially              to the position of the mat affect the force distribution and the
useful to evaluate saddle fit, rider position and riding technique.              assignment of summed forces to different areas, so it is important
Pressure mats marketed specifically for this purpose have an array               to standardize the position of the mat relative to both the horse’s
of sensors to measure forces acting normal (perpendicular) to their              back and to the saddle and to standardize the horse’s position for
surface. Early models were hard-wired to a laptop computer via a                 standing measurements.
long tether, which imposed limitations on the horse’s mobility. The                 As with all quantitative measurement devices, validity and reli-
latest generation of pressure mats use wireless technology, allowing             ability are important considerations. For a saddle pressure mat,
data to be collected on-board using a PDA or transmitted telemetri-              there should be a high correlation between the sum of the measured
cally to a computer, while the horse moves around freely.                        forces and the mass of the riders and saddle. Pressure bench tests
   Each sensor detects the force applied perpendicular to its surface            (Hochmann et al., 2002) indicate that the Pliance system (Novel
(normal force) and the output on the computer screen is color-                   GmbH, Munich, Germany) might be more reliable than the FSA
coded to represent bands of force. The operator sets the force range             (Vista Medical Ltd., Winnipeg, Canada), ClinSeat (Tekscan Inc.,
within each color band depending on the objective of the evalua-                 Boston, MA) and Xsensor (XSENSOR Technology Corporation,
tion. If saddle fit is being evaluated without a rider, a smaller range          Calgary, Canada) systems. The Pliance mat has also been shown to
of forces is required, whereas if the horse will be ridden, the added            be more reliable than the FSA device in equine practice (Jeffcott
weight of the rider requires a larger range of forces. The output can            et al., 1999; de Cocq et al., 2006, 2009). Subsequently, the Pliance
be displayed as a sensor plot, a two-dimensional contour plot or a               mat was proven valid for this purpose, but reliability measures
three-dimensional surface plot (Fig. 2.28). Total force summed over              indicate that the mat should remain on the horse’s back when
all sensors and maximal force in an individual sensor are also mea-              comparing different conditions (De Cocq et al., 2009). Pressure
sured. The data can be partitioned into smaller areas for analysis               mats have been used in saddle fitting to compare different saddle
                                                                                 brands (Werner et al., 2002) and tree width on saddle fit (Meschan
                                                                                 et al., 2007). In ridden horses, they have been applied in studies of
                                                                                 the horse’s gait and movements and rider technique (e.g. Freuh-
                                                                                 wirth et al., 2004; Peham et al., 2004; Geutjens et al., 2008).
Electromyography
Fig 2.28  Output from Pliance force mat (Novel GmbH, Munich, Germany) shown as individual sensor map (left), two-dimensional planar view (center) and
three-dimensional view (right). Pommel is toward top and left side is on the left for sensor map and two-dimensional planar view. The three-dimensional
view has been rotated slightly counterclockwise. Pressures are color-coded according to the scale on the right.
                                                                                                                                                             53
       2      Measurement techniques for gait analysis
54
                                                                                                                                           References
   The duration, from initial elevation until return to baseline, is         (Kimura, 1989). In human subjects, it may be possible to estimate
affected by the synchrony in firing of the individual muscle fibers          the number of active motor units at a given muscle contraction
and the conduction velocity. Discharges generated further from the           (Kimura, 1989) but in horses, it is difficult to judge the level of force
electrode form the low amplitude areas at the start and end of the           and, therefore, the value of evaluating the recruitment pattern is
MUP. The amplitude of the MUP, defined from peak to peak,                    limited (Wijnberg et al., 2002a, 2002b). This would require a more
depends on the distance from the electrode tip to the center of              sophisticated muscle model that incorporates the muscle architec-
maximal potential of the discharging unit. For example, fewer than           ture, the force–length and force–velocity relationships of the muscle
20 muscle fibers within a 1 mm radius of a concentric needle elec-           fibers, and the activation of the muscle, possibly from EMG signal
trode contribute to the spike of the motor unit. Both amplitude and          analysis.
duration of the MUP may be affected by the horse’s age and muscle               Electromyographic studies of athletic horses have described the
temperature. The shape of the MUP is described in terms of the               activation pattern of various muscles during normal locomotion
number of phases, with a phase being defined as the part of                  (Wentink, 1978; Korsgaard, 1982; Tokuriki et al., 1989; Tokuriki &
the curve between departure from and return to baseline, and turns,          Aoki, 1995; Robert et al., 1999) and have investigated the effects of
which are the changes in direction of the curve. Normal equine               speed and incline (Robert et al., 2000, 2001a, 2001b, 2002; Wickler
MUPs have been described as potentials that have two or three                et al., 2005) on muscle activation patterns. Over ground locomo-
phases, a duration of 3–10 ms and an amplitude of about 1500 µV              tion has been compared with swimming and walking in an under-
(Mayhew et al., 1978). More recently, MUP analyses have been                 water treadmill (Tokuriki et al., 1999) and the effects of fatigue on
reported in the horse for the subclavian muscle (Wijnberg et al.,            the EMG median frequency have been investigated (Colborne et al.,
2002a) and for the triceps and lateral vastus muscles (Wijnberg              2001).
et al., 2002b).
   The amplitude of the EMG signal depends on the dimensions of
the electrodes, their electrical contact with the muscle, and the kind       New technologies
of electrodes: signals from indwelling wire electrodes usually are
much lower than those obtained from surface electrodes. However,             The 21st century is an age in which technology is changing rapidly.
the major influence on the EMG signal amplitude is caused by the             Although the contents of this chapter are current at the time of
degree of activation of the muscle. When the muscle is completely            writing, by the time the text is printed some of the information may
activated, the EMG signal will reach a maximum. This relationship            be outdated and new methods and systems for locomotion analysis
allows the EMG signal amplitude to be used as a measure of the               will undoubtedly have become available. It is recommended
degree of activation, and thus indirectly, of muscle force develop-          that the reader treat the information in this chapter as a framework
ment (Hof, 1984). Recruitment is defined as successive activation            from which to evaluate future developments in gait analysis
of motor units with increasing strength of voluntary contraction             methodologies.
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     Spoor, C.W., Veldpaus, F.E., 1980. Rigid body         J. 9 (Suppl.), 110–118.                            muscle fnuction vs speed. II. Muscle
        motion calculated from spatial co-ordinates     van Weeren, P.R., van den Bogert, A.J.,               function trotting up an incline. J. Exp. Biol.
        of markers. J. Biomech. 13, 391–393.               Barneveld, A., 1992. Correction models for         208, 1191–1200.
     Stephens, P.R., Nunamaker, D.M., Butterweck,          skin displacement in equine kinematic gait      Wijnberg, I.D., Back, W., de Jong, M., Zuidhof,
        D.M., 1989. Application of a hall-effect           analysis. J. Equine Vet. Sci. 12, 178–192.         M.C., van den Belt, A.J.M., van der Kolk,
        transducer for measurement of tendon            Wakeling, J.M., Ritruechaia, P., Dalton, S.,          J.H., 2004. The role of electromyography in
        strain in horses. Am. J. Vet. Res:. 50,            Nankervis, K., 2007. Segmental variation in        clinical diagnosis of neuromuscular
        1089–1095.                                         the activity and function of the equine            locomotor problems in the horse. Equine
     Taylor, B.M., Tipton, C.M., Adrian, M.,               longissimus dorsi muscle during walk and           Vet. J. 36, 718–722.
        Karpovich, P.V., 1966. Action of certain           trot. Comp. Exerc. Physiol. 4, 95–103.          Wijnberg, I.D., Franssen, H., van der Kolk,
        joints in the legs of the horse recorded        Weishaupt, M.A., Hogg, H.P., Wiestner, T.,            J.H., Breukink, H.J., 2002a. Quantitative
        electrogoniometrically. Am. J. Vet. Res. 27,       Denoth, J., Stüssi, E., Auer, J.A., 2002.          motor unit action potential analysis of the
        85–89.                                             Instrumented treadmill for measuring               normal subclavian muscle in the horse.
     Thomason, J.J., Biewener, A.A., Bertram, J.E.A.,      vertical ground reaction forces in horses.         Am. J. Vet. Res. 63, 198–203.
        1992. Surface strains on the equine hoof           Am. J. Vet. Res. 63, 520–527.                   Wijnberg, I.D., Franssen, H., van der Kolk,
        wall in vivo: implications for the material     Weishaupt, M.A., Wiestner, T., Hogg, H.P.,            J.H., Breukink, H.J., 2002b. Quantitative
        design and functional morphology of the            Jordan, P., Auer, J.A., 2004a. Vertical            motor unit action potential analysis of
        wall. J. Exp. Biol. 166, 145–168.                  ground reaction force-time histories of            skeletal muscles in the warmblood horse.
     Thomason, J.J., Bignell, W.W., Sears, W., 2001.       sound warmblood horses trotting on a               Equine Vet. J. 34, 556–562.
        Components of variation of surface hoof            treadmill. Vet. J. 168, 304–311.                Wijnberg, I.D., van der Kolk, J.H., Franssen,
        strain with time. Equine Vet. J. Suppl. 33,     Weishaupt, M.A., Wiestner, T., Hogg, H.P.,            H., Breukink, H.J., 2003. Needle
        63–66.                                             Jordan, P., Auer, J.A., 2004b. Compensatory        electromyography in the horse compared
     Tokuriki, M., Aoki, O., 1995.                         load redistribution of horses with induced         with its principles in man: a review. Equine
        Electromyographic activity of the hind limb        weightbearing hind limb lameness trotting          Vet. J. 35, 9–17.
        muscles during the walk, trot and canter.          on a treadmill. Equine Vet. J. 36, 727–733.     Willemen, M.A., Jacobs, M.W.H., Schamhardt,
        Equine Vet. J. 18 (Suppl.), 152–155.            Weishaupt, M.A., Wiestner, T., Hogg, H.P.,            H.C., 1997. In vitro transmission and
     Tokuriki, M., Aoki, O., Niki, Y., Kurakawa, Y.,       Jordan, P., Auer, J.A., 2006a. Compensatory        attenuation of impact vibrations in the
        Hataya, M., Kita, T., 1989.                        load redistribution of horses with induced         lower forelimb of the horse. In: Willemen,
        Electromyographic activity of cubital joint        weight-bearing forelimb lameness trotting          M.A. (Ed.), Horseshoeing: a biomechanical
        muscles in horses during locomotion. Am.           on a treadmill. Vet. J. 171, 135–146.              analysis. PhD thesis, Utrecht University.
        J. Vet. Res. 50, 950–957.                       Weishaupt, M.A., Wiestner, T., Peinen, K., von,    Wilson, A.M., Pardoe, C.H., 2001.
     Tokuriki, M., Ohtsuki, R., Kai, M., Hiraga, A.,       Waldern, N., Roepstorff, L., van Weeren, R.,       Modification of a force plate system for
        Oki, H., Miyahara, Y., et al., 1999. EMG           et al., 2006b. Effect of head and neck             equine gait analysis on hard road surfaces:
        activity of the muscles of the neck and            position on vertical ground reaction forces        a technical note. Equien Vet. J. Suppl. 33,
        forelimbs during different forms of                and interlimb coordination in the dressage         67–69.
        locomotion. Equine Vet. J. 30 (Suppl),             horse ridden at walk and trot on a              Winter, D.A., 1990. Kinematics: forces and
        231–234.                                           treadmill. Equine Vet. J. Suppl. 36,               moments of force. In: Biomechanics and
     van den Bogert, A.J., 1989. Computer                  387–392.                                           motor control of human movement,
        simulation of locomotion in the horse.          Weller, R., Pfau, T., Babbage, D., Brittin, E.,       second ed. John Wiley & Sons, New York,
        PhD Thesis, University of Utrecht, Utrecht.        May, S.A., Wilson, A.M., 2006. Reliability of      pp. 75–102.
     van Heel, M.C.V., Barneveld, A., van Weeren,          conformational measurements in the horse        Witte, T.H., Knill, K., Wilson, A.M., 2004.
        P.R., Back, W., 2004. Dynamic pressure             using a three-dimensional motion analysis          Determination of peak ground reaction
        measurements for the detailed study of             system. Equine Vet. J. (2006) 38 (7),              force from duty factor in the horse
        hoof balance: the effect of trimming.              610–615.                                           (equus caballus). J. Exp. Biol. 207,
        Equine Vet. J. 36, 778–782.                     Wentink, G.H., 1978. Biokinetical analysis of         3639–3648.
     van Weeren, P.R., van den Bogert, A.J., Back,         the movements of the pelvic limb of the         Woltring, H.J., 1994. 3-D attitude
        W., Bruin, G., Barneveld, A., 1993.                horse and the role of the muscles in the           representation of human joints: a
        Kinematics of the standardbred trotter             walk and trot. Anat. Embryol. 152,                 standardization proposal. J. Biomech. 27,
        measured at 6, 7, 8 and 9 m/s on a                 261–272.                                           1388–1414.
        treadmill, before and after 5 months            Werner, D., Nyikos, S., Kalpen, A., Geuden, M.,    Zsoldos, R.R., Kotschwar, A., Kotschwar, A.B.,
        prerace training. Acta Anat. 146, 154–161.         Haas, C., Vontobel, H.D., et al., 2002.            Rodriguez, C.P., Peham, C., Licka, T., 2010.
     van Weeren, P.R., van den Bogert, A.J.,               Druckmessungen unter dem sattel: einem             Activity of the equine rectus abdominis and
        Barneveld, A., 1990a. A quantitative               elektronischen sattel-messsystem (Novel            oblique external abdominal muscles
        analysis of skin displacement in the               GmbH). Pferdeheilkunde, 18, 125–140.               measured by surface EMG during walk and
        trotting horse. Equine Vet. J. 9 (Suppl.),      Wessum, R. van, Sloet, M.M., Clayton, H.M.,           trot on the treadmill. Equine Vet. J. 42
        101–109.                                           1999. Electromyography in the horse in             (Suppl. 38), 523–529.
60
                                                                                                                        C H A PTER              3 
The concept of this chapter follows the signal beginning with mea-       Motion of a wheel
suring, then analog to digital conversion, signal processing and,
finally, decision-making.                                                A typical example of digital measurement equipment is a film
                                                                         camera. Let us consider an example when the camera takes 25 time-
                                                                         equidistant samples (pictures) of a motion every second. Depend-
Introduction and definition of signals                                   ing on the speed of the moving object this sampling rate may or
                                                                         may not be sufficient.
In equine motion analysis a signal is a measured physical property          In movies there is often a strange effect in moving stagecoaches.
of a movement presented as time-depended parameter or variable.          It is clearly visible that the stagecoach moves from left to right. But
It is acquired by different measurement methods, such as kine-           the wheels of the stagecoach appear to be revolving in the opposite
matic measurement (Fig. 3.1). This physical parameter can be a           direction (Figs 3.4 and 3.5).
coordinate (distance from origin), a force, acceleration, an angle          This so-called ‘alias effect’ is the result of under sampling. The
and so on. These signals are so-called bio signals. A bio signal pres-   conclusion is that the sampling rate is too low.
ents a time series of a physical parameter of a living being (Shiavi,       Figure 3.6 shows another example of a turning wheel with more
1999), and appears naturally in time-continuous form. Figure 3.2         spokes. The conclusion is that in fast movements more than 16
presents a typical signal in time-continuous form.                       pictures/turn (because there are eight segments) are necessary.
   Due to the measuring technique (analog to digital converter              The conclusion of the wheel experiment is the Nyquist – Shannon
(ADC)) today nearly every signal is detected as digital signal           sampling theorem, which states that the sampling frequency must
(Semmlow, 2004). The ADCs quantify the captured values. The              be at least twice the signal frequency to avoid the alias effect
effective range is always a power of 2. So a 12-bit ADC means that       (Werner, 2006):
the effective range is divided into 212 (4096) steps. A digital signal                  Fsample > 2*Fsignal where F is the frequency
consists of values measured at given time points, in most cases          Normally oversampling is used during the measurement. For
time-equidistance. Figure 3.3 shows the sampling (measuring)             instance, a sampling frequency that is five times higher than the
process of a signal.                                                     theoretical minimum sample frequency is used.
   The sampling signal represents a camera, which takes a picture of
the motion every 0.008 s (120 Hz sample rate). The result is a
sampled signal with measured values on given time points.                Resampling and normalization
   Therefore in (equine) motion analysis, signal processing is digital
                                                                         Often two different measurement systems are synchronized, e.g. a
signal processing (DSP). This knowledge is important for measuring
                                                                         kinematic system with a force plate or EMG equipment. Both
(sampling frequency) and signal processing.
                                                                         systems use different sampling frequencies. Since EMG measure-
   Normally noise and/or any other disturbances interfere with the
                                                                         ments need a much higher sampling frequency than the kinematic
desired signal (Semmlow, 2004). Sources of these disturbances may
                                                                         measurements, the result is two different time scales, i.e. one for
be errors of the measurement equipment, ADC (quantization
                                                                         kinematic and one for EMG. To solve this problem, resampling is
error), influence of an electrical field in case of EMG or ECG, etc.
                                                                         needed. If the sample frequency from EMG is reduced (Peham et al.,
DSP is necessary to get the most out of the measured data. The first
                                                                         2001a,b; Licka et al., 2004), it is comparable to smoothing or low-
step is to set up the measurement equipment in a way that the
                                                                         pass filtering. If there is a whole-numbered relation between the
digital signal represents the measured signal sufficiently.
                                                                         two sample frequencies, it is very easy to reduce or add the samples.
                                                                         The simplest method to reduce the samples is for instance to take
Choosing the sampling frequency                                          only every second or third sample and to add samples to calculate
                                                                         the values of the new samples by a linear relation between two
(Nyquist – Shannon sample theorem)                                       neighboring samples. Usually the procedure of resampling is done
                                                                         in two steps. The first step is to fit the curve (e.g. cubic spline, Fourier
Certain preconditions have to be fulfilled to represent a time           series, etc.) in the second step; the new samples will be extracted
continuous signal by a digital signal (time-equidistance sampled         from the fitted curve. If the sample frequency is to be reduced, it is
values). This characteristic is described by the Nyquist – Shannon       necessary to limit the bandwith by a low-pass filter.
sample theorem (Oppenheim & Willsky, 1996; Semmlow, 2004).                  The effect of reducing the samples (resampling) can be demon-
  The last graph of Figure 3.3 shows a sampled signal. Now the           strated by the moving average. The moving average is one of the
question arises, is the sample frequency sufficient?                     oldest and most popular technical analysis tools in motion analysis.
                                                                                                                                                        61
                                  3               Signals from materials
                                                          Horizontal coordinate of hoof motion of a horse                                                Analog signal of vertical coordinate of hoof motion
                                                                       walking on treadmill                                                                        of a horse walking on treadmill
                                    1200                                                                            Vertical coordinate (mm)   100
     Horizontal coordinate (mm)
                                                                                                                                                80
                                    1000                                                                                                        60
                                        800                                                                                                     40
                                                                                                                                                20
                                        600                                                                                                      0
                                        400                                                                                                          0      0.25           0.5              0.75          1        1.25
                                        200                                                                                                                                      Time (s)
                                          0
                                              0       1       2     3     4      5     6     7     8       9   10                                                       Sampling signal (Camera)
                                                                              Time (s)                                                           1
                                                                                                                    ADC
                                                                                                                                                80
                                         40                                                                                                     70
                                         20                                                                                                     60
                                                                                                                                                50
                                          0                                                                                                     40
                                              0       1       2     3     4      5     6     7     8       9   10                               30
                                                                              Time (s)                                                          20
                                                                                                                                                10
      Fig 3.2  Typical example of bio signals; hoof motion of a horse in walk.                                                                   0
                                                                                                                                                     0         0.25              0.5               0.75        1
                                                                                                                                                                                 Time (s)
      A moving average uses a fixed number of samples. These samples                                                 Fig 3.3  The sampling process.
      will be averaged to give a new sample. Then the working window
      is shifted by one sample.
         In case of a moving average of three, the mean is calculated from                                           evident when the duration of a motion cycle is normalized to 100%.
      the first three samples ( (s1 + s2 + s3)/3) to give the first new sample.                                      Normalization or a relative time scale is used as it makes the com-
      The next sample will be calculated by the mean of the samples                                                  parison of different motion cycles easier, and allows averaging of
      shifted by one ( (s2 + s3 + s4)/3) and so on (Fig. 3.7). This is a kind                                        multiple movement cycles into a single curve (a so-called ‘ensemble
      of resampling with the reduction of the sampling frequency. The                                                average’). The disadvantage is that the absolute time scale is lost.
      effect is a shift of the curve by one sample interval. If a moving                                             Sometimes the information of the variation of the duration of
      average of five samples is used, the delay will be two sample inter-                                           motion cycle is needed, which is then done before normalization.
      vals and so on. This combination of more samples is very similar                                                 Figure 3.7 shows a signal and the smoothed signal with a moving
      to a reduction of the sample frequency. So if it is used, it must be                                           average of three samples. It is obvious that the smoothing will shift
      realized that the signal is now low-pass filtered. A resampling is also                                        the signal.
62
                                                                                                                                                                                  Signal processing
                                                                                                                         Motion
                                                                                                                         Moving average of the motion
                                                                                                  1.615                                                                                              MA9
                                                                                                                                                                                        MA8
                                                                                                                                                                            MA7                            S9
                                                                                                   1.61                                                                                        S8
                                                                                                                                                                 MA6
                                                                                                                                                                                   S7
                                                                                                                                                      MA5
                                                                                                  1.605
                                                                                                                                                                       S6
                                                                                  Amplitude (m)
                                                                                                                                           MA4
                                                                                                                                                            S5
                                                                                                    1.6
                                                                                                                                MA3
                                                                                                                                                 S4
                                                                                                  1.595            MA2
                                                                                                                                      S3
                                                                                                                                                            MA1 = (S1+S2+S3)/3
                                                                                                   1.59       MA1
                                                                                                                                                            MA2 = (S2+S3+S4)/3
                                                                                                                          S2
                                                                                                                                                            MAn = (Sn+Sn+1+Sn+2)/3
                                                                                                              S1
                                                                                                  1.585
                                                                                                          0              0.01         0.02        0.03      0.04                0.05          0.06         0.07
                                                                                                                                                     Time (s)
Fig 3.4  An example of a stagecoach moving from left to right. The sequence
consists of two consecutive pictures. If the wheel turned clockwise for 30° (to   Fig 3.7  Moving average.
the right) then to the viewer it may appear to have moved anticlockwise for
15° (to the left), as the two consecutive spokes are 45° apart. So we interpret
(interpolate) a backward motion of the wheel. The actual turn of the wheel is
shown by the blue-colored segment of the wheel. In the second picture the
starting position is shown by red bars.
                                                                                                                                                                            B
                                                                                            Distance between A and B
Sample Interval
Fig 3.5 Turning wheel of a stagecoach. Fig 3.8 Derivation of a sampled signal.
                                                                                                                                                                                                                  63
                  3                   Signals from materials
     distance from A to B. The velocity for each sample interval is calcu-                      When differentiation is applied to data that contains noise, results
     lated by dividing the distance between two samples by the duration                         can be inaccurate. This will be discussed later.
     of a sample interval. The mean velocity for each interval is the                             Positive velocity indicates that the distance is increasing, whereas
     quotient of the distance and the elapsed time.                                             negative velocity stands for the decreasing distance.
                                                        distance between two samples              In Figure 3.9, it can be seen that when the head goes up the
                                              Vmean =                                 .         velocity is positive. When the head goes down the velocity is
                                                        duration of a sample interval
                                                                                                negative.
     The motion is represented by the slope of a straight line between                            At zero velocity, the motion reaches an extreme value, i.e.
     two points. If the sample rate is infinitive, the straight line is the                     maximum or minimum. When the velocity changes from positive
     tangent to this curve at a given time point. In the real world the                         to a negative value, this indicates a maximum. Whereas, when it
     sample rate is always finite. So in DSP it is possible to calculate the                    changes from negative to a positive value it indicates a minimum.
     mean velocity between two consecutive measures. Time series of
     velocity can be calculated by repeating this step for all intervals.
                                                                                                Integration
     Phase-plane analysis (practical use of differentiation)                                    Integration is very important in motion analysis. Additionally,
     Phase-plane analyses are used to show the stability of a system or                         many powerful mathematical tools are based on integration, e.g.
     a motion. Examples are stability of equine gait on a treadmill                             differential equations are the direct consequence of the develop-
     (Peham et al., 1998), harmony of horse and rider (Peham et al.,                            ment of integration. Calculation of impulse from the time curve of
     2001c) and stability of coupling via saddle of horse and rider                             force (Osterlinck et al., 2009), integrated EMG (Wijnberg et al.,
     (Peham et al., 2004). A phase-plane is a graph of a signal (motion)                        2009), and computation of speed from acceleration (Galloux et al.,
     versus its derivative (speed).                                                             1994) are a few examples of integration in motion analysis.
       Figure 3.9 shows the motion (first graph) and the velocity (second                          The integration of a function or data involves computing the area
     graph) of vertical motion of the head of the horse.                                        beneath the time curve. In most cases the time interval is constant,
                                                                                                because of constant sample rate of measurement equipment, e.g.
                                                                                                camera, force plate, EMG, and accelerometer, etc. It makes it very
     Increasing, decreasing and finding a local maximum or
                                                                                                easy to determine the area under the expected curve between two
     the minimum (extreme values)                                                               sample values.
     The derivative of data or a function can provide information about                            Figure 3.10 shows how the area under a curve can be calculated.
     any increase or decrease in the function and position of extreme                           The first step is computation of area of the square (side length =
     values.                                                                                    first sampled acceleration a1, Δt1 = sample interval) A1 = a1 × Δt1.
       Since the differentiation is the local linearization, the curve can                      The rest of the area is a right-angled triangle (side length a = differ-
     be replaced by tangents in every time point. We presented here only                        ence between the first and the second sampled acceleration a2 − a1,
     the simple linear method of differentiation (Fig. 3.8). More point                         side length b, Δt1 = sample interval) A2 = (a2 − a1) × Δt1/2.
     methods (e.g. 5-point) based on the Taylor series are often used.
                                                                                                      A s,1 = A  + A ∆ = a1*∆t1 + (a 2 − a1 )*∆t1/2 = (a1 + a 2 )*∆t1/2
                                                                                                                            ∆t
                                                                                                       As = ∑ i =1(ai + ai +1 ) ⋅
                                                                                                                n
                                                                                                                               + abegin (= Sum area under the curve)
                                                                                                                             2
                                                                                                             ai … samples, ∆t … time interval
                                   1.66
                                                                                                The equation above shows the calculation of the area for one inter-
                                   1.64
                                                                                                val and then for n sampled values (n-1 intervals).
                                   1.62
     Vertical motion of the
       horses' head (m)
                                    1.6
                                   1.58
                                   1.56
                                   1.54                                                         ∆t1=∆t2=∆t
                                   1.52
                                    1.5                                                                 Acceleration
                                          0        0.5           1              1.5   2   2.5
                                                                     Time (s)
                                      1
                                    0.8                                                          a2
                                    0.6
     Velocity of vertical motion
     of the horses' head (m/s)
                                    0.4
                                    0.2
                                      0
                                   -0.2                                                                                (a2-a1) *∆t1/2
                                                                                                 a1
                                   -0.4
                                   -0.6                                                                                   a1 *∆t1
                                   -0.8
                                     -1
                                          0        0.5           1              1.5   2   2.5                             ∆t1                   ∆t2
                                                                                                                                                                 Time
                                                                     Time (s)
     Fig 3.9  Differentiation of a signal.                                                      Fig 3.10  Calculation of the integral.
64
                                                                                                                                                      Signal processing
              1500                                                                                        -1
              1000                                              Stride length
               500                                                                          Fig 3.12  A rotating pointer giving a sine curve.
                 0
                           0.5             1              1.5           2             2.5
               -500
                                               Time (s)
                                          Horizontal motion
              4500
              4000        Horizontal hoof motion
              3500        Motion of the treadmill
                                                                                                 SL     SR        SL      SR        SL          SR     SL      SR
Motion (mm)
              3000
              2500
                                                                                             A                                                                      B
              2000
              1500                                                                          Fig 3.13  (A) Vertical head motion of a sound trotting horse. (B) Vertical head
              1000                                                                          motion of a trotting horse with a supporting forelimb lameness of the left
               500                                                                          extremity. SL, stance left; SR, stance right.
                 0
                      0    0.5             1           1.5              2             2.5
                                                 Time (s)                                   chewing motion without the movement of the whole head (Niederl
                                                                                            et al., 2006).
                                 Added motion of hoof and treadmil
              10000                                                                         Fourier analysis (time domain –
               9000                                                                         frequency domain)
               8000                                                                         The Fourier transform is named in honor of the French mathemati-
Motion (mm)
                                                                      Stride length         cian Jean Baptiste Joseph Fourier. The Fourier analysis is the most
               7000
                                                                                            important tool in signal processing. It is used in digital image pro-
               6000                                                                         cessing, medical image processing (CT, MRI, ultrasound, etc.) as
                                                                                            well as in engineering (communication, electrical and mechanical
               5000
                                                                                            engineering) and physics (optics, mechanics, etc.). The Fourier
               4000                                                                         transform separates a signal into sine waves with different frequen-
                      0    0.5             1           1.5              2             2.5   cies, whereas the inverse Fourier transform composes the time curve
                                                 Time (s)                                   from its frequency components. In other words the Fourier trans-
                                                                                            form takes a signal from the time domain to the frequency domain
Fig 3.11  Difference between firm ground and a treadmill motion (coordinate
transform).
                                                                                            and the inverse Fourier transform takes a signal from the frequency
                                                                                            domain to the time domain (Nambu et al., 2000).
                                                                                               Gait is a periodic process, so it can be compared to the motion
                                                                                            of a wheel. The motion of a wheel will be described by a sine func-
                                                                                            tion (Fig. 3.12).
                                                                                               A useful analogy is to interpret the Fourier analysis as a curve
Transformation of the coordinate system                                                     fitting tool, which uses only sinusoidal curves (sine and cosine). A
A coordinate transformation is a conversion from one system to                              very simple example is the vertical motion of the head, withers or
another to describe the same space. For example, in case of a com-                          sacral bone in walk and trot. Walk and trot are symmetrical gaits
parison of data from a moving horse on firm ground to data from                             and therefore used for lameness or symmetry evaluation. Figure
a horse moving on a treadmill a coordinate transformation is neces-                         3.13A shows the vertical motion of the head of a sound horse. The
sary. In this simple case, the horizontal excursions of the horse and                       head is lowered during both stance phases, i.e. twice in a motion
the treadmill have to be added. Figure 3.11 shows the difference                            cycle. This curve can be represented by a sine wave twice the fre-
between the motion signal on firm ground (first graph) and on a                             quency of the motion cycle.
treadmill (second graph). The third graph shows the transformed                                If the horse is severely lame on one of its front limbs, the head
motion (from treadmill to firm ground).                                                     motion changes. The head is then lowered only during the stance
   The description of the skeletal-system movement involves the                             phase of the sound limb and is less lowered during the stance phase
definition of specific sets of axes or frames that are either global or                     of the painful limb (Fig. 3.13B). It is now evident that the vertical
local (Cappozzo et al., 2005). The origin of the coordinate system                          motion of the head of the horse can be represented by a sine wave
has to be fixed on the belt where only the backward-movement is                             with the frequency of the motion cycle.
taken into account. It makes the trajectories of the fore and back                             Normally both frequency parts are included in the vertical head
movements comparable. This is a translation of the coordinate                               motion. So it is easy to calculate the symmetry index from this
system. A universal translation includes translations in the direction                      sinusoidal wave. The Fourier analysis decomposes the curve to these
of all the three coordinates (x, y, z) and two rotations, e.g. a coor-                      frequency parts (Peham et al., 1996, 1999, 2001d; Audigie et al.,
dinate system is fixed on the head of the horse to observe the                              2002). Sha et al. (2004) used Fourier series to determine the skin
                                                                                                                                                                              65
       3          Signals from materials
Mag. (dB)
                                                                                  Fig 3.16  Shows the necessary filter parameters. Apass, ripple range of the
                       Signal                                                     passband; Astop, attenuation of the stopband; Fs, sample frequency; 0-Fpass,
                                                                                  frequency range of the passband; Fstop-Fs/2, frequency range of the
                                                                                  stopband.
           HP                        LP
                                                                                  Filtering
           DS/2                     DS/2
                                                                                  Filtering of the collected data is crucial in signal processing. The
                                                                                  ideal filter will separate noise from the wanted signal, based on their
      Level 1 Coeff.                                                              different frequency content. In reality there is never a perfect separa-
                                                                                  tion between noise and signal. Filtering the collected data is, there-
                                                                                  fore, always a compromise between removing too much of the noise
                                                                                  and too much of the signal (Strampp & Vorozhtsov, 2004; Meffert
                        HP                        LP
                                                                                  & Hochmuth, 2004; Werner, 2006).
                                                                                     As we will see in the following example, differentiation needs a
                       DS/2                       DS/2                            low-pass filter, because of its characteristic to gain higher frequency
                                                                                  parts (Giakas & Baltzopoulos, 1997; Bisseling & Hof, 2006). The
                                                                                  frequency range of equine motion lies between 0 and the half of
                   Level 2 Coeff.                                                 the sampling frequency. In walking humans with a stride frequency
                                                                                  of 1 Hz, the highest harmonics were found to be in the toe and heel
                                                                                  trajectories, and it was found that 99.7% of the signal power was
                                    HP                      LP                    contained in the lower seven harmonics (below 6 Hz) (Winter,
                                                                                  1990). In most cases sampling frequencies of 100 Hz are used.
                                                                                  Clayton (1996) stated as a guideline that a digital low-pass filter
                                    DS/2                    DS/2                  with a cut-off frequency of 10–15 Hz is adequate for most video-
                                                                                  graphic studies on equine gait.
                                           Level 3 Coeff.                            It is generally assumed that raw surface EMG should be high-pass
                                                                                  filtered with cut-offs of 10–30 Hz to remove motion artifact before
     Fig 3.15  The wavelet decomposition of a signal via filter cascades. DS/2,   subsequent processing to estimate muscle force (Potvin & Brown,
     down-sampling by a factor of two; HP, high-pass; LP, low-pass.               2004).
                                                                                     If peak values are detected (e.g. EMG signal processing determines
                                                                                  the peak envelope), this will lead to an overestimate of the values.
     displacement over the radius. Back et al. (2006) showed changes in           This can be avoided by the use of low-pass filtering. On the other
     the frequency spectrum at impact between differently shod horses.            hand the cut-off frequency of the low-pass filter influenced the peak
     It is necessary to know the concept of the Fourier transform to              values obtained with the largest changes occurring between 15 and
     understand the following.                                                    40 Hz. Typically, researchers using lower sample rates have to filter
        The Fourier transform is limited when the frequency is changed            around 10 Hz and consequently are likely to underestimate peak
     during the measurements, i.e. when a horse accelerates or changes            angular velocities (Digby et al., 2005).
     the gait. In this case when the signals are non-stationary, Fourier             It is nearly impossible to determine the time occurrence in unfil-
     transform is not sufficient. The first attempt to fix this problem was       tered EMG signals (Durkin & Callaghan, 2005; Ives & Wigglesworth,
     to use very short time windows, but it has the disadvantage that             2003).
     resolution of the frequency scale is very wide (frequency resolution            The filter characteristic will be determined in the frequency
     = 1/duration of time window). The wavelet transform solves this              domain. In motion analysis, filters with a special transfer function
     dilemma of resolution to a certain extent (Fig. 3.14). Barrey and            are used. Most of this transfer functions are named to honour the
     Galloux (1997) used the wavelet transform to analyze acceleration            mathematicians who developed the transfer function or shape
     of jumping horses. Burn et al. (1997) decomposed the impact accel-           (polynomial) of the filter. The most popular are Butterworth (see
     eration (instationary signal) of jumping horses.                             Fig. 3.17), Chebyshev and Cauer.
        In short, the wavelet transform uses variable time windows (Fig.             The filters are defined by their type or polynomial (Butterworth,
     3.14) and therefore results in a time to frequency relation, a variable      Chebyshev or Cauer), order of the polynomial (e.g. third order,
     frequency scale and an efficient resolution in frequency domain              fourth order, etc.) and cut-off frequency used.
     (Meffert & Hochmuth, 2004; Strampp & Vorozhtsov, 2004; Polikar,                 The first step of filter design is to define the cut-off frequency. The
     1995). Figure 3.15 shows the analysis process of the signal via              cut-off frequency is the frequency where signal is attenuated by 3 dB
     wavelets. The signal will be low-pass and high-pass filtered and then        (square root of two, i.e. 1.41). It is possible to construct low-pass,
     the sample frequency will be reduced by a factor of two. This will           high-pass, band-pass and band-stop filters. See Figures 3.16 and
     be done iteratively (Fig. 3.15). Keegan et al. (2003) used the wavelet       3.17. In motion analysis the most common type is the Butterworth
     transform to detect lameness in horses.                                      filter.
66
                                                                                                                                         Signal processing
1.2                                                                                                1.66
                                      N=1           N=3       N=10
                                                                                                   1.64
 1                                    N=2           N=4
                                                                                                   1.62
0.8                                                                                                 1.6
                                                                             Motion (m)
0.6                                                                                                1.58
                                                                                                   1.56
0.4
                                                                                                   1.54
0.2                                                                                                1.52
                                                                                                    1.5
 0                                                                                                        0   0.5   1              1.5    2          2.5
      0         2            4              5             6          10
                                                                                A                                       Time (s)
Fig 3.17  Shows the influence of the order N to the filter characteristic.
                                                                                                     2
                                                                                                    1.5
                                  2             1                                                    1
                            H(ω ) =                  2N
                                          ω                                                       0.5
                                       1+  
                                           ωc 
                                                                             Velocity (m)
                                                                                                     0
where N is the order of the polynom, ω standardized frequency, ωc                                  -0.5
standardized cut-off frequency.
                                                                                                     -1
   In comparison to the other filter types the advantage of a But-
terworth filter is, that the signal distortion is low (linear phase).                              -1.5
Disadvantages are the relative wide transition range and the high                                    -2
order compared to Chebyshev and Cauer filters.
   The term ‘spline’ stems from shipbuilding. A spline is a curve                                  -2.5
                                                                                                          0   0.5   1              1.5    2          2.5
which connects given data points (samples) smoothly. So this
method is very useful in motion analysis. It can be used to smooth              B                                       Time (s)
data, then it is called smoothing spline, or as a curve fitting tool to
                                                                                                   300
fill gaps in the trajectories from incomplete measures (missing
data), or to resample data (curve fitting, calculation of the new
samples). In more detail, a function in most cases, cubic splines                                  200
(polynom of the third order) will be fitted in the data by optimizing
squared residuals (Vint & Hinrichs, 1996).
   The following section will show the necessity of low-pass filtering                             100
                                                                             Acceleration (m/s2)
                                                                                                     0
Differentiation in time and frequency domain
How to calculate a derivative is explained earlier. Figure 3.18 shows                              -100
real data of vertical motion, velocity and acceleration of the head
of a horse. Noise increases with every derivation. The wanted signal
has disappeared in the acceleration. What is the reason for this                                   -200
increase in noise?
   In the time domain, the derivative is divided by time/interval.
How are time and frequency related?                                                                -300
   If the duration of the period of a cosine wave is one second, the                                                    Time (s)
frequency of this signal is one Hertz. If the duration is half a                C
second, the frequency of this signal is two Hertz. The frequency is          Fig 3.18  Effect of derivation of an unsmoothed signal. Noise is increasing.
related to the reciprocal value of the time. If signal is divided            In the graphs of velocity and acceleration and the actual signal disappears.
by time in the time domain, the same operation in the frequency
domain will be a multiplication by the frequency (see Fig.
3.19). A signal part, two times derivated at 1 Hz, is multiplied by
1 (12); a signal part, two times derivates at 2 Hz, is multiplied            Integration in time and frequency domain
by 4 (22); and a signal part, two times derivates at 3 Hz is multi-          The method of calculating an integration has been explained earlier.
plied by 9 (32).                                                             Figure 3.20 gives an example of an integrated EMG. See also resa-
   This behavior is similar to a high-pass filter. High frequency parts      mpling. It is obvious that the noise is reduced by calculating the
are amplified in comparison to low frequency parts. Noise is pro-            integral of the EMG. What is the reason for this smoothing?
portional to the bandwidth (frequency range). Now it is clear why               In the time domain, the integral was calculated by determining
noise is amplified. So we have to limit the bandwidth by a low-pass          the area under the curve. This was done by a multiplication of time
filter to get representative results (Uhlir et al., 1997). Figure 3.9        (amplitude × time). Now we know that time is related to the fre-
shows the same data as Figure 3.18 but band-limited by low-pass              quency by the reciprocal value. In the frequency domain, the
filtering.                                                                   frequency parts are divided by their entire frequency.
                                                                                                                                                             67
                  3           Signals from materials
Amplitude Amplitude
D=2*π*f 1=1/2*π*f
                                                                    Frequency                                                                            Frequency
                          1 Hz    2 Hz       3 Hz     4 Hz                                              0.5Hz 1Hz      2Hz      3Hz         4Hz
                  Amplitude
                                                                                                           Amplitude
                                                                    Differentiated signal =
                                                                    signal*frequency
                                                                                                                                                         Integrated signal =
                                                                                                                                                         signal/frequency
                                                                    Frequency
                          1 Hz    2 Hz       3 Hz     4 Hz                                                                                               Frequency
     Fig 3.19  Effect of the derivation to the signal. Differentiation is a multiplica-                 0.5Hz 1Hz      2Hz      3Hz         4Hz
     tion by the frequency. If the bandwidth is not limited, the noise of the higher
     frequencies will be amplified and the signal to noise ratio will be very low.                      Fig 3.21  Effect of the integration. Lower frequency parts are amplified and
                                                                                                        higher frequency parts are dampened.
                  400
                  350                                                                                   is much easier in the frequency domain, because the convolution
                  300                                                                                   integral in time domain corresponds to a multiplication in the
                                                                                                        frequency domain. Therefore, in most cases the filters are developed
                  250
     IEMG (mVs)
        Figure 3.21 shows a signal in the frequency domain. The inte-                                                                                    output(ω )
                                                                                                                             transfer function(ω ) =
     grated signal part at 1 Hz is divided by 1; the integrated signal part                                                                               input(ω )
     at 2 Hz is divided by 2; and the integrated signal part at 3 Hz is                                 Peham and Schobesberger (2006) used the transfer function to
     divided by 3. This procedure gives us smoothed data and is com-                                    calculate the elasticity of the equine back by relating the EMG of
     parable to the moving average using two neighboring data points.                                   the long back muscle as input to the motion of the horses back as
     This is similar to a low-pass filter, because low frequency parts                                  output. The transfer function was developed in a differential equa-
     (below zero) are amplified and high frequency parts are dampened.                                  tion of second order and compared to the motion equation.
     In other words, a moving average reduces the samples by the                                           The convolution is similar in nature to the cross correlation (CC).
     number of data points that are included.                                                           The convolution calculates the CC of two signals whereas the
                                                                                                        reverse function of the second signal is used. The CC can be used
     System analysis in time and frequency domain                                                       to compare two different signals or find the content of one signal
                                                                                                        in the other signal. Strobach et al. (2006) used CC to show the limb
     (convolution, special filters)                                                                     coordination of ataxic, sedated and sound horses (by using the CC
     If special characteristics of the data are known, it is possible to                                to compare the motion of different limbs). Peham et al. (1996)
     develop a filter characteristic adapted to the wanted signal. Peham                                used CC to determine the wanted signal parts of vertical head
     et al. (1996) used this to filter the vertical head motion. Peham et al.                           motion, which were necessary for lameness evaluation.
     (2001b) filtered electromyographic signals of the left and right lon-                                 The auto-correlation is the CC of a signal with itself. This can be
     gissimus dorsi muscles, middle gluteal muscles and triceps brachii                                 used to find periodic elements in the signal or to determine, e.g. the
     muscle of horses walking on a treadmill with a special signal                                      stride frequency of a motion signal. Strobach et al. (2006) used the
     adapted filter characteristic. In both cases, the transfer function was                            auto-correlation to show the differences in the gait pattern in ataxic,
     developed from the motion of the limb.                                                             sedated and sound horses. If the auto-correlation was high, a stable
        In the time domain, the convolution integral of the signal and                                  motion pattern was present. Peham et al. (2001b) used the auto-
     the transfer function has to be calculated to get the filter signal. This                          correlation to calculate the signal to noise ratio.
68
                                                                                                                                                 Signal processing
Categorical Continuous
Yes No
   Kalman filters are used to estimate the dynamical behavior of                        Artificial neural network
linear systems. Halvorsen et al. (2008) used Kalman filtering to
exclude skin-movement of the distal part of the limb of horse.                          Artificial neural network (ANN) is a method of highly sophisti-
                                                                                        cated decision-making. ANN, often just called a ‘neural network’
                                                                                        (NN), is a mathematical model or computational model inspired
Decision-making                                                                         from biological neural networks. It consists of a network of inter-
Signal processing is necessary to interpret the signal or characteris-                  connected group of artificial neurons. The artificial neurons are
tics of the signal. To get reliable information from the processed                      in most cases switches that will be activated if a certain input
signal, statistics are needed to reflect trends, if any. Figure 3.22                    threshold is reached. Combination, activation and weight of
shows a simple flow chart regarding selection of an appropriate                         neurons are adapted to the problem. So an ANN is an adaptive
statistical test. A more detailed discussion of statistical methods is                  system that changes its structure based on external or internal
given by Hopkins (2007).                                                                information that flows through the network during the learning
                                                                                        phase.
                                                                                           An overview of ANN in motion analysis is given by Schöllhorn
Fuzzy logic                                                                             (2004).
The classical (binary) logic distinguishes between two values ‘black’                      In more practical terms neural networks are non-linear, non
and ‘white’. This binary logic implies the law of the excluded                          parametric statistical data modeling tools. They can be used to
middle, which states that for all propositions, either black or white                   model a complex relationship between inputs and outputs or
(not black) must be true, there being no middle true proposition                        to identify patterns in data (Schöllhorn, 2004; Jang et al., 1997).
(gray) between them.                                                                       Savelberg et al. (1997a) used ANN as a tool for complex calcula-
  It was Jan Łukasiewicz who first proposed a systematic alternative                    tion to determine ground reaction forces in horses with hoof wall
to the bi-valued logic of Aristotle and described the 3-valued logic                    deformation. Further use of ANN was seen for computing tendon
(black-gray-white), with the third value being possible (Jang et al.,                   forces from EMG data in cats (Savelberg et al., 1997b) and for cal-
1997).                                                                                  culation of fore and back force from pressure data (Savelberg et al.,
  Fuzzy sets have been introduced by Lotfi A. Zadeh (1965) as an                        1999).
extension of the classical notion of set. In classical binary set theory,                  Use of ANN as a decisive statistical tool was shown by Schobes-
two states (black and white) are possible. Other states are not ele-                    berger and Peham (2002). They used a multilayer feed forward ANN
ments of the set. By contrast, fuzzy set theory permits the gradual                     to quantify lameness in horses. The classification via ANN was
assessment of the membership of elements in a set (e.g. 50% of                          correct in 78.6% of cases. They concluded that after proper training,
black and 50% of white gives us gray). Let us say, ‘fuzzy logic is                      ANNs were potentially capable of making a non-human diagnosis
more adapted to the (bio-) logic of the real world, because in the                      of equine lameness.
real world (life) there are always more than two colors or a fixed                         Schöllhorn et al. (2006) showed that a Kohonen map (a special
number of solutions’.                                                                   type of ANN; it compares the input data with standard data by
  Fuzzy clustering is used in clinical motion analysis to distinguish                   vector products) combined with a cluster analysis is sensitive
between sound and lame gait patterns. Keegan et al. (2004) used                         enough to identify a specific motion pattern in the horse-rider
fuzzy clustering to detect spinal ataxia in horses.                                     interaction.
                                                                                                                                                                     69
       3      Signals from materials
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                                                                                                                   C H A PTER            4 
                                            Locomotor neurobiology
                                            and development
                                            Albert Gramsbergen
                                                                                                                                                 73
       4      Locomotor neurobiology and development
74
                                                                                                                Muscles, motors of movements
distribution of fiber types in sections taken perpendicular to the       storage of large quantities of glycogen for rapid use in type II
longitudinal axis of the muscle at several levels. Multiple biopsies     muscle fibers.
only allow an approximation of such data. In a classical method
of processing (Dubowitz & Brooke, 1973), the muscle material is          Summary
preincubated at different pHs and the ATPase staining technique
then enables differentiation of the muscle fiber types. More recent      Muscles are composed of type I muscle fibers (slow-twitch, fatigue-
methods apply myosin-related antibodies to identify several sub-         resistant) type IIA fibers (fast-twitch, moderately fatiguable) and
types of muscle fibers (Schiaffino et al., 1986). Investigations with    type IIB (fast-twitch, fatiguable); intermediate types also exist.
these methods have demonstrated that all muscles consist of a
mixture of type I, type IIa and type IIb muscle fibers, but the rela-
tive proportions of these fibers differ greatly. Extremity muscles
                                                                         Muscular development
and particularly the flexor muscles may contain higher propor-           Muscle cells or myocytes develop by the fusion of a longitudinal
tions of type IIa and IIb fibers and fewer type I muscle fibers. The     array of mesenchymal cells. The first generation of these multinu-
antigravity muscles in the extremities, in contrast, contain             clear myoblasts, extending from tendon to tendon, are the primary
increased proportions of types I and IIa muscle fibers. This is          myotubes. Each of these is soon innervated by a multitude of moto-
understandable when realizing that these muscles have to carry           neuronal axons. At a later stage, a second generation of secondary
the weight of the animal for long periods of time. The propor-           myotubes develops in the vicinity of the middle region of the pri-
tions of type I muscle fibers are particularly pronounced in the         maries. The secondary myotubes also are initially innervated by
soleus muscle in the hind legs, and portions of the flexor carpi         multiple motoneuronal axons (Ontell & Dunn, 1978; Goldspink &
ulnaris muscle in the forelegs. In these muscles, the type I             Ward, 1979; Bennett, 1983). During further development, the con-
muscles fibers may be as high as 100% (e.g. in rats). It is note-        tractile proteins actin and myosin increase enormously in the myo-
worthy that the type I fibers both in the extensors and the              tubes of both types. The motor endplate develops its folded
flexor-muscles are mostly concentrated in the deeper portions            appearance and from a certain stage of development these cells have
of the muscles, close to the skeletal elements (Wang & Kernell,          acquired the characteristics of the mature myocyte. It is generally
2001). Similar data have been obtained in horses (Grotmol                accepted that the primary myotubes are the precursors of type I
et al., 2002).                                                           muscle fibers and the secondary myotubes of the type II muscle
   The trunk muscles also contain elevated percentages of type I         fibers (see Wilson et al., 1988).
and IIa muscle fibers. This holds particularly for the multifidus and       Wilson and coworkers studied in rats the effects of severe under-
the longissimus muscles in the back (Gramsbergen et al., 1996).          nutrition from early gestation and through the lactation period on
Similar results have been obtained in horses (Gellman et al.,            muscular development. The number of primary myotubes remained
2002). The high percentage of type I and IIa muscle fibers make          unaffected but they detected a dramatic decrease in the number of
these particular muscles fatigue resistant and therefore these           secondary myotubes. These and other results has led them to
muscles are ideally suited for postural functions, such as keeping       hypothesize that the development of primary myotubes is geneti-
the trunk straight and carrying the body weight (for a review on         cally determined while that of the secondary myotubes is suscep-
regional differences in the distribution of type I and type II muscle    tible to environmental factors, such as under-nutrition, hormonal
fibers, see Kernell (1998)).                                             factors and also training (Wilson et al., 1988). In addition, non-
   Horse breeds differ in the size and composition of their muscles.     differentiated satellite cells develop and these cells may differentiate
Horses of some breeds are heavily built with bulky muscles that          at a later stage into myocytes after damage to the muscle or after
have a large cross-sectional area and these horses are kept in order     training.
to sustain enduring agricultural or transportation tasks. Their             The muscle-fiber type distribution within muscles is, to some
muscles contain large proportions of type I and type IIa muscle          extent, related to their topological origin. The muscles in the trunk
fibers which are able to produce forces for long-lasting periods (see    arise from the segmentally arranged myotomes. The intercostal
Miyata et al., 1999). Horses of other breeds are characterized by a      muscles (together with the rib and the spinal cord segment inner-
slender and athletic build that is appropriate for speed racing. Their   vating these muscles) have clearly retained this segmental origin in
muscles have increased proportions of type II muscle fibers that         all mammals. But, the long muscles in the neck and in the back,
allow them to produce immense forces but only for relatively short       the abdominal muscles and the diaphragm are also of axial origin.
periods of time.                                                         These muscle are particularly important for the stabilization of the
   Investigations in man with EMG recordings and, in addition,           trunk and the head and, therefore, for postural control. At adult age,
power spectral analysis of the EMG and the calculation of EMG-           the trunk muscles contain high proportions of slow-twitch, fatigue-
fatigue indices, indicated that loading for long periods induces the     resistant muscle fibers.
recruitment of satellite cells in the muscle (see below), their devel-      The muscles in the four legs arise from limb buds. The limb buds
opment into muscle cells and a relative increase in type II muscle       develop at the ventrolateral aspect of the body axis and these origi-
fibers (Mileva et al., 2009). Investigations, e.g. in rats, have shown   nate from groups of mesenchymal cells which migrated from the
that per individual muscle the number of type I muscle fibers            trunk. The extensor muscles in the limbs (e.g. the gastrocnemius
remains unchanged (or, is genetically determined; see Wilson et al.,     and the quadriceps muscles in the hind leg) develop from the
1988; see also, Mileva et al., 2009) and Mileva’s results, therefore,    ventral plates in the buds and they are involved in ‘anti-gravity’ tasks
point towards an absolute increase in type II fibers. Other investiga-   such as standing, and also in the heel strike phase of walking and
tors suggest, in contrast, that training may influence the fiber type    running. These muscles later contain considerable percentages of
distribution of muscles by shifts in the numbers of both type I and      type I muscle fibers. The flexor muscles develop from the dorsal
type II fibers (e.g. Duclay et al., 2009).                               plate in the limb bud, they are particularly active during the swing
   Other training effects are hypertrophy of muscle fibers as indi-      phase of the leg and these muscles contain increased proportions
cated by an increase in their cross sectional area, increases            of type II muscle fibers.
in mitochondrial content (important for aerobic glycolysis)
(Grünheid et al., 2009), changes in muscular architecture (which
might be secondary to the muscle fiber hypertrophy) (Duclay
                                                                         Summary
et al., 2009), as well as vascular changes by angiogenesis and an        Muscles develop, cytologically, from primary and secondary myo-
increase in arteriolar density (for review, Laughlin and Roseguini       tubes. Trunk and extremity muscles originate from myotomes and
(2008)). Short-term effects of training aim at increasing the            limb buds, respectively.
                                                                                                                                                    75
       4      Locomotor neurobiology and development
     The motor unit and motoneurones                                           (Wang et al., 2002). Therefore, the polyneural innervation at first
                                                                               and its regression thereafter should rather be regarded as a fine-
                                                                               tuning in the matching-process.
     Groups of muscle fibers in a muscle are innervated by one moto-
     neuron in the spinal cord (or in the brain stem) and the complex
     of an α-motoneuron, together with the muscle fibers, is called a          Summary
     ‘motor unit’. All muscle fibers of a motor unit tend to have identical    Muscle fibers initially are polyneurally innervated. Mononeural
     physiological properties (such as twitch speed and relaxation time)       innervation develops by a regressive process before the muscle is
     and these properties match the physiological and morphological            involved in its adult functioning.
     properties of the motoneurons.
        Research mainly in cats, has indicated that the small-sized moto-
     neurons innervate the type I muscles fibers and in neurophysio           Size principle
     logical research, these units have been coined ‘S-type units’             The motoneurons within a motoneuronal pool differ in their sizes
     (slow-twitch, fatigue-resistant). Motoneurons of intermediate sizes       (see above). Henneman & Mendell (1981) have demonstrated that
     innervate type IIa muscle fibers and physiologists have distinguished     within a motoneuronal pool, the motoneurons are recruited in an
     ‘FR-type units’, fast-twitch, fatigue-resistant units and ‘Fint-type      orderly fashion from small to large, with increasing intensities of
     units’, with fast-twitch and intermediate fatigue-resistant units. The    neuronal drive (e.g. from higher brain centers). During motor tasks
     largest motoneurons are part of the ‘FF-type units’, innervating type     which require only low muscle forces only the smallest motoneu-
     IIb muscle fibers; these units are fast-twitch and fatigable (Burke,      rons are activated (these motorneurons innervate groups of type
     1981).                                                                    I-muscle fibers). With increasing forces, additional motoneurones
        The motorunits systematically differ in the numbers of muscle          with larger sizes are recruited, first those with FR properties, later
     fibers which are innervated by the motoneuron. The smaller moto-          those with Fint properties and finally the FF units are activated with
     neurons innervate relatively small numbers of type I muscle fibers.       their large numbers of type IIb muscle fibers. This orderly recruit-
     Both the low tension produced by each of these fibers and the rela-       ment of motoneurons is related to differences in the membrane
     tively small number of muscle fibers in each of these units, explain      properties of the smaller and larger motoneurons. Interestingly, the
     why these units produce relatively low forces. The larger motoneu-        relative force-increase by recruiting additional motor units at adult
     rons innervate larger numbers of (type II) muscle fibers. Each of         age is more or less the same over a wide range of forces (Milner-
     these fibers produce higher tensions, and consequently these units        Brown et al., 1973) and this leads to a smooth increase of force
     produce relatively large forces (for a review see Kernell, 2006).         with increasing intensities of neuronal drive.
     Summary                                                                   Summary
     Small motoneurons innervate a group of slow-twitch, fatigue-              Motoneurons are recruited in an orderly fashion from small to
     resistant muscle fibers, producing low forces, motoneurons of inter-      large, with increasing intensities of neuronal drive.
     mediate sizes innervate groups of fast-twitch, intermediate-fatigable,
     and the largest neurons produce strong forces by their fast-twitch,
     fatigable muscle fibers.                                                  Dendrite bundles
                                                                               Apart from their size, motoneurons also differ in the morphology
                                                                               of their dendritic tree. The motoneurons in particular pools have
     Development of muscular innervation                                       their dendrites running in bundles both in a longitudinal direction
     At early stages of development, muscle cells are innervated by more       as well as in transverse directions, while in other motoneuronal
     than one axon (see above) and this is known as polyneural innerva-        pools such organization is absent. Motoneurons with dendrite
     tion. Later, and already in early development, this multiple inner       bundles have been described in cats (Scheibel & Scheibel, 1970), in
     vation of muscle cells is replaced by mononeural innervation (for         rats (Gramsbergen et al., 1996) and in the human spinal cord
     reviews, Bennett, 1983; Jansen & Fladby, 1990). Research from             (Schoenen, 1982) and because of their wide occurrence it seems
     many groups has indicated that this regressive process is near com-       highly likely that dendrite bundles also occur in the horse’s spinal
     pletion when the behavioral function in which the muscle is               cord. Dendrite bundles consist of up to 15 dendrites in close vicin-
     involved has developed (Gramsbergen et al., 1997). Rats are a pre-        ity for several hundreds of millimeters (Fig. 4.1), and connected via
     cocious species and they are born at an early stage of brain develop-     long-stretched gap-junctions (Matthews et al., 1971; van der Want
     ment. Still, mononeural innervation of respiratory muscles in this        et al., 1998). Dendrite bundles specifically occur in pools of axial
     species has already been reached at birth when the animals start          muscles in the trunk and neck as well as in pools of anti-
     breathing continuously. On the other hand, in the psoas muscle in         gravity muscles in the extremities (notably, the soleus and the
     the hind leg, this regression of polyneural innervation is only com-      gastrocnemius muscles in the hind limb and the flexor carpi ulnaris
     pleted around the 16th postnatal day (IJkema-Paasen & Gramsber-           muscle in the forelimb). Interestingly, these are the very muscles
     gen, 1998). This is precisely the point at which they start the           that contain high percentages of type I muscle fibers.
     adult-like pattern of walking. Horses are a precocious species, born         The physiological significance of dendrite bundles is not known
     with a nervous system at an advanced stage of development. They           but one possibility is that they serve to electrotonically couple
     are able to stand and walk shortly after their birth and, therefore, it   motoneurons in pools stretching over several spinal cord segments
     is safe to postulate that most of their muscles are mononeurally          which innervate long muscles, e.g. in the back or abdomen. Our
     innervated from birth.                                                    study into the development of the dendritic tree of motoneurons
        It has been suggested that the great excess of axons innervating       innervating the soleus muscle (mainly consisting of type I muscle
     the primitive muscle fibers at early stages and the selective regres-     fibers) revealed that, until the 14th postnatal day in rats, the den-
     sion of supernumerary nerve fiber-endings thereafter plays a role in      drites of these neurons run in a seemingly disorganized fashion.
     matching the properties of muscle fibers to those of the motoneu-         From that age, however, the dendrites reorganize into prominent
     rons (O’Brien et al., 1978; Greensmith & Vrbova, 1991). More              bundles. This fast development coincides with the occurrence of the
     recent research has indicated, however, that even at the earliest         adult-like walking pattern in rats. On the other hand, the dendrites
     stages ingrowing axons follow a trajectory towards a specific mus-        of the motoneurons innervating the tibialis anterior muscle (a
     cular region with a preponderance of particular muscle fiber types        flexor muscle, and the antagonist to the soleus muscle) do not
76
                                                                                                                                                     The motor unit and motoneurones
Fig 4.1  Motorneuronal pools of the longus capitis muscle: (A) microphotograph and (B) reconstruction of another pool. Bars: 100 µm.
Reprinted from Gramsbergen, A., Ijkema-Paassen, J., Westerga, J., Geisler, H.C., 1996. Dendrite bundles in motoneural pools of trunk and extremity muscles in the rat. Experi. Neuro. 137 (1), 34–42,
with permission from Elsevier.
develop dendrite bundles at any age (Westerga & Gramsbergen,                                         on a treadmill. Forssberg et al. (1980) demonstrated after spinal
1992). The organization of dendrites into bundles depends on the                                     cord transection that the coordination patterns in the limbs follow
ingrowth of descending projections from higher levels as (in rats)                                   the increasing speed of the treadmill, provided that the limb affer-
a spinal cord transection at early age prevents these bundles from                                   ents are left intact. At higher speeds they even observed a gallop-like
developing (Gramsbergen et al., 1995). In cats, such interference at                                 coordination. Shik and Orlovsky (1976) studied cats after spinal
adult ages leads to their hypotrophy or even atrophy (Reback et al.,                                 cord transection when walking on a treadmill with two belts, driven
1982).                                                                                               at different speeds. When the speed differences became too large,
                                                                                                     the frequencies of the CPG stepwise shifted to a 1 : 2 relationship
                                                                                                     and on this basis and other evidence it is considered that each limb
Summary                                                                                              has its own CPG (Fig. 4.2).
                                                                                                        The neural principles involved in CPGs have been elucidated in
Dendrite bundles are typical for motoneuronal pools of muscles
                                                                                                     a series of investigations in the lamprey, a primitive fish which has
with an important postural function.
                                                                                                     a less complex spinal cord than mammals and no extremities. Here,
                                                                                                     each spinal cord segment along the trunk has a CPG which subse-
                                                                                                     quently and with a short phase lag become active. This leads to the
Central pattern generators                                                                           rhythmic curving of the trunk which produces the swimming move-
Walking, trotting or galloping is produced by rhythmic and alter-                                    ments. Grillner and coworkers demonstrated that each spinal cord
nating leg movements in varying patterns. Graham Brown (1914)                                        segment has two networks on the left and right side, each consisting
was the first to demonstrate that such rhythmic and alternating                                      of excitatory and inhibitory interneurons and with motoneurons as
extremity movements can occur even after several dorsal roots of                                     the output elements (Grillner et al., 1991). The networks on both
the lumbar spinal cord have been severed. This demonstrates that                                     sides are connected via inhibitory connections functioning as
proprioceptive feedback is not essential for these movements to                                      coupled oscillators with an output of alternating activation on the
occur. A few years earlier, Sherrington (1910) had demonstrated                                      right and the left side. Networks in adjacent spinal cord segments
that rhythmic limb movements also remain after severing descend-                                     are connected via propriospinal interneurons.
ing projections in the thoracic spinal cord. These results together                                     Based on neuroanatomical and neurochemical data derived from
indicate that local neuronal networks in the spinal cord are able                                    studies in the lamprey, the network was modeled and computer
to autonomously generate rhythmic movement patterns. Brown                                           simulations indicated that increases in the frequency of the most
has coined these assemblies ‘half-centers’ and later they became                                     rostral segment are spread along the spinal cord and this leads to
know as ‘central pattern generators’ (CPGs). Von Holst in 1935                                       higher swimming speeds (Grillner et al., 1991). Such increases in
similarly described that rhythmic swimming movements in tele-                                        speed in natural life are induced by supraspinal influences.
osts remain after transection of the spinal cord and Weiss reported                                     The CPGs for extremity movements in tetrapods obviously are
such results in salamanders after partial deafferentation of the                                     more complex and probably consist of a series of coupled oscilla-
limbs (Weiss, 1936). These results provide strong counterevidence                                    tors for the different muscle groups. In experiments performed in
against the concept of rhythmic limb movements being a chain of                                      the isolated spinal cord of newborn rats by Cazalets et al. (1995)
reflexes.                                                                                            fictive locomotion was recorded from electrical activity in the
   Most of the studies on CPGs for extremity movements have con-                                     ventral roots (see also Kjaerulff & Kiehn, 1996). Cazalets and
centrated on the hind limb. Grillner and Zangger (1975) demon-                                       co-workers showed that the CPG for hind limb movements in the
strated that adult cats with a low thoracic spinal cord transection                                  rat is located in the first lumbar segment. They also identified the
maintained a delicate pattern of orderly starting and stopping of                                    neural transmitters which are involved such as the excitatory amino
EMG activities in the hind limb flexors and extensors during walking                                 acids L-glutamate and aspartate as well as 5-HT, dopamine and
                                                                                                                                                                                                        77
          4      Locomotor neurobiology and development
                                                                                                       Summary
                                                                                                       CPGs in the spinal cord are able to autonomously generate rhyth-
                                                                                                       mical locomotor patterns in the trunk muscles in fish and amphib-
      B                                                                                                iae and in the extremities in quadrupeds and bipeds. Afferent
                                                                                                       feedback and CPGs mutually influence each other. In rats, the CPG
     Fig 4.2  Schematic representation of the neural control of locomotion.                            for hind limb movements is localized in the first lumbar segment.
     (A) Dorsal view. Interlimb coordination is achieved by interaction of the central                 Postural adjustments during walking might be governed largely by
     pattern generators (CPGs) of each of the four limbs. The general level of activity                supraspinal influences.
     in the different generators that are capable of rhythmic activity is set by a
     supraspinal descending command, whereas actual coordination is due to inter-
     action between the four different generators via coordinating neurons. (B)
     Lateral view. The CPG of each limb is influenced by peripheral input from a
                                                                                                       Descending projections
     variety of somatosensory receptors as well as descending influence from supra-
     spinal centers. Through peripheral output pathways, appropriate muscles are                       In vertebrates, the topography of the descending projections in the
     contracted to perform their task and result in intralimb coordination.                            spinal cord to the motoneurones innervating the trunk and extrem-
     (A) Reprinted from Grillner, S., 1975. Locomotion in vertebrates: central mechanisms and reflex   ity muscles reflect to some extent their phylogenetical descent. Axial
     interaction, 55 (2), 247–304, with permission from The American Physiological Society.            muscles in the trunk (the ‘oldest’ muscles from an evolutionary
     (B) Reprinted by permission of the publisher from FUNCTIONAL VERTEBRATE MORPHOLOGY,               perspective) are innervated by medially descending motor projec-
     edited by Milton Hildebrand, Dennis M. Bramble, Karel F. Liem, and David W. Wake, p. 339,         tions as the reticulospinal and vestibulospinal tracts. On the other
     Cambridge, Mass.: The Belknap Press of Harvard University Press, Copyright © 1985 by the          hand, the motoneurones innervating the ‘newer’ extremity muscles
     President and Fellows of Harvard College.                                                         are located laterally in the ventral horn and these are innervated by
                                                                                                       laterally descending tracts.
     GABA. However, the neural elements and the circuitry of these CPGs                                   The medially descending projections, such as the vestibulospinal,
     for rhythmic alternating limb movements in higher vertebrates are                                 reticulospinal and tectospinal projections, are particularly impor-
     still unknown.                                                                                    tant for the innervation of the muscles in the neck and trunk and
        Obviously, locomotion in intact animals is adapted to environ-                                 also muscles in the proximal segments of the extremities. Anatom
     mental constraints. Avoiding an object in the trajectory, walking on                              ical investigations in rats demonstrated that these projections
     a slope or anticipating an unevenness in the path lead to adjust-                                 descend early during neuro-ontogeny.
     ments of the limb excursions or their rhythmicity. Exteroceptive and                                 In quadrupeds, the rubrospinal tract (RST) is particularly impor-
     proprioceptive information influences the extension and flexion                                   tant in the innervation of the motoneurones of the extremity
     phases of the step cycle via segmentally arranged circuitry. Stum-                                muscles. This projection has not been studied yet in horses but it
     bling over unexpected objects on the trajectory leads to adjustments                              seems safe to speculate that in this species this will be the main
     of the step cycle (Rossignol et al., 1988) and other experiments have                             tract involved in adjusting the excitation of motoneurons and in
     demonstrated that increasing the load on the extended limb and                                    steering non-rhythmic extremity movements (such as jumping,
     input from Golgi-tendon organs via group II afferents also leads to                               etc.). The RST arises from the red nucleus and descends contra
     adjustments of the step cycle (Duysens & Pearson, 1980).                                          laterally. In rats and cats, this tract arises mainly from the most
        The CPG itself, in turn, influences the input from proprioceptive                              caudally located magnocellular part and to a lesser extent from the
     afferents. This probably is affected by activating the inhibitory inter-                          rostral parvocellular part. It crosses in the ventral tegmental decus-
     neurons mediating the reciprocal Ia inhibition (Hultborn, 1972).                                  sation and descends via the lateral funiculus. The axons terminate
     Input from the visual and the vestibular system is relayed along                                  upon excitatory and inhibitory interneurons in the spinal cord.
     descending projections and cerebellar circuitry probably plays an                                 The red nucleus receives its major input from the deep cerebellar
     important role in adjustments (see below).                                                        nuclei and possibly also from the motor cortex, both via direct
78
                                                                                                    Central brain mechanisms and locomotion
connections (and in horses possibly via collaterals from Bagley’s        the transitions into other coordination patterns probably are medi-
bundle). The cerebellum and the vestibular complex play an impor-        ated by indirect activation, via noradrenergic projections arising
tant role in the regulation of locomotor movements and the regula-       from the locus coeruleus and adjacent cell groups. These nuclei are
tion of postural maintenance.                                            located close to the MLR and the fiber-projections are part of the
   The CST will be less well expressed in horses (Verhaart & Sopers-     LMS (see above).
Jurgens, 1957) and horses may, in this respect, resemble the expres-
sion of the CST in rabbits. In rabbits, the unmyelinated fibers of the
CST terminate at the 2nd cervical segment (Hobbelen et al., 1992;        The cerebellum
for review see Nudo & Masterton, 1988). Verhaart and Sopers-
Jurgens demonstrated Bagley’s bundle by dissection of the horse’s        The cerebellum plays important roles in adjusting motor com-
brain and concluded that this tract only descends as far as upper        mands during locomotion. Cerebellar lesions in cats and rats (e.g.
spinal cord levels. In horses, transcranial magnetic stimulation on      Brooks, 1975; Gramsbergen, 1982) or cooling of the cerebellum
the skull and the recording of muscle activation in extremity muscles    (Udo et al., 1979) lead to atactic gait and irregularities in foot
might help in future research to elucidate the nature of the descend-    placing, and, for this reason, it is generally considered that the
ing projections (see Nollet et al., 2003).                               cerebellum plays a key role in finely adjusting the limb movements
   Parallel to the projections of the (three) so-called somatic motor    during the step cycle.
systems referred to above (the vestibule- and tectospinal tracts, the       The cerebellum receives massive information from spinal
RST and the CST), another system of diffusely projecting monoami-        sources both from a direct and indirect nature. The projections
nergic fibers, the ‘fourth motor system’ plays an important role in      convey information on the ‘ongoing movements’ (by input from
modulating motor activities. This was termed the limbic motor            premotor neurons, interneurons adjacent to the motoneurons) as
system (LMS) by Kuypers (1982) and the emotional motor system            well as information on the ‘position of limbs and the tension in
(EMS) by Holstege (1991, 1995). The LMS originates in the                muscles’ (by input from muscle spindles and tendon organs). The
medial portions of the hypothalamus and the mesencephalon.               information from both these sources reaches the cerebellum along
Its medial components modulate the excitatory state of interneu-         the ventral and dorsal spinocerebellar tracts respectively. Indeed,
rons and motoneurons via diffusely projecting noradrenergic and          Arshavsky and coworkers (1972, 1986) have recorded rhythmic
serotonergic fibers. An increased excitatory state induces motoneu-      activity in the ventral spinocerebellar in phase with rhythmic
rons being more readily activated by a neuronal drive (e.g. from         activity in the limbs and this is in agreement with the anatomical
suprasegmental levels). The LMS is the earliest of the descending        data. The projections terminate on the parallel fibers in the cere-
projections to develop. At birth in the rat, its fibers have descended   bellar cortex (with collaterals, e.g. on neurons in the deep cerebel-
already to lumbar levels where they have established 5-HT contain-       lar nuclei). The parallel fibers contact the Purkinje cells. The axons
ing synapses (Rajaofetra et al., 1989); in comparison, the CST in        of the Purkinje cells are the sole output of the cerebellar cortex.
the rat has descended to lumbar levels only around the 10th post-           Another important input which is highly relevant for steering
natal day. As the terminals are initially widespread, but at later       locomotor activity stems from the vestibular nuclei and these
stages restricted to the dorsal and ventral horns, Rajofetra hypoth-     give information on the position as well as the movements of
esized that an initial role during early stages of these 5-HT contain-   the head.
ing fibers might be to stabilize the innervation patterns of other          An important indirect input to the cerebellum is via the inferior
projections to the spinal cord.                                          olivary nucleus. The inferior olivary nucleus receives indirect
                                                                         (multisynaptic) information from the spinal cord and several
                                                                         areas in the CNS. Axons from these neurons reach the Purkinje
Summary                                                                  cells in the cerebellar cortex as climbing fibers, each of which has
                                                                         thousands of synaptic contacts with one Purkinje cell (e.g.
The medially descending vestibulospinal and reticulospinal tracts,       Ruigrok & Cella, 1995). The physiological significance of the
project upon motoneurons of axial muscles and these phylogeneti-         input from the inferior olivary nucleus to the cerebellum is still
cally old systems are functional from early stages. The laterally        unclear. In one theory, the climbing fiber system, together with
descending projections project upon motoneurons of extremity             the parallel fiber system (see above), is considered to be decisive
muscles. The cerebellum, via the crossed rubrospinal tract starts its    in motor learning (Marr, 1969). A more recent theory suggests
adult-like functioning at a late stage.                                  that the ION plays an important role in regulating a distributed
                                                                         processing of afferent information in the cerebellar cortex (Llinas
                                                                         & Muhletaler, 1988).
Central brain mechanisms and locomotion                                     The outflow of cerebellar processing is transported via the deep
                                                                         cerebellar nuclei to the red nucleus and thalamic nuclei and from
                                                                         there along descending tracts to pre-motoneurons of extremity
The mesencephalic locomotor region                                       muscles. This input is crucial for postural adjustments and postural
Strong evidence has been collected from research in cats that the        control during walking and running.
rhythmic leg movements in locomotion are ‘initiated’ by activity in         Our own experiments in rats indicated that the cerebellum plays
a group of cells in the mesencephalic brain stem. Electrical stimula-    an important role in adjusting postural control to limb movements
tion of this area in intact cats induced the leg movements on a          during walking. This postulate is based upon the finding that ves-
moving treadmill (Shik et al., 1966). Since then this area has been      tibular deprivation in rats retards the development of postural
termed the mesencephalic locomotor region (MLR). Anatomically,           control and this, in turn, leads to a delay in the development of the
its neurones are localized around the pedunculopontine tegmental         adult-like walking pattern (see, above; Gramsbergen, 1998, 2001,
nucleus (Spann & Grofova, 1989). Descending fibers probably              2005a, b).
course via the reticulospinal tract and impinge upon the CPGs
where they start the rhythmical activity.
   The experiments indicated also that by increasing the stimulus
                                                                         Summary
intensity the walking speed increased (by an increase in the CPG-        Locomotion is initiated by activity in the MLR, which in turn might
frequency) and eventually the animals made a transition to trot or       be activated by higher centers. The LMS plays a role in the accelera-
gallop (indicating an alternative phasing-pattern within the CPGs)       tion or deceleration of walking speed. Cerebellar circuitry plays a
(Shik et al., 1966; Shik & Orlovsky, 1976). The speed ‘increases’ and    role in adjustments of postural control during walking.
                                                                                                                                                  79
       4      Locomotor neurobiology and development
80
                                                                                                                           Development of postural control
                F           E1     E2           E3                                    Summary
                                                                                      Flexors in the hind limb are activated simultaneously, shortly before
                                                                                      the swing phase of the hind limb and extensors are activated shortly
 QF                                                            Knee                   before the stance phase. The longissimus muscles in the back are
 GC                                                            Ankle
                                                                                      activated during extension of the hind limbs and EMG activity in
                                                                                      this muscle is strongest during the stance phase of the ipsilateral
SOL                                                            Ankle                  hind limb.
                                                                                                                                                                81
       4      Locomotor neurobiology and development
Muscles
                                                                                                                                                                 Muscles
     ments and acquisition and performance of skilled movement pat-
     terns but also in making postural adjustments during extremity                              Ext                                               Ext
     movements. As to this latter function, the data available suggest that
     the cerebellum is the key structure in coupling and adjusting the                        Feedback                                           Feedback
     activities of the evolutionary newer structures, i.e. the muscles in
     the legs and their control with those of the older structures, i.e. the       Fig 4.5  Diagram representing CPG in relation to motorneurons (Fl, flexors;
     axial muscles along the trunk and their neural control. Trunk                 Ext, extensors) and ascending and descending tracts. CPG, central pattern
     muscles and particular extremity muscles, the so-called anti-gravity          generator; Feedback, proprioceptive feedback from muscles, tendons and
     muscles are specialized to subserve postural tasks. They contain              joint receptors; RST, rubrospinal tract; LVST, lateral vestibulospinal tract; VSCT,
                                                                                   ventral spinocerebellar tract; SRCP, spinoreticulocerebellar tract; MLR, mesen-
     large proportions of type I muscle fibers which are specifically able
                                                                                   cephalic locomotor region; LMS, limbic motor system.
     to sustain force-loads for long periods. These muscles are innervated
     by motoneurons which, in part, are connected by dendrite bundles
     (possibly an evolutionary older type of interneuronal connectivity;
     Gramsbergen et al., 1996; Gramsbergen, 2005b). These muscles,
     containing large proportions of type I muscle fibers are innervated           rats) a locomotor region in the mesencephalon exists. This cell
     by motoneuronal pools with conspicuous dendrite bundles (as in                group, in turn, is activated by other brain areas, and most probably
     the soleus muscle and the trunk muscles), or in other cases by                by the sensory-motor cortex (or it’s analogue in horses). The speed
     motoneuronal pools with a few regions of dendrite bundles (as the             of walking is adjusted by the LMS. In situations of fear or strong
     gastrocnemius and vastus medius muscles). Other extremity muscles             activation during races, the LMS may induce the CPG to switch to
     and particularly the flexor muscles are composed of large propor-             increased rhythms and incidentally to other coordination
     tions of type IIa and IIb muscles. These muscles are particularly             patterns.
     involved in heavy exercises which they can, however, can only                    Training procedures in horses aim at optimizing muscular sizes
     sustain for relatively short periods.                                         and muscular properties. EMG-recordings and advanced automatic
        The basic rhythmicity in alternating limb movements (even at               analysis techniques such as the computation of power density
     varying footfall patterns) is produced by neuronal circuits, localized        spectra and the recording of shifts in these spectra during exercises
     at spinal levels, CPGs (Fig. 4.5).                                            and training or fatigue in conjunction with kinematic recordings
        Walking starts by activation from the MLR in the mesencephalic             and analysis will prove to be important tools in devising the most
     brain stem. It is supposed that also in horses (like in cats and in           effective training schemes.
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84
                                                                                                                    C H A PTER           5 
                                                                                                                                                 85
86
     Table 5.1  Classification and main characteristics of equine gaits
                                                                                                                                                                                       5
     Classification     Gait               Gait variations         Footfall           Rhythm          Type of        Speed      Stride    Stride       Limb            Suspension
                                                                   sequence           (beat/stride)   symmetry       (m/s)      length    frequency    stance          phase (s or %
                                                                                                                                (m)       (stride/s)   phase (s or     stride)
                                                                                                                                                       % stride)
     Walking gaits      Walk               Collected, medium,      RH, RF, LH, LF     4               Right/left     1.2–1.8    1.5–1.9    0.8–1.1       65–75%        0
                                           extended, free                                             bipedal
                        Toelt, paso,                               RH, RF, LH, LF     4               Right/left     3.4–5.3    1.7–2.3   2.23–2.36      40–55%        0
                        rack, foxtrot                                                                 lateral
     Running gaits      Trot               Piaffe, passage,        RH-LF, susp,       2               Right/left     2.8–14.2   1.8–5.9    0.9–2.52      26–53%        0–9%
                                           collected, working,     LH-RF, susp                        diagonal
                                                                                                                                                                                       Gaits and interlimb coordination
                                           medium, extended,
                                           flying-trot
                        Pace                                       RH-RF, susp,       2               Right/left     9.1–16.0   4.5–6.3    1.8–2.4     0.130–0.138 s   0.081–0.094 s
                                                                   LH-LF, susp                        lateral
                        Canter             Collected, medium,      Trail.H,           3               Asymmetry      2.9–9      1.9–4.6    1.6–2.0      0.28–0.30 s    0–0.013 s
                                           extended, disunited     lead.H-trail.F,                    with a phase
                                                                   lead.F, susp                       lag between
                                                                                                      limb pair
                        Gallop             Transverse, rotary      Transverse:        4               Asymmetry       9–20      4.5–7.2   2.27–2.92    0.085–0.09 s    0.063–0.114 s
                                                                   trail.H, lead.H,                   with a phase                                                     16–28%
                                                                   trail.F, lead.F,                   lag between
                                                                   susp                               limb pair
                                                                                                                                         Classification and description of gaits
Attitude 1
                                     0.35
               0.35                                      1st time
                                    1st time
0 0.1 0 0.1 0 0 0 0
Attitude 4
                                               Stride duration
                         Contralateral
                      advance placement
RF LF RF
LH RH LH
Fig 5.1  Methods for representing the footfall sequences and temporal characteristics of the gaits. (A) Drawings of the footfall sequence observed at the
flying trot. (B) Gait and bar diagram of the trot. The bars represent the stance phase duration of each limb. (C) Drawings of the relative phases between the
limbs in various quadrupedal gaits.
     the forelimbs trot. The model consists of four coupled                                       (Barbeau & Rossignol, 1987). There are four distinct
     oscillators that simulate the cyclical patterns of the                                       rhythm generators (CPG) for the two hind limbs and for the
     four limb movements. It is possible to generate all types                                    two forelimbs (Forssberg et al., 1980a, b). Such a generator
     of equine gaits using five ways of coupling the oscillators.                                 has been identified in the lumbar spinal cord of the newborn
     This type of functional model can be useful for                                              rat (Cazalets et al., 1996). In horses, the characteristics of
     understanding locomotor control by the central                                               these rhythm generators should determine the stride
     nervous system. Experimental results in neurophysiology                                      frequency and its variability. Great stability is required in
     demonstrated that the rhythmic activity of the skeletal                                      dressage while rapid changes are nessary for jumping or
     muscles of each limb comes from the central nervous system                                   racing horses.
                                                                                                                                                                                   87
        5        Gaits and interlimb coordination
     Fig 5.1  Continued (D) Pie gait diagram of the gallop in Quarter Horses showing the footfall sequence and the durations of the suspension phase, stance
     phases and overlaps expressed in seconds and as a percentage of stride duration. The sequence rotates counterclockwise.
     (A) Reproduced from Barroil (1887). (C) From Alexander, R. McN. The gait of bipedal and quadrupedal animals. Int. J. Robotics Res. 3, 49–59, Copyright ©1984, reprinted by permission of SAGE.
     (D) Reproduced from Deuel & Lawrence (1987).
88
                                                                                                                                                                      Classification and description of gaits
1. (31-0)
                                                    10
                                                                                                                                                      4. (36-6)
                                                                                                2. (57-9)                          3. (43-10)
                                                                                                                                                                           5. (29-12)
20
                                                                                                                                                        10. (32-22)
Lateral advanced placement (% of stride duration)
                                                                             7. (66-22)                                        9. (46-22)
                                                                                                    8. (54-24)
30 6. (73-25)
                                                                                                                                                                        14. (30-29)
                                                                                                                 12. (54-31)                    13. (40-31)
11. (66-33)
40
15. (59-38)
                                                                                                                                17. (46-44)
                                                    50
                                                    60
                                                                                                                                                                  20. (33-57)
   Fig 5.2  Classification of symmetrical gaits according to the temporal characteristics of the gait.
   From Hildebrand, M., 1965. Symmetrical gaits of horses. Science 150 (3657), with permission from AAAS.
   characteristics are very important for dressage ability and should                                                          France, the French saddle horses were mainly selected for jumping.
   be used for early selection at 2 or 3 years old. Slow stride fre-                                                           However, a new breeding program for dressage was set up at the
   quency, high dorsoventral activity and high propulsion accelera-                                                            end of the 20th century. It has been shown that specific conforma-
   tion vector and longitudinal activity are the trot characteristics                                                          tion and gait characteristics in German breeds can explain their
   required for performing in dressage. The heritabilities were higher                                                         higher ability for dressage competition (Barrey et al., 2002). For
   at trot than at walk.                                                                                                       dressage performance, the trot characteristics and variations are very
      Because of the heritabilities of the gait parameters, it was assumed                                                     important because they form the basis of passage and piaffe which
   that some of these traits could be genetically selected and contrib-                                                        should be performed at the top level. According to the FEI rules,
   uted to dressage performance. Several breeds have been specifically                                                         the trot should be a two-beat gait with free, active and regular steps;
   selected for dressage. In Spain, Andalusian horses have been bred                                                           the regularity and elasticity of the steps, and engaged hind quarters,
   for dressage since the 15th century. The Andalusian horses were                                                             should be the main qualities of the trot. The same cadence and
   used for military work at several royal riding academies in Spain,                                                          rhythm should be maintained during trot variations. The trot char-
   Italy, France and Austria from the 15th to 18th centuries. According                                                        acteristics of the German horses showed good similarities with the
   to the international competition results, several German breeds or                                                          FEI rules: a slow stride frequency, high regularity, large dorsoventral
   crossed breeds (Hannoverian, Oldenburger, Westphalian and Dutch                                                             displacement and activity, which means elasticity and good propul-
   Warmblood) are today the best performers. In these studbooks, the                                                           sion (see Table 5.3). Spanish horses have a shorter stride length, a
   dressage ability was the main objective of genetic selection. In                                                            higher stride frequency and a lower dorsoventral displacement and
                                                                                                                                                                                                                89
          5         Gaits and interlimb coordination
                                                                                                                Longitudinal motion
                                                                                                                Mean propulsion vector               0.19 (0.07)       0.20 (0.11)        n/a
                                                                                                                Propulsion duration                  0.69 (0.13)       0.38 (0.15)        n/a
                                                                                                                Longitudinal activity                n/a               0.44 (0.14)        0.46 (0.20)
90
                                                                                                                                                   Classification and description of gaits
activity than German horses. Spanish horses exhibited elevated                                        flying trot. At racing speed, the pace, like the trot, becomes a four-
movements (large flexion of carpus and tarsus) rather than extended                                   beat gait, with dissociation of the lateral limb pairs at impact and
movements of the limbs. Spanish and German groups have a high                                         lift-off. The hind limb contacts the ground about 26–30 ms before
propulsion and longitudinal activity, which should be an advantage                                    the lateral forelimb (Wilson et al., 1988a). In comparison with the
for collecting the trot to passage and piaffe. The German horses had                                  flying trot, there is less problem of limb interference at the pace
gait characteristics more adapted for dressage competition and that                                   because the lateral sequence avoids any contact between the ipsilat-
could already be measured in 3-year-old horses.                                                       eral limbs. Consequently, there are fewer coordination problems
   In harness trotters, the trot is so extended that it can reach a                                   and it is easier for the horse to increase stride length. These differ-
maximum speed of 14.2 m/s with a maximum stride frequency of                                          ences may explain the higher speed records obtained by pacers
2.52 strides/s and a maximum stride length of 5.92 m (Barrey et al.,                                  9.4–16.0 m/s (Wilson et al., 1988b) than by trotters 11.8–14.2 m/s
1995). The diagonal sequence usually changes to a four-beat rhythm                                    (Barrey et al., 1995).
due to asynchrony of the impact (and lift-off) of the diagonal limb
pairs (Drevemo et al., 1980). This particular gait is named the flying
trot (Fig. 5.5). The hind limb touches the ground first (positive                                     Canter and gallop
advanced placement), and the dissociation at lift-off is greater than                                 Canter and gallop refer to the same gait performed at different
at impact.                                                                                            speeds: the canter is a slow speed, three-beat gait and the gallop
   Various irregularities in the rhythm of the trot can occur during                                  is a four-beat gait performed at a higher speed. At the canter, the
a harness race, which may result in the horse being disqualified by                                   stance phases of the diagonal limb pair (leading hind and trailing
the gait judges. Irregular gait patterns that occur relatively frequently                             fore) are synchronized while at the gallop the footfalls of the
are called the aubin and the traquenard in French. At the ‘aubin’,                                    diagonal are dissociated, with the leading hind limb contacting
the forelimbs gallop and the hind limbs trot, while, at the ‘traque-                                  the ground before the trailing forelimb. The gallop is the fastest
nard’, the forelimbs trot and the hind limbs gallop. A trotter is also                                equine gait, and is the racing gait of Thoroughbreds and Quarter
disqualified for pacing or galloping. With increasing speed, the                                      Horses. Canter parameters are highly heritable (mean heritability,
stride length increases linearly but interference between the hind                                    h2 = 0.43) and could also be used for genetic selection (Table 5.2)
limb and the lateral forelimb becomes a limiting factor. A large                                      (Barrey, 2004).
amount of overreaching by the hind limbs is possible only if the                                         The canter and gallop show asymmetric movements of both the
hind limbs move outside (lateral to) the forelimbs during the swing                                   hind and forelimbs. There are two possible footfall sequences: right
phase. Heritabilities of the trot parameters measured in harness                                      lead canter or gallop and left lead canter or gallop. Horses at liberty
trotters (French totters) at high speed are moderate to high (stride                                  prefer to canter or gallop through a turn with the inside limbs
frequency, 0.40 stride/s; stride length, 0.36 m; longitudinal activity,                               leading.
0.23 W/kg (Leleu, 2004) ). The heritability of the trot symmetry                                         The ‘lead change’ is the transition between the footfall sequences
index is zero and the regularity of the stride in time is very low                                    of the right and left leads. Racehorses usually change the forelimb
(0.09), which demonstrate that these coordination parameters are                                      lead before the hind limb lead. However, in dressage the rider can
more trained than inherited.                                                                          elicit the canter lead change during the suspension phase so the
   The foxtrot is a four-beat symmetric gait in which the footfalls of                                change is initiated in the hind limbs (Clayton, 1994). In racing,
the diagonal limbs occur as couplets. The interval between footfalls                                  horses change leads eight or more times per mile to avoid excessive
of the fore hoof and the diagonal hind hoof is 15% of stride, com-                                    muscular fatigue due to the asymmetric work of the limbs and also
pared with 35% of stride between footfalls of the hind hoof and the                                   to minimize the centrifugal forces as they accommodate to the curve
lateral fore hoof. During a complete stride, the overlap periods were                                 (Leach et al., 1987).
tripedal with two hind limbs and one forelimb (8.9%), diagonal                                           At the gallop, there are two ways of coordinating the hind or fore
bipedal (60.6%), tripedal with one hind limb and two forelimbs                                        footfalls. These are called the ‘transverse gallop’ and the ‘rotary
(8.9%) and lateral bipedal (21.7%) (Clayton & Bradbury, 1995).                                        gallop’ (Fig. 5.6). The transverse gallop is used more frequently by
                                                                                                      horses than the rotary gallop but the rotary sequence is observed
                                                                                                      temporarily during a lead change initiated by the forelimbs or when
Pace                                                                                                  muscular fatigue occurs during racing. The disunited canter has the
This lateral symmetric gait is used in harness racing mainly in North                                 same footfall sequence as the rotary gallop except that stance phase
America and Australia. The maximum speed is higher than at the                                        of the lateral limbs is synchronized. It can be observed for one or
                                                                                                                                                                                                         91
        5        Gaits and interlimb coordination
Rotary gallop
LH LF
RH RF
Transverse gallop
LH LF
                      RH               RF
     Fig 5.6  Differences of the footfall sequences of transverse and rotary gallops.
     Reprinted from Leach, 1984. Stride characteristics of horses competing in Grand Prix jumping, with permission from the American Journal of Veterinary Research http://avmajournals.avma.
     org/loi/ajvr.
     more strides after a bad lead change in dressage or landing after                                  The footfall sequence of various gait transitions has been
     jumping.                                                                                        described by Marey (1873), Barroil (1887) and Lenoble du Teil
                                                                                                     (1893) (Fig. 5.7). Kinematic studies have described alternative foot-
                                                                                                     fall sequences observed in dressage horses during transitions
     Jump                                                                                            between the walk and trot transition (Argue & Clayton, 1993a) and
                                                                                                     during the transitions between trot and canter (Argue & Clayton,
     The jump is a gallop stride in which the airborne phase is a long
                                                                                                     1993b).
     dissociation of the diagonal. The footfalls of the jump stride
                                                                                                        The combination of gait analysis by accelerometry and wavelet
     are: trailing hind and leading hind at lift-off, jump suspension, then
                                                                                                     analysis allows quantitative description of some temporal and
     trailing fore and leading fore at landing. At lift-off, the hind limb
                                                                                                     kinetic characteristics of gait transitions (Biau et al., 2002). Transi-
     stance phases are more synchronized than in a normal gallop stride
                                                                                                     tion duration, dorsoventral activity and frequency were specific for
     to produce a powerful push-off. The footfalls of the forelimbs at
                                                                                                     each transition. Training improved smoothness of braking decelera-
     landing are not synchronized (Leach et al., 1984b). A lead change
                                                                                                     tion and frequency changes with a long transition duration. The
     can take place during the airborne phase and, in this case, the
                                                                                                     walk-halt transition was characterized by the largest transition dura-
     change of forelimb placement order occurs before that of the hind
                                                                                                     tion, the lowest dorsoventral activity, and a low braking decelera-
     limbs. A disunited canter can be observed after the jump if the lead
                                                                                                     tion. The change of the vertical activity during this transition was
     change of the hind limbs does not occur immediately after the
                                                                                                     smooth but the decrease of stride frequency was sudden. The trot-
     landing phase.
                                                                                                     walk transition was characterized by a short duration with a large
                                                                                                     braking deceleration and a great change of vertical activity. An
                                                                                                     increase of transition duration allowed a smooth transition with
     Gait transitions                                                                                lower braking deceleration. Canter-halt, canter-walk and canter-trot
                                                                                                     transitions were characterized by a great dorsoventral activity and a
     In order to increase its velocity, the horse can switch gaits from walk                         middle braking deceleration. It was explained by progressive
     to trot, from trot to canter and then extend the canter into a gallop.                          decrease of dorsoventral activity before the gait change, which mini-
     Each gait can be extended by changing the spatial and temporal                                  mized the braking deceleration at the end of the canter, especially
     characteristics of its strides. Ponies were shown to have a preferred                           for experienced horses. The transition duration increased signifi-
     speed for the trot to gallop transition and this particular speed was                           cantly with training for trot-walk, canter-halt and canter-trot transi-
     related to an optimal metabolic cost of running (Hoyt & Taylor,                                 tions. The lengthening of the transition duration allowed a slow
     1981). However, another experiment demonstrated that the trot-                                  decrease of stride frequency (canter-trot transition) and a smooth
     gallop transition was triggered when the peak of ground reaction                                decrease of vertical activity (canter-halt and trot-halt transition).
     force reached a critical level of about 1–1.25 times the body weight                            The rider adapted his technique to the locomotion and level of the
     (Farley & Taylor, 1991). Carrying additional weight reduced the                                 horse. By lengthening transition duration, experienced horses could
     speed of the trot-gallop transition.                                                            perform a smooth deceleration. In contrast, young horses could not
92
                                                                                                                              Velocity-related changes in stride variables
Position 1 4
                     0.30
                                             0.90
                                                                                                      3
                                                 0.15
Position 2
                                                                                                      2
                                   0.30   0.30
                                                                                                      0
                                                                                                              1   2   3   4    5       6   7   8   9   10   11    12
Position 3
                                                                                                                              Velocity (m/s)
                                                                              Fig 5.8  Linear relationship between the stride length and velocity of the
                                                                              gaits. Data are from 6-month-old Quarter Horse foals.
                                                                              Reprinted from Leach, 1984. Stride characteristics of horses competing in Grand Prix
                                                                              jumping, with permission from the American Journal of Veterinary Research http://
                                                    0.20                      avmajournals.avma.org/loi/ajvr.
Position 4
                                                                                                      3
                                  0.90
                                                 0.30
                                                                                                      2
                                                                             Frequency (strides /s)
Position 5
                                          1st time
                                                                                                      1
                                                                                                                                                            C–G
                                                           1.00
Position 6                                                                                                                         T
                                                                                                                  W
                                                            1.50
                                                                                                      0
                                                 1.50              1.50                                   0   1   2   3   4   5        6   7   8   9   10   11    12
                                            2nd time              2nd time                                                    Velocity (m/s)
Fig 5.7  Example of limb placement sequence during a transition from walk     Fig 5.9  Non-linear relationship between the stride frequency of the gaits.
to canter.
                                                                              Reprinted from Leach, 1984. Stride characteristics of horses competing in Grand Prix
Reproduced from Barroil (1887).
                                                                              jumping, with permission from the American Journal of Veterinary Research http://
                                                                              avmajournals.avma.org/loi/ajvr.
prepare their gait transition and would suddenly brake which pro-             order to repeat the limb movements more frequently. The stride
duced a high peak of deceleration. The amplitude of frequency                 frequency (SF) and stride length (SL) are the two main components
change during the gait transition decreased with training for all             of speed. The mean speed can be estimated by the product of the
transitions, especially for canter-halt and trot-walk transition.             stride frequency and stride length: speed = SF × SL. The speed-
                                                                              related changes in stride parameters have been studied in many
                                                                              horse breeds and disciplines. Stride length increases linearly with
                                                                              the speed of the gait (Fig. 5.8).
Velocity-related changes in stride variables                                     Stride frequency increases non linearly and more slowly (Dusek
                                                                              et al., 1970; Leach & Cymbaluk, 1986; Ishii et al., 1989) (Fig. 5.9).
To increase speed at a particular gait, the amplitude of the steps            During rapid acceleration, such as that occurring at the start of a
becomes larger and the duration of the limb cycle is reduced in               gallop race, the stride frequency reaches its maximum value very
                                                                                                                                                                             93
                     5        Gaits and interlimb coordination
                                Speed     Stride length     Stride frequency                                                there are some objective indicators of good trot. A slow stride fre-
                     20                                                                                                     quency with a long swing phase, a large amplitude of scapular
                                                                                                                            rotation, maximal forelimb retraction and maximal hind limb pro-
                                                                                                                            traction lead to a long stride length with a good trot. The vertical
                                                                   8.0
94
                                                                                                                                                     Locomotion and respiratory coupling
                                      5.0
           Stride length (m)
                                                                                                                                 0.1 seconds
                                      4.5                                                                A                                           Time
                                                            (1) S L = 0.38V + 1.15 r = 0.99**
                                      4.0
                                                                                                                                                                                                        95
       5      Gaits and interlimb coordination
     exercise intensity. At the gallop racing speed, less than 50% of the           muscular fatigue onset may occur quickly at high speed because of
     stride duration is available for the expiration. At 16 m/s, the expira-        this decrease in expiration duration, which is mechanically linked
     tion during the trailing and leading forelimb support represents               to the stride cycle both at the trot and gallop.
     45% of the stride duration (Barrey et al., 2000). At high speed on                At the walk, trot and pace there is no consistent coupling between
     a treadmill (11 m/s), the respiratory and stride cycles are exactly            the locomotor and respiratory cycles. At trot, the ratio between
     synchronized with one inspiration/expiration per stride in Stan-               locomotor and respiratory frequency ranged between 1–3 depend-
     dardbreds. The inspiration takes place during the support phase of             ing on speed, duration of exercise and breed of horse (Hörnicke
     one diagonal and most of the preceding and following suspension                et al., 1987; Art et al., 1990). A similarly variable coupling mecha-
     phases. About 57% of the stride duration was available for inspira-            nism was observed at the pace where the ratio between the stride
     tion and only 43% for expiration. Hypercapnia, acidosis and                    and respiratory frequencies ranged from 1–1.5 (Evans et al., 1994).
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   8–12 September, Berlin, H4–2, pp                 Leach, D.H., Cymbaluk, N.F., 1986.                    intra-stride speed variation on treadmill
   558–559.                                            Relationship between stride length, stride         locomotion. Proc. 2nd world congress of
Hildebrand, M., 1965. Symmetrical gaits of             frequency, velocity and morphometrics of           biomechanics, amsterdam.
   horses. Science 191, 701–708.                       foals. Am. J. Vet. Res. 47, 2090–2097.          Sloet van Oldruitenborgh-Oosterbaan, M.M.,
Hiraga, A., Yamanobe, A., Kubo, K., 1994.           Leach, D.H., Ormrod, K., Clayton, H.M.,               Barneveld, A., Schamhardt, H.C., 1997.
   Relationships between stride length, stride         1984a. Standardised terminology for                Effect of treadmill inclination on
   frequency, step length and velocity at the          the description and analysis of equine             kinematics of the trot in Dutch warmblood
   start dash in a racehorse. J. Equine Sci. 5,        locomotion. Equine Vet. J. 16,                     horses. Equine Vet. J. Suppl. 23, 71–75.
   127–130.                                            522–528.                                        Valette, J.P., Barrey, E., Auvinet, B., Galloux, P.,
Holmström, M., Fredricson, I., Drevemo, S.,         Leach, D.H., Ormrod, K., Clayton, H.M.,               Wolter, R., 1992. Comparison of track and
   1994. Biokinematic differences between              1984b. Stride characteristics of horses            treadmill exercise tests in saddle horses: a
   riding horses judged as good and porr at            competing in grand prix jumping. Am. J.            preliminary report. Annale de Zootechnie
   the trot. Equine Vet. J. Suppl. 17, 51–56.          Vet. Res. 45, 888–892.                             41, 129–135.
Holmström, M., Fredricson, I., Drevemo, S.,         Leach, D.H., Springings, E.J., 1979. Gait          Wilson, B.D., Neal, R.J., Howard, A.,
   1995. Variation in angular pattern                  fatigue in the racing thoroughbred. J.             Groenendyk, S., 1988a. The gait of pacers:
   adaptation from trot in hand to passage             Equine Med. Surg. 3, 436–443.                      I. Kinematics of the racing stride. Equine
   and piaffe in the grand prix dressage horse.     Leach, D.H., Springings, E.J., Laverty, W.H.,         Vet. J. 20, 341–346.
   Equine Vet. J. Suppl. 17, 51–56.                    1987. Multivariate statistical analysis of      Wilson, B.D., Neal, R.J., Howard, A.,
Hörnicke, H., Meixner, R., Pollmam, U., 1987.          stride-timing measurements of nonfatigued          Groenendyk, S., 1988b. The gait of pacers:
   Respiration in exercising horses. In: Snow,         racing thoroughbreds. Am. J. Vet. Res. 48,         II. Kinematics of the racing stride. Equine
   D.H., Persson, S.G.B., Rose, R.J. (Eds.),           880–888.                                           Vet. J. 20, 347–351.
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                                                                                                                      C H A PTER           6 
                                              Forelimb function
                                              Hilary M. Clayton, Henry Chateau, Willem Back
Terminology                                                               of the joint moment and that joint’s angular velocity, measures the
                                                                          rate of mechanical energy generation and absorption across a joint.
                                                                          Discrete bursts of positive and negative work can be quantified as
This chapter reviews the structure and functions of the equine fore-      the areas under the positive and negative phases, respectively, of the
limbs in relation to locomotor activity, including kinematics (move-      power curve. Positive work is done when the net joint moment acts
ments) and kinetics (forces) during the stride. A stride is regarded      in the same direction as the angular velocity of the joint, indicating
as the unit of measurement. The stride starts and ends with consecu-      that the muscle shortens as it generates tension (concentric contrac-
tive occurrences of the same event, which is often a specific footfall.   tion). Negative work is done when the net joint moment acts in the
Within a stride, each limb has a stance phase when the hoof is in         opposite direction to the angular velocity of the joint, so the muscle
contact with the ground, and a swing phase when the hoof is swing-        lengthens as it generates tension (eccentric contraction) and acts to
ing through the air. The stance phase starts at the moment of initial     restrain joint movement in opposition to gravity or some other
ground contact, after which the hoof is decelerated during the            external force.
impact phase. In the middle part of the stance phase the limb is             This chapter describes the structure of the forelimb musculature,
loaded by the horse’s body weight then unloaded. Breakover is the         the movements of the forelimb and the role of specific muscle
terminal part of stance when the heels leave the ground and rotate        groups in causing and controlling those movements. These concepts
around the toe, which is still in ground contact. The various gaits       are important in understanding how the muscles of the forelimb
are defined by the sequence and timing of the limb movements              work to cause or control segmental and joint motion. The role of
during the stride.                                                        the forelimb joints and musculature as determined by inverse
   Forelimb kinematics are described in terms of temporal (timing),       dynamics analysis will be described later in this chapter.
linear (distance) and angular variables. In order to interpret data
describing segment and joint angles, it is important to know where
the angles were measured. For example, joint angles may be mea-
sured between the proximal and distal segments on the anatomical          Musculotendinous architecture
flexor aspect or as the angle by which the distal segment deviates
from alignment with the proximal segment, or some combination             In small, non-cursorial mammals, the forelimb is attached to the
of these methods (Fig. 6.1). Furthermore, the angle may be expressed      trunk via a shoulder girdle, in which the clavicle articulates with
in absolute terms or it may be normalized to the standing angle,          the sternum and scapula, imposing some constraints on forelimb
the angle at ground contact or the average angle during the stride        motion. Horses do not have a clavicle or shoulder girdle. Instead,
(Mullineaux et al., 2004).                                                the articulation between the forelimb and the trunk is a synsarco-
   The ground reaction force (GRF) vector is usually resolved into        sis, consisting of a substantial group of extrinsic muscles and their
vertical, longitudinal and transverse components to facilitate inter-     associated soft tissues. The absence of a clavicle allows the scapula
pretation of its effects. Due to their proximity to the horse’s center    more freedom to rotate and translate relative to the ribcage,
of mass, the forelimbs carry more weight (57–58%) than the hind           which may contribute to an increase in stride length. As a conse-
limbs (42–43%) and have proportionately higher vertical forces            quence of this translational motion, the instantaneous center of
and impulses. This supportive function is reflected in the pillar-like    rotation of the scapulothoracic joint changes throughout the
alignment of the antebrachial and metacarpal segments.                    stride.
   GRF data can be combined with kinematic data using a link                 Locomotor muscles account for about 42% of the horse’s body
segment model to calculate internal forces within the limb that           mass (Gunn, 1978) with the large, powerful muscles concentrated
cannot be measured directly (see Chapter 19 for details). Briefly, in     in the proximal limb, while the distal forelimb makes use of long,
a two-dimensional link segment model, each segment is repre-              elastic tendons to reduce the metabolic cost of locomotion. The
sented as a solid bar and the location of its center of mass is known     bulk of the musculature is in the proximal limb, which reduces the
relative to the coordinates that define the segment. The input for        moment of inertia of the limb as a whole. The functions of
the model comprises kinematic and force data that are synchro-            the musculotendinous system of the equine forelimb include con-
nized in time and space, together with segment morphometric data          necting the forelimb to the trunk; supporting the body mass; stabi-
(Fig. 6.2, Table 6.1). An inverse dynamic solution is used to compute     lizing the joints in opposition to the force of gravity during the
net joint moments and net joint powers (Colborne et al., 1997a,b).        stance phase; generating forces that are used for propulsion, braking
The net joint moment represents the net torque acting around a            and turning; and flexing the joints to lift the hoof clear of the
joint, which is produced primarily by the soft tissues (muscle,           ground during the swing phase. At first glance, there appears to be
tendon and ligament). Net joint power, calculated as the product          considerable redundancy in muscular function but muscles with
                                                                                                                                                   99
        6        Forelimb function
                                                                                                                     4
                                                                                                                                    5
                                                                                                                                     6
                                                                                                             7
           A                                           B
      Fig 6.1  Two methods of measuring joint angles of the forelimbs with the                      Fig 6.2  Skin markers used to locate the centers of mass of the forelimb
      measured angles being represented by black arcs. Left: measurement of the                     segments in Table 6.1, which are separated according to the incision lines
      angle between the proximal and distal segments on the anatomical flexor                       shown in red.
      aspect. Right: measurement of the angle by which the distal segment differs                   Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M., Scharmhardt, H.C., Barneveld, A., 1997,
      from alignment with the proximal segment; deviation toward the flexor                         Inertial properties of Dutch Warmblood horses, Journal of Biomechanics, 30 (6), 653–658,
      aspect is negative (−), deviation toward the extensor aspect is positive (+).                 with permission from Elsevier.
       Table 6.1  Forelimb segmental masses, densities, reference lines for division of segments (see Fig. 6.2 for key to marker locations), and
       position of segmental centers of mass in the sagittal plane*
       *Position of center of mass is expressed along the x-axis (longitudinal, positive distally from the more proximal marker), then along the y-axis (perpendicular to x-axis, positive
       cranially). Distances are expressed as percentage segment length between the two reference markers. Location along the x-axis is measured first from the proximal reference
       marker toward the distal reference marker, then shifted along the y-axis. Data are mean ± SD for 12 forelimbs of 6 Warmblood horses.
       Reprinted from Willemen, M.A., Savelberg, H.H.C.M., Barneveld, A., 1997, The improvement of the gait quality of sound trotting warmblood horses by normal shoeing and its
       effect on the load on the lower forelimb, Livestock Production Science, 52 (2), 145–153, with permission from Elsevier.
      similar attachments may, in fact, have quite different functional                             volume, has been determined to be 1.075 g/cm3 over a range of
      responsibilities. Evaluation of the geometry and architecture of the                          muscles, with different muscles varying by only a small amount
      musculotendinous units is helpful in understanding whether their                              (Brown et al., 2003). Fiber length and pennation angle affect the
      function is to produce rapid movements or generate large forces to                            range of motion through which the muscle contracts and its ability
      stabilize the joints.                                                                         to generate force. Long fibers arranged in parallel with the long axis
         Muscle size is expressed in terms of its mass and volume, which                            of the muscle belly have the greatest capacity to shorten the muscle.
      are closely correlated. Muscle density, calculated as mass divided by                         Thus parallel fibers impart the largest range of motion and the most
100
                                                                                                                                           Musculotendinous architecture
Table 6.2 Architectural properties of the extrinsic muscles of the equine forelimb
 Muscle                                          Mass (kg)           Volume (cm3)              MFL (mm)              PCSA (cm2)             Force (kN)           Power (W)
 Pectoralis transversus                           1.54               1434                      200                    77                     2310                231
 Pectoralis descendens                            2.84               2649                      461                    60                     1800                415
 Pectoralis ascendens                            21.0                1954                      292                    72                     2160                315
 Serratus ventralis cervicis                     29.9                2781                        49                  577                    17310                424
 Serratus ventralis thoracis                     24.3                2349                      693                    62                     1860                 644
 Brachiocephalicus/Omotransversarius             13.0                1217                      519                    23                      690                 179
 Subclavius                                       0.68                 631                     191                    42                     1260                 120
 Trapezius                                        1.83               1705                      378                    53                     1590                 301
 Rhomboideus cervicis                             0.55                 503                     311                    15                      450                  70
 Rhomboideus thoracis                             0.43                 409                     139                    24                      720                  50
 Latissimus dorsi                                 1.83               1705                      378                    53                     1590                 301
 MFL, mean fiber length; PCSA, physiological cross-sectional area; force, maximal isometric force generation capacity estimated by multiplying muscle PCSA by the maximal
 isometric stress of skeletal muscle, taken as 0.3 MPa; power, maximal power output calculated as one-tenth of the product of force and maximal contraction velocity, which
 was estimated based on published values of equine muscle fiber-typing.
 Reprinted from Payne, R.C., Veenman, P., Wilson, A.M., 2004, The role of the extrinsic thoracic limb muscles in equine locomotion, Journal of Anatomy, with permission from
 John Wiley and Sons.
rapid shortening velocities. These characteristics are associated with                     Extrinsic muscles of the forelimb
muscles that act as prime movers. When fibers insert into the tendon
at an angle (pennation angle), the amount of force transmitted to                          The extrinsic muscles of the forelimb, which have an attachment to
the tendon is determined as force developed in the fiber multiplied                        the bones of the limb and an attachment to the trunk, are respon-
by the cosine of the pennation angle. Thus, fibers with a pennation                        sible for suspending the trunk between the forelimbs and for
angle of 40° transmit only 77% of the force generated by the muscle                        moving the forelimbs relative to the trunk. In general, these are large
fiber to the tendon. In the equine antebrachial muscles, a close                           muscles with long fibers arranged parallel with the long axis of the
inverse relationship between muscle fiber length and pennation                             muscle belly (Table 6.2) that insert on the bones via short tendons
angle has been demonstrated (Brown et al., 2003), and this rela-                           or aponeurotic sheets (Payne et al., 2004). This internal architec-
tionship may be true for other anatomical areas.                                           tural style favors the ability to contract rapidly through a wide range
   Physiological cross-sectional area (PCSA), which is a determinant                       of motion at the expense of the ability to generate high forces. The
of the maximal isometric force that can be generated by a muscle,                          exception is serratus ventralis thoracis, which has short, pennate fibers
is calculated from muscle volume divided by fiber length. For                              and is encased in a strong aponeurotic sheath. These features suggest
muscles with equal volumes, PCSA is larger in muscles with short,                          that serratus ventralis thoracis bears primary responsibility for anti-
pennated fibers because a larger number of fibers can be contained                         gravitational support of the trunk, whereas the other extrinsic
within the volume. These characteristics, which confer an increase                         muscles move the forelimb relative to the trunk during the swing
in passive stiffness to the muscle, are typical of the anti-gravity                        phase or advance the trunk over the grounded limb during the
muscles that support the body during the stance phase. Short,                              stance phase.
highly pennated fibers in combination with a long, elastic tendon                             Serratus ventralis thoracis (Fig. 6.3, Table 6.2) is the largest extrinsic
are characteristic of muscles involved in elastic energy storage and                       muscle of the forelimb both in mass and volume and has the short-
release.                                                                                   est mean fiber length. It is a broad flat muscle covered medially and
   The force of contraction of a muscle can be estimated in a Hill-                        laterally by broad aponeurotic sheets. The shortness of the muscle
type model based on four parameters: fiber length, maximal fiber                           fibers (49 mm) relative to the length of the aponeurosis (500 mm)
shortening velocity, pennation angle, and peak isometric muscle                            offers limited ability for muscular contraction to compensate for
force (Zajac, 1989). In general, muscle size (volume and mass) and                         stretching of the aponeurosis, which implies that this muscle would
fiber length decrease in a proximal to distal direction within the                         not be effective in moving or positioning the limb. The elasticity of
equine limbs. Muscles in the proximal forelimb tend to be large                            the aponeurosis may contribute to the overall elastic properties of
and powerful with long fibers arranged parallel to the muscle belly                        the limb by acting in series with the spring-like tendons in the more
to move the joints through a large range of motion. By comparison,                         distal part of the limb and may support protraction of the scapula
muscles in the distal limb are smaller and less powerful with short,                       (Smythe et al., 1993). Pennation of the fibers and the consequent
pennate fibers that are not capable of a large amount of shortening                        increase in cross-sectional area gives the muscle considerable passive
but are well suited to contract isometrically. When muscle length is                       stiffness and allows it to generate sufficiently high forces to with-
controlled by an isometric contraction, the long tendons are loaded                        stand gravitational loading of the limbs during galloping. Serratus
elastically as the limb accepts weight in early stance, then recoil to                     ventralis thoracis is the primary muscular component of the thoracic
release the stored elastic energy at the end of stance. Large, cursorial                   sling, which suspends the trunk between the forelimbs and controls
animals use this musculotendinous arrangement to move at high                              the position of the thorax and withers relative to the scapulae when
speeds with a relatively economical metabolic cost (Alexander,                             the forelimbs are weight-bearing. During standing, the trunk is sup-
2002).                                                                                     ported passively by elongation of the muscle fibers and the series
                                                                                                                                                                               101
         6       Forelimb function
Splenius
Rhomboideus
Trapezius
Latissimus dorsi
Brachiocephalicus
Omotransversarius
Descending pectoral
                                                                                                                                                Serratus ventralis
                                                                                                                 Ascending pectoral             thoracis
      elastic elements. Much higher forces must be resisted during loco-                     descendens and pectoralis transversus) are smaller muscles with
      motion when gravitational and inertial loads on the limbs produce                      medium length fibers (Payne et al., 2004).
      peak vertical forces of at least 8 kN per limb for a 500 kg horse                         Subclavius (Table 6.2) has long fibers (519 mm) that allow genera-
      (McGuigan & Wilson, 2003). Loading during locomotion is easily                         tion of large forces to assist in adduction and retraction of the
      resisted by the maximal isometric force-generating capacity of ser-                    forelimb or stabilization of the scapula (Payne et al., 2004).
      ratus ventralis thoracis, which is estimated to exceed 17 kN. This                        Trapezius (Fig. 6.3) and rhomboideus are the smallest extrinsic
      muscle is more variable in its mass than the other extrinsic muscles,                  muscles of the forelimb and have medium-length fibers (Table 6.2)
      which may reflect adaptation in response to the amount and type                        (Payne et al., 2004). Both muscles insert on the dorsal scapula and
      of training.                                                                           have fiber orientations ranging from vertical in the middle of the
         Serratus ventralis cervicis (Fig. 6.3, Table 6.2) is somewhat smaller               muscle to almost longitudinal towards the extremities. The orienta-
      than the thoracic part of the muscle and differs in having relatively                  tion of the vertical fibers suggests that their function is to hold the
      long fibers and a smaller cross-sectional area (Payne et al., 2004),                   proximal scapula against the trunk (preventing winging of the
      that confer the ability to support the base of the neck or to retract                  scapula) by opposing the action of the pectoral muscles that adduct
      the limb by rotating the proximal scapula cranially. In dogs, it has                   the distal scapula and humerus. The longitudinal fibers likely con-
      been suggested that the primary function of serratus ventralis cervicis                tribute to forelimb protraction, retraction and stabilization.
      is to stabilize the position of the fulcrum about which the forelimb                      Brachiocephalicus (Fig. 6.3) and omotransversarius are considered
      rotates in a craniocaudal direction during active retraction of the                    together since their fibers cannot be separated close to their
      forelimb, thus ensuring that the GRF vector passes close to the                        origins in the shoulder region. They form a large, powerful muscle,
      center of scapular rotation (Carrier et al., 2006).                                    with long fibers oriented parallel to the muscle belly (Payne et al.,
         The pectoral muscles (Fig. 6.3, Table 6.2) are large with relatively                2004). Fiber lengths in Table 6.2 represent a mean of the two
      long fibers that suggest a primary role in adducting the forelimb                      muscles, though brachiocephalicus has longer fibers than omotrans-
      (Payne et al., 2004). The deep pectoral (pectoralis ascendens) is a                    versarius. The fiber direction suggests a primary role in forelimb
      large, powerful muscle with long fibers. It is active through most of                  protraction.
      the stance phase when it may assist in moving the trunk forward                           Latissimus dorsi (Fig. 6.3, Table 6.2) is a moderately large and
      over the grounded limb. The superficial pectorals (pectoralis                          powerful muscle with fairly long fibers (Payne et al., 2004). It is
102
                                                                                                                 Musculotendinous architecture
enveloped by an aponeurotic sheath that is part of the thoracolum-       movement is required. In a galloping horse, the biceps tendon has
bar fascia. The fiber orientation suggests a primary role in forelimb    been estimated to release 243 J in 0.11 s, which would require the
retraction. Compared with the primary limb protractors, brachioce-       power output of 50 kg of non-elastic muscle (Wilson & Watson,
phalicus and omotransversarius, latissimus dorsi develops similar        2003). Thus the biceps catapult is an effective and efficient mech-
amounts of force but less than half as much power. Electromyo-           anism for protracting the forelimb in galloping horses. A further
graphic studies indicate that this muscle is active in late swing and    benefit of using tendon elasticity rather than muscular force is
at hoof contact (Preedy, 1998), when it may act to retract the limb      that the tendon has low energy dissipation, returning an impres-
in preparation for ground contact and stabilize the trunk during the     sive 93% of the work done stretching it and with only 7% dissipa-
impact phase.                                                            tion as heat.
                                                                             Part of the internal tendon of biceps brachii emerges from the
                                                                         muscle and continues distally as the lacertus fibrosus, a tendinous
                                                                         band that blends with the epimysium of extensor carpi radialis. Lac-
Intrinsic muscles of the forelimb                                        ertus fibrosus has a much smaller mass than the internal tendon of
The intrinsic muscles of the forelimb are characterized by being         biceps brachii and is capable of storing much less energy (10–28 J)
smaller in volume than the extrinsic musculature with short, highly      (Watson & Wilson, 2007). These properties are consistent with its
pennate fibers and long tendons relative to muscle length. Total         role in stabilizing the forelimb as part of the stay apparatus.
mass of the intrinsic musculature is around 17 kg in each forelimb.          Biceps brachii has tonic activity during standing (Tokuriki et al.,
Pennation of the muscle fibers results in a larger PCSA than for         1989), which supports the suggestion that the lateral part of the
equal-sized muscles with parallel fibers. This confers the ability to    muscle, with its high proportion of type I muscle fibers, acts in series
resist elongation of the muscle (isometric contraction) as the limb      with lacertus fibrosus and extensor carpi radialis to stabilize the shoul-
is loaded, so elongation of the musculotendinous unit is due to          der as part of the passive stay apparatus (Hermanson, 1997). During
stretching of the tendon that acts in series with the muscle. As the     locomotion at walk, trot and canter, biceps brachii is active in early
tendons stretch, they store elastic energy, which is released later in   and midstance (Tokuriki et al., 1989). This is in contrast to brachia-
the stance phase when the limb is unloaded. This mechanism               lis, which acts as an elbow flexor in early swing (Tokuriki et al.,
reduces muscular work and increases the economy of locomotion            1989) and contributes to the flexor moment at the elbow at this
(Alexander, 2002).                                                       time in walk (Clayton et al., 2000a, b) and trot (Lanovaz et al.,
   Supraspinatus, with a mass of 793–1546 g and fiber length of          1999).
5–12 cm, has limited force generating capacity and a small moment            Triceps brachii is a biarticular muscle crossing the flexor aspect of
arm at the shoulder, which makes it more suitable for stabilization      the shoulder (long head) and extensor aspect of the elbow. It is by
than dynamic movement of the joints (Watson & Wilson, 2007).             far the largest of the intrinsic forelimb muscles. As the name sug-
Supraspinatus and infraspinatus are active during early and mid-         gests, it has three heads. The biarticular long head (mass, 3200–
stance in walk, trot and canter (Aoki et al., 1984; Robert et al.,       6663 g; fiber length, 19–26 mm) and the monoarticular lateral
1998), when the primary action of supraspinatus appears to be sta-       head (mass, 514–1240 g; fiber length, 17–24 mm) comprise 81%
bilization of the shoulder joint. The instability seen with paralysis    and 15%, respectively, of the extensor muscle mass at the elbow
of the supraspinous nerve (Sweeney) supports this presumptive            (Ryan et al., 1992). They contain predominantly fast-twitch fibers
function.                                                                suggesting they are important in locomotion. By contrast, the small
   The medial and lateral heads of the biarticular biceps brachii span   medial head of triceps (mass, 85–271 g; fiber length, 9–17 cm) and
the extensor aspect of the shoulder and the flexor aspect of the         the anconeus muscle each account for only 2% of elbow extensor
elbow. The lateral head, with a mass of 171–343 g, is composed of        muscle mass and both are composed almost entirely of slow-twitch
short (5–8 mm), pennate fibers (Watson & Wilson, 2007), a large          fibers, suggesting their role is to support the elbow in extension
percentage of which are slow-twitch and well suited to postural          during stance (Ryan et al., 1992).
control. The medial head, which has longer fibers (15–40 mm) and             The actions of triceps are to extend the elbow, to retract and
fewer slow-twitch fibers, may be more important in locomotion            extend the distal forelimb and, perhaps, to extend the limb when
(Hermanson & Hurley, 1990). Compared with supraspinatus, biceps          it is being used to raise the forehand. It is active in late swing and
brachii has a larger force generating capacity and a larger moment       early stance (Tokuriki et al., 1989; Preedy, 1998; Robert et al.,
arm at the shoulder joint, which suggests that it may be a more          1998), with activity in the long head preceding activity in the lateral
effective extensor of the shoulder (Watson & Wilson, 2007).              head. Since biceps brachii and the long head of triceps brachii are
   A strong internal tendon (mass, 122–260 g; fiber length,              biarticular, their interaction affects motion and stability of both
9–17 cm) runs through the muscle belly of biceps brachii uniting         shoulder and elbow joints. The nature of this interaction differs
the tendons of origin and insertion. This tendon plays an impor-         between the inverted pendulum behavior of the limb during
tant role in elastic energy storage, having the potential to store       walking and the mass-spring behavior during trotting. In the walk
277–591 J. It is estimated to withstand forces of 3.2 × 104 − 5.4 ×      ing horse, the shoulder acts primarily as an energy damper, with a
104 N when stretched as the forelimb is retracted in late stance         large burst of energy absorption on its extensor (cranial) aspect in
with the shoulder and elbow in extension (Watson & Wilson,               midstance (Clayton et al., 2000a), which is likely due to eccentric
2007). Recoil of the stretched biceps tendon in the galloping            action of biceps brachii controlling extension of the shoulder. At the
horse has been described as a catapult mechanism that provides           elbow there are bursts of energy generation on the extensor aspect
rapid acceleration of the distal forelimb (Wilson & Watson,              in early stance, which is thought to be due to concentric action of
2003). In a catapult, a large force is applied to store energy, which    triceps brachii, and on the flexor aspect in late stance, which coin-
is then released rapidly to accelerate a small mass. In the horse’s      cides with electrical activity in biceps brachii (Tokuriki et al., 1989).
forelimb, the biceps tendon is stretched by forward movement of          During trotting, the elbow has well-defined bursts of energy absorp-
the trunk and the changing orientation of the ground reaction            tion on the extensor side of the joint in early stance followed by
force vector relative to the shoulder and elbow joints during the        energy generation on the extensor aspect in midstance (Clayton
stance phase. Stretching continues as long as the carpus is locked       et al., 1998). Energy absorption and generation on the extensor
in extension. When the carpus buckles, the forearm is released           (cranial) aspect of the shoulder joint are similar in magnitude to
allowing the biceps tendon to recoil. The effect is rapid extension      those at the elbow joint but occur slightly later in the stance phase.
of the shoulder, flexion of the elbow and forward acceleration of        There is an additional burst of energy generation on the extensor
the distal limb. Tendons can recoil elastically much faster than         aspect of the shoulder in late stance (Clayton et al., 1998) corre-
muscles shorten, which is beneficial in situations where rapid           sponding with activity in biceps brachii (Tokuriki et al., 1989). Thus
                                                                                                                                                      103
        6       Forelimb function
       Muscle                                               Mass (kg)                  Volume (cm3)                    MFL (mm)                    PCSA (cm2)                  MPA (°)
       Flexor carpi radialis                                1.80                       166                             89.7                         18                           6.7
       Extensor carpi radialis                              8.15                       754                             76.0                         99                         16.0
       Flexor carpi ulnaris                                 2.62                       245                             18.3                        134                         31.6
       Ulnaris lateralis                                    3.64                       337                             17.4                        194                         34.3
       Superficial digital flexor                           2.45                       227                              7.5                        303                         41.6
       Deep digital flexor – humeral head                   5.61                       524                             43.8                        120                         21.6
       Deep digital flexor – radial head                    0.45                        42                             10.6                         39                         32.3
       Deep digital flexor – ulnar head                     0.96                        89                             37.2                         24                         20.3
       Common digital extensor                              3.16                       295                             81.4                         36                         13.3
       MFL, mean fiber length; PCSA, physiological cross sectional area; MPA, mean pennation angle.
       Reprinted from Brown, N.A.T., Kawcak, C.E., McIlwraith, W., Pandy, M.G., 2003, Architectural properties of distal forelimb muscles in horses, Equus caballus, Journal of Morphology,
       with permission from John Wiley and Sons.
      biceps brachii appears to be responsible for a net extensor moment                           the inertially driven carpal flexion (Colborne et al., 1997a, b).
      at the shoulder through most of stance, while triceps brachii is gen-                        Rupture of the extensor carpi radialis tendon allows the carpus to
      erating an extensor moment at the elbow. In the swing phase,                                 hyperflex during the swing phase at walk and may cause the horse
      forelimb protraction is driven by the elbow flexors, which generate                          to stumble or fall at trot because it cannot protract the forelimb
      a flexor moment in early swing, and retraction is driven by the                              rapidly enough. Later in the swing phase, the net joint moment
      elbow extensors, which generate an extensor moment in late swing                             moves to the caudal side of the carpus (Lanovaz et al., 1999), with
      (Lanovaz et al., 1999).                                                                      flexor carpi radialis controlling carpal extension and retracting the
         The muscles of the forearm move and stabilize the carpal and                              distal limb in preparation for ground contact.
      digital joints. The architectural properties of these muscles have                              The digital flexor and extensor muscles (Table 6.3) are character-
      been described (Hermanson, 1997; Hagen et al., 2002; Brown et al.,                           ized by having long tendons relative to their muscle length. However,
      2003; Zarucco et al., 2004) and are summarized in Table 6.3. The                             there are marked differences in muscle architecture and tendon
      carpal flexors and extensors have longer muscle bellies with shorter                         properties of the deep and superficial digital flexor muscles that are
      tendons than the digital flexors and extensors. The carpal net joint                         indicative of the different roles played by these musculotendinous
      moment acts on the palmar aspect through most of stance, suggest-                            units in locomotion.
      ing that tension in the carpal flexors assists the passive tendinous                            The deep digital flexor (DDF) has three distinct muscle bellies,
      structures in maintaining joint stability (Clayton et al. 1998,                              humeral, ulnar and radial, each of which is innervated by a separate
      2000a, b). Flexor carpi ulnaris and ulnaris lateralis have short, highly                     branch of the median nerve suggestive of neuromuscular compart-
      pennated fibers (pennation angle close to 30o), which results in a                           mentalization (Zarucco et al., 2004). The DDF is also compartmen-
      large PCSA (Brown et al., 2003). Both of these muscles insert on                             talized morphologically into regions with different lengths of fibers
      the accessory carpal bone, which increases their moment arm and                              in the range 5–117 mm (Hagen et al., 2002; Brown et al., 2003;
      facilitates their ability to stabilize the carpus during stance. These                       Zarucco et al., 2004). The humeral head, which comprises about
      muscles show electromyographic activity in late swing and early                              74% of total muscle volume, has the longest fibers of any muscle
      stance (Jansen et al., 1992) indicating a possible role in stabilizing                       in the antebrachium, but also has some short and medium length
      the carpus through the impact phase. (Note that ulnaris lateralis                            fibers. Its tendon is long, but not as long as that of the ulnar head,
      represents the extensor carpi ulnaris but, since its distal attachment                       which also has long fibers but relatively small mass and PCSA
      is to the accessory carpal bone in horses, it acts as a carpal flexor                        compared with the humeral head. In contrast, the fibers in the
      rather than a carpal extensor.)                                                              radial head are short and highly pennated (pennation angle close
         Flexor carpi radialis and extensor carpi radialis (Table 6.3) have long                   to 30°). The functions of the DDF are to flex the digital joints during
      muscle fibers with small pennation angles (less than 20°), a small                           the swing phase and to generate a propulsive force during the
      PCSA, and short tendons (Brown et al., 2003). These qualities                                second half of stance. Since the DDF muscle has a relatively high
      suggest a role in initiating and controlling carpal flexion/extension                        percentage of fast-twitch fibers, it is susceptible to fatigue during
      during the swing phase. Extensor carpi radialis also shows evidence                          exercise (Hermanson & Cobb, 1992; Butcher et al., 2007). The DDF
      of a degree of compartmentalization; the proximal portion has a                              tendon, which functions as a positional tendon, has a higher
      predominance of fast-twitch fibers that can contract powerfully,                             modulus of elasticity than the SDF tendon, which is used for elastic
      while the distal portion has more slow-twitch fibers (Hermanson,                             energy storage and release (Birch, 2007). At the walk, the deep head
      1997). The fatigue resistant slow-twitch fibers arranged in series                           of DDF is active throughout stance with peaks of activity in early
      with the tendons of biceps brachii and lacertus fibrosus are part of the                     stance and late stance (Jansen et al., 1992). Horses with palmar foot
      passive stay apparatus of the forelimb. Electromyographic activity                           pain may prolong the activation of DDF in early stance to move the
      in extensor carpi radialis is concentrated at the beginning of swing                         center of pressure beneath the hoof in a dorsal direction, thereby
      (Jansen et al., 1992) when the elbow and carpus are flexing. At this                         relieving weight-bearing in the palmar part of the hoof (Wilson
      time, the net joint moment is on the cranial side of the joints                              et al., 2001).
      (Lanovaz et al., 1999) indicating that the biarticular extensor carpi                           The superficial digital flexor (SDF) muscle has a much smaller
      radialis is flexing the elbow to protract the limb and is controlling                        volume than the DDF muscle. However, the fibers are very short
104
                                                                                          Sagittal plane analysis of forelimb kinematics and kinetics
(2–10 mm) and highly pennate (pennation angle up to 60°)                       In the equine distal limb, the suspensory ligament and SDF
(Grandage, 1981; Dimery et al., 1986; Hermanson & Cobb, 1992;               tendon are primarily responsible for storing and releasing elastic
Biewener, 1998; Wilson et al., 2001; Brown et al., 2003; Zarucco            energy. They are subject to high tendon strains as the limb is loaded
et al., 2004), resulting in the largest cross-sectional area of the         during stance, especially at the trot. In the canter, overall limb
antebrachial muscles and endowing a large force-generating capac-           loading decreases with less elastic energy being stored in the SDF
ity (Hagen et al., 2002; Brown et al., 2003). As a consequence of           tendon, and the DDF tendon being more loaded (Butcher et al.,
the large pennation angle, the SDF is capable of minimal shortening         2007). With an increase in galloping speed, the DDF muscle and
and only about 71% of the total muscle force is transmitted to the          its associated tendon assume a greater role in support of the MCP
tendon. The SDF muscle has a high percentage of slow-twitch                 joint, thus relieving some stress on the SDF tendon. The DDF
muscle fibers (Butcher et al., 2007) that are resistant to fatigue. This    muscle, however, has fast-twitch fibers that contract concentrically
fiber composition is well suited for its support role as part of the        and are susceptible to fatigue. When the DDF muscle becomes
stay apparatus (Swanstrom et al., 2005), and for attenuating high-          fatigued, the SDF tendon is over-loaded and predisposed to strain
frequency forces associated with impact (Wilson et al., 2001). The          injury (Butcher et al., 2007), which occurs frequently in equine
fatigue-resistant, slow-twitch fibers of the SDF tendon act eccentri-       athletes, especially in Thoroughbred racehorses (Peloso et al.,
cally or isometrically during stance with changes in length of the          1994). Even though the elastic tendons are highly energy efficient
musculotendinous unit being due almost entirely to stretching of            and dissipate only 7% of the stored elastic energy as heat, tempera-
the elastic tendon (Butcher et al., 2007).                                  tures around 45°C have been found in the SDF tendon of race-
   The third interosseous muscle (suspensory ligament) acts as an           horses after galloping (Birch et al., 1997). Repeated loading of the
energy-storing tendon and has an even lower modulus of elasticity           musculotendinous unit during training and racing may lead to the
than the SDF tendon (Birch, 2007). It supports the metacarpopha-            accumulation of subclinical microdamage if the processes of repair
langeal (MCP) joint during the stance phase, which is critical to the       and adaptation are unable to keep up with the rate of tissue damage
function of the equine limb. During standing, the suspensory liga-          (Hill et al., 2001).
ment is fully capable of supporting the horse’s weight passively               Hoof angle affects strain distribution between the tendoligamen-
(Dyce et al., 1996). It has been speculated that reduction in the           tous structures in the distal limb. Elevation of the heels reduces peak
muscular function of the equine interosseus began about 15 million          strain in the DDF tendon and increases peak strain in the SDF
years ago, when ancestral horses were increasing in size and moving         tendon and suspensory ligament, whereas raising the toe has the
to the grasslands where efficient overground locomotion was                 opposite effects (Lawson et al., 2007).
required (Camp & Smith, 1942). Today, muscle fibers comprise
about 10% of the suspensory ligament. These muscle fibers are short
(~0.88 mm) and highly pennate (pennation angles >45°), which                Sagittal plane analysis of forelimb kinematics
increases the PCSA and contributes to the ability to generate forces
but produces little work. The vast majority (95%) of the muscle
                                                                            and kinetics
fibers are type I, and presumably slow-twitch (Wilson et al., 2001;
Soffler & Hermanson, 2006). Thus, the muscular content of the               The joints of the horse’s forelimb from the elbow distally are more
suspensory ligament is small but significant and the architecture of        or less constrained to move in a sagittal plane with relatively small
the fibers suggests that it contributes to forelimb stability and elastic   amounts of abduction/adduction and internal/external rotation
energy storage during locomotion.                                           (Thompson et al., 1992; Degueurce et al., 1996). Studies of three-
   The common digital extensor (CDE) (Table 6.3) and lateral                dimensional forelimb kinematics, which will be described at the
digital extensor muscles have long fibers, small PCSA and long              end of this chapter, have confirmed that flexion/extension is the
tendons (Brown et al., 2003). The CDE muscle is active in terminal          dominant rotation at the carpal, metacarpophalangeal, proximal
swing at the walk, when it extends the digit in preparation for             interphalangeal (PIP) and distal interphalangeal (DIP) joints
ground contact, (Jansen et al., 1992). The CDE tendon has a stiffer         (Chateau et al., 2004, 2006; Clayton et al., 2004, 2007a, b; Hobbs
matrix than the SDF tendon, which may be due to the smaller fibril          et al., 2006). Inverse dynamic analysis has been used to calculate
diameters (Birch, 2007).                                                    net moments of force, net joint powers and net joint energies for
   As horses bounce over the ground in the trot, canter and gallop,         the joints of the equine forelimb at walk and trot (Hjertén &
the forelimbs have been estimated to contribute one-third of the            Drevemo, 1993; Clayton et al., 1998, 2000a, b; Colborne et al.,
energy storage compared with two-thirds in the hind limbs                   1998; Lanovaz et al., 1999; Hodson et al., 2000; Khumsap et al.,
(Biewener, 1998). During trotting, changes in potential and kinetic         2002, Dutto et al., 2006).
energy of the horse’s center of mass are in phase, which allows the            When using skin markers to represent two-dimensional motion
distal limb to make substantial contributions to elastic energy             of the limb segments, a minimum of two markers per segment is
storage (Biewener, 1998). In canter and gallop, the relationship            required. Typical marker configurations involve either placing a
between kinetic and potential energy varies during the stride               marker over the center of rotation of each joint or aligning two
(Minetti et al., 1999), which limits the ability to store elastic           markers along the long axis of each segment (Fig. 6.4). Intra-limb
energy in the distal limb. At faster speeds, vertical excursions of         coordination patterns can be visualized using stick figures or joint angle–
the center of mass are reduced and the limb sweeps through a                time graphs (Fredricson & Drevemo, 1972; Fleiss et al., 1984;
larger angle during its stance phase causing the horse to bounce            Martinez-del Campo et al., 1991; Holmström et al., 1994; Back
off the ground more quickly (Farley et al., 1993). The concept              et al., 1994; Degueurce et al., 1997; Nicodemus & Holt, 2006;
of the forelimb acting as a spring implies that changes in joint            Martuzzi et al., 2007; Nicodemus & Booker, 2007).
angles as the limb accepts weight result in shortening of the bony             Skin displacement relative to the underlying bones is always a
column and stretching of the musculotendinous units. During gal-            concern when kinematic studies are based on skin-fixed markers.
loping, the proximal limb from scapula to elbow shortens by                 In the equine forelimb, artifacts due to skin displacement may be
about 12 mm, whereas the limb distal to the elbow shortens                  small enough to be negligible on the antebrachial and metacarpal
by around 127 mm. One of the most obvious articular changes is              segments, but are large enough to alter sagittal plane kinematics
extension of the MCP joint, the magnitude of which can be pre-              significantly on the scapular, brachial, and pastern segments. Since
dicted from vertical ground reaction force (McGuigan & Wilson,              skin displacement has a cyclic pattern, it has been possible to
2003). In general, the limb spring is stiffer in larger animals             develop mathematical correction algorithms for many of the ana-
but, within an individual, stiffness of the limb spring is nearly           tomical locations that are commonly used for marker placement
independent of speed.                                                       (van Weeren et al., 1990a, b; Sha et al., 2004).
                                                                                                                                                          105
           6       Forelimb function
                                             12
                                                                                          Shoulder joint
      11                                                                                  The shoulder joint is extended at initial ground contact, then flexes
                                                                                          as the limb is loaded. There is so much skin movement over the
                                                  11                                      scapula and humerus that it is not possible to describe shoulder
                                                                                          joint kinematics in late stance or during the swing phase based on
                                                       10                                 skin-fixed markers unless correction procedures are applied (Fig.
                                                                                          6.5) (van Weeren et al., 1990a; Back et al., 1995a). The net joint
                                                                                          moment at the shoulder (Fig. 6.6) moves from the cranial to the
                                                            9                             caudal aspect and back to the cranial (extensor) aspect in early
                                   10                                                     stance, then sustains a cranial (extensor) moment until lift-off due
                                                                                          to the action of biceps brachii assisted by other extensors of the
                                                            8                             shoulder (Clayton et al., 1998). The power profile suggests a com-
                                     7                                                    ponent of elastic energy storage and release as the joint is loaded
                                                            6                             in early stance, followed by energy generation on the extensor aspect
                                                                              5           in terminal stance (Fig. 6.6). Early in the swing phase, there is an
                                                                                          extensor moment at the shoulder joint as the extensor musculature
                                                            4
                                                                                          acts eccentrically to control flexion, then the net joint moment
                   4                     5                                                moves to the flexor side, where the muscles work eccentrically to
                                                                            14            slow extension and initiate flexion (Lanovaz et al., 1999; Clayton
                                                        1                   3             et al., 1998; Singleton et al., 2003).
               2
           A                                      B
      Fig 6.4  Bony landmarks underlying skin-fixed markers in two marker-                Elbow joint
      placement schemes. Left: markers placed over centers of joint rotation with         The elbow joint extends through most of stance reaching maximal
      limb segments being represented by lines joining the markers. Right: two            extension near the end of stance (Fig. 6.7). During the swing phase
      markers placed along the long axis of each segment are joined to represent          it undergoes a flexion cycle. The amplitudes of flexion and extension
      the segment with adjacent segments intersecting at the joints. The hoof             do not appear to be influenced much by skin displacement, but
      may be represented by different combinations of markers with radiographic           without correction the swing phase flexion peak occurs somewhat
      identification of the center of rotation of the DIP joint relative to the hoof      later (Fig. 6.4) (van Weeren et al., 1990a; Back et al., 1995a).
      markers. 1, hoof at toe; 2, hoof at mid-lateral distal wall; 3, hoof at heel;          The net joint moment at the elbow acts predominantly on the
      4, hoof at coronary band; 5, distal condyle of metacarpus; 6, proximal
                                                                                          caudal (extensor) side during most of the stance phase to resist
      metacarpus; 7, ulnar carpal bone; 8, distal radius at lateral styloid process; 9,
                                                                                          collapse of the joint under the influence of gravity (Fig. 6.7). This
      proximal radius at collateral ligament of elbow; 10, distal humerus at lateral
      epicondyle; 11, proximal humerus at caudal greater tubercle; 12, distal
                                                                                          is probably due to the action of triceps brachii, which shows electro-
      scapular spine; 13, proximal scapular spine; 14, proximal first phalanx.            myographic activity at this time (Korsgaard, 1982; Tokuriki et al.,
                                                                                          1989; Robert et al., 1998). The net joint moment shifts to the
                                                                                          cranial (flexor) side of the elbow in latestance. The power profile
                                                                                          indicates a phase of energy generation and absorption in early
                                                                                          stance, followed by a larger phase of energy generation in mid-
                                                                                          stance (Fig. 6.7). There is a final period of energy absorption on
      The trot                                                                            the flexor aspect as elbow extension slows at the end of stance
      The trot is the most important gait for evaluation of the quality of                (Singleton et al., 2003). During the first half of swing, the elbow
      a horse’s movement and for detection of lameness. It is a two-beat                  flexes with a flexor moment (Lanovaz et al., 1999) indicating active
      gait with the limbs coordinated by diagonal pairs. The diagonal                     flexion driven by the internal tendon of biceps brachii and flexor
      support phases are usually separated by aerial or suspension phases                 muscles, such as brachialis (Tokuriki et al., 1989). There is a short
      in which all feet are off the ground (Alexander & Jayes, 1978). Back                period at midswing when the elbow continues to flex after the net
      et al. (1995a) used standardized procedures to describe sagittal                    joint moment has moved to the extensor side coinciding with
      plane kinematics of the trot in a large group of Warmblood horses.                  the activation of triceps brachii (Korsgaard, 1982; Tokuriki et al.,
      The joint angle–time diagrams were analyzed simultaneously with                     1989) and, later, flexor carpi ulnaris (Korsgaard, 1982; Jansen et al.,
      corresponding stick figures and marker diagrams to create a com-                    1992). The elbow extensor muscles slow flexion (eccentric action)
      plete picture of equine forelimb motion at the trot that could be                   and then actively extend the elbow joint (concentric action) in
      related to limb function (Back et al., 1995a). Variability between                  preparation for ground contact (Lanovaz et al., 1999; Singleton
      horses was evaluated, and the effect of correcting for skin displace-               et al., 2003).
      ment on joint angle–time diagrams was quantified and illustrated
      graphically (Fig. 6.5) (van Weeren et al., 1990a; Back et al., 1995a).
                                                                                          Carpal joint
                                                                                          After initial ground contact the carpus quickly snaps into its over-
      Scapula                                                                             extended (close-packed) position and remains in this stable posi-
      The scapula rotates around a point close to its proximal end                        tion during most of stance. At faster trotting speeds, the carpus
      with a sinusoidal pattern that corresponds with protraction and                     may snap into its stable position just before initial ground contact
106
                                                                                                                     Sagittal plane analysis of forelimb kinematics and kinetics
Fig 6.5  Mean joint angle–time diagrams of the forelimb of an individual horse trotting on a treadmill at a speed of 3 m/s before (continuous line) and after
(dotted line) correction for skin displacement.
Reprinted from Back, W., Schamhardt, H.C., Savelberg, H.H.C.M,. et al. (1995a) How the horse moves: significance of graphical representations of equine forelimb kinematics. Equine Vet. J. 27,
31–38, with permission from the Equine Veterinary Journal.
(Back et al., 1993, 1995a; Johnston et al., 1997). A functional simi-                              where it controls the whiplash effect in the distal limb that results
larity between the equine carpus and the human knee has been                                       in carpal extension (Fig. 6.8) (Lanovaz et al., 1999). The flexor
identified (Colborne et al., 1997a,b). After a second extension peak                               moment increases during the last one-third of swing as flexor carpi
at midstance, the carpus starts to flex and, before the end of stance,                             ulnaris is activated (Korsgaard, 1982). In preparation for initial
initiates rapid flexion that peaks in midswing (Fig. 6.8). Correction                              ground contact, elbow extension is accompanied by synchronous
for skin displacement does not significantly alter carpal kinematics                               extension of the carpus and MCP joint with a proximal to distal
(Fig. 6.4) (van Weeren et al., 1990a; Back et al., 1995a). The amount                              transfer of angular momentum.
of hyperextension during stance increases with speed and is greater                                   If the carpal joint of an anesthetized horse is flexed, it snaps back
when moving on an uphill gradient than when traveling on flat                                      into its stable extended position. The mechanism responsible is
ground at the same speed (Burn et al., 2006).                                                      known as the clicking phenomenon (Alexander & Trestik, 1989). It
   The net carpal moment is on the palmar aspect through most of                                   is due to the eccentric attachments of the collateral ligaments rela-
stance and peaks around midstance indicating that the deep palmar                                  tive to their rotation axis, which makes the joint bistable: it springs
carpal ligament and other soft tissues on the palmar aspect limit                                  either into full extension or strong flexion. Functions attributed to
hyperextension (Fig. 6.8) (Clayton et al., 1998). There are small                                  this clicking phenomenon include storage of elastic energy (Rooney,
bursts of positive and negative work but, compared with the other                                  1990) and damping of oscillations (Mosimann & Micheluzzi,
forelimb joints, the carpus plays only a small role in energy genera-                              1969). The moments required to produce these movements in vitro
tion and absorption in the stance phase. However, it does play an                                  are so small compared to those occurring in vivo that if the clicking
important role in supporting the forelimb as a propulsive strut                                    phenomenon plays any role in locomotion, it must be during the
(Smythe et al., 1993).                                                                             swing phase when the limb is not loaded. It is speculative whether
   During early swing, carpal flexion is controlled by an extensor                                 the inflection in the carpal flexion curve in early swing that coin-
moment (Lanovaz et al., 1999) that is most likely due to the action                                cides with the first metacarpophalangeal flexion peak is due
of passive structures, such as lacertus fibrosus, together with activa-                            to a clicking phenomenon and thus enables rapid movement
tion of extensor carpi radialis (Korsgaard, 1982; Jansen et al., 1992).                            (Palmgren, 1929) contributing to the elegance of gait (Alexander &
In midswing, the moment at the carpus moves to the flexor side                                     Trestik, 1989).
                                                                                                                                                                                                  107
                       6          Forelimb function
140 150
                                                                                                         140
                       135
      Angle (deg)
                                                                                           Angle (deg)
                                                                                                         130
                       130
                                                                                                         120
                       125                                                                               110
                              0           20          40                60   80   100                           0      20          40               60    80         100
1.5 0.3
1.0 0.2
0.1
                                                                                        Moment (Nm/kg)
      Moment (Nm/kg)
                       0.5
                                                                                                         0.0
                                                                                                                       20          40               60    80         100
                       0.0                                                                               -0.1
                                          20          40                60   80   100
                                                                                                         -0.2
                       -0.5
                                                                                                         -0.3
                       -1.0                                                                              -0.4
                                                                                                                                   Time (% stance)
                       3.0                                                                               3.0
                       2.0
      Power (W/kg)
Power (W/kg)
                       1.0                                                                               0.0
                                                                                                                       20          40               60    80         100
                       0.0
                                          20          40                60   80   100
                       -1.0                                                                              -1.0
                                                           Stance (%)                                                                   Swing (%)
                 A                                                                                 B
      Fig 6.6  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
      positive) for the shoulder joint during the stance phase (left) and swing phase (right) at the trot.
                                                                                                         joint and its maximal palmar moment. Both the SDF and DDF
      Metacarpophalangeal (MCP) joint                                                                    muscles contract actively in the first half of stance (Korsgaard,
      The angle-time graph (Fig. 6.9) shows rapid fetlock extension in                                   1982) to generate a palmar moment at the distal joints (Lanovaz
      early stance peaking at midstance, after which the joint flexes                                    et al., 1999). In addition, the proximal and distal accessory liga-
      through late stance, sometimes with an inflexion preceding hoof                                    ments provide mechanisms for passive support and the generation
      lift. During the swing phase, two flexion peaks are separated by a                                 of a palmar moment later in stance. The net joint power profile of
      slight extension, and then, in late swing, the fetlock extends in                                  the MCP joint during stance shows almost equal amounts of nega-
      preparation for ground contact. Correction for skin displacement                                   tive and positive work (Clayton et al., 1998), which is typical of
      does not change the MCP joint pattern when the proximal (P1)                                       elastic energy storage and release. Energy is absorbed in the first
      and middle (P2) phalanges are treated as a single, rigid segment                                   half of stance by the SDF tendon and suspensory ligament then
      (Back et al., 1995a). The net joint moment (Fig. 6.9) acts on the                                  released later as a result of elastic recoil.
      palmar (flexor) side of the MCP joint during the entire stance                                        In the swing phase, the MCP joint shows two flexion peaks (Fig.
      phase peaking around midstance (Clayton et al., 1998). This                                        6.9) (Back et al., 1995a; Lanovaz et al., 1999), the first of which
      reflects the elastic support of the palmar soft tissues as the MCP                                 occurs soon after toe-off and is an elastic phenomenon due to
      joint extends during weight acceptance then flexes for push-off.                                   loading of the SDF tendon and suspensory ligament during the
      The SDF tendon, DDF tendon and suspensory ligament experience                                      preceding stance phase. The amount of flexion is controlled by a
      peak strains around midstance (Riemersma et al., 1988a, b),                                        net dorsal moment provided by the digital extensor tendons
      which corresponds with the time of peak extension of the MCP                                       (Lanovaz et al., 1999). After the elastic rebound, MCP joint flexion
108
                                                                                                            Sagittal plane analysis of forelimb kinematics and kinetics
140 140
                                                                                  Angle (deg)
Angle (deg)
                                                                                                 130
               135
                                                                                                 120
               130                                                                               110
                      0   20    40                60      80          100                               0     20           40               60      80          100
1.3 0.20
0.9 0.10
                                                                            Moment (Nm/kg)
Force (N/kg)
               0.5                                                                            0.00
                                                                                                              20           40               60      80          100
               0.1                                                                           -0.10
                          20    40                60      80          100
               -0.3                                                                          -0.20
5.0 0.8
                                                                                                 0.6
               3.0
Power (W/kg)
Power (W/kg)
                                                                                                 0.4
               1.0
                                                                                                 0.2
                          20    40                60      80          100
               -1.0
                                                                                                   0
                                                                                                              20           40               60      80          100
               -3.0                                                                              -0.2
          A                          Stance (%)                                              B                                  Swing (%)
Fig 6.7  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
positive) for the elbow joint during the stance phase (left) and swing phase (right) at the trot.
can be fully explained by inertial forces: the dip in the joint flexion                       tendon acting through its distal accessory ligament combined with
curve is simply a relative extension of the MCP joint due to rapid                            tension in the navicular ligaments. The extensor branches of the
flexion of the carpus. When carpal flexion slows, MCP flexion                                 suspensory ligament are taut to control hoof placement and prevent
resumes. After midswing, the proximal forelimb is decelerated and                             buckling of the interphalangeal joints in early stance (Jansen et al.,
a distal transfer of angular momentum results in a whiplash effect                            1992). Later in stance, the DIP joint extends against a palmar
in the digit, causing the MCP joint to extend under the control of                            moment provided by the DDF tendon acting through its distal
a net palmar moment. Many of the movements of the MCP joint                                   accessory ligament (Riemersma et al., 1988a, 1998b). In early
are driven inertially in the swing phase, with input from the flexor                          swing, a small extensor moment controls joint flexion after lift-off
and extensor muscles in late swing that prepares the hoof for                                 (Lanovaz et al., 1999). Since there is little evidence of activity in the
ground contact.                                                                               extensor muscles at this time (Korsgaard, 1982; Jansen et al., 1992),
                                                                                              this can be interpreted as a passive effect of tendinous and ligamen-
                                                                                              tous attachments. As the limb extends in the later part of the swing
Distal interphalangeal (DIP) joint                                                            phase, there is a whiplash effect with angular momentum being
The DIP joint flexes in early stance reaching maximal flexion before                          transferred distally causing the DIP joint to extend under the control
midstance (Fig. 6.10), then extends as the forelimb is retracted.                             of a flexor moment provided by the DDF muscle (Korsgaard, 1982;
Maximal extension occurs just after heel-off, after which the DIP                             Jansen et al., 1992) that slows joint extension prior to initial ground
joint flexes rapidly through early swing (Back et al., 1995a). The net                        contact.
DIP joint moment (Fig. 6.10) acts on the palmar (flexor) side                                    The power curve (Fig. 6.10) has a burst of energy absorption
throughout the stance phase, peaking at 63% stance (Clayton et al.,                           beginning one-third of the way through stance, peaking around
1998). The palmar moment is provided by tension in the DDF                                    75% stance when the longitudinal propulsive force is maximal, and
                                                                                                                                                                          109
                       6          Forelimb function
190
                       185
         Angle (deg)
180
                                                                                                           180
                       175
                                                                                          Angle (deg)
                                                                                                           160
                       170
                              0           20          40                60   80   100                      140
                                                                                                           120
                       0.0
                                          20          40                60   80   100
                                                                                                           100
                                                                                                                  0       20         40               60     80         100
      Moment (Nm/kg)
                                                                                                            0.1
                       -1.0
                                                                                          Moment (Nm/kg)
                                                                                                            0.0
                                                                                                                          20         40               60     80         100
-2.0
2.0 -0.1
                       1.0                                                                                 0.05
      Power (W/kg)
-1.0 -0.15
-2.0 -0.25
                       -3.0                                                                            -0.35
                 A                                         Stance (%)                               B                                     Swing (%)
      Fig 6.8  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
      positive) for the carpal joint during the stance phase (left) and swing phase (right) at the trot.
      continuing into breakover as the DIP joint extends against a palmar                                  distal limb. In midswing, the forward velocity of the proximal limb
      moment and acts as an energy damper (Clayton et al. 1998).                                           is reduced and it may even stop rotating temporarily, which pro-
                                                                                                           duces a whiplash effect that advances the distal limb rapidly with
                                                                                                           a proximal to distal transfer of angular momentum that helps to
      Functional interpretation                                                                            conserve energy during swing (Hildebrand, 1987).
      In the swing phase, forelimb motion has been likened to a pendu-                                        During the stance phase, the net joint moment is on the caudal/
      lum rotating around the proximal scapula (Krüger, 1938). All the                                     palmar side of all joints except the shoulder through most of the
      forelimb joints have their net joint moment on the cranial/dorsal                                    stance phase at the trot (Clayton et al., 1998). During impact, the
      side at the start of swing (Lanovaz et al., 1999), which is the exten-                               hoof is decelerated and impact shock is absorbed by mechanisms
      sor side for all joints except the elbow. The elbow joint drives the                                 that include shortening of the limb at the distal radius and proximal
      forelimb movements during the swing phase at the trot; at the other                                  metacarpus (Hjertén & Drevemo, 1993), with a corresponding
      joints the muscles act eccentrically to control the motion of the                                    deviation in the vertical GRF (Merkens & Schamhardt, 1994). At the
      joints (Lanovaz et al., 1999). This is associated with generally low                                 same time, rapid flexion of the DIP, MTP, and elbow joints assist in
      EMG signals during the majority of swing (Korsgaard, 1982;                                           damping the rapid build-up of force at impact (Back et al., 1995c;
      Tokuriki et al., 1989; Jansen et al., 1992). The cranial/dorsal                                      Johnston et al., 1995). Forelimb mechanics in the stance phase at
      moments gradually decrease in magnitude and move to the caudal/                                      trot are described in terms of a spring-mass system in which limb
      palmar side between 35% and 52% of swing. Peak values of the                                         loading by the body mass stretches elastic springs that subsequently
      swing phase net joint moments decrease in a proximal to distal                                       recoil as the limb is unloaded thus increasing the efficiency of gait
      direction, with peak moments at the shoulder and elbow joints                                        (Dimery et al., 1986). The shoulder, elbow, carpal and MCP joints
      being several times larger than those at the distal joints. At the                                   show elastic behavior (Clayton et al., 1998) with the MCP joint
      elbow, the net joint moment actively flexes and extends the joint                                    being the main site of elastic energy storage and release primarily
      during swing, which has the effect of protracting and retracting the                                 due to the actions of the SDF tendon and the suspensory ligament.
110
                                                                                                              Sagittal plane analysis of forelimb kinematics and kinetics
240
                 230
                                                                                                 200
   Angle (deg)
                 220
                                                                                                 180
                                                                               Angle (deg)
                 210
                                                                                                 160
                 200
                        0   20   40                60     80           100
                                                                                                 140
                                                                                                        0        20          40               60      80          100
                 0.0
                            20   40                60     80           100
                 -0.2                                                                            0.01
                 -0.4
Moment (Nm/kg)
-0.6
                                                                                Moment (Nm/kg)
                 -0.8
                 -1.0                                                                             0.0
                 -1.2                                                                                            20          40               60      80          100
                 -1.4
                 -1.6
                 -1.8                                                                        -0.01
                 6.0
                                                                                                 0.04
                 4.0
                                                                                             -0.00
                                                                                                                 20          40               60      80          100
                 2.0
Power (W/kg)
Power (W/kg)
                                                                                             -0.04
                 0.0
                            20   40                60     80           100                   -0.08
                 -2.0
                                                                                             -0.12
                 -4.0
-6.0 -0.16
Fig 6.9  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
positive) for the metacarpophalangeal joint during the stance phase (left) and swing phase (right) at the trot. The pastern segment (proximal and middle
phalanges) was treated as a rigid segment.
In addition to their role in energy efficiency, the limb springs act as                          similar with regard to the joint motion pattern and swing duration
shock absorbers (Schauder, 1952).                                                                (Table 6.3, Fig. 6.11), but the faster speed of the trot requires the
                                                                                                 limb to perform the same movements in a shorter time. Similarities
                                                                                                 in stance distance and swing time at different speeds and in differ-
The walk                                                                                         ent gaits (Table 6.4) have also been noted in cats and dogs (Grillner,
Like the trot, the walk is a symmetrical gait, but inter-limb coordina-                          1975). The limbs cover a shorter distance over the ground during
tion is quite different in walking and trotting. The walk is a four-beat                         the swing phase at walk and there is less forelimb protraction. Also,
gait with a lateral sequence of limb placements and support                                      the elbow and carpal joints are less flexed in the swing phase at
sequences that always include at least one fore and one hind foot                                walk, resulting in a longer pendulum and a slower forward motion
on the ground. The walk does not have a suspension phase and                                     with less protraction. Apparently, the limbs have to be more loaded
walking mechanics are described in terms of an inverted pendulum                                 during stance and more flexed during swing to enable faster
mechanism that implies an exchange between kinetic and potential                                 locomotion.
energy as the body vaults over the supporting limb (see Chapter 19).                               The forelimb MCP joint extension pattern is quite different at
   In the literature, forelimb stick figures and joint angle–time dia-                           walk and trot (Fig. 6.11). In walking, there are two extension peaks
grams for the walk have been reported for individual horses (Walter,                             that ‘melt’ together at the trot, which mirrors the vertical ground
1925; Krüger, 1937, 1938; Fleiss et al., 1984) and for groups of                                 reaction force traces at walk and trot (Niki et al., 1982; Back et al.,
horses of various breeds (Back et al., 1996; Galisteo et al., 1996;                              1996; Khumsap et al., 2002). Schryver et al. (1978) explained this
Hodson et al., 2000; Nicodemus & Holt, 2006; Martuzzi et al.,                                    phenomenon as a result of the transition from a double to a single
2007). In a comparison of the kinematics of walk (1.6 m/s) and                                   limb support. Alexander and Jayes (1978) proposed that this phe-
trot (4.0 m/s), Back et al. (1996) showed that the two gaits were                                nomenon was related to mechanical properties of the distal limb
                                                                                                                                                                            111
                       6          Forelimb function
210 210
                                                                                                             200
                       190
      Angle (deg)
                                                                                          Angle (deg)
                                                                                                             190
                       170
                                                                                                             180
                       150                                                                                   170
                              0           20          40                60   80   100                              0     20          40               60     80         100
                       0.0                                                                                0.02
                                          20          40                60   80   100
                                                                                                          0.01
      Moment (Nm/kg)
                                                                                        Moment (Nm/kg)
                                                                                                          0.00
                       -0.2                                                                                              20          40               60     80         100
                                                                                                         -0.01
-0.02
-0.4 -0.03
1.0 0.04
                       0.0                                                                                0.02
                                          20          40                60   80   100
      Power (W/kg)
Power (W/kg)
                       -1.0                                                                               0.00
                                                                                                                         20          40               60     80         100
-2.0 -0.02
-3.0 -0.04
      Fig 6.10  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
      positive) for the distal interphalangeal joint during the stance phase (left) and swing phase (right) at the trot. The pastern segment (proximal and middle
      phalanges) was treated as a rigid segment.
      and presented a mathematical model that is capable of describing                                    neck, which undergo larger excursions as velocity increases. The
      both possibilities and the gradation between them. Computer sim-                                    timing of these oscillations is such that the head is lowered as each
      ulation experiments have shown that oscillations in the vertical GRF                                forelimb provides a braking force and raised as each forelimb pro-
      have roughly (not exactly, since muscle stiffness depends on muscle                                 vides propulsion. The resulting torque around the cervicothoracic
      activation) the same frequency in walk and trot (van den Bogert,                                    junction tends to rotate the trunk in the opposite direction, which
      1989). Thus, in the trot only one peak occurs since the limb is lifted                              increases the braking effect as the head is lowered and increases the
      before the second peak.                                                                             propulsive effect as the head is raised (Khumsap et al., 2002). There-
         Peak vertical ground reaction force is smaller at walk than trot                                 fore, the larger head and neck excursions at faster walking velocities
      (Ueda et al., 1981; Merkens & Schamhardt, 1994; Schamhardt &                                        are a mechanism to increase braking in early stance and propulsion
      Merkens, 1994), which is not surprising since a suspension phase                                    in late stance, with the balance between braking and propulsion
      is lacking in the walk. The vertical force has two peaks separated by                               being maintained regardless of velocity.
      a slight dip, with the second peak being higher than the first in the                                  During the walking stance phase, retraction of the forelimb is
      forelimbs (Merkens & Schamhardt, 1988; Hodson et al., 2000). As                                     associated with the predominant joint moment being on the
      walking speed increases, the heights of both peaks increase. The                                    caudal/palmar aspect of all forelimb joints except the shoulder, at
      longitudinal ground reaction force initially has a braking effect,                                  which the peak moment is considerably higher than at any other
      followed by a propulsive effect, with the braking impulse being                                     joint (Clayton et al., 2000b). The net moment moves to the cranial/
      larger than the propulsive impulse in the forelimbs. Peak braking                                   dorsal side of all the joints during protraction in early swing, then
      and propulsive forces increase with walking velocity but the corre-                                 moves to the caudal/palmar side in late swing as protraction slows
      sponding impulses decrease (Khumsap et al., 2002) as a conse-                                       and retraction begins.
      quence of a large reduction in stance duration.                                                        The entire forelimb shows a net absorption of energy in both
         The velocity-dependent increases in peak ground reaction forces                                  stance and swing phases (Clayton et al., 2000a). The elbow pro-
      are thought to be associated with cyclic movements of the head and                                  vides most of the positive work and is the only joint that shows net
112
                                                                                                                                           Sagittal plane analysis of forelimb kinematics and kinetics
                                                                            Angle (degrees)
                                                                                               60                                                         aligned: extension is negative; flexion is positive.
                                                                                                                                                          The red bar represents the duration of the
                   65                                                                                                                                     forelimb stance phase at walk. The green bar
                                                                                               40                                                         represents the duration of the forelimb stance
                   60                                                                                                                                     phase at trot.
                                                                                                                                                          Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M.,
                                                                                               20
                  55                                                                                                                                      Scharmhardt, 1994, Kinematics of treadmill versus
                                                                  Walk                                                                          Walk
                  Ext                                              Trot                       Ext                                                Trot
                                                                                                                                                          overground locomotion in horses, Veterinary Quarterly, 16,
                  50                                                                           0                                                          sup 2, with permission from Taylor & Francis Ltd, http://
                         0        20       40       60       80       100                            0           20      40       60       80       100   www.informaworld.com.
                                        Time (% of stride)                                                            Time (% of stride)
                   100                                                                          40
                  Flex       Carpus                                                           Flex       Fore fetlock
                    80                                                                         20
                    60                                                                          0
Angle (degrees)
Angle (degrees)
40 -20
20 -40
                    0                                                                         -60
                                                                  Walk                                                                          Walk
                  Ext                                              Trot                       Ext                                                Trot
                  -20                                                                         -80
                         0        20       40       60       80       100                            0        20         40       60       80       100
                                        Time (% of stride)                                                            Time (% of stride)
 generation of energy over the entire stride. Bursts of energy genera-                                                      is the leading limb. Horses use a transverse sequence in which the
 tion at the elbow occur on the extensor (caudal) aspect in early                                                           trailing and leading limbs are on the same side for the fore and
 stance to maintain forward motion of the trunk as the braking                                                              hind limb pairs. The sequence of footfalls is trailing hind limb,
 longitudinal force increases and on the flexor (cranial) aspect                                                            leading hind and trailing forelimbs together, then the leading fore-
 during breakover to initiate swing phase protraction. Extension of                                                         limb. An aerial (suspension) phase usually follows lift-off of the
 the carpus aligns the limb allowing it to act as a supportive strut                                                        leading forelimb.
 during stance, but does not play an important role in either energy                                                           In the literature, the canter has been described at speeds ranging
 absorption or generation. A small burst of positive work on the                                                            from 3.0 to 11.0 m/s under various circumstances overground and
 flexor aspect of the carpus at the start of breakover is indicative of                                                     on a treadmill (Clayton, 1994, 1995; Corley & Goodship, 1994;
 an active role in initiating breakover at the walk. The fetlock func-                                                      Deuel & Park, 1990; Back et al., 1997). Forelimb kinematic patterns
 tions elastically to store and release strain energy during stance,                                                        during cantering have been illustrated using stick figures (Walter,
 while the coffin joint acts as an energy damper through most of                                                            1925; Krüger, 1937, 1938), and have been described in terms of
 stance with a small burst of energy generation on the flexor aspect                                                        inter-limb timing variables (Deuel & Park, 1990; Clayton, 1993,
 during breakover. An increase in walking velocity is not accompa-                                                          1994; Nicodemus & Booker, 2007). Changes in temporal and linear
 nied by a comparable increase in energy generation across the joints                                                       kinematics induced by training have been documented (Corley &
 of the forelimb (Khumsap et al., 2002).                                                                                    Goodship, 1994).
    In the swing phase, peak magnitudes of the net joint powers                                                                Back et al. (1997) compared the kinematics of the leading and
 decrease in a proximal to distal sequence (Clayton et al., 2000a).                                                         trailing forelimbs of Dutch Warmbloods, cantering on a treadmill
 The elbow is the only joint that has a positive power profile, which                                                       at a speed of 7.0 m/s (Fig. 6.12). The leading forelimb is more
 is indicative of its role in driving limb protraction and retraction.                                                      protracted due to greater elbow flexion, whereas the trailing fore-
 Power is generated by the elbow flexors in early swing to protract                                                         limb is retracted further due to greater caudal rotation of the
 the distal limb and by the elbow extensors later in swing to                                                               scapula. Also, the MCP joint is more extended in the trailing fore-
 reverse the direction of limb movement in preparation for ground                                                           limb suggesting that this limb is relatively more loaded than the
 contact. The shoulder joint absorbs energy during swing. At the                                                            leading forelimb (Sloet et al., 1995), which is in accordance with
 carpal and digital joints, net joint powers act to control joint                                                           force plate studies showing higher vertical forces in the trailing
 motions that are driven by inertial forces.                                                                                forelimb of horses ridden overground at the canter (Niki et al.,
                                                                                                                            1984; Merkens et al., 1993) (Table 6.4). In order to achieve the
                                                                                                                            larger range of protraction and retraction in the trailing forelimb,
 The canter                                                                                                                 the carpal joint is more flexed in the swing phase to allow the distal
 The canter is an asymmetrical gait in which the footfalls of the                                                           limb to rotate further in the same swing time. Greater carpal flexion
 forelimb pair and hind limb pair occur as couplets. The first limb                                                         has been reported as an effect of training in young Thoroughbreds
 of the couplet to contact the ground is the trailing limb, the second                                                      (Corley & Goodship, 1994) and Quarter Horses (Deuel, 1994).
                                                                                                                                                                                                                       113
           6     Forelimb function
       Table 6.4  Forelimb kinematic variables for horses walking at 1.6 m/s, trotting at 4.0 m/s (Back et al., 1996) and cantering at 7.0 m/s (Back
       et al., 1997)
Stance duration (s) 0.69 ± 0.04* 0.27 ± 0.01* 0.18 ± 0.01 0.19 ± 0.02
Stance duration (%) 63.2 ± 1.7* 40.3 ± 1.7* 33.6 ± 1.4 34.5 ± 2.4
Swing duration (s) 0.40 ± 0.03 0.40 ± 0.03 0.36 ± 0.02 0.36 ± 0.03
       Scapula
       Angle of max protraction (°)                         20.2 ± 1.6*                      21.5 ± 1.5*                 24.9 ± 2.1#                              33.4 ± 3.2#
       Angle of max retraction (°)                        −22.5 ± 1.7                      −22.8 ± 1.5                  −31.6 ± 1.8#                             −24.7 ± 1.7#
       Max pro-/retraction range (°)                        42.8 ± 2.5*                      44.4 ± 1.7*                 56.5 ± 1.6                               58.1 ± 3.2
       Shoulder joint
       Angle of max extension (°)                           53.8 ± 5.9                       54.6 ± 4.2                  83.7 ± 3.9                               80.2 ± 4.4
       Angle of max flexion (°)                             66.9 ± 4.2*                      69.9 ± 5.1*                 −0.5 ± 0.8                               −2.0 ± 2.2
       Range of motion (°)                                  13.1 ± 1.9                       15.3 ± 1.8                  25.8 ± 1.6#                              23.9 ± 2.3#
       Elbow joint
       Angle of max extension (°)                           23.4 ± 3.1*                      24.5 ± 3.1*                 20.1 ± 2.1#                              23.5 ± 3.8#
       Angle of max flexion (°)                             75.2 ± 3.6*                      84.7 ± 4.3*                 81.9 ± 4.6#                              91.2 ± 6.7#
       Range of motion (°)                                  51.8 ± 3.6*                      60.2 ± 4.0*                 61.8 ± 4.8#                              67.7 ± 5.6#
       Carpal joint
       Angle of max extension (°)                            1.3 ± 2.3*                      −2.9 ± 2.6*                 −6.7 ± 3.6                               −4.4 ± 2.8
       Angle of max flexion (°)                             69.9 ± 6.2*                      87.9 ± 7.4*                 83.0 ± 7.9  #
                                                                                                                                                                  91.2 ± 8.3#
       Range of motion (°)                                  68.7 ± 5.7*                      90.8 ± 7.1*                 89.7 ± 7.0                               95.6 ± 8.1
       Metacarpophalangeal joint
       Angle of max extension (°)                         −41.1 ± 6.1*                     −55.9 ± 6.2*                 −62.4 ± 4.7                              −59.0 ± 8.1
       Angle of max flexion (°)                             16.5 ± 6.4*                      21.3 ± 6.8*                 22.8 ± 7.3#                              29.1 ± 6.1#
       Range of motion (°)                                  60.2 ± 1.4*                      80.6 ± 7.1*                 85.2 ± 8.0                               88.1 ± 7.5
       Joint angles are defined zero when the adjacent bone segments are aligned: extension is negative; flexion is positive. Scapular angle is measured relative to the vertical;
       protraction angles are positive, retraction angles are negative. Values are mean ± SD.
       *Variables that differ significantly between walk and trot (p <0.05).
       #
        Variables that differ significantly between trailing and leading limbs at canter (p <0.05).
       Reproduced from Back et al. (1996, 1997).
      The gallop                                                                                      1987). Stance duration has been reported to be longer in the leading
                                                                                                      forelimb than the trailing forelimb (Leach et al., 1987), but Witte
      The gallop is an asymmetrical gait in which the footfalls of both                               et al. (2006) did not find any differences between kinematic vari-
      the fore and hind limbs occur as couplets, with an aerial (suspen-                              ables for trailing and leading forelimbs. Mean stance durations of
      sion) phase following lift-off of the leading forelimb. The transition                          the forelimbs have been reported to be 131 ms and 77 ms, at speeds
      from a slow speed canter to the higher speed gallop involves a dis-                             of 9.0 m/s and 17.0 m/s, respectively. Although the duration of the
      sociation of the footfalls of the diagonal limb pair, such that the                             suspension phase is independent of speed, overlaps between the
      leading hind contacts the ground before the trailing forelimb in the                            limbs decreases with speed and approaches zero at maximal speed
      gallop.                                                                                         (Witte et al., 2006). The intervention of a suspension phase between
         The function of the forelimbs during galloping is to support the                             lift-off of the trailing forelimb and contact of the leading forelimb
      forehand as the body mass moves forward and to generate the forces                              has been described at very high galloping speeds in some horses
      needed for braking and turning. As gallop speed increases, the trail-                           (Seder & Vickery, 2003).
      ing and leading fore and hind limb pairs act more synchronously,                                   Fatigue is associated with changes in limb coordination: the per-
      so the gait becomes more like a bound or bunny hop (Leach et al.,                               centage of stride between contacts of the leading hind and trailing
114
                                                                                                                                                                           Three-dimensional kinematics
                                                                           Angle (degrees)
                   75                                                                         60                                                         negative; flexion is positive. The red bar
                                                                                                                                                         represents the duration of the stance phase in
                   70                                                                                                                                    the trailing forelimb, the green bar represents
                                                                                              40                                                         the duration of the stance phase of the leading
                   65
                                                                                                                                                         forelimb. The red bar represents the stance
                   60                                                                                                                                    duration of the trailing forelimb, the green bar
                                                                                              20
                                                                                                                                                         represents the stance duration of the leading
                  55                                          Trailing                                                                      Trailing     forelimb.
                  Pro                                        Leading                         Ext                                           Leading
                  50                                                                           0                                                         Reprinted from Back, W., Hartman, W., Schamhardt, H.C.,
                         0        20      40       60       80       100                            0           20      40       60       80       100   Bruin, G. and Barneveld, A. (1995b) Kinematic response to
                                       Time (% of stride)                                                            Time (% of stride)                  a 70-day training period in trotting Dutch Warmbloods.
                                                                                                                                                         Equine Vet. J. 18 (suppl.), 127–131, with permission from
                  100                                                                         40                                                         the Equine Veterinary Journal.
                  Flex       Carpus                                                          Flex       Fore fetlock
                   80                                                                         20
                   60                                                                          0
Angle (degrees)
Angle (degrees)
40 -20
20 -40
                    0                                                                        -60
                                                              Trailing                                                                      Trailing
                  Ext                                        Leading                         Ext                                           Leading
                  -20                                                                        -80
                         0        20      40       60       80       100                            0           20      40       60       80       100
                                       Time (% of stride)                                                            Time (% of stride)
 forelimbs decreases, the percentage of stride between contacts of the                                                     higher for horses with good forelimb motion and these horses were
 two hind limbs and the two forelimbs increases, and the percentage                                                        58% more likely to win a graded stakes race than horses with bad
 of stride occupied by the suspension phase increases (Leach &                                                             forelimb motion.
 Sprigings, 1979). It has been suggested that at the end of a race, the
 fatigued Thoroughbred is at serious risk of developing chip fractures
 of the carpal bones (Johnston et al., 1999) due to carpal hyperex-
                                                                                                                           Three-dimensional kinematics
 tension, and Burn et al. (2006) have confirmed that carpal hyper-
 extension increases with speed. Furthermore, fatigue of the DDF                                                           In two-dimensional kinematic studies, angular data are reported as
 muscle may overload the SDF tendon and suspensory ligament                                                                flexion and extension in the sagittal plane with the estimated
 increasing the risk of injury to the MCP joint and its supporting soft                                                    centers of joint rotation being used as landmarks for placement of
 tissues (Butcher et al., 2007).                                                                                           skin markers. Measurements are limited to one degree of freedom
    In Quarter Horses galloping at 13.1 m/s, it was observed that                                                          in rotation. This type of analysis ignores abduction–adduction and
 temporal patterns of forelimb motion originated proximal to the                                                           axial rotation of the joints and the role of movements occurring
 elbow and there was a high degree of reciprocity in shoulder joint                                                        outside the sagittal plane in the pathogenesis of injuries cannot be
 action in the trailing and leading forelimbs. In the stance phase,                                                        explored.
 maximal carpal extension preceded maximal elbow extension,                                                                   An alternative method is to establish a three-dimensional joint
 while in the swing phase, maximal flexions occurred sequentially                                                          coordinate system, based on the axes of the bone segments, which
 at the carpus, shoulder and elbow joints (Deuel, 1994).                                                                   are independent of the joint centers of rotation. Establishment of a
    In the Thoroughbred, forelimb motion in the swing phase has                                                            joint coordinate system requires the definition of orthogonal frames
 been correlated with racetrack performance and earnings by mea-                                                           that are rigid with the bones and numerically described with an
 suring metacarpal angulation in the sagittal and frontal planes                                                           orientation matrix by the use of a minimum of three, non-colinear
 (Seder & Vickery, 2005). In the sagittal plane, peak angulation of                                                        kinematic markers per segment (for details, see Chapters 2 and 19).
 the metacarpus to the ground during the swing phase retraction was                                                        With this method the three angles of rotation of the joints can be
 graded on a scale of 1–5. Grade 1 was forelimbs minimally lifted                                                          described.
 with little rotation of the metacarpus, which is commonly referred                                                           In the equine forelimb, in vivo three-dimensional kinematics have
 to as a ‘daisy cutter action’. Grade 5 was excessive metacarpal rota-                                                     been reported on a hard surface at walk (Chateau et al., 2004;
 tion with the hoof hitting the elbow, which is described as ‘high                                                         Hobbs et al., 2006) and trot (Clayton et al., 2004, 2007a, b) and
 knee action’. In the frontal plane, abduction (‘winging’) and adduc-                                                      also at trot on a treadmill (Chateau et al., 2006).
 tion (‘paddling’) of the distal limb was graded on a scale of 1–5                                                            In Chateau et al. (2004) and Hobbs et al. (2006), joint rotations
 with 1 being very little lateral motion in the forelimbs (i.e. almost                                                     were calculated by use of a cardan sequence x, y, z, also known as
 vertical) and 5 being excessive lateral motion in the forelimbs.                                                          the joint coordinate system (JCS) introduced by Grood and Suntay
 Horses with good forelimb motion (low scores) earned more purse                                                           (1983). With this method, flexion-extension is calculated around
 money and had greater stakes level success than horses with bad                                                           the transverse axis of the proximal segment of the joint, axial
 forelimb motion (high scores). Median earnings per start was 83%                                                          rotation around the vertical axis of the distal segment, and
                                                                                                                                                                                                                     115
         6        Forelimb function
      abduction–adduction around a floating axis perpendicular to the                                   In the digital joints, abduction and adduction occur passively
      two other axes (Fig. 6.13). This technique, which follows the recom-                           rather than being generated by abductor or adductor muscles.
      mendations of the International Society of Biomechanics (Wu &                                  Denoix (1999) introduced the term collateromotion to describe these
      Cavanagh, 1995), clearly defines the axes around which rotations                               passive movements: lateromotion is passive abduction and medio-
      are expressed and preserves the link with clinical and physiological                           motion is passive adduction.
      terminology. Clayton et al. (2004, 2007a, 2007b) used a slightly                                  The majority of equine kinematic studies have been based on
      different method in which relative angular motions (helical angle                              tracking markers attached to the skin, which provide a simple and
      changes) between the segments were calculated using a spatial atti-                            non-invasive method of visualizing joint motion (Clayton, 2007b),
      tude method (Woltring, 1994). This method, which is also well                                  but large errors may arise due to soft tissue movement over the
      known and recognized in human biomechanics, calculates the                                     underlying bone (Reinschmidt et al., 1997; van Weeren et al., 1986;
      angles around slightly different axes and this can explain small dif-                          Crevier-Denoix et al., 2001). In three-dimensional kinematics,
      ferences between the results of different studies.                                             those errors are crucial because they counteract the rigid-body
                                                                                                     theory (Fuller et al., 1997). Besides, skin markers are difficult to use
                                                                                                     in the distal forelimb because of the small size of P1 and P2. Indeed,
                                                                                                     those phalanges have usually been modeled as a single, rigid
                                                                                                     segment, and any motion at the PIP joint has been incorporated
                                                                                                     into the kinematics of the MCP and DIP joints. To overcome the
                                                                                                     problems inherent in using surface markers, bone-fixed markers can
                                                                                                     be used for direct measurement of skeletal motion. This technique
                                                                                                     provides the most accurate means for determining bone movements
                                                                                                     (Ramsey & Wretenberg, 1999). Several kinematic studies (Ramsey
                                  Lateromotion                                                       et al., 2001; Lafortune et al., 1992; Reinschmidt et al., 1997) have
        Floating axis (XI)             (+)
                                                                                                     implanted bone pins in human subjects, none of whom reported
                                                                                                     pain or substantial discomfort during the experiments. Bone pins
                                                                                                     have also been used in horses (van Weeren et al., 1986; Lanovaz
                                                                                                     et al., 2002; Dyhre-Poulsen et al., 1994). Steinmann pins implanted
      Mediomotion (-)                                                                                in a 6 mm canal drilled through the bone cortex, do not have a
                                                                                                     significant effect on locomotion of horses (van Weeren et al., 1986).
                                                                                                     More recently, Chateau et al. (2004, 2005, 2006) and Clayton et al.
                                                                                                     (2004, 2007a, 2007b) have used markers rigidly fixed to the radius,
                                                                                                     third metacarpal bone, P1, P2 and the hoof wall to characterize
                                                                                                     three-dimensional rotations of the carpal, MCP, PIP and DIP joints.
                                                                                                        Development of non-invasive methods for quantifying three-
                                                                                                     dimensional motion would be advantageous in a clinical setting.
                                                                                      Extension      Hobbs et al. (2006) used plaster casts to attach marker clusters to
                                                                                                     the skin and were able to measure flexion–extension motions,
                                                                                                     including the PIP joint, with an acceptable degree of accuracy, but
                                                                                                     not internal–external rotation, which highlights the difficulties in
                                                                                                     quantifying extrasagittal movements non-invasively (Hobbs et al.,
                                                                                               Yp    2006).
116
                                                                                                                                                              Three-dimensional kinematics
                                                                                                                        Lateral
                                                          Backward
                                                                                                                                                                                        Medial
        45                                                             2                                                                0
                                                                       0
Hoof
        40                                                                                                                              -5
                                                                       -2
        35                                                             -4                                                              -10
Forward
                                                                                                                                                                                        Lateral
                                                                                                                        Medial
        30                                                             -6                                                              -15
             0        20      40           60   80       100                0        20     40          60   80       100                    0        20      40         60   80       100
             IMP HS         MS                   CH CH   TO                 IMP HS         MS                 CH CH   TO
        30                                                            10
Backward
                                                                                                                        Adduction
        20                                                             8
        10                                                             6                                                                                   WALK
                                                                       4                                                                               CIRCLE mean            se
Mc3
         0
                                                                       2
       -10                                                             0                                                                      STRAIGHT LINE mean              se
                                                                                                                        Abduction
                                                          Forward
       -20                                                            -2
       -30                                                            -4
             0        20      40           60   80       100                0        20     40          60   80       100
                                                                                                                                                                                        Lateral
                                                          Flexion
                                                                                                                        Lateromotion
       165                                                              0                                                                0
       160                                                                                                                              -2
       155                                                             -2
                                                                                                                                        -4
MCPJ
       150                                                             -4
       145                                                                                                                              -6
                                                                                                                        Mediomotion
                                                                       -6
                                                                                                                                        -8
                                                          Extension
       140
                                                                       -8
                                                                                                                                                                                        Medial
       135                                                                                                                             -10
       130                                                            -10
             0        20      40           60   80       100                0        20     40          60   80       100                    0        20      40         60   80       100
                                                                                                                                                                                        Lateral
                                                          Extension
Lateromotion
                                                                        4                                                                2
       198
                                                                        2                                                                0
       196
                                                                        0                                                               -2
PIPJ
       194
                                                                       -2                                                               -4
                                                                                                                        Mediomotion
       192
                                                                       -4                                                               -6
                                                          Flexion
190
                                                                                                                                                                                        Medial
                                                                       -6                                                               -8
       188
             0        20      40           60   80       100                0        20     40          60   80       100                    0        20      40         60   80       100
Lateromotion
                                                                        8
       200                                                                                                                               0
                                                                        6
       190                                                                                                                              -2
                                                                        4
DIPJ
       180                                                                                                                              -4
                                                                        2
                                                                                                                        Mediomotion
       170                                                                                                                              -6
                                                                        0
                                                                                                                                        -8
                                                          Flexion
       160
                                                                                                                                                                                        Medial
                                                                       -2
       150                                                                                                                             -10
             0        20      40           60   80       100                0        20     40          60   80       100                    0        20      40         60   80       100
                                                                                          Time (% stance)
Fig 6.14  Mean attitude angle and joint angle–time diagrams of the left distal forelimb of a group of four horses walking in a straight line and turning
sharply to the left. Angles (°) are plotted against time (expressed as % of the stance phase). Mc3, third metacarpal bone; MCPJ, metacarpophalangeal joint;
PIPJ, proximal interphalangeal joint; DIPJ, distal interphalangeal joint; IMP, impact; HS, hoof stabilization; MS, midstance; CH, heel-off; TO, toe-off. Note that for
some curves the standard error bars are superimposed on the mean values.
Reprinted from Chateau, H., Degueurce, C. and Denoix, J.-M. (2005) Three-dimensional kinematics of the equine distal forelimb : effects of a sharp turn at the walk. Equine vet. J. 37, 12–18,
with permission from the Equine Veterinary Journal.
                                                                                                                                                                                                  117
             6           Forelimb function
Backward
Lateral
                                                                                                                                                                                             Medial
              40                                                           8                                                                     2
                                                                           6                                                                     0
              30                                                           4
      Hoof
                                                                                                                                                -2
              20                                                           2
                                                                           0                                                                    -4
                                                              Forward
                                                                                                                                                -6
                                                                                                                                                                                             Lateral
                                                                                                                             Medial
              10                                                          -2
                                                                          -4                                                                    -8
                   0        20      40           60   80    100                 0      20       40          60    80       100                       0     20    40         60    80      100
                   IMP      HS           MS            HO   TO                  IMP   HS             MS            HO       TO
              30                                                          10
Backward
                                                                                                                             Adduction
              20
              10                                                            5
               0                                                                                                                            TROT (4m/s on a treadmill) mean       se
      Mc3
             -10
             -20                                                            0
                                                                                                                             Abduction
                                                              Forward
             -30
             -40                                                           -5
                   0        20      40           60   80    100                 0      20       40          60    80       100
Lateromotion
                                                                                                                                                                                             Lateral
                                                                                                                                                 0
             160                                                           -2
                                                                                                                                                -2
             150                                                           -4
      MCPJ
                                                                                                                                                -4
             140                                                           -6
                                                                                                                             Mediomotion
                                                                                                                                                -6
                                                              Extension
130 -8
                                                                                                                                                                                             Medial
             120                                                                                                                                -8
                   0        20      40           60   80    100                 0      20       40          60    80       100                       0     20    40         60    80      100
Lateromotion
                                                                                                                                                                                             Lateral
                                                                            2                                                                    0
             200                                                            0                                                                   -2
      PIPJ
             195                                                           -2                                                                   -4
                                                                                                                             Mediomotion
             190                                                           -4                                                                   -6
                                                              Flexion
                                                                                                                                                                                             Medial
             185                                                           -6                                                                   -8
                   0        20      40           60   80    100                 0      20       40          60    80       100                       0     20    40         60    80      100
Lateromotion
             190                                                            4                                                                    0                                           Lateral
             180
                                                                            2                                                                   -2
      DIPJ
             170
                                                                            0                                                                   -4
                                                                                                                             Mediomotion
             160
                                                                                                                                                -6
                                                              Flexion
             150                                                           -2
                                                                                                                                                                                             Medial
             140
                   0        20      40           60   80    100                 0      20       40          60    80       100                       0     20    40         60    80      100
                                                                                             Time (% stance)
      Fig 6.15  Mean attitude angle and joint angle–time diagrams of the left distal forelimb in a group of three horses trotting on a treadmill (4 m/s). Angles (°)
      are plotted against time (expressed as % of the stance phase). Mc3, third metacarpal bone; MCPJ, metacarpophalangeal joint; PIPJ, proximal interphalangeal
      joint; DIPJ, distal interphalangeal joint; IMP, impact; HS, hoof stabilization; MS, midstance; CH, heel-off; TO, toe-off). Note that for some curves the standard
      error bars are superimposed on the mean values.
      Reprinted from Chateau H, Degueurce C, Denoix J-M. (2006) Three-dimensional of the distal forelimb in horses trotting on a treadmill and effects of elevation of heel and toe. Equine vet. J. 38,
      164–169, with permission from the Equine Veterinary Journal.
118
                                                                                                                                           Three-dimensional kinematics
 Table 6.5  Mean value ± SD for range of motion in flexion and                           Table 6.6  Three-dimensional motion of the hoof, third
 extension of the digital joints of the left forelimb of four horses                     metacarpal bone and digital joints in three horses trotting on
 walking in a straight line on a hard track at 1.3 m/s (Chateau                          a treadmill at 4.0 m/s (Chateau et al., 2006). Values are mean
 et al., 2004) and three horses trotting on a treadmill at 4.0 m/s                       and (SD)
 (Chateau et al., 2006)
                                                                                                                       Landing              Weight               Breakover
                                    Walk                                 Trot                                                               bearing
 MCPJ ext                           −27.6 ± 3.3                          −45.7 ± 7.0     Hoof         Pitch               1.7 (4.8)            0.1 (0.9)         −20.3 (6.7)
 MCPJ flex                            24.9 ± 3.1                           41.2 ± 8.2                 Roll               −8.9 (4.4)*         −1.2 (1.0)             3.4 (1.6)*
 PIPJ flex                           −0.9 ± 0.9                           −1.7 ± 2.6
                                                                                                      Yaw                 0.9 (2.7)          −0.4 (1.2)           −0.7 (3.0)
 PIPJ ext                             10.0 ± 2.5                           14.3 ± 2.8
                                                                                         Mc3          Pitch              −6.0 (1.8)         −38.1 (3.8)          −13.5 (4.3)
 DIPJ flex                          −16.4 ± 3.1                          −21.7 ± 3.8
                                                                                         MCPJ         Flex-Ext         −25.6 (3.7)*            2.8 (5.5)          18.3 (6.7)
 DIPJ ext                             42.4 ± 4.4                           45.6 ± 5.5
                                                                                                      Collat              0.8 (1.7)*           1.0 (1.5)*           0.5 (2.5)
 MCPJ, metacarpophalangeal joint; PIPJ, proximal interphalangeal joint; DIPJ, distal                                                         −0.4 (1.0)
                                                                                                      Axial rot           1.2 (1.6)*                              −1.1 (1.2)*
 interphalangeal joint.
 Reproduced from Chateau et al. (2004, 2006).                                            PIPJ         Flex-Ext            1.3 (2.6)*          11.5 (2.7)*         −0.9 (1.4)*
                                                                                                      Collat             −0.4 (2.0)          −0.2 (1.4)             0.2 (1.4)
function of the digital joints in compensating for asymmetrical hoof
                                                                                                      Axial rot          −1.5 (2.1)*           1.7 (1.6)*           0.2 (0.5)
placement. Interestingly, medial rotation and lateromotion of the
DIP joint were coupled, which has been observed during asymmet-                          DIPJ         Flex-Ext         −19.3 (5.0)*           31.3 (7.1)*         11.9 (5.8)*
ric loading of isolated forelimbs in other studies (Denoix, 1999;
Chateau et al., 2002). When a heel wedge was applied unilaterally,                                    Collat              1.4 (3.3)*           0.5 (2.3)          −0.5 (1.6)
the DIP joint showed collateromotion with narrowing of the joint                                      Axial rot          −1.7 (3.0)          −2.3 (2.9)*            1.3 (1.5)*
space on the side of the wedge, together with axial rotation away
from the raised side. The same association of movement has also                          *Values differ significantly (p <0.05) between the beginning and the end of the
been reported at the start of breakover with a combination of lat-                       period.
eromotion (abduction) and medial (internal) rotation (Chateau                            Mc3, third metacarpal bone; MCPJ, metacarpophalangeal joint; PIPJ, proximal
et al., 2004; Clayton et al., 2007b).                                                    interphalangeal joint; DIPJ, distal interphalangeal joint.
                                                                                         Landing is from impact to hoof stabilization; Weight bearing is from hoof
                                                                                         stabilization to heel-off; Breakover is from heel-off to toe-off.
Proximal interphalangeal joint
                                                                                         For segment angles, pitch angle around the transverse axis is positive during
The PIP joint (Figs 6.14 and 6.15, Table 6.5) flexes in early stance                     backward (palmar or plantar) rotation; roll angle around the longitudinal axis is
reaching maximal flexion at about 14% of stance (Chateau et al.,                         positive during lateral inclination; and yaw angle around the vertical axis is positive
2004; Clayton et al., 2007b). This movement is brief and slight in                       during medial rotation of the segment. For joint angles, lateromotion (passive
walking horses (less than 1°) and almost comparable at the trot                          abduction) and lateral rotation are designated positive.
(about 1.7°). Then, the PIP joint extends through most of stance                         Reprinted from Chateau H, Degueurce C, Denoix J-M. (2006) Three-dimensional of
until the start of breakover. Chateau et al. (2004, 2006) reported                       the distal forelimb in horses trotting on a treadmill and effects of elevation of heel
the mean amplitude of this extension to be 10° ± 2.5° at walk and                        and toe. Equine vet. J. 38, 164–169, with permission from the Equine Veterinary
14.3° ± 2.8° at trot, while Clayton et al. (2007b) reported 9.4° ±                       Journal.
1.7° at walk and 8.5° ± 0.6° at trot. The results confirm that flexion
and extension of the PIP joint cannot be neglected in biomechani-
cal models of the distal portion of the forelimbs. In horses walking                    in a straight line. The three-dimensional motions of the PIP joint,
in a straight line, the PIP joint accounts for approximately 5% of                      especially axial rotation, coupled with asymmetric landing of the
the entire interphalangeal flexion (0.9° of PIP joint flexion vs. 16.4°                 hoof at impact, should be taken into account, even when a horse
of DIP joint flexion) and 19% of the entire interphalangeal exten-                      is walking in a straight line, to explain concussion of the joints and
sion (10° of PIP joint extension vs. 42.4° of DIP joint extension).                     pain that may result from mediolateral imbalances.
The substantial involvement of the PIP joint in digital extension
could explain why arthrodesis is sometimes followed by a worsen-
ing of navicular conditions (Martin et al., 1984), since loss of exten-                 Metacarpophalangeal joint
sion following PIP joint arthrodesis is likely to be compensated                        During the stance phase, the MCP joint (Figs 6.14 and 6.15, Table
primarily by the DIP joint.                                                             6.5) undergoes extension and then flexion. As already observed in
   For locomotion in a straight line, extrasagittal motions of the PIP                  two-dimensional kinematic studies at the walk, extension is pro-
joint are minimal (Figs 6.14 and 6.15, Table 6.6). Chateau et al.                       longed with a tendency toward two peaks separated by a slight dip,
(2004) did not detect a significant pattern in collateromotion for                      whereas in trot there is a single cycle of extension. No particular
the PIP joint. Internal rotation of P2 relative to P1 occurs during                     pattern of collateromotion was detected for the MCP joint during
landing, concurrent with the medial rocking motion of the hoof                          stance (Chateau et al., 2004) but P1 twisted laterally relative to the
(Chateau et al., 2004; Clayton et al., 2007b). During breakover,                        third metacarpal bone during extension and medially during
lateral rotation of the PIP joint occurs in association with lateral                    flexion. This is in contrast to the study of Clayton et al. (2007a), in
rocking motion and lateral rotation of the hoof (Chateau et al.,                        which all horses showed lateromotion during stance. The difference
2004).                                                                                  between studies is a consequence of the alignment of the segmental
   Extrasagittal movements of the PIP joint, like those of the DIP                      coordinate systems. If the coordinate system of P1 used by Clayton
joint, occur mainly during landing and breakover when horses walk                       et al. (2007a) is rotated externally around its longitudinal axis by
                                                                                                                                                                                   119
                                        6        Forelimb function
                                            6                                                              Motions outside the sagittal plane in the digital joints have been
                                                                                                        studied ex vivo during asymmetric loadings of isolated forelimbs.
                                            4                                                           Intra-articular injection of a colored solution was used to evaluate
                                                                                                        variations in the contact areas between articular surfaces as a
                                                                                                        consequence of asymmetrical hoof placement (Denoix, 1999).
                                            2
                                                                                                        Radiographic assessment has also been proposed (Caudron et al.,
                                                                                                        1998), but this method was limited to the measurement of com-
                                            0                                                           bined movements between the PIP and DIP joints and carries a risk
                                                         20          40           60   80      100      of misinterpretation due to the geometrical projection on a single
                                            -2                                                          plane. Changes in the transverse orientation of the foot quantified
                                                                                                        ex vivo using three-dimensional kinematics (Chateau et al., 2001,
                                                                                                        2002) have shown that asymmetric placement of the foot induced
                                        10                                                              a collateromotion (narrowing of the articular space) in the direction
                                                                                                        of the elevated part of the foot and an axial rotation in the opposite
                                            8
      Int(+)/ext(-) rotation (deg)
120
                                                                                                                                                 Three-dimensional kinematics
 Table 6.7  Three-dimensional motion of the hoof, third metacarpal bone and digital joints in four horses walking in a straight line and
 around a small circle (Chateau et al., 2005). Values are mean and (SD)
Roll −6.2 (2.7)* 0.7 (3.8)# −0.6 (0.9) 0.2 (0.8) 1.9 (1.3)* 4.6 (2.8)*#
                           Yaw                           0.9 (3.7)             −2.4 (4.2)              −0.1 (0.9)            −0.1 (2.6)         −1.3 (4.5)             −11.3 (8.6)*#
 Mc3                       Pitch                       −3.7 (1.7)*             −3.5 (1.0)*            −41.0 (4.4)*         −33.6 (3.7)*#        −5.8 (1.4)*              −7.7 (3.0)*#
                           Roll                          1.2 (1.2)*            −0.6 (1.1)#             −7.5 (5.5)*            7.3 (5.2)*#       −1.5 (1.0)*              −2.7 (1.8)*#
 MCPJ                      Flex-Ext                   −10.9 (4.6)*           −12.2 (5.1)*              −0.1 (3.4)            −7.4 (5.9)*#         9.0 (1.9)*             13.4 (3.4)*#
                           Collat                        0.2 (1.7)             −0.1 (0.7)                0.3 (0.8)            0.0 (0.7)         −0.3 (0.9)                0.0 (1.0)
                           Axial rot                     0.2 (0.9)              1.3 (0.7)*      #
                                                                                                         0.2 (1.3)           −1.1 (0.5)*  #
                                                                                                                                                −0.3 (0.8)                0.2 (0.6)
 PIPJ                      Flex-Ext                      0.9 (1.8)              0.9 (4.2)                9.2 (2.4)*           6.5 (2.1)*  #
                                                                                                                                                −0.2 (0.6)                1.3 (0.9)*#
                           Collat                      −0.6 (1.5)              −0.2 (0.9)                0.4 (1.1)           −0.3 (0.8)           0.5 (0.7)*              0.8 (0.6)*
                           Axial rot                   −2.2 (1.1)*             −0.5 (1.3)#               1.1 (1.7)*          −4.0 (1.7)*#         0.6 (0.8)*              2.9 (0.8)*#
 DIPJ                      Flex-Ext                   −12.1 (2.2)*             −9.3 (4.8)*#            33.1 (3.4)*           18.4 (5.9)*#         5.1 (2.5)*             12.3 (4.4)*#
                           Collat                        0.9 (2.4)*            −0.4 (2.2)#             −1.9 (1.6)*            2.0 (1.8)*#       −0.3 (0.8)                0.2 (1.1)
Axial rot −1.7 (1.6)* 1.0 (2.0)# −2.2 (2.5)* −10.2 (3.9)*# 1.5 (1.6)* 3.6 (1.3)*#
 *Values differ significantly (p <0.05) between the beginning and the end of the period.
 #
  ROM differs significantly (p <0.05) from the straight line.
 Mc3, third metacarpal bone; MCPJ, metacarpophalangeal joint; PIPJ, proximal interphalangeal joint; DIPJ, distal interphalangeal joint; IMP, impact; HS, hoof stabilization; HO,
 heel-off; TO, toe-off.
 Landing is from impact to hoof stabilization; Weight bearing is from hoof stabilization to heel-off; Breakover is from heel-off to toe-off.
 For segment angles, pitch angle is positive during backward rotation, roll angle is positive during lateral inclination and yaw angle is positive during medial rotation of the
 segment. For joint angles, lateromotion (passive abduction) and lateral rotation are designated positive.
 Reprinted from Chateau, H., Degueurce, C. and Denoix, J.-M. (2005) Three-dimensional kinematics of the equine distal forelimb : effects of a sharp turn at the walk. Equine vet. J.
 37: 12–18, with permission from the Equine Veterinary Journal.
of the circle. During the rest of stance, the inside forefoot is immo-                              the stance phase do not have the same biomechanical consequences
bile on the ground and the horse’s body mass moves over the limb                                    on the three-dimensional motion of the interphalangeal joints and
in the direction of the turn. The third metacarpal bone undergoes                                   thus on the stress imposed on the collateral ligaments.
large movements relative to the hoof in the transverse plane                                           Alterations induced by limb adduction also induce a substantial
(Chateau et al., 2005) showing an adduction that is maximal when                                    involvement of the PIP joint (Chateau et al., 2005), which under-
the heels leave the ground (Fig. 6.14).                                                             goes medial rotation during the bearing phase in a turn. At heel-off,
   Because the third metacarpal bone is more abducted at the begin-                                 the PIP joint contributes 33% of the total amount of axial rotation
ning of stance in the limb on the inside of a turn, the DIP joint                                   in the digital joints during a sharp turn compared with 10% for the
initially shows a combination of mediomotion (adduction) and                                        MCP joint and 57% for the DIP joint. The amount of axial rotation
lateral rotation. Adduction of the limb during the stance phase with                                was greater than the amount of flexion at the DIP joint during sharp
the hoof flat on the ground, reverses the direction of these move-                                  turns, which demonstrates the strong involvement of this joint in
ments and the DIP joint undergoes a combination of lateromotion                                     movements that occur outside the sagittal plane. These results cor-
(2.0 ± 1.8) and medial rotation (10.2 ± 3.9) (Chateau et al., 2005).                                roborate clinical observations related to pathological conditions of
During this movement, the articular space becomes pinched later-                                    this joint showing that degenerative diseases of the PIP joint occur
ally and P3 rotates medially relative to P2. In other words, collat-                                most frequently in horses that make tight turns and rapid twisting
eromotion occurs in the direction of movement, while axial rotation                                 movements (Stashak, 1987; Schaer et al., 2001). Injuries include
occurs in the opposite direction. Interestingly this combination of                                 pulling or tearing of the attachments of the joint capsule and col-
articular rotations is the same as those observed in vitro during                                   lateral ligaments (McIlwraith & Goodman, 1989). Thus decreased
asymmetric loadings of the limb (Caudron et al., 1998; Denoix,                                      range of motion following PIP arthrodesis may exacerbate stresses
1999; Chateau et al., 2002; Viitanen et al., 2003).                                                 on the DIP joint and navicular apparatus and explain why long-
   The changes in direction of DIP joint angulation are easily seen                                 term radiographic evaluation after PIP joint arthrodesis often
on the angle-time diagrams when the curves for collateromotion                                      reveals degenerative disease involving the DIP joint or even navicu-
and axial rotation intersect (Fig. 6.14). The effects of these angular                              lar disease (Martin et al., 1984; MacLellan et al., 2001). The biome-
changes should be considered during examination of a lame horse                                     chanical importance of the PIP joint should be kept in mind when
on a tight circle at the walk because the cranial and caudal parts of                               arthrodesis is considered as a treatment option and particular
                                                                                                                                                                                        121
        6      Forelimb function
      attention should be paid to mediolateral hoof balance for manage-            ground during breakover. Average amplitude of this movement
      ment of the treated horses (Clayton et al., 2007b).                          when walking around a sharp turn on a hard surface is about 11°.
                                                                                   This movement of the hoof contributes to the sudden realignment
                                                                                   of the interphalangeal joints that were strongly medially rotated just
      Breakover (from heel-off to toe-off)                                         before the start of breakover (Fig. 6.14).
      The results of Chateau et al. (2005) show that, during turning,                 Delaying breakover is likely to exacerbate extrasagittal stresses in
      extrasagittal stress in the interphalangeal joints is maximal just           the interphalangeal joints, so prevention and treatment strategies
      before the start of breakover because adduction of the limb is               for traumatic or degenerative diseases of the interphalangeal
      maximal at heel-off. Unweighting of the palmar part of the foot              joints should take into account the biomechanical influence on
      allows the heels to lift-off and the hoof to rotate laterally on the         breakover.
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         Ground reaction force patterns of Dutch              Lundberg, A., et al., 1997. Tibiofemoral          van Schamhardt, H.C., Barneveld, A., 1995.
         warmbloods at the canter. Am. J. Vet. Res.           and tibiocalcaneal motion during walking:         Effects of weight and riding on workload
         54, 670–674.                                         external vs. skeletal markers. Gait Posture       and locomotion during treadmill exercise.
      Minetti, A.E., Ardigo, L.P., Reinach, E., Saibene,      6, 98–109.                                        Equine Exerc. Physiol. 4, 413–417.
         F., 1999. The relationship between                Riemersma, D.J., Bogert, A.J., van den            Smythe, R.H., Goody, P.C., Gray, P., 1993.
         mechanical work and energy expenditure               Schamhardt, H.C., Hartman, W., 1988b.             Horse structure and movement. Allen &
         of locomotion in horses. J. Exp. Biol. 202,          Kinetics and kinematics of the equine             Co, London.
         2329–2338.                                           hind limb: in vivo tendon strain and           Soffler, C., Hermanson, J.W., 2006. Muscular
      Mosimann, W., Micheluzzi, P., 1969. Die                 joint kinematics Am. J. Vet. Res. 49,             design in the equine interossues muscle. J.
         bewegung im cubitus des pferdes als                  1353–1359.                                        Morph. 267, 696–704.
         gedampfte, erzwungene schwingung.                 Riemersma, D.J., Schamhardt, H.C., Hartman,       Stashak, T.S., 1987. Adams’ lameness in
         Zentbl. Vet. Med. Reihe A 16, 180–184.               W., Lammertink, J.L.M.A., 1988a. Kinetics         horses, fourth ed. Philadelphia: Lea &
      Mullineaux, D.R., Clayton, H.M., Gnagey,                and kinematics of the equine hind limb: in        Febiger, pp. 76, 88, 102 and 487–785.
         L.M., 2004. Effects of offset-normalizing            vivo tendon loads and force plate              Stubbs, N.C., Clayton, H.M., 2008. Activate
         techniques on variability in motion                  measurements in ponies. Am. J. Vet. Res.          your horse’s core. Mason: Sport Horse
         analysis data. J. Appl. Biomech. 20,                 49, 1344–1352.                                    Publications.
         177–184.                                          Robert, C., Valette, J.P., Denoix, J.M., 1998.    Swanson, T.D., 1988. Degenerative disease of
      Nicodemus, M.C., Booker, J.E., 2007.                    Surface electromyographic analysis of the         the proximal interphalangeal (pastern)
         Two-dimensional kinematics of the jog and            normal horse locomotion: a preliminary            joint in performance horses. Proc. Am.
         lope of the stock breed western pleasure             report. In: Lindner, A. (Ed.), Proc. Conf.        Assoc. Equine Practnr. 34, 393–397.
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Swanstrom, M.D., Zarucco, L., Stover, S.M.,       Van Weeren, P.R., van den Bogert, A.J.,             Wilson, A.M., Watson, J.C., 2003. A catapult
   Hubbard, M., Hawkins, D.A., Driessen, B.,          Barneveld, A., 1990a. A quantitative               action for rapid limb protraction. Nature
   et al., 2005. Passive and active mechanical        analysis of skin displacement in the               421, 35–36.
   properties of the superficial and deep             trotting horse. Equine Vet. J. 9 (Suppl.),      Witte, T.H., Hirst, C.V., Wilson, A.M.,
   digital flexor muscles in the forelimbs            101–109.                                           2006. Effect of speed on stride
   of anesthetized thoroughbred horses.           Van Weeren, P.R., van den Bogert, A.J.,                parameters in racehorses at gallop
   J. Biomech. 38, 579–586.                           Barneveld, A., 1990b. Quantification of            in field conditions. J. Exp. Biol. 209,
Thompson, K.N., Herring, L., Shapiro, R.,             skin displacement in the proximal parts of         4389–4397.
   1992. A three dimensional kinematic study          the limbs of the walking horse. Equine Vet.     Woltring, H.J., 1994. 3-D attitude
   of the metacarpophalangeal joint in horses.        J. 9 (Suppl.), 110–118.                            representation of human joints: a
   J. Equine Vet. Sci. 12, 172–176.               Viitanen, M.J., Wilson, A.M., McGuigan, H.R.,          standardization proposal. J. Biomech. 27,
Tokuriki, M., Aoki, O., Niki, Y., Kurakawa, Y.,       Rogers, K.D., May, S.A., 2003. Effect of foot      1399–1414.
   Hataya, M., Kita, T., 1989.                        balance on the intra-articular pressure in      Wu, G., Cavanagh, P.R., 1995. ISB
   Electromyographic activity of cubital joint        the distal interphalangeal joint in vitro.         recommendations for standardization in
   muscles in horses during locomotion. Am.           Equine Vet. J. 35, 184–189.                        the reporting of kinematic data. J.
   J. Vet. Res. 50, 950–957.                      Walter, K., 1925. Der bewegungsablauf an den           Biomech. 28, 1257–1261.
Ueda, Y., Niki, Y., Yoshida, K., Masumitsu, H.,       freien gliedmassen des pferdes im schritt,      Zajac, F. E., 1989. Muscle and tendon
   1981. Force plate study of equine                  trab und galop. Arch. Wiss. Pract. Tierheilk.      – properties, models, scaling, and
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   Equine Res. Inst. 18, 28–41.                       architecture of bideps brachii, triceps            359–411.
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   simulation of locomotion in the horse.             J. Anat. 210, 32–40.                               Determination of muscle architecture and
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Van Weeren, P.R., Barneveld, A., 1986. A              den Bogert, A.J., 2001. Horses damp                deep digital flexor muscles in the forelimbs
   technique to quantify skin displacement in         the spring in their step. Nature 414,              of adult horses. Am. J. Vet. Res. 65,
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                                                                                                                        C H A PTER             7 
Introduction                                                               that are well-suited for generating force economically. Muscle size
                                                                           and fiber length are not correlated, however, so the larger muscles
                                                                           do not necessarily have longer fibers and smaller muscles do not
This chapter reviews the structure and functions of the equine hind        always have shorter fibers (Table 7.1). Fiber length variability is low
limbs in relation to stride kinematics (movements) and kinetics            in the digital flexor muscles both within an individual horse and
(forces), and highlights differences between the fore and hind             between different horses. The amount of force transmitted to the
limbs. The hind limbs carry only about 43% of body mass, so the            tendon is calculated as the product of PCSA and the cosine of the
vertical ground reaction force and vertical impulse are lower in the       pennation angle. When pennation angle exceeds about 20° it sig-
hind limbs than in the forelimbs. In the longitudinal direction,           nificantly reduces the component of force transmitted to the tendon.
the propulsive component of the ground reaction force tends to be          The benefit of larger pennation angles is the increase in force-
larger and the braking component smaller in the hind limbs com-            generating capacity as a result of the larger PCSA for a given volume.
pared with the forelimbs. The angulations of the hip, stifle and           These muscular characteristics are typical of musculotendinous
tarsal joints are well suited to play an active role in generating pro-    units used for elastic energy storage and recoil, which reduces the
pulsion, which is in contrast to the supporting function of the more       need for energetically expensive changes in muscle length, while
strut-like forelimbs.                                                      minimizing distal limb mass. The suspensory ligament represents
                                                                           the end point of such modification, having minimal muscular tissue
                                                                           in the adult horse (Klomkleaw et al., 2002). Some muscles, notably
Musculotendinous architecture                                              fibularis tertius and superficial digital flexor, have so little muscular
                                                                           tissue that they function as strong tendinous bands to synchronize
Horses are cursorial animals and within the genus Equus different          flexion–extension movements of stifle and tarsus in an arrangement
breeds have been developed for different occupations. Breeds spe-          known as the reciprocal apparatus (Wentink, 1978b).
cialized for racing tend to have long, gracile limbs, whereas draft           During trotting, changes in potential and kinetic energy of the
breeds have shorter, stouter limbs in proportion to body size (Gunn,       horse’s center of mass are in phase, which allows the distal limb to
1983). Fat and muscle distribution also differ between breeds but,         make substantial contributions to elastic energy storage (Biewener,
regardless of breed, successful athletes tend to have body fat per-        1998). In canter and gallop, the relationship between kinetic and
centages in the range of 7.8–8.8% (Lawrence et al., 1992; Kearns           potential energy varies during the stride (Minetti et al., 1999),
et al., 2002). In athletic horses, muscles comprise about 53% of           which limits the ability to store elastic energy in the distal limb. It
body mass compared with 42% in non-athletes, and the propulsive            has been estimated that the hind limbs are responsible for two-
muscles in the hind limb account for a larger portion of that muscle       thirds of the elastic energy savings in horses (Biewener, 1998).
mass (Gunn, 1987). These muscles are responsible for generating               Payne et al. (2005) described the morphology and architecture
external work that is required for acceleration or to raise the center     of the hind limb musculature in horses of different sizes (body mass
of mass when moving uphill or jumping (Clayton et al., 2002;               430–600 kg) and ages (10–30 years) (Table 7.1). Data for muscle
Dutto et al., 2004a, b). The muscles in the proximal hind limb are         mass were scaled to body mass and measurements of fiber length
characterized by having large physiological cross sectional areas          were scaled to (body mass (kg) )1/3, which resulted in similar values
(PCSA), associated with large mass and volume and relatively long          among the seven subjects for most muscles, with the exceptions of
fibers that move the joints through a large range of motion. Many          gluteus medius and the hamstrings, which may have adapted in
of these muscles have multiple bellies: the more proximal bellies          response to different types of training. After scaling for geometric
have both their origin and insertion located more proximally than          similarity, fiber lengths varied more than muscle masses, particu-
the distal bellies allowing the entire muscle to exert force over a        larly in the vertebral head of semitendinosus and in semimembranosus.
wide range of joint positions without needing long muscle fibers.          In general, the hamstring group is capable of generating large forces
The muscle fibers are arranged in series with elastic tissue and they      and high powers. All the hind limb muscles have pennation angles
attach to the bones directly or via short tendons. These characteris-      greater than 20° and many have considerably larger angles. Most
tics are typical of muscles that are specialized for doing work. Many      of the proximal muscles have little, if any, tendon and, when tendon
of the hind limb muscles are multi-articular and have complex              tissue is present, it is light in weight (5.3–34.2 g) compared with
fascial attachments and connections that make it difficult to sepa-        tendons in the distal limb (44.8–208.7 g).
rate extrinsic and intrinsic functions.                                       Hind limb muscle architecture has been compared in Arabians,
   Muscle volume and fiber length decrease, and pennation angles           a breed that excels in endurance races, with Quarter Horses, a
increase in a proximal to distal direction, so the muscles in the distal   breed noted for its sprinting speed (Crook et al., 2008). Overall
hind limb are smaller and less powerful with short, pennate fibers         height and mass of the horses did not differ but the Quarter Horses
                                                                                                                                                       127
       7          Hind limb function
Table 7.1 Architectural properties of the muscles of the equine hind limb
      MFL, mean fascicle length; PCSA, mean physiological cross sectional area; Angle, mean (range) of pennation angles of fibers; Force, maximal isometric force generation capacity
      estimated as the product of PCSA and maximal isometric stress of skeletal muscle, taken as 0.3 MPa; Power, maximal power output calculated as one-tenth of the product of
      force and maximal contraction velocity, which was estimated based on published values of equine muscle fiber-typing. Unless indicated, different heads of the muscles were
      combined.
      Data from Payne et al. (2005).
128
                                                                                                                           Musculotendinous architecture
Superficial gluteal
Middle gluteal
                                                                              Biceps femoris
                                                                              Semitendinosus
                                                                                 Semimembranosus
Gracilis
Fig 7.1 Musculature in the proximal hind limb viewed from the side (left) and from behind (right).
had greater muscle mass and volume in both proximal and distal                     and early stance (Robert et al., 1998). It contributes to a burst of
muscles and larger PCSAs allowing the development of larger                        power generation across the hip joint that pushes the trunk forward
forces (Crook et al., 2008). Thoroughbreds trained for sprinting                   over the grounded hind limb (Clayton et al., 2001). The muscle
have a higher hind limb muscle to body mass ratio than those                       fibers attach onto broad aponeurotic sheets that are somewhat com-
trained for hurdling (Gunn, 1987). Fiber lengths and pennation                     pliant and may provide some elastic energy storage and return.
angles are similar in different breeds of horses (Crook et al., 2008).             Gluteus medius represents 2.0% of body mass in Quarter Horses and
This is in contrast to human sprinters who tend to have longer                     1.7% in Arabians (Crook et al., 2008), which is indicative of the
fibers and smaller pennation angles in their calf muscles compared                 specialization of Quarter Horses for acceleration and speed. Inter-
with distance runners (Abe et al., 2000), though this may be an                    nally, gluteus medius shows functional compartmentalization; the
effect of a specific type of training. PCSA and calculated maximal                 superficial parts of the muscle are composed primarily of type IIb
isometric force decrease as follows: biceps femoris; semitendinosus;               fibers, which suggests a propulsive function, whereas the deeper
gastrocnemius; vastus lateralis; extensor digitorum longus; tibialis               parts have more type I fibers that are typical of a postural function
cranialis.                                                                         (Lopez-Rivero et al., 1992; Serrano et al., 1996). Muscle fiber
   Gluteus superficialis (Fig. 7.1, Table 7.1), the smallest of the gluteal        lengths do not appear to have a superficial to deep gradation and
muscles, is a hip flexor. It is one of the few muscles in the proximal             range from 135 mm to 300 mm throughout the muscle.
hind limb that has a distinct tendon. This tendon is short in length                  Gluteus profundus (Table 7.1) is a smaller muscle than gluteus
(980 mm), small in mass (14.0 g) and volume (12.5 cm3) but has                     medius in terms of size and PCSA, with shorter fibers but similar
a relatively large cross-sectional area (1.39 cm2). It may provide                 pennation angles.
some elastic energy storage and return. Calculated stress in the                      Biceps femoris (Fig. 7.1, Table 7.1) is a multi-articular muscle that
tendon is quite low (13.0 MPa).                                                    can act as a hip extensor, stifle flexor and tarsal extensor. It plays an
   Gluteus medius (Fig. 7.1, Table 7.1) is a monoarticular hip exten-              important role in stabilization of the hip and stifle joints. The three
sor and is the largest muscle of the hind limb in terms of mass                    heads (intermediate, vertebral and caudal) have a combined mass
(8577 g) and PCSA (398 cm2). The fibers are long with pennation                    of 7928 g making it one of the largest muscles in the hind quarters.
angles in the range 15–45° (Payne et al., 2005). These characteris-                It has a large PCSA, especially the biarticular vertebral head, due to
tics are indicative of a primary role in force and power generation.               its large volume (Payne et al., 2005). This study reported pennation
In fact, gluteus medius has been estimated to have by far the largest              angles within the range of 20–55° in all three heads, whereas Crook
force-generating capacity of all the hind limb muscles and plays an                et al. (2008) described a parallel fiber orientation (pennation angle,
important role in propulsion. Electromyographic studies at trot                    ≤5°) in the intermediate and caudal heads and 55° pennation
indicate that it is active during hind limb retraction in late swing               angles in the vertebral head. Biceps femoris is the only muscle in the
                                                                                                                                                               129
        7      Hind limb function
      proximal hind limb that has a large tendon (mass, 106 g; CSA,             action of the resultant load on the tibia thus reducing the strain due
      9.54 cm2) though this tendon is short in length (100 mm). During          to bending (Wentink, 1978a).
      trotting, it is active during hind limb retraction in late swing and         Fibularis (peroneus) tertius forms the cranial arm of the reciprocal
      early stance (Robert et al., 1998).                                       apparatus and is entirely tendinous (mass, 64.3 g; volume, 57.4 cm3;
         Semitendinosus (Fig. 7.1) has vertebral and pelvic heads. Accord-      CSA, 1.59 cm2). Rupture of fibularis tertius as a consequence of
      ing to Payne et al. (2005), both heads have pennation angles in the       hyperextension of the tarsus, does not have much effect on the
      range of 20–45° (Table 7.1) whereas Crook et al. (2008) identified        horse’s stance or walking ability (Strubelt, 1928; Schamhardt et al.,
      distinct differences between the two head with the pelvic head            1985), although Wentink (1978b) recorded slight hyperextension
      having parallel fibers (pennation angle, ≤5°) and fibers in the ver-      at the end of stance and less flexion of the tarsal joint during swing.
      tebral head having a mean pennation angle of 23°, which supports          At trot, the loss of elastic rebound of fibularis tertius is responsible
      its presumptive role in propulsion This muscle is thought to be           for delayed protraction of the distal limb in early swing.
      important in generating large forces during hind limb retraction.            Flexor digitorum superficialis (SDF) (Fig. 7.1, Table 7.1) in the hind
      PCSA of semitendinosus in Quarter Horses is double that of Arabians       limb is almost entirely tendinous, forming the caudal arm of the
      (Crook et al., 2008). Semitendinosus is active during retraction of       reciprocal apparatus that synchronizes stifle and tarsal motion in
      both the ipsilateral and the contralateral hind limb in late swing        the sagittal plane. The muscle belly has a small volume of only
      and early stance (Robert et al., 1998).                                   105 cm3 with uniformly short (1–6 mm) and highly pennate (40–
         Semimembranosus (Fig. 7.1) has vertebral and pelvic heads that         60°) fibers, resulting in a surprisingly large PCSA (417 cm2) (Table
      cannot easily be separated and are considered together in Table 7.1.      7.1). Estimates suggest that SDF has a capacity to generate high force
      A notable feature of this muscle is its large range of fiber lengths      (12500 N) but low power (17 W). The SDF tendon is long
      from 80–760 mm. Some fibers run the entire length of the belly            (748 mm) with a large mass (2.25 cm2) (Payne et al., 2005). As a
      from origin to insertion; others are staggered along the muscle belly.    consequence of having short muscle fibers and a long tendon, the
      Similar to the other hamstring muscles, semimembranosus is mul-           hind limb SDF is particularly well suited to elastic energy storage
      tiarticular and is estimated to have the capacity to develop large        and release and is more effective in this regard than the forelimb
      force and high power (Payne et al., 2005).                                SDF (Brown et al., 2003).
         Adductor has two parts (magnus and brevis) that are united, and           Flexor digitorum profundus (DDF) has three parts. Flexor digitorum
      so are considered together in Table 7.1. Like semimembranosus, the        medialis and tibialis caudalis are characterized by small volumes
      adductor is a large muscle characterized by a wide range of fascicle      and short to medium length fibers (Fig. 7.1, Table 7.1), whereas
      lengths (80–390 mm) and it is estimated to produce large force and        flexor digitorum lateralis has a larger volume and short fibers (3–
      high power.                                                               55 mm) embedded within large amounts of aponeurotic tendi-
         Quadriceps femoris has four parts, of which the biarticular head,      nous tissue that give the muscle belly a striated appearance on
      rectus femoris, is notable for its large PCSA (220 cm2) as a conse-       gross morphological examination (Payne et al., 2005). This muscle
      quence of its large volume (2161 cm3). The fiber lengths are short        is estimated to have the capacity to develop high force (21100 N)
      (<179 mm). Quadriceps assists in support and stabilization of the         but relatively low power (157 W) (see Table 7.3). Although the
      stifle joint, which is the key joint in the hind limb stay apparatus.     short muscle fibers and large PCSA are not compatible with active
      Details of this mechanism are given later. Rectus femoris may also        shortening of the musculotendinous unit, this architecture is well
      play a role in hip flexion.                                               suited to work isometrically during elastic energy storage and
         Tensor fascia latae is estimated to be capable of producing moder-     release.
      ate force and power (Fig. 7.1, Table 7.1). The tendon is relatively          Flexor digitorum lateralis is particularly effective in this regard, and
      long (227 mm) but with a small CSA (1.35 cm2). Electromyo-                more so than the humeral, radial or ulnar head of DDF in the
      graphic studies indicate that this muscle is active during late swing     forelimb (Brown et al., 2003; Payne et al., 2005). The DDF tendon
      and early stance (Robert et al., 1998). It is thought to play a role in   has the largest cross-sectional area of the distal limb tendons
      stabilizing the stifle during the stance phase (Tokuriki & Aoki,          (3.64 cm2). Stress in the flexor digitorum lateralis tendon has been
      1995).                                                                    estimated to be as high as 105 MPa (Ker et al., 1988) or as low as
         Tibialis cranialis is a small muscle with a wide range of fiber        40–50 MPa (Biewener et al., 1998). Tendons fail at stresses of
      lengths (17–218 mm) and highly pennate fibers (41°) capable of            approximately 120 MPa (Zajac, 1989), indicating that flexor digito-
      generating fairly high force but low power (Table 7.1). It is notable     rum lateralis may be operating close to, and may even exceed, its
      for having a short (92 mm), thick (CSA, 2.61 cm2) tendon of attach-       limit during isometric muscular contractions that generate high
      ment (Payne et al., 2005). Fibers in the proximal part of this muscle     forces. In spite of this prediction, digital flexor tendon injuries do
      are longer than those in the distal part (Crook et al., 2008) and it      not occur frequently in the equine hind limbs.
      is the only muscle in the distal hind limb that has long fibers.             Extensor digitorum longus is a small muscle that generates a moder-
         Gastrocnemius (Fig. 7.1, Table 7.1) is the largest muscle of the       ate force but little power (Fig. 7.1, Table 7.1). Its long (472 mm)
      distal limb. The medial and lateral heads combined have a volume          tendon has a small cross-sectional area (1.13 cm2) and experiences
      of 1543 cm3 and mass 1625 g (Payne et al., 2005), with the lateral        low stress. Estimates of peak stress range from 14.4 MPa (Payne
      head being larger than the medial head but having shorter fiber           et al., 2005) to 36 MPa (Ker et al., 1988).
      lengths (Crook et al., 2008). The muscle belly contains extensive
      tendinous bands organized in series and in parallel and united by
      short (48–56 mm), pennate muscle fibers (see Table 7.3) (Payne            The stay apparatus
      et al., 2005). This architecture is consistent with a capacity for eco-
      nomical force generation via tendinous stretch and recoil within the      In the standing horse, the body weight acts through the hip joint
      muscle belly. As a consequence of the fiber pennation, the lateral        and is counteracted by the ground reaction force acting through the
      head has the largest PCSA of all the hind limb muscles (644 cm2).         hoof. The net effect is to exert a compressive force on the hind limb.
      The estimated force-generating capacity of gastrocnemius is quite         The joints are maintained in extension by the action of the extensor
      high (8930 N) and is combined with a relatively large power-              musculature. In general, the magnitude of extensor muscle force
      generating ability (244 W). The two heads have a thick (3.32 cm2)         required to maintain the standing posture increases with body mass
      common (calcanean) tendon. Stress in the calcanean tendon has             and with joint angulation. Thus, smaller animals tend to adopt a
      been estimated as 47 MPa (Ker et al., 1988), 30 MPa (Biewener             crouched posture with more flexion of the joints, whereas larger
      et al., 1998) and 27 MPa (Payne et al., 2005). The gastrocnemius and      animals stand with more upright limb angulations to reduce
      cranial-tibial muscles may also play a role in centering the line of      loading of the extensor musculature (Biewener, 1989). Horses
130
                                                                                             Sagittal plane analysis of hind limb kinematics and kinetics
Although kinematic gait analysis of the equine hind limb has been
performed since the early part of this century (Walter, 1925; Krüger,
1938), the development of the computer gave new impetus to this                 are required. Typical marker configurations involve either placing a
field of research, both in the area of clinical applications (Fleiss            marker over the center of rotation of each joint or aligning two
et al., 1984; Kobluk et al., 1989; Martinez-del Campo et al., 1991;             markers along the long axis of each segment (Fig. 7.3). Intra-limb
Back et al., 1995a, 1995b) and in computer simulation studies (van              coordination patterns can be visualized using stick figures or by
den Bogert & Schamhardt, 1993). The reciprocal apparatus, which                 joint angle–time graphs (Fredricson & Drevemo, 1972; Martinez-
couples stifle and tarsal joint motion, has been studied extensively            del Campo et al., 1991; Holmström et al., 1994; Back et al., 1994;
(Strubelt, 1928; Molenaar, 1983; Wentink, 1978b; van Weeren                     Hodson et al., 2001, Dutto et al., 2006).
et al., 1990). Back et al. (1995b) standardized the graphical presen-              Errors introduced into kinematic data due to skin movement
tation of kinematic data of the equine hind limb using joint angle–             relative to the underlying skeletal landmarks (van Weeren et al.,
time diagrams in a large group of horses.                                       1992) may be small enough to be neglected on the crural and
   The hip joint is the pivot point for rotation of the hind limb, and          metatarsal segments, but are large enough to cause obvious changes
the ball and socket construction allows some motion outside of the              in sagittal plane kinematics on the pelvic, thigh and pastern seg-
sagittal plane. The more distal joints are constrained to move pri-             ments (Fig. 7.4). Errors as large as 15° in stifle angle and 30% in
marily in a sagittal plane with only small amounts of abduction–                moment arm of gastrocnemius have been attributed to the effects of
adduction and internal–external rotation (Lanovaz et al., 2002).                skin displacement in a walking pony (van den Bogert et al., 1990).
Thus kinematic analysis in the two-dimensional sagittal plane cap-              Correction algorithms have been developed for many of the ana-
tures most of the kinematic information describing hind limb                    tomical locations that are commonly used for marker placement for
movement patterns. Hind limb joint angles may be measured in                    two-dimensional analysis of hind limb kinematics (van Weeren
several ways (Fig. 7.2): between the proximal and distal segments               et al., 1992).
on the anatomical flexor aspect; as the angle by which the distal                  Kinematic information can be combined with ground reaction
segment deviates from alignment with the proximal segment; or as                forces and morphometric data for the equine hind limb segments
some variation of these methods. The angle may be expressed in                  (Buchner et al., 1997; Nauwelaerts et al., 2011) (Fig. 7.5, Table 7.2)
absolute terms or it may be normalized to the standing angle, the               to calculate net joint moments and net joint powers using inverse
angle at ground contact or the average angle during the stride (Mul-            dynamic analysis (see Chapter 19 for details). This method offers a
lineaux et al., 2004). Three-dimensional kinematics of the tarsal               more complete description of the functional responsibilities of the
joint have been measured using bone-fixed markers (Lanovaz et al.,              joints. In the equine hind limb, inverse dynamic analysis has been
2002) and will be described at the end of this chapter.                         used to improve understanding of joint function during walking
   When skin markers are used to represent sagittal plane motion                (Colborne et al., 1997a, 1997b; Clayton et al., 2001; Dutto et al.,
of the hind limb segments, a minimum of two markers per segment                 2006) and trotting (Clayton et al., 2002; Dutto et al., 2006).
                                                                                                                                                            131
                              7            Hind limb function
                                             3
                                                                                         4
                                                                                                   5
                                                 6
                                                                                                            7
                                                                  8                                                                 8
                                                                                                            9
                                                                                                                                   13
                                                 9
                               A                                11             B         10                                        12
                                30                                                                                     50
                              Flex         Hip                                                                       Flex        Stifle
                               20
                                                                                                                      30
                                                                                             Joint angle (degrees)
      Angle (degrees)
                               10
                                                                                                                      10
                                  0
                                                                                                                     -10
                              -10
                              Ext                                                                                    Ext
                              -20                                                                                    -30
                                       0         20      40      60        80      100                                       0            20      40      60        80    100
                                                      Time (% of stride)                                                                       Time (% of stride)
                                60                                                                                     80
                              Flex         Tarsus                                                                    Flex        Hind
                                                                                                                      60         Fetlock
                               40
      Joint angle (degrees)
40
20 20
                                                                                                                         0
                                   0
                                                                                                                     -20
                              Ext                                                                                    Ext
                              -20                                                                                    -40
                                       0         20      40      60        80      100                                       0            20      40      60        80    100
                                                      Time (% of stride)                                                                       Time (% of stride)
       Fig 7.4  Mean angle–time diagrams for the joints of the hind limb in a group of horses trotting on a treadmill at 3 m/s before (red line) and after (green line)
       correction for skin displacement. The horizontal zero line indicates the joint angle of the horse standing square. The vertical dashed line marks the transition
       from stance to swing phase. At the fetlock there is no difference after correction for skin displacement.
       Reprinted from Back, W., Schamhardt, H.C., Savelberg, H.H.C.M., et al., 1995b. How the horse moves: significance of graphical representations of equine hind limb kinematics. Equine Vet. J. 27,
       39–45, with permission from the Equine Veterinary Journal.
132
                                                                                                              Sagittal plane analysis of hind limb kinematics and kinetics
The trot                                                                                       breeds of horses (Clayton, 1994a; Holmström et al., 1994; Back
                                                                                               et al., 1995b; Galisteo et al., 1997; Galisteo et al., 1998; Cano et al.,
The trot is a symmetrical, two-beat gait with the limbs moving by                              1999; Cano et al., 2001; Nicodemus & Holt, 2006; Nicodemus &
diagonal pairs. The diagonal stance phases are usually separated by                            Booker, 2007). The following paragraphs describe sagittal plane
aerial or suspension phases, so the trot is classified as a running or                         kinematics and kinetics of the joints of the hind limb during trot-
leaping gait in which the body mass is modeled as a spring mass                                ting and indicate the effects of skin displacement on the amplitude
system. Since the trot is the most important gait for lameness detec-                          and pattern of joint angular displacement (Fig. 7.4).
tion, it has been the focus of many kinematic studies in various                                  In Warmblood horses trotting at 4.0 m/s, stride duration is
                                                                                               0.67 s, and hind stance duration occupies about 40% of stride dura-
                                                                                               tion (Table 7.3) (Back et al., 1995b). Stride and stance durations
                                                                                               are negatively correlated with velocity (Robert et al., 2002).
                                                                                               Although hind limb swing duration is the same at walk and trot,
                                                                                               the limbs rotate through a larger range of motion at trot, requiring
                                                                                               greater force and impulse generation, and with more flexion of the
                                                                                               stifle and tarsal joints during the swing phase, which shortens the
                                                                                               limb pendulum and hastens protraction. As trotting speed increases,
                                                                                               range of motion increases in the hip and tarsal joints (Hoyt et al.,
                                                                                               2002).
                                                                                                  As in the forelimb, gait efficiency in the hind limb is increased
                                                                                               by using the tendons as energy-conserving elastic springs (Dimery
                                                                                               et al., 1986). Energy is stored by stretching the tendons as the limb
                                                                                               is loaded and it is released during the unloading phase when it
                                                                                               contributes to propulsion and joint flexions during the swing phase.
           1                                                                                   In early swing, the release of elastic energy supports tarsal and stifle
                                                                                               flexion (Wentink, 1978b), which occur synchronously, since these
                                                                                               joints are coupled by the reciprocal apparatus. In general, electro-
               2                                                                               myographic activity in the hind limb musculature is low during the
                                                                                               swing phase at trot (Wentink, 1978a; Jansen et al., 1992; Tokuriki
                                                                                               & Aoki, 1995), which supports the idea that movements in the
                       3                                                                       swing phase are heavily reliant on passive energy from elastic recoil
                                                                                               of the tendons. In the absence of ground reaction forces, resistance
                                                                                               to limb movements in the swing phase is due mainly to segmental
                                                                                               inertia. Flexion of all the hind limb joints as the limb is protracted
                                        4                                                      reduces the effective limb length and moment of inertia about the
                                                                                               hip joint.
                       5
                                                                                               Hip joint
                   6
                                                                                               The hip joint shows a more or less sinusoidal flexion and extension
Fig 7.5  Locations of skin markers used to locate the centers of mass of the                   pattern. In early stance, hip angle is constant during the impact
hind limb segments in Table 7.2. The segments are separated along the                          phase, after which the joint extends to reach maximal extension in
incision lines shown in red.                                                                   terminal stance. The swing phase flexion cycle peaks just after mid-
Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M., Scharmhardt, H.C., Barneveld, A., 1997.   swing, which represents the position of maximal hind limb protrac-
Inertial properties of Dutch Warmblood horses. J. Biomech. 30 (6), 653–658, with permission    tion. The hip then extends and retracts the limb prior to hoof
from Elsevier..                                                                                contact with the ground (Fig. 7.6). In the absence of correction for
  Table 7.2  Hind limb segmental masses, densities, reference lines for division of segments (see Fig. 7.2), and position of segment centers of
  mass in sagittal plane
  Position of center of mass is determined first along the segmental x-axis (longitudinal, positive distally from the proximal reference marker toward the distal reference marker),
  then shifted along the y-axis (perpendicular to x-axis, positive cranially). Distances are measured as a percentage of the segment length between the two reference markers.
  Data are mean ± SD for 12 hind limbs of six Warmblood horses.
  Reprinted from Muir, W.W., Hubbell, J.A.E., 2008. Equine Anaesthesia, monitoring and emergency therapy, 2e, Mosby, with permission from Elsevier.
                                                                                                                                                                                       133
           7     Hind limb function
       Table 7.3  Hind limb kinematic variables for horses walking at 1.6 m/s, trotting at 4.0 m/s (Back et al., 1996b), and cantering at 7.0 m/s
       (Back et al., 1997)
       Pro-/retraction
       Angle of max protraction (°)                       23.1 ± 1.8*                      21.6 ± 1.3*                 22.7 ± 1.4#                              35.8 ± 1.7#
       Angle of max retraction (°)                      −23.6 ± 1.6*                     −26.6 ± 1.5*                −37.6 ± 1.2#                             −29.7 ± 1.0#
       Max pro/retraction range (°)                       46.7 ± 2.9*                      48.1 ± 1.6*                 60.3 ± 1.7#                              65.5 ± 1.6#
       Hip joint
       Angle of max extension (°)                         68.9 ± 3.8*                      67.8 ± 3.9*                 66.7 ± 4.4                               73.8 ± 3.2
       Angle of max flexion (°)                           93.7 ± 3.2*                      91.1 ± 3.6*                 91.0 ± 3.6                               96.3 ± 3.2
       Range of motion (°)                                24.8 ± 1.9*                      23.3 ± 1.8*                 24.3 ± 1.9                               22.5 ± 1.8
       Stifle
       Angle of max extension (°)                          7.0 ± 4.9*                      11.0 ± 4.0*                 13.5 ± 4.6#                               2.3 ± 5.1#
       Angle of max flexion (°)                           46.1 ± 5.9*                      58.3 ± 5.1*                 55.5 ± 3.0                               57.9 ± 4.3
       Range of motion (°)                                39.1 ± 3.7*                      47.3 ± 3.8*                 42.0 ± 3.9 #
                                                                                                                                                                55.5 ± 4.7#
       Tarsus
       Angle of max extension (°)                         10.4 ± 3.5                       10.3 ± 2.9                   7.0 ± 2.6                                8.1 ± 3.0
       Angle of max flexion (°)                           46.0 ± 0.1*                      65.7 ± 5.1*                 56.0 ± 8.0 #
                                                                                                                                                                64.5 ± 8.6#
       Range of motion (°)                                35.6 ± 4.5*                      55.4 ± 5.3*                 49.0 ± 8.3#                              56.5 ± 7.6#
       Metatarsophalangeal
       Angle of max extension (°)                       −37.0 ± 4.2*                     −53.0 ± 4.0*                −60.6 ± 3.4#                             −53.9 ± 3.8#
       Angle of max flexion (°)                           34.8 ± 9.1*                      32.0 ± 7.5*                 35.6 ± 8.9#                              43.8 ± 7.3#
       Range of motion (°)                                71.8 ± 9.0*                      85.0 ± 7.7*                 96.1 ± 9.1                               97.7 ± 7.0
       *Indicates variables that differ significantly between walk and trot (p <0.05).
       #
        Indicates variables that differ significantly between trailing and leading limbs at canter (p <0.05).
       Angles are expressed relative to 180° alignment of the proximal and distal segments; flexion angles are positive, extension angles are negative. Protraction and retraction angles
       are measured relative to the vertical: protraction positive, retraction negative. Values are mean ± SD.
       Reproduced from Back et al. (1996b, 1997).
      skin displacement, the pattern of hip joint motion hardly changes                               range of motion of around 11° during trotting (Gomez Alvarez
      but the range of motion is reduced by about half resulting in an                                et al., 2008).
      underestimation of the range of flexion–extension by as much as                                    There is an extensor moment at the hip joint through most of
      30° (Fig. 7.4) (Back et al., 1995b).                                                            stance with two bursts of energy generation in the extensor muscu-
         The hip joint–time curve and the cranio-caudal oscillations of a                             lature that push the trunk forward over the grounded hind hoof
      marker on the distal metatarsus have a similar pattern of movement                              (Fig. 7.6). The net joint moment moves to the flexor aspect during
      (Back et al., 1995b) indicating that the entire hind limb can be                                breakover and remains there through the first one third of swing.
      considered to move like a pendulum with a rotation point in the                                 Positive work is done as hind limb protraction is initiated by con-
      acetabulum. Maximal protraction occurs almost 10% later in the                                  centric action of the hip flexors followed by passive recoil of elastic
      stride for the hind limb compared with the forelimb. Pelvic rotation                            structures, such as the tendon of tensor fascia latae (Tokuriki & Aoki,
      contributes little to hind limb motion in the sagittal plane as the                             1995) and fibularis tertius (Wentink, 1978b). Energy generation in
      pelvis maintains a fairly constant angle relative to the horizon.                               the hip flexors in early swing increases linearly with trotting velocity
      However, pelvic rotation in the horizontal plane is larger with a                               (Clayton et al., 2002). The net joint moment is low during
134
                                                                                                           Sagittal plane analysis of hind limb kinematics and kinetics
120 130
                 110                                                                            110
Angle (deg)
                                                                                Angle (deg)
                 100                                                                             90
                  90
                        0   20   40          60           80          100                        70
                                                                                                       0          20           40          60           80          100
                 1.0
                 0.8                                                                            0.6
                 0.6
Moment (Nm/kg)
0.4 0.3
                                                                               Moment (Nm/kg)
                 0.2
                 0.0                                                                            0.0
                            20   40          60           80          100                                         20           40          60           80          100
                 -0.2
                 -0.4                                                                           -0.3
                 -0.6
                                                                                            -0.60
                 2.5
                   2                                                                            1.4
                                                                                                1.2
                 1.5
Power (W/kg)
                                                                                                1.0
                                                                               Power (W/kg)
                   1
                                                                                                0.8
                 0.5                                                                            0.6
                   0                                                                            0.4
                            20   40          60           80          100                       0.2
                 -0.5
                                 Time (% stance)                                                0.0
           A                                                                                           0          20           40          60           80          100
B Time (% swing)
Fig 7.6  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
positive) for the hip joint during the stance phase (left) and swing phase (right) at the trot.
midswing, then in late swing the extensor moment increases as the              2002; Dutto et al., 2006). In early swing, an extensor moment cor-
hip extensor muscles do positive work to initiate hind-limb retrac-            responds with a period of energy absorption as the stifle extensors
tion in preparation for ground contact (Khumsap, 2002). Gluteus                control the amount of flexion. In late swing, a flexor moment is
medius, biceps femoris and semitendinosus are active at this time              present as energy is absorbed by the stifle flexors, which are acting
(Robert et al., 1998). The magnitude of this late swing phase burst            eccentrically to control large bursts of joint extension (Fig. 7.7)
increases with velocity squared (Clayton et al., 2002), which may              (Khumsap, 2002). The early swing phase burst of energy absorption
reflect the need to overcome the forward kinetic energy                        increases linearly with velocity, whereas the later burst increases
( 1 2 mv2) of the limb.                                                        with velocity cubed (Clayton et al., 2002).
                                                                                                                                                                          135
                       7          Hind limb function
170 170
                       165                                                                               150
      Angle (deg)
                                                                                         Angle (deg)
                       160                                                                               130
                       155                                                                               110
                              0           20           40          60    80   100                               0    20          40           60         80          100
                       0.4                                                                             0.15
                       0.2                                                                             0.10
      Moment (Nm/kg)
0.05
                                                                                    Moment (Nm/kg)
                       0.0
                                          20           40          60    80   100                      0.00
                       -0.2                                                                                          20          40           60         80          100
                                                                                                     -0.05
                       -0.4
                                                                                                     -0.10
                       -0.6                                                                          -0.15
                                                                                                     -0.20
                       3.0
                       2.0                                                                                0.1
                                                                                                          0.0
      Power (W/kg)
                       0.0                                                                               -0.3
                                          20           40          60    80   100                        -0.4
                       -1.0                                                                              -0.5
                                                                                                         -0.6
                       -2.0
                                                                                                         -0.7
                 A                                     Time (% stance)                                   -0.8
                                                                                                                                  Time (% swing)
                                                                                                     B
      Fig 7.7  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
      positive) for the stifle joint during the stance phase (left) and swing phase (right) at the trot.
      appears to extend more than the stifle in late stance due to stretch-                             The passive spring action and coupling mechanism in the tarsus
      ing of fibularis tertius, especially at faster speeds. In attempting to                        can be reproduced in a horse under general anesthesia in lateral
      explain these discrepancies, Molenaar (1983) assigned functional                               recumbency. The joint moves rapidly into maximal flexion or
      significance to the axial and abaxial insertions of fibularis tertius.                         extension as it passes through a critical mid-point angle (Alexan-
         The net joint moment is on the extensor aspect of the tarsus                                der & Trestik, 1989). This snapping action is a consequence of the
      throughout stance, with the value peaking in midstance. The power                              eccentric attachments of the tarsal collateral ligaments relative to
      profile varies somewhat according to the kinematic pattern in mid-                             the center of rotation of the tarsocrural joint (Updike, 1984;
      stance but consistent features include a burst of energy absorption                            Badoux, 1987). Inflections in the joint angle–time curves of the
      in the first half of stance and a burst of energy generation later in                          tarsal joint in vitro indicate the positions at which a labile equilib-
      stance that may represent elastic recoil (Fig. 7.8) (Dutto et al.,                             rium is passed and the joint rapidly flexes or extends. Evidence of
      2006). The net joint moment is on the flexor aspect in the first half                          this phenomenon is also seen in vivo; three-dimensional analysis
      of swing. It corresponds with a phase of elastic energy release in                             of tarsal kinematics shows that craniocaudal translation becomes
      fibularis tertius, which was stretched in late stance. There may also                          decoupled from tarsal flexion–extension as the joint passes
      be active energy generation in the tarsal flexors and/or digital exten-                        through −50° of flexion and becomes coupled again later in swing
      sors, such as the long digital extensor, which shows electromyo-                               as the joint passes back through that same angle (Lanovaz et al.,
      graphic activity at this time (Jansen et al., 1992). The net joint                             2002).
      moment moves to the extensor (caudal) side of the tarsus in the
      second half of swing, when energy generation in the tarsal extensors
      actively extends the joint and lowers the hoof in preparation for                              Metatarsophalangeal (MTP) joint
      ground contact. This is in contrast to the forelimb in which carpal                            After initial ground contact, the MTP joint extends and reaches
      extension in late swing is due to inertia and is controlled by the                             maximal extension at midstance. The joint then flexes through the
      carpal extensor muscles. The early swing phase burst of energy                                 remainder of stance to reach a flexion peak in early swing through
      generation increases linearly with trotting velocity, whereas the                              the passive action of the SDF tendon (Molenaar, 1983). After a
      burst of energy generation in late swing increases with velocity                               slight extension in midswing there is a second flexion peak that
      cubed (Clayton et al., 2002).                                                                  occurs close to the time of maximal flexion of the stifle and tarsal
136
                                                                                                           Sagittal plane analysis of hind limb kinematics and kinetics
180 170
                 160
                                                                                                 150
Angle (deg)
                                                                               Angle (deg)
                 140
120 130
                 100
                        0   20   40          60           80          100                        110
                                                                                                       0      20           40          60           80          100
                 1.2
                                                                                              0.15
                 1.0
                                                                                              0.10
Moment (Nm/kg)
0.8
                                                                            Moment (Nm/kg)
                 0.6                                                                          0.05
                 0.4
                                                                                              0.00
                 0.2                                                                                          20           40          60           80          100
                                                                                             -0.05
                 0.0
                            20   40          60           80          100                    -0.10
                 -0.2
                                                                                             -0.15
                 4.0
                                                                                                 0.3
Power (W/kg)
                 2.0
                                                                               Power (W/kg)
0.2
                 0.0
                            20   40          60           80          100                        0.1
                 -2.0
                                 Time (% stance)                                                 0.0
           A                                                                                           0      20           40          60           80          100
B Time (% swing)
Fig 7.8  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
positive) for the tarsal joint during the stance phase (left) and swing phase (right) at the trot.
joints. At the end of swing, when the stifle and tarsal joints are                            extension is during breakover in the terminal part of stance. In the
extending, the MTP joint extends under the control of the digital                             swing phase, the DIP joint flexes rapidly via a small flexion peak to
flexor muscles (Fig. 7.9). No differences are found between the                               reach peak flexion at midswing. It then extends to initial ground
curves before and after correction for skin displacement when                                 contact (Fig. 7.10) (Back et al., 1995b).
the pastern is treated as a rigid segment (Fig. 7.4) (Back et al.,                               The net joint moment is on the flexor (plantar) aspect throughout
1995b).                                                                                       stance. Some horses show a little negative work in early stance, the
   The net joint moment is on the flexor (plantar) aspect of the MTP                          presence of which may be related to hoof angulation, then in late
joint throughout the stance phase, where it acts to support and                               stance there is a burst of energy absorption on the flexor aspect of
control the amount of extension. The power profile is typical of                              the DIP joint (Fig. 7.10). The net joint moment is on the extensor
elastic energy storage and release with a phase of energy absorption                          aspect of the DIP joint in early swing where it acts to control joint
followed immediately by an almost equal phase of energy genera-                               flexion during protraction (Khumsap, 2002).
tion (Fig. 7.9) (Khumsap, 2002; Dutto et al., 2006). At the begin-
ning of the swing phase, MTP flexion is actively supported by
activity of the DDF muscle (Jansen et al., 1992), but the net joint                           Hoof interaction with the ground
moment is on the extensor aspect at this time indicating that the                             Although the fore and hind distal limbs are anatomically similar,
extensors are controlling MTP flexion. The net moment moves to                                they have different angles, velocities and accelerations during the
the flexor aspect in the second half of swing to control MTP exten-                           impact phase (Back et al., 1995d). The hind hooves have a more
sion by the long digital extensor tendon in preparation for ground                            exaggerated heel first contact and so take longer to become flat on
contact (Khumsap, 2002; Dutto et al., 2006).                                                  the ground (Merkens & Schamhardt, 1993; Schamhardt & Merkens,
                                                                                              1994; Back et al., 1995d). Furthermore, the angle of the metatarsus
                                                                                              at impact is smaller than that of the metacarpus (Clayton, 1994a;
Distal interphalangeal (DIP) joint                                                            Back et al., 1995d).
The DIP joint flexes during the rapid loading phase at the begin-                                Within approximately 3% of stride duration, hoof angle, vertical
ning of stance reaching peak flexion before midstance. Maximal                                velocity and vertical acceleration of the hoof are zero, but it is not
                                                                                                                                                                          137
                       7            Hind limb function
240 200
                       230
      Angle (deg)
220 180
                                                                                                 Angle (deg)
                       210
200 160
                       190
                                0           20           40          60    80   100
                                                                                                               140
                       0.2                                                                                            0   20        40           60         80          100
                       0.0
                                            20           40          60    80   100                        0.008
      Moment (Nm/kg)
                       -0.2
                       -0.4                                                                                0.006
                       -0.6
                                                                                                           0.004
                       -0.8
                                                                                      Moment (Nm/kg)
                       -1.0                                                                                0.002
                       -1.2                                                                                0.000
                                                                                                                          20        40           60         80          100
                                                                                                       -0.002
                            5
                            4                                                                          -0.004
                            3
                                                                                                       -0.006
      Power (W/kg)
                            2
                            1
                            0                                                                                  0.05
                           -1               20           40          60    80   100
                           -2                                                                                  0.00
                           -3                                                                                             20        40           60         80          100
                                                                                                           -0.05
                           -4
                                                                                            Power (W/kg)
B Time (% swing)
      Fig 7.9  Joint angle (above, extension positive), net joint moment (center, extensor moment positive) and net joint power (below, power generation
      positive) for the metatarsophalangeal joint during the stance phase (left) and swing phase (right) at the trot.
138
                                                                                                             Sagittal plane analysis of hind limb kinematics and kinetics
210 200
                                                                                                  190
                     190
   Angle (deg)
                                                                                Angle (deg)
                                                                                                  180
                                                                                                  170
                     170
                                                                                                  160
                     150                                                                          150
                            0   20   40          60       80          100                                0        20          40           60          80          100
                  0.05                                                                         0.004
                  0.00
                                20   40          60       80          100
Moment (Nm/kg)
-0.05 0.002
                                                                            Moment (Nm/kg)
                 -0.10
                                                                                               0.000
                 -0.15                                                                                            20          40           60          80          100
                 -0.20
                                                                                               0.002
                 -0.25
                                                                                               0.004
                      0.5
                      0.0
                     -0.5       20   40          60       80          100                        0.08
   Power (W/kg)
                     -1.0
                     -1.5                                                                        0.04
                                                                                Power (W/kg)
                     -2.0
                     -2.5                                                                        0.00
                                                                                                                  20          40           60          80          100
                     -3.0
                                                                                                 -0.04
                 A                   Time (% stance)
                                                                                                 -0.08
                                                                                             B                                 Time (% swing)
Fig 7.10  Joint angle (above, extension positive), net joint moment (center, extension moment positive) and net joint power (below, power generation
positive) for the distal interphalangeal joint during the stance phase (left) and swing phase (right) at the trot.
Merkens, 1994), which is associated with less MTP extension and                              change with velocity (Khumsap et al., 2001a). The left and right
less tarsal flexion during stance. Push-off is less powerful in walk                         hind stance phases overlap by 12% of stride duration and, during
than trot.                                                                                   this time, the vertical and braking longitudinal forces increase in
   At a walking speed of 1.6 m/s, hind stance duration occupies                              the hind limb that is accepting weight. The first vertical force peak
63.4% of stride duration (Table 7.3) (Back et al., 1996). Stance                             coincides with lift-off of the contralateral hind limb. The dip in
duration is negatively correlated with walking velocity (McLaughlin                          vertical force occurs during tripedal support (one hind, two fore),
et al., 1996; Khumsap et al., 2001a). Although swing duration is                             then the second peak is during the support by a lateral pair of limbs.
the same for walk and trot, the limbs swing through a smaller                                The midstance position, marked by the hind hoof being vertically
range of motion at walk, requiring less force and impulse genera-                            beneath the hip joint, occurs at 28% stride, which is close to the
tion. The stifle and tarsal joints are less flexed during the swing                          time that the longitudinal force changes from braking to propulsive
phase at walk, which results in a longer pendulum and a slower                               at 30% stride (Hodson et al., 2001).
forward swing.                                                                                  Flexion and extension of the hip joint are responsible for protrac-
   During walking, the vertical ground reaction force of the hind                            tion and retraction of the entire hind limb during walking. Maximal
limb shows two peaks separated by a dip. As walking velocity                                 protraction occurs shortly before the end of swing, and maximal
increases, the first vertical force peak increases, while the dip                            retraction is during breakover. The thigh, crural and metatarsal seg-
decreases and becomes more distinct. This indicates that, as the                             ments rotate caudally with fairly constant angular velocities through
horse walks faster, the limb is loaded more in early stance and then                         the middle part of stance. As the limb is loaded in early stance, the
unloaded to a greater extent in midstance, which is partly due to                            stifle, tarsal and DIP joints flex and the MTP joint hyperextends.
rebound of the more heavily loaded limb spring. At very low veloci-                          After an initial flexion, the tarsus extends through the remainder of
ties, the vertical dip almost disappears (Khumsap et al., 2001a). The                        stance, while the stifle flexes a little after midstance. The MTP joint
hind limb longitudinal ground reaction force has a braking phase                             extension pattern during the stance phase at walk has two extension
followed by a propulsive phase that peaks just before the start of                           peaks coinciding with those in the vertical ground reaction force.
breakover. At walk, only one limb provides braking and only one                              These peaks are more pronounced at a faster walk and ‘melt’ into
limb provides propulsion at any time (Merkens et al., 1986). The                             one extension peak at the trot, similar to vertical ground reaction
timing of the peaks in the longitudinal force do not appear to be                            force recordings at walk and trot (Back et al., 1996; Niki et al.,
related to kinematic events and the magnitudes of the peaks do not                           1982).
                                                                                                                                                                            139
           7      Hind limb function
                                                               60                                                    start of the swing phase, the hip, stifle and tarsal joints flex to raise
                                                              Flex       Fetlock angle                               and protract the distal limb. The crural, pastern and hoof segments
                                                                                                                     start to swing cranially soon after the hind hoof lifts off (around
                                                               40
                                                                                                                     70% stride), which coincides with the first swing phase flexion peak
                   Joint angle (degrees)                                                                             at the MTP joint. Peak flexions of the stifle, tarsal and DIP joints
                                                               20                                                    occur around 80% stride, followed by peak hip flexion at 85%
                                                                                                                     stride. The thigh and cannon segments reverse their direction of
                                                                                                                     rotation and begin to swing caudally at 90% stride followed by the
                                                                0
                                                                                                                     crural segment at 95% stride. Maximal hind-limb protraction occurs
                                                                                                                     at 97% stride.
                                                              -20                                                       The net joint moment is on the caudal/plantar side of all hind
                                                                                                                     limb joints at the start of stance when the limb is being actively
                                                              Ext
                                                                                                                     retracted. It moves to the cranial/dorsal side around 24% stride at
                                                              -40                                                    the hip and stifle and in terminal stance at the more distal joints.
                                                                     0         20      40       60        80   100
       A                                                                                                             It remains on the cranial/dorsal side of all joints during the first
                                                                                 Time (% of total stride)
                                                                                                                     half of swing when the proximal joints provide active limb pro-
                                                                                                                     traction, then moves to the caudal/plantar aspect to initiate retrac-
                                                                                                                     tion prior to ground contact. The hip joint is the main source of
                                                             1500                                                    energy generation during walking. It is assisted by the tarsal joint,
                                                              Flex       Fetlock velocity
                                                                                                                     in both stance and swing phases, and by the MTP joint during
                                                             1000                                                    stance. The DIP joint acts as an energy damper during stance,
                   Joint angle velocity (degrees/s)
140
                                                                                                                                               Sagittal plane analysis of hind limb kinematics and kinetics
                                                                               Angle (degrees)
                                                                                                                                                              bone segments are aligned. Bars at bottom of
                                                                                                                                                              graph indicate stance and swing phases at walk
                   80                                                                                                                                         (red bars) and at trot (green bars).
                                                                                                                                                              Reprinted from Keg, P.R., Scharmhardt, H.C., van Weeran,
                                                                                                  20                                                          P.R., et al., 1996. The effect of the high palmar nerve block
                   70                                                                                                                                         and the ulnar nerve block on lameness provoked by a
                                                                                                                                                              collagenese-induced tendonitis of the lateral branch of
                                                                     Walk                                                                           Walk
                   Ext                                                Trot                       Ext                                                 Trot     the suspensory ligament, Veterinary Quarterly, 18, sup 2,
                   60                                                                              0                                                          with permission from Taylor & Francis Ltd, http://www.
                         0            20      40       60       80       100                            0            20      40       60       80       100   informaworld.com.
                                           Time (% of stride)                                                             Time (% of stride)
                   70                                                                             40
                  Flex       Tarsus                                                              Flex       Hind fetlock
                   60                                                                             20
                   50
                                                                                                   0
Angle (degrees)
Angle (degrees)
                   40
                                                                                                 -20
                   30
                                                                                                 -40
                   20
                   10                                                                            -60
                                                                     Walk                                                                           Walk
                   Ext                                                Trot                       Ext                                                 Trot
                    0                                                                            -80
                         0            20      40       60       80       100                            0            20      40       60       80       100
                                           Time (% of stride)                                                             Time (% of stride)
Angle (degrees)
                   70                                                                             60
                  Flex       Tarsus                                                              Flex       Hind fetlock
                   60                                                                             40
                   50                                                                             20
Angle (degrees)
Angle (degrees)
40 0
30 -20
20 -40
                                                                                                                                                                                                                              141
           7      Hind limb function
Medial Lateral
Abduction Adduction
Flexion
                                           Tibial
                                           BCS
                                                                                                                  Extension
                                      Metatarsal
                                        BCS
A B
      Fig 7.14  Caudolateral view of the right tarsus showing the local coordinate systems of the crural and metatarsal segments (left) and the three rotations
      measured in three-dimensional analysis of the tarsus (right).
      Reprinted from Lanovaz, J.L., Khumsap, S., Clayton, H.M., Stick, J.A., Brown, J., 2002. Three-dimensional kinematics of the tarsal joint at trot, Equine Vet. J., 34 (Suppl.), 308–313, with permission
      from the Equine Veterinary Journal.
      at canter, the hind footfalls occur as couplets. The trailing limb is                                 to be coupled with flexion–extension; there is a small cycle of
      the supporting limb and carries more load.                                                            abduction in stance and a larger cycle in swing with approximately
                                                                                                            1° of abduction for every 3° flexion. In stance, there is a small
                                                                                                            cycle of internal rotation followed by a small cycle of external rota-
      Three-dimensional kinematics of the tarsal                                                            tion in swing (Fig. 7.15). Translational movements in the stance
                                                                                                            phase consist of cranial then caudal translation, lateral then medial
      joint at trot                                                                                         translation and distal followed by proximal translation. The same
                                                                                                            patterns occur in the swing phase but the magnitudes are larger in
      Three-dimensional tarsal kinematics have been measured using                                          accordance with the greater angular excursions.
      marker triads fixed rigidly to the tibia and third metatarsus (Fig.                                      The tarsocrural joint is assumed to be the source of most of the
      7.14) to describe three-dimensional motion in terms of three rota-                                    motion of the tarsus. The trochlea of the talus and the tibial cochlea
      tions (flexion–extension, abduction–adduction, internal–external                                      act like threads on a bolt with the tibia following an almost circular
      rotation) and three translations (mediolateral, craniocaudal and                                      path along the talar ridges (Badoux, 1987). Experimental measure-
      proximodistal) (Lanovaz et al., 2002). At a velocity of 2.8 m/s,                                      ments are in general agreement with these predictions (Lanovaz
      stance duration occupied 38% of the stride. Flexion–extension pat-                                    et al., 2002). If the tarsocrural joint behaves as a pure screw joint and
      terns and magnitudes were very similar to those recorded during                                       is the only source of motion within the tarsus, all movements should
      sagittal plane analysis, even though the flexion–extension axis is                                    be highly coupled to the flexion–extension angle and any non-
      defined differently in two-dimensional and three-dimensional                                          coupled movement would indicate motion at other sites within the
      analyses (Fig. 7.14). This is not surprising, however, since even                                     joint complex. Abduction–adduction and the three translations are
      large misalignments of the flexion–extension axis have little effect                                  strongly coupled with flexion–extension but internal–external rota-
      on the measured values when this is the dominant motion                                               tion is uncoupled during weight-bearing. In the swing phase, around
      (Ramakrishnan & Kadaba, 1991). The tarsus flexes during stance,                                       55% of stride duration, the cranial–caudal displacement becomes
      reaches peak extension around the time of lift-off, then undergoes                                    uncoupled from flexion–extension indicating that the third metatar-
      a larger flexion cycle during swing. Abduction–adduction appears                                      sus is displaced slightly cranially relative to the talus and tibia.
142
                                                                                                                                                                                       References
                            10                                                                               15
Flexion(-)/Extension(+)
                             0
                                                                                     Cranial(+)/Caudal(-)
                                                                                     Displacement (mm)
                                                                                                             10
                            -10
      Angle (deg)
                            -20                                                                               5
                            -30
                                                                                                              0
                            -40
                            -50                                                                               -5
                                  0   20     40         60      80         100                                     0   20     40         60         80          100
                                           Time (% of stride)                                                               Time (% of stride)
                             4                                                                                5
Adduction(+)/Abduction(-)
                                                                                     Displacement (mm)
                                                                                     Medial(+)/Lateral(-)
                             0
                                                                                                              0
      Angle (deg)
                             -4
                                                                                                              -5
                             -8
                            -12                                                                              -10
                                  0   20     40         60      80         100                                     0   20     40         60         80          100
                                           Time (% of stride)                                                               Time (% of stride)
                             2                                                                                5
                                                                                                              0
Internal(+)/External(-)
 Rotation Angle (deg)
                                                                                     Proximal(+)/Distal(-)
                                                                                     Displacement (mm)
                             0
                                                                                                              -5
                             -2                                                                              -10
                                                                                                             -15
                             -4
                                                                                                             -20
                             -6                                                                              -25
                                  0   20     40         60      80         100                                     0   20     40         60         80          100
                                           Time (% of stride)                                                               Time (% of stride)
Fig 7.15  Three rotations and three translations measured at the tarsal joint during trotting overground at 2.8 m/s. Left panel shows rotations:
flexion–extension (above), abduction–adduction (middle) and external–internal rotation (below). Right panel shows translations: craniocaudal (above),
mediolateral (middle) and proximodistal (below). Vertical dashed lines show transition from stance to swing phase.
Reprinted from Lanovaz, J.L., Khumsap, S., Clayton, H.M., Stick, J.A., Brown, J., 2002. Three-dimensional kinematics of the tarsal joint at trot. Equine Vet. J. 34 (Suppl.), 308–313, with permission
from the Equine Veterinary Journal.
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   patterns and kinematics in the walking and        Robert, C., Valette, J.P., Denoix, J.M., 1998.           animal locomotion. Acta Anat. 146,
   trotting horses. Equine Vet. J. 17 (Suppl.),         Surface electromyographic analysis of the             95–102.
   67–70.                                               normal horse locomotion: a preliminary             van den Bogert, A.J., van Weeren, P.R.,
Merkens, H.W., Schamhardt, H.C., Hartman,               report. In: Lindner, A. (Ed.), Proc. Conf.            Schamhardt, H.C., 1990. Correction for
   W., Kersjes, A.W., 1986. Ground reaction             Equine Sports Med. Sci. Wageningen Press,             skin displacement errors in movement
   force patterns of Dutch warmblood                    Wageningen, The Netherlands, pp. 80–85.               analysis of the horse. J. Biomech. 23,
   horses at normal walk. Equine Vet. J. 18,         Robert, C., Valette, J.P., Pourcelot, P., Audigie,       97–101.
   207–214.                                             F., Denoix, J.M., 2002. Effects of trotting        Walter, K., 1925. Der Bewegungsablauf an den
Merkens, H.W., Schamhardt, H.C., van Osch,              speed on muscle activity and kinematics in            freien gliedmassen des pferdes im schritt,
   G.J.V.M., van den Bogert, A.J., 1993.                saddlehorses. Equine Vet. J. 34 (Suppl.),             trab und galop. Arch. Wiss. Pract. Tierheilk.
   Ground reaction force patterns of Dutch              295–301.                                              53, 316–352.
   warmbloods at the canter. Am. J. Vet. Res.        Sack, W.O., 1989. The stay-apparatus of the           Van Weeren, P.R., van den Bogert, A.J.,
   54, 670–674.                                         horse’s hind limb – explained. Equine Prac.           Barneveld, A., 1992. Correction models
Minetti, A.E., Ardigo, L.P., Reinach, E., Saibene,      11, 31–35.                                            for skin displacement in equine kinematic
   F., 1999. The relationship between                Schamhardt, H.C., Hartman, W., Lammertink,               gait analysis. J. Equine Vet. Sci. 12,
   mechanical work and energy expenditure               J.M.L.A., 1985. In vivo bone strain in the            178–192.
   of locomotion in horses. J. Exp. Biol. 20,           equine tibia before and after transection of       Van Weeren, P.R., van den Bogert, A.J.,
   2329–2338.                                           the fibularis tertius muscle. Res. Vet. Sci. 39,      Barneveld, A., Hartman, W., Kersjes, A.W.,
Molenaar, G.J., 1983. Kinematics of the                 139–144.                                              1990. The role of the reciprocal apparatus
   reciprocal apparatus in the horse. J. Vet.        Schamhardt, H.C., Merkens, H.W., 1994.                   in the hind limb of the horse investigated
   Med. Ser. C- Anat. Histol. Embryol. 12,              Objective determination of ground contact             by a modified CODA-3 opto-electronic
   278–287.                                             of the limbs of the horse at the walk and             kinematic analysis system. Equine Vet. J. 9
Mullineaux, D.R., Clayton, H.M., Gnagey,                trot: comparison between ground reaction              (Suppl.), 95–100.
   L.M., 2004. Effects of offset-normalizing            forces, accelerometer data and kinematics.         Wentink, G.H., 1978a. Biokinetical analysis of
   techniques on variability in motion                  Equine Vet. J. 17 (Suppl.), 75–79.                    the movement of the pelvic limb of the
   analysis data. J. Appl. Biomech. 20,              Schuurman, S.O., Kersten, W., Weijs, W.A.,               horse and the role of the muscles in the
   177–184.                                             2003. The equine hind limb is actively                walk and trot. Anat. Embryol. 152,
Nauwelaerts, S., Allen, W., Lane, J., Clayton,          stabilized during standing. J. Anat. 202,             261–272.
   H.M., 2011. Inertial properties of equine            355–362.                                           Wentink, G.H., 1978b. An experimental study
   limb segments. J. Anat. 218, 500–509.             Serrano, A.L., Petrie, J.L., Rivero, J.L. L.,            on the role of the reciprocal tendinous
Nicodemus, M.C., Booker, J.E., 2007.                    Hermanson, J.W., 1996. Myosin isoforms                apparatus of the horse at walk. Anat.
   Two-dimensional kinematics of the jog and            and muscle fiber characteristics in equine            Embryol. 154, 143–151.
   lope of the stock breed western pleasure             gluteus medius muscle. Anat. Rec. 244,             Zajac, F.E., 1989. Muscle and tendon
   horse equine compar. Exerc. Physiol. 4,              444–451.                                              – properties, models, scaling, and
   59–70.                                            Stashak, T.S., 1987. Adams’ lameness in                  application to biomechanics and motor
Nicodemus, M.C., Holt, H.M., 2006. Two-                 horses. fourth ed. Lea & Febiger,                     control. Critical Reviews Biomed. Eng. 17,
   dimensional kinematics of the flat-walking           Philadelphia, pp. 76, 88, 102.                        359–411.
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                                                                                                                      C H A PTER            8 
Introduction                                                               connects the skin above from the hoof wall below. Deep to the
                                                                           coronet lies the dermis that produces the horn tubules of the hoof
                                                                           wall via the horn papillae, which project distally into the horn of
To deliver maximal performance it is essential that a horse has good       the hoof wall. The horn tubules are responsible for the striated
balance. A part of the required balance comes from factors con-            appearance of the hoof wall. The nonpigmented innermost part of
nected to the hoof (Balch et al., 1991a; Curtis, 1999, Aoki, 1999;         the tubular hoof wall is less stiff than the outer part and serves as
Arabian et al., 2001; Eliashar, 2007). ‘No foot, no horse’ is a well-      a mechanical buffer zone assisting the feet of horses in transmitting
known saying that emphasizes the important role of the hoof                load through the tissues without inflicting damage (Wagner et al.,
(Davies, 2002).                                                            2001, 2002).
  After domestication of the horse 5000–6000 years ago, man                   Projecting from the inner surface of the hoof wall are the primary
assumed much of the responsibility for the balance between hoof            epidermal lamellae (600/hoof) and secondary epidermal lamellae
growth and hoof wear. The Greek horse people (hippiaters) were in          (100–200/primary lamella). The insensitive horn of these epider-
favor of breeding horses with good hoof quality that did not need          mal lamellae interdigitates with the sensitive dermal lamellae to
shoes. The Romans invented the hipposandal that was attached to            form the functional connection between the hoof wall and P3. The
the hoof with straps and was used to protect the feet of the horse         horn that forms the epidermal lamellae is unstructured (non-
en route to the battlefield, where they were removed. The first iron       tubular). As the hoof wall grows, it moves distally by a mechanism
horseshoes with nails were made by the Celts 2000 years ago and            that allows the primary epidermal lamellae to slide past the station-
were similar to the ones we use today (Fig. 8.1).                          ary secondary epidermal lamellae. Primary epidermal laminae
  During locomotion every stride involves forces at the hoof–              morphology (spacing, orientation and curvature) is responsive to
ground interface that load the locomotor apparatus. Repeated appli-        mechanical stress at the laminar junction (Thomason et al., 2005,
cation of forces that have a high magnitude and/or an abnormal             2008). On the solar surface, the white line demarcates the junction
direction of action, overload the limb and may lead to the develop-        between sensitive and insensitive tissues and is in fact a distal pro-
ment of pathological processes (Johnston & Back, 2006). When we            jection of dermal and epidermal laminae (cf. terminal papillae).
have an insight how these forces work, we can modulate them by             When shoes are nailed in place, the nails should enter peripheral
corrective hoof trimming and optimal shoeing as rational measures          to the white line.
to treat and prevent lameness, e.g. at purchase (Anderson, 1992).             The bony skeleton of the hoof consists of the distal phalanx (P3)
That is the basic theme of this chapter.                                   or coffin bone, the navicular bone and part of the middle phalanx
                                                                           (P2) or short pastern bone. All three of these bones take part in the
                                                                           formation of the distal interphalangeal or coffin joint (Fig. 8.3).
Functional anatomy of the foot                                             During flexion of the coffin joint, the navicular bone generally
                                                                           follows the coffin bone although small but consistent motions exist
General anatomy                                                            between the navicular bone and the coffin bone (Bowker et al.,
                                                                           2001; Van Dixhoorn et al., 2002).
The equine foot has evolved from the third digit, which has been              The medial and lateral hoof cartilages (ungual cartilages) are
greatly elongated and strengthened. The hoof wall has developed            square-shaped structures located on either side of P3 and are con-
from the nail of the third digit. The hoof of the first digit is still     nected to P1 and P2 by connective tissue. They are large and flexible.
present, though rudimentary, in the form of the chestnut on the            Between them lie the digital cushion and a venous plexus. Compres-
medial side of the radius (forelimb) or metatarsus (hind limb),            sion of these structures during locomotion assists the return of
while that of the fifth digit, especially in Coldbloods, persists as the   venous blood to the heart (Hoffman et al., 2001; Pietra et al.,
ergot on the palmar/plantar side of the metacarpo-/metatarsopha-           2004). The navicular bone is connected to P3 by the distal navicular
langeal joint (Dyce & Wensing 1980; Pollitt 1995).                         or ‘impar’ ligament, to P2 by connective tissue and the synovial
   The hoof capsule consists of several parts: the coronet, the wall,      membranes of the coffin joint, navicular bursa and tendon sheath,
the sole, the frog and the heels (Fig. 8.2). The horn of each part         and to P1 by the proximal navicular ligaments. The navicular bone
of the hoof is produced by a corresponding area of dermis (corium).        is covered on one side by hyaline cartilage and on the opposite side
The estimated horn regeneration time based on a growth rate of             by fibrocartilage (Viitanen et al., 2003b). Its hyaline cartilage side
8–10 mm/month is 12 months for the toe, 6–8 months for the                 is in contact with the palmar/plantar aspect of P2 and P3. The deep
quarters, and 4–5 months for the heels. The coronet separates and          digital flexor tendon (DDFT) curves around the palmar/plantar
                                                                                                                                                    147
           8      The role of the hoof and shoeing
                                                                                                   contents; low palmar nerve blocks just distal to the fetlock joint
                                                                                                   anesthetize the entire hoof.
                                                                                                   Proprioception
                                                                                                   Bowker et al. (1993, 1995) described the concentration of nocicep-
                                                                                                   tors in the palmar/plantar part of the frog and in the proximal
                                                                                                   navicular area. It is hypothesized that these so-called lamellar
       A                                             B                                             bodies supply the central nervous system and the brain with pro-
                                                                                                   prioceptive information describing the location of the body in space
                                                                                                   (Van Wulfen & Bowker, 2002). This information is needed to
                                                                                                   control the central pattern generator (CPG) and thus intra- and
                                                                                                   inter-limb coordination (Fig. 8.6).
                                                                                                      Studies of the effects of local anesthesia in sound horses have
                                                                                                   yielded conflicting results. Keg et al. (1996) demonstrated no effect
                                                                                                   of a low palmar nerve block on gait symmetry as evaluated kineti-
                                                                                                   cally, whereas Kübber et al. (1994) did detect some kinematic
                                                                                                   effects. It is not known whether the differences between these
                                                                                                   studies were due to the sensitivity of the analytic equipment or to
                                                     D
                                                                                                   the (un-) soundness of the horses.
       C
                                                                                                   Hoof–pastern axis
                                                                                                   Ideally, hoof trimming optimizes the interaction between the hoof
                                                                                                   and the ground during locomotion. Since the hoof is a three-
                               E                                                                   dimensional structure, it should be balanced in both the craniocau-
                                                                                                   dal and mediolateral planes. Forces at the toe, medial and lateral
      Fig 8.1  The development of the horseshoe. (A) Ancient grass sandal. (B)                     heels collectively are optimally distributed when the hoof and
      Roman iron hipposandal fastened without nails. (C) Celtic horseshoe with                     pastern angles are aligned (Balch et al., 1997; Davies, 2002).
      oval nailholes. (D) Medieval shoe with square nail holes. (E) Renaissance
      shoe with fullering.
      Reprinted with kind permission of Butler, Doug, The Principles of Horseshoeing, 1995, Doug   Hoof balance
      Butler Enterprises, Inc. www.dougbutler.com.
                                                                                                   Craniocaudal balance
                                                                                                   Craniocaudal balance evaluates the hoof in a lateral view (Fig.
                                                                                                   8.7). It is assessed with the horse standing square on a level
      aspect of the navicular bone before attaching to the flexor surface                          surface. Alignment of the dorsal hoof wall with the pastern axis is
      of P3. The navicular bursa is interposed between the DDFT and the                            achieved by adjusting the absolute and relative lengths of the
      fibrocartilage of the navicular bone.                                                        heels, the quarters and the toe. A hoof that is balanced in this
                                                                                                   manner usually contacts the ground flat-footed or slightly heel
                                                                                                   first. When the hoof has a more acute angle than the pastern, the
      Vascular supply                                                                              hoof–pastern axis is said to be broken backwards. Conversely,
                                                                                                   when the angle of the hoof is more upright than that of the
      The blood supply enters the hoof via the palmar/plantar digital                              pastern, the hoof–pastern axis is said to be broken forward. Radio-
      arteries, which run through the terminal arch within P3 (Fig. 8.4).                          graphic studies have shown that P1 is always a little more upright
      A network of arteries perforates the dorsal surface of P3 and ramifies                       (vertical) than P2 and P3 with the three phalanges being most
      in the lamellar dermis. Some branches from this plexus are directed                          closely aligned when the hoof is trimmed with the dorsal hoof
      proximally to supply the coronet, where they anastomose with                                 wall parallel to the pastern axis (Bushe et al., 1987). Under these
      branches of the circumflex artery of the coronet. The dorsal branches                        circumstances the angle between the solar surface of P3 and the
      leave the palmar/plantar digital arteries just before they enter the                         ground is approximately 5°, whereas the dorsal face of P3 is paral-
      terminal arch of P3. The palmar/plantar branches run to the heel                             lel to the dorsal hoof wall at a distance of about 19 ± 0.5 mm in
      region where they form the venous plexus and anastomose with the                             Warmbloods (Back, 2001).
      circumflex artery of the sole.                                                                  There is a difference between the shape of the fore and hind
                                                                                                   hooves: the fore hoof is wider and usually has a smaller (more
                                                                                                   acute) hoof angle, while the hind hoof is narrower and has a larger
                                                                                                   hoof angle. In farriery books (Hermans, 1984; Hertsch et al., 1996;
      Nerve supply                                                                                 Ruthe et al., 1997), angles ranging from 45–50° for the forelimbs
      The hoof is innervated by the palmar/plantar digital nerves, which                           and 50–55°for the hind limbs have been reported, but more
      are located caudal to the vein and artery in the pastern region (Fig.                        recently the average angles have been reported to be over 50° in the
      8.5). The nerves can be blocked by injection of a local anesthetic at                        forelimb and over 55° in the hind limbs (Clayton, 1988; Kobluk
      the proximal pastern level where the nerves are crossed by the liga-                         et al., 1990; Balch et al., 1991a; Butler, 1995; Hickman & Hum-
      ment of the ergot (low palmar block) or more distally as the nerve                           phrey, 1997; Oosterlinck et al., 2010c). In racehorses, a significant
      passes deep to the hoof cartilage (palmar digital block). Palmar                             decrease in hoof angle was observed in association with starting
      digital nerve blocks anesthetize the caudal third of the hoof and its                        fast exercise work (Peel et al., 2006). According to the same study,
148
                                                                                                                       Hoof mechanics in the standing horse
Primary lamellae
                                                                          1
                                                                              2
                                                                                                                              5
                                                                                                                                           Secondary
                                                                                                                                           lamellae
                                                                                          5
                                                                                                  4
                                                  5
              3
                                                  3
             4                        4
                         5
                  6               6
              7                       7                                  Fig 8.2  The hoof capsule and its parts. (A) Lateral view. 1, Coronary band
                                                                         epidermal layer; 2, coronary band germinative layer; 3, horn papillae and
                                                                         tubulae; 4, unstructured horn; 5, primary and secondary epidermal lamellae. (B)
  B                                                                      Ventral view. 1, Pigmented outer hoofwall; 2, unpigmented inner hoofwall; 3,
                                                                         white line; 4, sole; 5, frog, 6, sulcus; 7, heels. (The interrupted lines indicate the
                                                                         projected location of the navicular bone and the third phalanx.) (C) Schematic
                                                                         drawing of the correct location of a hoof nail.
                                                                         Reprinted from Dyce, K.M. and Wensing, C.J.G. (1980) De Anatomie Van Het Paard. Utrecht:
                                          C                              Uitgeverij Bohn, Scheltema, Holkema, with permission of K.M. Dyce.
wet pasture conditions may also be associated with a reduced                  back-foot axis that becomes more upright with increased bone
hoof angle.                                                                   growth and tendon strength.
   There exist also differences in hoof shape between contralateral              The second component of craniocaudal balance is the location
limbs. A study on radiographic measurements of the front feet of              of the bearing surface of the hoof relative to the weight-bearing axis
normal Warmblood horses found that in 70% of the horses the left              through the cannon bone. The bulbs of the heel should lie vertically
hoof capsule and coffin bone were significantly larger than the right         below the central axis of the cannon bone in the sagittal plane. In
(Kummer et al., 2006; White et al., 2008). According to Wilson                some horses, although the hoof–pastern axis is aligned, the whole
et al. (2009), contralateral differences in hoof spread are related to        hoof capsule is located too far forward so that the bulbs of the heels
generalized asymmetry in forelimb left–right morphometry. Con-                are ahead of the central axis of the cannon bone. The resulting
tralateral differences in hoof shape may suggest unequal loading of           caudal concentration of the weight bends the hoof tubules at the
limbs, which in turn may contribute to injuries and reduced perfor-           heels, which reduces their ability to withstand compression, and
mance. Kroekenstoel et al. (2006) determined that foals with                  leads to underrun heels (Stashak, 1987; Balch et al., 1997). Nor-
uneven feet show asymmetrical loading of the interphalangeal                  mally, the dorsal toe wall and caudal heel wall should run parallel
joints (Lejeune et al., 2006), whereas foals are born with a broken           to each other and the toe wall length relative to heel wall length
                                                                                                                                                                    149
         8       The role of the hoof and shoeing
1i
                                                                                            11
                                                           17
                                                                                            13
                                                           1
2i
                                                       7
                                                                                                                                                                     2
                                                  17
                                                                                                                                                                     3
                                                                                                                                       6
                                                                                            5
                                            8                                          14
                                       17
                                                                                   2
                                                                              12
                                   9
                              17                                         3                                                           3ii
                                                                         15
                                                                         10
                                                                                                                           4                                    3i
                                                                                                                                                            2
                                                                                                    B
         A                         4            16 6                                                                                   5
      Fig 8.3  (A) Sagittal section of the equine distal fore limb. 1, Metacarpal bone (McIII); 2, first phalanx (P1); 3, second phalanx (P2); 4, third phalanx (P3);
      5, proximal sesamoid bone; 6, navicular bone; 7, fetlock joint; 8, pastern joint; 9, coffin joint; 10, navicular bursa; 11, suspensory ligament; 12, straight
      sesamoidean ligament; 13, deep digital flexor tendon; 14, superficial digital flexor tendon; 15, synovial membrane of coffin joint, navicular bursa and tendon
      sheath with connective tissue; 16, distal navicular ‘impar’ ligament; 17, attachments of common digital extensor tendon to first, second and third phalanges.
      (B) Schematic drawing of tendons and ligaments of the equine lower limb. 1, Superficial digital flexor tendon; 1I, proximal accessory ligament; 2, deep digital
      flexor tendon; 2I, distal accessory ligament; 3, suspensory ligament; 3I, straight sesamoideum ligament; 3II, rami extensori; 4, proximal navicular ligament; 5,
      distal navicular ‘impar’ ligament; 6, common digital extensor tendon; 7, extensor carpi radialis tendon.
      Reprinted from Dyce, K.M. and Wensing, C.J.G. (1980) De Anatomie Van Het Paard. Utrecht: Uitgeverij Bohn, Scheltema, Holkema, with permission of K.M. Dyce.
      should be 2 : 1.0 in the fore hooves and 2 : 1.5 in the hind hooves                            Caudron et al. (1997a,b, 1998) used radiographs to evaluate and
      (Hermans, 1984). Underrun heels have been defined as having a                                  correct this balance. In the dynamic method, the hoof is trimmed
      difference between the angles of the toe and heels that is more than                           so that the medial and lateral sides contact the ground simultane-
      5° (Balch et al., 1997).                                                                       ously, which adds a new dimension to the equation and makes the
                                                                                                     solution even more elusive. In a horse with ideal conformation,
                                                                                                     static and dynamic balancing will show a rather similar result, but
                                                                                                     when conformational defects are present the two methods produce
      Mediolateral balance                                                                           different results.
      Mediolateral balance evaluates the hoof in a frontal plane and                                    When a horse is standing quietly, the force due to gravity is com-
      attempts to optimize hoof balance by either a static or a dynamic                              pensated by the ground reaction force (GRF) acting near the geo-
      evaluation (Seeherman, 1991; Balch et al., 1997). Static balance                               metric center of pressure (CP) of the foot, which lies around the
      seeks to achieve symmetry in the square standing horse so that a                               apex of the frog (Barrey, 1990; Balch et al., 1997; Ovnicek, 1997).
      line that bisects the limb longitudinally is intersected at 90° by a                           The hoof rotates around the instantaneous center of rotation of the
      transverse line drawn across the heels (geometric limb axis).                                  coffin joint, which is located in the distal part of P2. Equilibrium
150
                                                                                                                                        Hoof mechanics in the standing horse
Proximal phalanx
                                           Middle phalanx
                    Arterial circle of middle phalanx
                                                                                                   Palmar digital arteries
                  Coronary circumflex artery
Lamellar arteries
                                                            Dorsal branch of
                                                            middle phalanx
                                                                 Proximal navicular
                                                                 plexus
                                                                      Distal navicular
                                                                      plexus
                                                                       Dorsal branch of
                                                                       distal phalanx
                                                                        Distal navicular
                                                                        artery
                 Palmar branch of                           Circumflex artery of sole      Fig 8.4  The main arteries of the foot: (A) lateral view, (B) caudal view.
                 distal phalanx       Distal interosseus ligament                          Reprinted from Pollit, C. (1995) Color Atlas of the Horse’s Foot. Mosby, with permission from
     B                                                                                     Elsevier and C. Pollit.
                                                                                                                                                                                           151
         8       The role of the hoof and shoeing
152
                                                                                                                      Hoof mechanics during locomotion
                                                                      Fig 8.6  (A) Sensory receptors in the foot. In the sagittal view the four zones
                                                                      of the sole (S1–S4) represent locations of the lamellated corpuscles with the
                                                                      relative density being indicated by the intensity of the green shading in zones
                                                                      S1–S4. S4 shows the highest density of lamellated corpuscles. In the ventral
                                                                      view the lamellated corpuscles were obtained from the areas shaded in green.
                                                                      (B) Sensory receptors in the navicular region. Inset shows the three levels from
                                                                      which drawings a–c were obtained. Note that the lamellated corpuscles
                                                                      (dots) are located primarily abaxially and proximal to the collateral
                                                                      sesamoidean ligament (CSL) often in association with the palmar digital nerve
                                                                      (n), as well as with the artery (a) and vein (v). d is a parasagittal drawing from
                                                                      the abaxial region of CSL. Sensory receptors are shown as red dots. PII: pastern
                                                                      bone; PIII: coffin bone; DDF: deep digital flexor tendon; Nav: navicular bone.
                                                                      (A) Reprinted from Bowker, 1993, Sensory receptors in the equine foot, American Journal of
                                                           Digital    Veterinary Research, with permission from American Journal of Veterinary Research http://
                                                           cushion    avmajournals.avma.org/loi/ajvr. (B) Reprinted from Bowker, R.M., Linder, K.E., Sonea, I.M. and
                                                                      Guida, L.A. (1995) Sensory nerve fibers and receptors in the equine distal forelimbs and their
                                                                      potential role in locomotion. Equine Vet. J. 18, 141–146, with permission of the Equine
          Hoof dermis           Sole   S1 S2 S3 S4                    Veterinary Journal.
Central
Medial
Lateral
Frog
                                                     Lamellated
                                                     corpuscles
v,a,n
                      A                                              PII
                                                                                   DDF
                  B       PII
                 C
                                                               A
PIII
                                                                     PII
                                                                                   DDF
                                                                                                                               PII
                                                               B
                                                                                                                                 Nav
                                                                                                                       PIII
                                                                     PII
                                                                                   DDF
B C
                                                                                                                                                                       153
          8      The role of the hoof and shoeing
                                                                                  Fig 8.7  Diagrams of straight, ideal and correct hoof–pastern axes and common
          Broken back                Correct          Broken forward              deviations viewed (A) from the front and (B) from the side.
                                                                                  Reprinted with kind permission of Butler, Doug, The Principles of Horseshoeing, 1995, Doug Butler
      B                                                                           Enterprises, Inc. www.dougbutler.com.
      et al., 2009) and accelerometers (Benoit et al., 1993; Burn et al.,                The impulsive loading that occurs during impact has been impli-
      1997; Back et al., 2006). The hoof and interphalangeal joints atten-            cated as a causative factor in arthritis in animals (Radin et al.,
      uate the shock wave associated with impact (Dyhre-Poulsen et al.,               1981; Pratt, 1997; Radin 1999) and in humans (Folman et al.,
      1994; Lanovaz et al., 1998; Willemen et al., 1998). Approximately               1986; Ker et al., 1989). The time during which these forces have to
      67% of the damping of impact vibrations takes place at the interface            be absorbed is reduced as speed increases. For example, the time
      between the hoof wall and the distal phalanx. The attenuation of                taken to absorb impact shock at the canter (7 m/s) is 50% of that
      impact vibrations at the interphalangeal joints and the metacarpo-              at the walk (1.6 m/s), which is a consequence of the shorter time
      phalangeal joint seems considerably less (12% and 9% respectively)              the foot is on the ground. Back et al. (1995) found that during
      leaving approximately 12% of the impact vibrations detectable                   trotting on a treadmill the hoof was flat on the ground, and the
      at the level of the metacarpus (Willemen et al., 1999a). Neverthe-              vertical speed and acceleration were zero within 3% (20 ms) of the
      less, the forces acting in different directions have the potential to           total stride duration. Surprisingly, it took 6% (40 ms) of total
      damage the body (Fig. 8.9). Friction between the hoof and the                   stride duration for the horizontal speed to reach zero, but as dem-
      ground and hardness of the ground affect the forces applied to the              onstrated by Gustås et al. (2001) the time lapse of this horizontal
      limb during the impact phase (Hjertén & Drevemo, 1993, 1994).                   retardation of the hoof is an important factor in the attenuation of
      The amplitude of impact vibrations at the level of the hoof wall is             the impact.
      15% higher in shod versus unshod hooves independent from the                       The forelimbs appeared to land with a higher vertical velocity and
      type of shoe that is used (shoes with or without pad). At the level             the hind limbs with a higher horizontal velocity (Back et al., 1995).
      of the first phalanx and the metacarpus the difference between shod             Thus, the forelimbs ‘bounce’, whereas the hind limbs ‘slide’. On the
      and unshod vanishes (Willemen et al., 1999a).                                   other hand, Gustås et al. (2004) found no significant difference in
154
                                                                                                                                          Hoof mechanics during locomotion
CA
                                                                                        Acceleration (m/s2)
                                                                                                                                         Time (s)
                                                                                          A
                                                                                                       8
                                                                                                                                  VGRF
Front contact               CP                                      Rear contact
       points                         CRP                                                                                         LGRF
                                                                    points                             6
                                                                                                                        e
                                                                                                       4            d
 A                                                                                  Force (kN)                                                              f
                                                                                                              b c                                                       g
                                                                                                       2
                                                                                                                              HGRF
                                                                                                       0
                                                                                                                                  TGRF
                                                                                                  -2
                                                                                                              0             100                     200                      300
                                                                                                                                     Time (ms)
                                                                                          B
                                                                                    Fig 8.9  (A) The impact phase is the short period immediately following
                                                                                    initial ground contact, in which the decelerating hoof is oscillating relative
                                                                                    to the ground until hoof velocity has been reduced to zero. (B) During
                                                                                    impact the vertical landing (VGRF) and horizontal braking (HGRF) forces
                                                                                    acting on the hoof are transferred into longitudinal (LGRF) and transverse
                                                                                    (TGRF) forces acting on the equine lower limb.
                                                                                    Reprinted from Hjertén, G. and Drevemo, S. (1994) Semi-quantitative analysis of hoof strike in
                                                                                    the horse. J. Biomech. 17, 997–1004, with permission from Elsevier.
                                                                                                                                                                                     155
         8         The role of the hoof and shoeing
156
                                                                                                                                             Hoof mechanics during locomotion
Fig 8.11  Shoes used to compare breakover. Left, a standard flat shoe (Mustad 22/10 LB); right and a shoe with a rolled toe (Mustad 22/10 equilibrium).
Reprinted from Van Heel, M.C., van Weeren, P.R., Back, W. (2006b) Shoeing sound warmblood horses with a rolled toe optimises hoof-unrollment and lowers peak loading. Equine Vet. Jour.
38 (3), 258–62, with permission of the Equine Veterinary Journal.
joint angle: strain increases when this joint extends. The load dis-                                            12
tribution between the tendinous structures changes with alterations
in hoof balance: strain reduction in one tendon may result in an                                                10
increased strain in another structure. Also the horse may compen-
sate, to a certain extent, for hoof imbalances by adjusting the length
                                                                                                                 8
of the muscle bellies of the SDFT and DDFT or by changing the
Breakover                                                                                                        2
Breakover is the terminal part of the stance phase from heel-off to
toe-off. Rotation of the hoof is brought about as a result of tension                                            0
in the DDFT and DAL, and in the navicular ligaments (Schamhardt                                                      0    50               100                  150                200
et al., 1991; Riemersma et al., 1996b). Farriery modifications that                                                                    Time (msecs)
facilitate breakover may reduce tension in the DAL and in the
navicular ligaments and also reduce pressure of the DDFT against                                Fig 8.12  Craniocaudal displacement of the center of pressure (COP) from
the navicular bone. The onset and duration of breakover are sensitive                           midstance to toe off in the same horse with a flat shoe (red line and
to changes in hoof balance, especially hoof angle and toe length.                               squares) and a rolled toe (blue line and squares). The peak indicates heel lift.
                                                                                                The higher peak in the flat shoe condition represents a more abrupt
Hooves trimmed with a low heel and long toe have a significantly
                                                                                                breakover process.
longer breakover duration, although other stride variables like stride
                                                                                                Reprinted from Van Heel, M.C., van Weeren, P.R., Back, W. (2006b) Shoeing sound
duration do not change significantly (Clayton, 1988, 1990a,b). On
                                                                                                warmblood horses with a rolled toe optimises hoof-unrollment and lowers peak loading.
the other hand, rocker, rolled and square toe shoes (Fig. 8.11) did
                                                                                                Equine Vet. Jour. 38 (3), 258–62, with permission of the Equine Veterinary Journal.
not significantly alter breakover duration of horses trotting on a
hard surface (Clayton et al., 1991; van Heel et al. 2006b) or on a
rubber floor (Willemen et al., 1996). However, breakover tends to                                  After the hoof leaves the ground, the limb swings forward to reach
occur earlier (Eliashar et al., 2002) and is smoother with a lower                              its position of maximal protraction, and is then retracted prior to
peak loading (van Heel et al., 2006b; Fig 8.12). In contrast to the                             contact with the ground. The final retraction is important for reduc-
effect of heel wedges, shoes that facilitate breakover do not reduce                            ing the forward velocity of the hoof relative to the ground and so
the peak distal interphalangeal joint moment nor the absolute force                             decreasing hoof deceleration at ground contact and preventing the
exerted on the navicular bone (Eliashar et al., 2002).                                          horse from stumbling. Protraction of the limb is driven by muscles
   Off-center breakover has been associated with swing abnormali-                               in the proximal limb, with the distal limb following passively (Back
ties of the foot that interfere with the opposite limb and contouring                           et al., 1995). In the forelimb the joints from the carpus proximally
the hoof or shoe on one side are common techniques to correct for                               are driven by muscular action, while the fetlock, pastern and
this. Recent research by Keegan et al. (2005) using gyroscopic                                  coffin joints move in response to inertial effects (Lanovaz et al.,
sensors mounted on the hoof confirmed that shoes with a con-                                    1999). As maximal protraction is approached, the motion of the
toured lateral branch induce greater lateral roll during breakover.                             proximal limb is slowed and reversed by muscular action, while the
However, this effect was only observed at a trot and was limited to                             distal limb continues moving forward until resisted by the passive
the first half of breakover.                                                                    structures (bones, ligaments, tendons). Swinging the limbs back and
                                                                                                forth uses considerable energy, and a number of energy-saving mech-
                                                                                                anisms have evolved. One of the most important is the use of elastic
Flight arc                                                                                      structures as springs; energy is stored when elastic tissues are
The flight arc of the hoof represents the summation of all the joint                            stretched as the limb is loaded during the stance phase, then released
movements in the limb (Fig. 8.13). The highest point in the flight                              during unloading to bounce the limb off the ground and assist in
arc occurs soon after lift-off with a second, smaller elevation, which                          flexing the joints. At the trot the SDFT, DDFT and SL are maximally
may coincide with an upward flip of the toe, at the time of maximal                             stretched at midstance which corresponds with the time of maximal
protraction. This gives a slightly biphasic flight arc (Clayton, 1990a;                         weight-bearing. Thus, the elbow, carpal and fetlock joints behave
Balch et al., 1991a, 1997; Back et al., 1995).                                                  elastically during the stance phase at the trot (Clayton et al., 1998).
                                                                                                                                                                                          157
          8                 The role of the hoof and shoeing
                                                                                                     Fig 8.13  (A) Special shoes with glass-fiber molds that were mounted on the
                                                                                                     hooves of trotter and recorded using high-speed cine cameras. (B) Three-
                                                                                                     dimensional rotations (pitch, red; yaw,blue; roll, green) of the hoof during
                                                   4                                                 trotting. could be illustrated in (B) a three-dimensional hoof coordination
                              ROLL                                                                   diagram.
                                                                                                     Reprinted from Fredricson, I. and Drevemo, S. (1971) A new method of investigating equine
                                     3                                                               locomotion. Equine Vet. J. 3, 137–140, with permission of the Equine Veterinary Journal.
PITCH
                                                             YAW
      A
                    Degrees                                                                                                                                            Degrees
                       50
                                         Support               Swing               Support             Swing               Support                 Swing                    40
                                                                                                                                                                                  Yaw angle
                                                                                                                                                                            20
                               0                                                                                                                                            0
                                                                                                        Yaw                                                                 –20
              Pitch angle
                                                                                                                                                                            –40
                             –50
                                                                                                        Pitch                                                               40
                                                                                                                                                                            20
                                                                                                                                                                                  Roll angle
                            –100
                                                                                                                                                                            0
                                                                                                         Roll                                                               –20
                            –150                                                                                                                                            –40
                                     300    400        500   600   700       800     900 1000 1100 1200 1300 1400              1500 1600 1700 1800              1900
      B                                                                                Time (msec)
         Below the elbow and stifle joints the horse’s limbs are designed                                 pastern becomes more upright creating a broken-back hoof pastern
      to move in a sagittal plane, which is another energy-saving strategy.                               axis (Bushe et al., 1987). Conversely, when horses are trimmed with
      The distal limbs sometimes deviate from this ideal pattern by being                                 a short toe and/or long heels, the hoof angle becomes more upright
      abducted (winging) or adducted (plaiting) during protraction as a                                   and the pastern angle becomes more sloping. Raising the heels
      result of slight asymmetries in the articular surfaces, which also have                             decreases strain in the DDFT and DAL (Leach, 1983; Bushe et al.,
      a tendency to cause breakover to occur on the medial or lateral side                                1987; Thompson et al., 1993; Riemersma et al. 1996a), but
      of the toe. If horses that naturally show these deviations are shod                                 increases strain in the SDFT and SL (Willemen et al., 1999b). One
      in a manner that forces them to breakover the center of the toe, it                                 of the goals of hoof trimming is to achieve a flat landing with the
      creates torsional forces before and after breakover. As the hoof                                    objective of disseminating the forces on the foot as much as pos-
      leaves the ground, these torsional forces cause it to deviate medially                              sible. When the hoof angle is more upright, the hoof has a more
      or laterally, depending on the type of asymmetry. Careful observa-                                  exaggerated heel first landing (Clayton, 1988; Back et al., 1995).
      tion of the horse in motion, together with an examination of the                                       Barrey (1990) looked at the relation between hoof angle and
      wear pattern on the ground surface of the shoe or hoof, will reveal                                 force distribution: 75% of the weight was borne by the heels when
      the preferred side of breakover. If the horse is shod to facilitate                                 the hoof angle was 39°, and this was reduced to 57% when the
      breakover at the preferred location, there will often be a marked                                   hoof angle was increased to 55° (Fig. 8.14). This agrees with the
      reduction in winging or plaiting and this, in turn, affects the hoof’s                              finding that a larger toe angle results in more strain of the hoof wall
      angle of approach to, and contact with, the ground.                                                 at the toe (Thomason, 1998). Nevertheless, the quarters experience
         Light-weight tactile stimulation devices attached around the                                     higher forces during stance than the toe (Barrey, 1990).
      pastern may increase the height of the flight arc and thus may rep-                                    Many racehorses are trimmed with an acute hoof angle because
      resent a useful adjunct in physical therapy aiming at mobilization                                  it is believed that the long toe low heel conformation enhances
      of joints and reinforcement of (atrophied) muscles (Clayton et al.,                                 performance by increasing stride length. Comparison of the trot
      2011). However, short-term habituation does occur, especially in the                                stride for a normal hoof angle versus an acute hoof angle showed
      forelimbs (Clayton et al., 2008). Application of the stimulators for                                no significant changes in stride length or suspension, and the
      short periods is recommended, although it is unknown how rapidly                                    flight arc of the hoof was almost identical with the two angula-
      horses rehabituate to the effect of tactile stimulation of the pastern                              tions (Clayton, 1990a; Balch et al., 1997; Girtler et al., 1995).
      over different sessions.                                                                            However, the acute hoof angle was associated with an increased
                                                                                                          frequency of toe-first contacts, which was thought to be a conse-
                                                                                                          quence of the proprioceptive reflexes ensuring a fairly flat place-
      Effects of hoof manipulations                                                                       ment of P3 regardless of the shape of the hoof capsule (Clayton,
                                                                                                          1990a). Since toe-first contacts are associated with a tendency to
                                                                                                          trip or stumble, this may be an undesirable effect. Decurnex et al.
      Hoof angle                                                                                          (2009) investigated the effect of training on proximal hoof cir-
      When a horse is trimmed with relatively long toes and/or short                                      cumference in young Thoroughbred racehorses being prepared for
      heels the hoof angle becomes more acute or sloping, while the                                       racing. Front hoof circumference immediately below the coronary
158
                                                                                                                                                                    Effects of hoof manipulations
Normal
47°
                                                                          Hoof force
                                                                          pattern at
                                           Quarter
                                                                          the walk                           Toe                   Quarter
            Toe
A t t t t
Quarter
                               16.9 ±6.5
                                                                                                                      Toe
                                                         .1
                                                                                                           ±2.0
                                                  .8 ± 242
              Force (daN/kg)
Force (daN/kg)
     Walk
                                                                                                                                .7
                                                                                                                              31
                                                          Impulse =
                                                                                                                             ±2
                                           Initial slo
                                                           6.7± 3.5
                                                                                                                        6.5
                                                                                                                                 3.4±1.5
                                                                                                                       18
                                                                                Date
                                                 19.0 40.4 54.4           100                                                  55.8
                                                 ±2.5 ±5.0 ±7.6                                                                ±3.8
                               23.7±6.1
              Force (daN/kg)
Force (daN/kg)
     Trot
                                                    .2
                                                                                                        10.7±4.6
                                                ± 382
                                                                                                                              .1
                                                                                                                            25
                                                              4.4 ± 1.3
                                           1072.9
±2
                                                                                                                                 1.5±0.8
                                                                                                                      6.9
                                                                                                                     44
                                                          27.8                                                                  400
 B                                                        ±7.9                                                                 ±6.1
Fig 8.14  (A) The influence of foot axis on the individual vertical hoof force distribution at the toe and at the quarters. (B) Forces experienced at the medial
toe and quarters at walk (above) and trot (below) in a group of 10 horses. Values on the graphs indicate mean +/− SD for force peaks, slope of initial slope,
impulse and times of occurrence of the force peaks and troughs.
Reprinted from Barrey, E. (1990) Investigation of the vertical hoof force distribution in the equine forelimb with an instrumented horseboot. Equine Vet. J. 9 (Suppl.), 35–38, with permission
from the Equine Veterinary Journal.
band was measured weekly with a measuring tape in all horses                                                                   The duration of breakover was prolonged with the acute hoof
present at the stable. Most horses showed a similar pattern of                                                              angulation and the orientation of the limb segments at the start of
change. The proximal hoof circumference decreased during the                                                                breakover suggested an increased tension in the DAL and navicular
training periods and increased when the horse was rested. Appar-                                                            ligaments (Fig. 8.15). The effects of an acute hoof angle on break-
ently, horses showed a decrease in circumference during race train-                                                         over may be mitigated on a softer surface that allows penetration
ing that reversed when they were rested, thus contributing to a                                                             of the toe during the terminal part of the stance phase, since flexion
possible ‘environmental’ explanation for the long toe low heel                                                              of the coffin joint reduces tension in the DAL and navicular
conformation often found in racehorses. Furthermore, measure-                                                               ligaments.
ment of front hoof circumference is a simple method to assess                                                                  The hoof wall grows approximately 1 cm every 6 weeks, with
change in hoof shape. It provides an opportunity to investigate the                                                         the wall at the toe growing faster than at the heels (Hertsch et al.,
relationships between specific training, hoof shape and soundness                                                           1996). When a horse is shod the hoof wears mainly in the heel
(Peel et al., 2006).                                                                                                        region. Consequently, the hoof angle changes between farriery
                                                                                                                                                                                                     159
         8       The role of the hoof and shoeing
      treatments and this is associated with alterations in the pressure                          injury. Therefore, horses should receive regular farrier treatment
      on the navicular area (Hermans, 1984). Willemen et al. (1999b)                              every 6–8 weeks or earlier when considerable changes in hoof
      calculated a decrease in force on the navicular bone of 24% when                            angle can be expected in a particular horse. Recent studies also
      the angle was 6° more upright. The mean toe angle of the fore-                              indicate that, by 2 weeks of age, foals already show a limb prefer-
      limbs of the 12 horses used in that study was 55°. At the end of                            ence when grazing at pasture (Van Heel et al., 2006a; Fig. 8.16),
      an 8-week shoeing interval, the decrease in hoof angle results in a                         and thus their hooves can become uneven (Kroekenstoel et al.,
      broken-back hoof-pastern axis thereby increasing extension in the                           2006; Fig. 8.17).
      distal interphalangeal joint and decreasing extension of the fetlock
      joint (Tacchio et al., 2002; Moleman et al., 2006; van Heel et al.,
      2006c). The deep digital flexor tendon has to compensate for this
                                                                                                                                   Left foot low hoof angle
      conformational change which puts the tendon at increased risk for
                                                                                                                                         10.0
                                                                                                                                          8.0
                                                                                                                                          6.0
                                                                                                                                          4.0
Right preference
                                                                                                                                                                                        Left preference
                                                                                                                                          2.0
                                                                                                                                          0.0
                                                                                                                    -3.0   -2.0   -1.0                   1.0          2.0         3.0
                                                                                                                                          -2.0
                                                                                                                                          -4.0
                                                                                                                                          -6.0
                                                                                                                                          -8.0
                                                                                                                                         -10.0
                                                                                                                                  Right foot low hoof angle
160
                                                                                                                          Effects of shoe manipulations
Hoof length
Long hooves, often augmented by pads and weights, are a feature
of some gaited breeds in which they are used to give a showy, exag-
gerated elevation of the distal limbs during the swing phase.
   In a study designed to investigate the effects of overall hoof length
on the flight arc of the hoof, pads were applied to increase hoof
length by 5 cm without changing the total weight of the shoe-pad                            A
combination (Balch et al., 1994). Compared with a normal hoof
length, the long hooves were associated with a prolongation of
stride duration, swing duration and breakover, but overall stride
length and stance duration did not change. The flight arc of the hoof
peaked earlier and higher with the longer hooves, but the normal
movement pattern was re-established in the later part of the swing
phase. Although stride length did not change, the prolongation of
the swing phase may be esthetically pleasing. However, longer toes
also lead to more strain on the dorsal hoof wall, which predisposes
to hoof wall pathology (Thomason, 1998). Under natural social
and environmental conditions, hoof length shows seasonal varia-
tions with ‘self-trimming’ attributable to periods of increased wear
being an important phenomenon in the self-maintenance of the                B
equine hoof (Florence & McDonnell, 2006).
                                                                                                                                                          161
        8       The role of the hoof and shoeing
       Table 8.1  Kinetic comparison of unshod versus shod conditions                           Table 8.2  Kinetic comparison of three shoe manipulations of a
       in a group of 12 horses trotting on a treadmill at 4 m/s                                 group of 12 horses trotting on a treadmill at 4 m/s
       Swing phase retraction (%)                        9.8 ± 3.7               6.9 ± 3.4*     Maximal moment at                    211 ± 40           231 ± 67          231 ± 63
                                                                                                fetlock joint of DDFT (Nm)
       Range of carpal motion (°)                       86.7 ± 7.1              98.2 ± 6.1*
                                                                                                Maximal moment at                    726 ± 115*         676 ± 110         674 ± 97
       Maximum carpal flexion (°)                       80.6 ± 6.5              92.5 ± 6.0*     fetlock joint of SDFT and
                                                                                                SL (Nm)
       Range of fetlock motion (°)                      81.2 ± 8.3              91.5 ± 8.8*
                                                                                                Force on navicular bone            3060 ± 438*         3546 ± 526        3504 ± 459
       Maximum fetlock extension (°)                    25.5 ± 2.7              24.3 ± 3.5
                                                                                                by DDFT (N)
       Maximum fetlock flexion (°)                      55.6 ± 8.3              67.2 ± 8.5*
                                                                                                *Indicates a statistically significant difference compared with the value of the flat
       Range of vertical displacement                   10.0 ± 3.6              17.4 ± 4.5*     shoe (p < 0.05). DDFT, deep digital flexor tendon; GRF, ground reaction force; Nm,
       hoof (cm)                                                                                Newton meters; SDFT, superficial digital flexor tendon; SL, suspensory ligament.
                                                                                                Values are mean ± SD.
       Range of vertical displacement                   18.0 ± 3.9              20.0 ± 3.7*
                                                                                                Reprinted from Willemen, M.A., Savelberg, H.C.C.M. and Barneveld, A. (1997) The
       fetlock (cm)
                                                                                                improvements of the gait quality of sound trotting warmblood horses by normal
       Range of vertical displacement                   11.0 ± 3.4              13.9 ± 3.0*     shoeing and its effect on the load on the lower forelimb. Livestock. Prod. Sci. 52,
       carpus (cm)                                                                              145–153, with permission from Elsevier.
       *Indicates a statistically significant difference between unshod and shod (p < 0.05).
       Nm, Newton meters. Values are mean ± SD.
       Reprinted from Willemen, M.A., Savelberg, H.C.C.M. and Barneveld, A. (1997) The
       improvements of the gait quality of sound trotting warmblood horses by normal
       shoeing and its effect on the load on the lower forelimb. Livestock. Prod. Sci. 52,
       145–153, with permission from Elsevier.                                                  A                                            B
                                                                                                C                                            D
      Shoe length
                                                                                               Fig 8.19  Shoes to support the caudal heel at stance. (A) Egg bar;
      The hoof is more elastic in the heel area and its geometry changes                       (B) straight bar; (C) (adjustable) heart bar; (D) trailer with caulk at the
      when loaded: the heels expand and sink caudally, while the toe                           lateral heel.
      retracts (Douglas et al., 1998). Lengthening the heels of the shoe
      depending on foot conformation in routine shoeing automatically
      allows for this change in shape (Balch et al., 1997).                                    (Auer & Butler, 1986; Willemen et al. 1999b) (Table 8.2). The net
         The extended heel of an egg bar shoe does not change the posi-                        effect is that egg bar shoes have a negligible effect on tendon strain
      tion of the center of pressure within the hoof during the stance                         patterns in sound ponies at a walk (Riemersma et al., 1996a).
      phase. Compared with flat shoes, however, it reduces the torque at                       Bouley shoes, which have a lengthened heel, may be effective,
      the fetlock joint by changing the orientation of the GRF vector so                       however, in cases of severed tendons, especially if the DDFT or DAL
      that its line of action is closer to the fetlock joint on its dorsal side                is involved (Figs 8.19 & 8.20).
162
                                                                                                                           Effects of shoe manipulations
                                                                                                                             D
Fig 8.20  The longer heels of a Bouley shoe support a dropped fetlock joint
caused by severe flexor tendon lacerations.
                                                                                B
   In the absence of tension in the DDFT, the hoof rotates to such
an extent that the point of application of the GRF vector is directly
below the center of rotation of the coffin joint. The tip of the toe
lifts up and the hoof rolls back onto the heels, which puts the hoof
in an unstable position. In these cases, egg bar shoes stabilize the
hoof, and provide pain relief in horses with injury of the DDFT or
DAL, laminitis or navicular disease (Auer & Butler, 1986). Bar shoes             C                                           E
may also be useful to prevent lifting of the tip of the toe on soft
ground (Wright & Douglas, 1993).                                              Fig 8.21  Toe manipulations of shoes to reduce breakover time. (A) Rolled
   In horses trotting on a rubber floor there was no significant dif-         shoe; (B) rocker toed shoe; (C) full roller motion shoe; (D) square toe shoe;
ference in limb loading between egg bars and flat shoes (Willemen             (E) reversed shoe.
et al., 1999b), although the ‘animation’ effect was more pronounced
with flat shoes. Egg bar shoes, as a result of having more ground
support and stability, should prevent the heels from sinking into             unshod hooves the impact shock had a velocity of 450 m/s2 and
the ground and allow reestablishment of heel growth leading to an             this increased to 800 m/s2 when steel shoes were applied, which is
increased toe angle (Scheffer & Back, 2001, Chateau et al., 2006b).           in accordance with Hertsch et al. (1996) and Back et al. (2006).
Furthermore, it has been proven indirectly that the dorsal laminar            Various shock-absorbing pads have been developed to decrease the
blood flow is enhanced by egg bar or heart bar shoes in laminitic             amount of shock transmitted to the limb (Marks et al., 1971). Good
horses, as a result of distributing the weight more caudally and thus         attenuation of the impact shock was achieved using an aluminum
protecting the toe region of the foot (Ritmeester et al., 1998). It           shoe combined with a polyurethane pad, which had a value of
should be remembered that egg bars on the fore hooves are more                200 m/s2. Benoit et al. (1993) recommended using a shoe with a
likely to be stepped on and torn off by overreaching. Bell boots can          pad of rubber or polyurethane and working the horse on soft
be applied to the forelimbs to prevent this.                                  footing to reduce the risk of lameness. A polyurethane/elastomer/
   Bar shoes in general provide more ground support and thus                  viscoelastic hoof pad is a much better shock absorber than rubber
might reduce limb rotation and pain in horses that are lame due to            (Marks et al., 1971; Vasko & Farr, 1984; Rooser et al., 1988; Back
bone spavin. This effect can also be achieved using a unilateral              et al., 2006). For an optimal effect, hoof pads or silicone should be
trailer (heel extension) at an angle of 45° (Stashak, 1987; Balch             put under pressure to prevent it moving and to show increased
et al., 1997; Martinelli & Ferrie, 1997). Trailers are also supposed          shock damping (Jörgensen & Ekstrand, 1988). This is also ideal for
to give more medial or lateral support and to change the medio               increasing the surface area to disseminate high-frequency oscilla-
lateral landing pattern depending on whether they are applied on              tions at impact.
the inside or outside. In foals with contracted flexor tendons toe               An additional benefit is that increased deformation of the hoof
extensions are used to stretch the DAL and DDFT at the end of the             also leads to an increase in the hoof mechanism and thus
stance phase.                                                                 circulation.
                                                                                 It should be noted that most of the studies of the effects of shoes
                                                                              and pads on impact shock have evaluated the effects at the level of
Shoe width                                                                    the hoof wall. Little information is available regarding attenuation
As mentioned previously, the geometry of the hoof changes when                of the amplitude or frequency of the vibrations within the hoof. In
the hoof is loaded: the heels expand and sink caudally, and the toe           vitro studies have suggested that the hoof acts as a filter to protect
retracts (Douglas et al., 1998). Increasing the width of the shoe             the more proximal bones and joints from the potentially damaging
accommodates for these movements (Balch et al., 1997). Another                effects of impact shock (Dyhre-Poulsen et al., 1994; Lanovaz et al.,
application for widening the shoes is in foals with angular limb              1998; Willemen, 1998).
deformities. The goal is to bring the weight-bearing surface of the
limb, and thus the point of application of the GRF, under the fetlock
joint as opposed to under the hoof capsule.                                   Toe of the shoe
                                                                              Breakover is defined as the time from the moment of heel-off to
Hoof pads                                                                     toe-off. In theory, the speed of hoof rotation during breakover can
                                                                              be enhanced by shoes that facilitate the movement of the hoof in
Shoes increase pressure on the navicular region (Willemen et al.,             rolling over the toe or by raising the heel (Fig. 8.21). For horses
1997, 1999b). Compared with horses that are bare-footed, shod                 trotting even on a hard surface, however, the duration of breakover
horses have less damping of the impact forces and both the median             was no different for a rolled toe, a rocker toe or a square toe, com-
and maximal amplitudes of the frequencies are higher (Balch et al.,           pared with a flat shoe (Clayton et al., 1991; Willemen et al., 1996).
1991b; Benoit et al., 1993; Dyhre-Poulsen et al., 1994).                      A possible disadvantage, particularly with the square-toed shoes, is
  Benoit et al. (1993) explored the shock absorbing damping effect            that they direct the breakover point to the middle of the toe, which
on the hoof wall of different combinations of shoes and pads. For             is not the natural position in all horses. This might enhance the
                                                                                                                                                              163
        8      The role of the hoof and shoeing
      likelihood of lameness, especially at high speeds when rapid move-        not taken into account, which may have affected the accuracy of the
      ments of the hoof occur (Clayton, 1990a; Wilson et al., 1992).            measurements.
      Therefore, Caudron et al. (1997b) successfully used a full roller            With a toe wedge, strain in the DDFT and DAL increases, whereas
      motion shoe to provide easy breakover in all directions for horses        strain in the SDFT and SL decreases both at a walk and a trot
      with poorly balanced hooves, whereas the principle behind these           (Thompson et al., 1993; Lawson et al., 2007). Since the DAL
      shoes was proven by Van Heel et al. (2006b).                              has no muscular component that can actively change its length,
                                                                                strain in this structure is totally dependent on limb configuration,
                                                                                especially the angle of the coffin joint. The DAL is normally maxi-
      Wedges                                                                    mally strained at the start of breakover, which is when heel wedges
                                                                                have their greatest effect on the GRF (Fig. 8.22). This emphasizes
      Side wedges                                                               the importance of the DAL in influencing limb forces and move-
      Wedges are applied to one or both heels for specific reasons. In          ments in the final part of the stance phase. Raising the heels seems
      horses with bone spavin, a lateral wedge is used to relieve pressure      appropriate in DAL injury, though this may slightly increase SDFT
      from the medial side of the hock. In horses with upward fixation          loading. During recuperation from DAL injury, however, the limita-
      of the patella, lateral wedges should enhance inward rotation of the      tions on exercise make it unlikely that the safety margin of the SDFT
      hoof and promote rolling over the medial toe. In the light of             will be exceeded even with heel wedges in place. Toe wedges are
      evidence-based medicine, Back et al. (2003) studied the effect of         used clinically as a passive flexion test in lameness examination.
      lateral heel wedges on sagittal and transverse plane hind limb kine-         Nevertheless, one should realize that a balanced foot is the ideal.
      matics. It was found that lateral heel wedges cause significant           Altered foot orientation as a result of the use of wedges influences
      changes in the transversal plane angles of all joints in the hind limb.   intra-articular pressure and articular contact area at the level of the
      Just before the end of the stance phase, the stifle joint becomes         distal interphalangeal joint. A study by Viitanen et al. (2003a) has
      more adducted whereas the tarsal and fetlock joint become more            demonstrated a significant increase in distal interphalangeal joint
      abducted, in fact a more ‘cow hocked’ position of the tarsal joints.      pressure and pressure on the dorsal side of the joint by elevating
      Conceivably, lateral heel wedges relieve tension from the medial          the heels by 5°.
      patellar ligament and decrease pressure on the medial side of the
      tarsal joint. However, the fetlock joint experiences considerably
      more out of plane stress (Back et al., 2003) while digital imbalance      Toe grabs and heel caulks
      puts the horse at risk for interphalangeal joint injury (Chateau          On a soft, slippery surface, caulks are screwed into the horse’s shoes,
      et al., 2002).                                                            where they act in a similar manner to spikes in a runner’s shoes
         Colahan et al. (1991) and Wilson et al. (1998) found that lateral      (Thompson & Herring, 1994). Toe grabs are used in racing Thor-
      wedges shifted the center of pressure to the lateral side of the hoof.    oughbreds with the objective of increasing the propulsion at the
      Firth et al. (1988) put lateral wedges under the feet of foals and        toe. There have not been any studies to prove these beneficial effects.
      found a rapid compensation of bone strain to this alteration. Lateral     However, results of a preliminary study indicate that landing and
      corrective trimming restored the mediolateral balance of 15 horses        breakover in horses with toe grab shoes occurs much more abruptly
      with chronic digital lameness using a radiological protocol to assess     which could represent an increased risk for injury (Ryan et al., 2006;
      the imbalance of the foot (Caudron et al., 1998).                         Schaer et al., 2006). A correlation has been shown between the
                                                                                presence of toe grabs and the incidence of breakdowns involving
      Heel/toe wedges                                                           the suspensory-sesamoidean apparatus (Kane et al., 1996). The
                                                                                higher the toe grab, the greater the risk of injury. Thompson and
      Heel wedges facilitate rolling over the toe and are used to relieve       Herring (1994) found also a decrease in the dorsal metacarpopha-
      pressure from the heels, as in navicular disease. A wedge of 6°           langeal, and an increase in the dorsal inter phalangeal joint excur-
      resulted in a 24% load reduction on the navicular bone in trotting        sion in the sagittal plane during the stance phase, while in the
      horses (Willemen et al., 1999b). Heel wedges caused only slight           transverse plane the distal limbs appeared to take a limb conforma-
      changes in strain of the SDFT, DDFT and SL during walking                 tion similar to a varus limb.
      (Riemersma et al., 1996a,b), though a larger increase in SDFT strain
      has been recorded at the trot (Stephens et al., 1989). Using in vivo
      data and an accurate subject-specific model, Lawson et al. (2007)         Rims, clips and nails
      calculated that at walk and trot, heel wedges decrease DDFT peak
                                                                                A minimum number of nails should be used, usually 6–8, to mini-
      strain and increase SL peak strain. Calculated SDFT peak strain,
                                                                                mize damage to the hoof wall and to reduce blocking the hoof
      however, increases at a walk but not a trot. With heel wedges there
                                                                                mechanics to a minimum (Balch et al., 1997). Therefore nailing
      is an earlier shift of the center of pressure from the mid-hoof to the
                                                                                should be done from the toe to the widest part of the hoof, with
      toe and the unloading of the heels is enhanced, whereas toe wedges
                                                                                the clinches being formed one-third of the way up in a line parallel
      delay the forward shift of the center of pressure and the unloading
                                                                                to the ground. Clips and rims reduce the shearing stress upon the
      of the heels is delayed (Riemersma et al., 1996a,b; Wilson et al.,
                                                                                nails especially when more traction is needed, for example in barrel
      1998; Crevier-Denoix et al., 2001). Heel wedges affect the sagittal
                                                                                racing and polo (Stashak, 1987; Balch et al., 1997; Martinelli &
      plane kinematics of the digital joints both in vitro (Deguerce et al.,
                                                                                Ferrie, 1997).
      2001) and in vivo. A wedge of 6° significantly increases maximal
      flexion of the proximal (PIPJ) and distal (DIPJ) interphalangeal
      joints while decreasing maximal extension of these joints at heel-off
      both at a walk and at a trot (Degueurce et al., 2001; Chateau et al.,     Effect of footing
      2004, 2006a). Inverse effects were observed with the use of toe
      wedges (except for PIPJ maximal extension at a trot). In the same         Properties of the ground
      studies, it was found that heel wedges significantly increase maximal
      extension of the metacarpophalangeal joint at a walk (Chateau             The hoof–ground interaction has been found to be the major deter-
      et al., 2004) but not at a trot (Chateau et al., 2006a). The latter       minant in studies relating track properties to limb pathology, both
      finding is in contrast with the study of Scheffer and Back (2001)         in horses (Kane et al., 1996) and in humans (Folman et al., 1986).
      that found a decrease in maximal fetlock extension when horses            Two important phenomena play a role: the banking and the
      were shod with heel wedges. However, in that study the PIPJ was           surface type.
164
                                                                                                                                                         Effect of footing
                    10                                                                     10
                              Tendon strain at the walk                                              Tendon strain at the trot
Strain (%) 5 5
                                                                              Strain (%)
                     0                                                                      0
                                        ICL                                                                     ICL
                                        SL                                                                      SL
                     -5                 SDFT                                                -5                  SDFT
                                        DDFT                                                                    DDFT
                    -10                                                                    -10
                          0        20          40          60      80   100                      0        20           40          60         80           100
                                                                                  Fig 8.22  (A) Strain in the palmar soft tissues at walk (left) and trot (right)
                                                                                  (Schamhardt et al., 1991); SL, suspensory ligament; ICL, inferior check
                                                                                  ligament; SDFT, superficial digital flexor tendon; DDFT, deep digital flexor
                                                                                  tendon. (B) Some examples of wedged shoes used to change strain
                                                                                  distribution among the palmar soft tissues. Left, shoe with wedged heel;
                                                                                  center, shoe with heel calk; right, shoe with wedge pad.
                                                                                  (A) Reprinted from Schamhardt, H.C., Hartman, W., Jansen, M.O. and Back, W. (1991)
                                                                                  Biomechanics of the thoracic limb of the horse. Swiss Vet. 8, 7–10, with permission from Swiss
                                                                                  vet. (B) Reprinted from Wright, I.M. and Douglas, J., Biomechanical considerations in the
                                                                                  treatment of navicular disease. Vet. Rec. 7, 109–114, Copyright© 1993 with permission from
B                                                                                 BMJ Publishing Group Limited.
   Fredricson et al. (1971, 1975 a,b) made three recommendations                    the softer track due to the lower impact shock combined with more
for banking to improve racetracks for trotters: increase the banking                elastic rebound (Buchner et al., 1994; Riemersma et al., 1996b).
of the curve, incorporate a transition curve and eliminate slopes in                Newer track surfaces like synthetic all-weather waxed tracks further
the straight part of the track. Davies (1997) also stressed the impor-              reduce the impact shock by 50% compared to sand tracks (Robin
tance of the track shape to prevent shin soreness. She found a                      et al., 2009; Chateau et al., 2009a,b). Furthermore, all-weather
considerable increase in dorsal bone strain when horses gallop                      waxed tracks smooth horizontal braking as a result of decreased
through turns.                                                                      friction. As a drawback, they reduce stride length and acceleration
   Most tracks and arenas are constructed with two layers: a looser                 of the hoof at breakover. Hence, the all-weather waxed track
cushion on top of a firmer base. Variations in the depth and                        seems an ideal training track but is most likely less efficient for
quality of the base and the cushion affect both performance and                     performing at racing speed.
soundness of the horses (Thomason & Peterson, 2008). Running                           Barrey et al. (1991) categorized the damping properties into three
on a rough instead of smooth track surface changed the vertical                     types: no damping (asphalt), friction damping (sand) and struc-
hoof force and balance of the resultant hoof forces (Kai et al.,                    tural damping (wood). Sand tracks can have different properties
1999). Hard surfaces absorb little energy, which leads to fast race                 depending on the moisture content, dry density and depth of the
times, but they are associated with a high incidence of lameness                    layers (Ratzlaff et al., 1997). Apart from damping, sand tracks allow
(Cheney et al., 1973; Pratt, 1997). The hardness of the ground is                   a forward rotation of the hoof at midstance and thus relief of pres-
related to the impact time: the harder the surface, the shorter the                 sure in the navicular area (Scheffer & Back, 2001). Surprisingly, the
impact time (Drevemo & Hjertén, 1991). Ratzlaff et al. (2005)                       same study observed a concurrent decrease in maximal fetlock
found a significant correlation between track rebound rate and                      extension and thus unloading of the fetlock joint.
negative vertical hoof acceleration peaks. Any factor that reduces                     In wild horses, hoof growth appeared to be related to hoof wear.
phase of the hooves will increase stride efficiency by allowing a                   By natural selection only horses with good hoof quality survive.
smoother transition from braking to propulsion. Hence, track                        Ovnicek et al. (1995, 1997) found differences between the hooves
dynamic properties are important in determining the safety of                       of the wild horses that had lived for a prolonged period on one of
racing surfaces.                                                                    three surfaces: sand, gravel or firm soil (Fig. 8.23). The form of the
   A loose top layer of 5 cm or more can give dynamic response                      hoof adapts to the surface (Hampson et al., 2011). On sand, less
values that reduce impact by 40–60% (Cheney et al., 1973). Reduc-                   shock damping was needed so the hoof wall carried more weight.
tion of impact forces and enhancement of energy absorption can                      The hooves did not show more wear as one would have expected,
be achieved using a layer of wood shavings (Barrey et al., 1991;                    but on both sides of the wall spikes were formed at the quarters to
Drevemo & Hjertén, 1991). Wood products are effective shock                         give more grip in the sand (‘natural caulks’). The hoof angle was
absorbers but are sufficiently resilient that little impulse is lost.               about 55°. On a firmer surface of gravel, the hoof angle was more
Wood products (shavings, mulch, chips) mixed with sand give good                    upright at the toe but the spikes at the quarters were lower, so the
shock damping with lower vibration frequencies (Barrey et al.,                      angle was again 55°. On firm soil the hoof wall was worn
1991). Rubber chips from recycled tires can also be mixed with sand                 flat without a heel spike, which would not be useful in this type
to reduce impact shock without losing much impulse. Differences                     of ground. Again the hoof angle was 55°. Regardless of the type of
were found for horses trotting on a concrete track compared with a                  surface the horse moved over, the toe was always rolled (Ovnicek
rubber or a sand track: stride and swing duration were longer on                    et al., 2003).
                                                                                                                                                                                   165
           8      The role of the hoof and shoeing
               11˚                                                       6˚
       A                                                           B                                                         C
      Fig 8.23  Hoof conformation of wild horses living on different ground surfaces. (A) Soft, (B) medium and (C) hard surfaces.
      Reprinted from Ovnicek, G., 1997, New Hope for Soundmess, reprinted with kind permission of EDSS Publishers, Equine Digit Support System, Inc.
166
                                                                                                                         Practical application to lameness
                                                                                                                                                                167
        8      The role of the hoof and shoeing
      the hoof capsule (Willemen, 1998) and the distal limb were able
      to attenuate impact shock quite considerably (Dyhre-Poulsen et al.,
      1994; Lanovaz et al., 1998). A polyurethane/elastomer/viscoelastic
      pad is a much better shock absorber than rubber (Marks et al., 1971;
      Vasko & Farr, 1984; Rööser et al., 1988; Back et al. 2006). A leather
      pad is more susceptible to variations in moisture content of the
      ground (Stashak, 1987). For arthritis of the distal interphalangeal
      joint, Caudron et al. (1997a,b, 1998) used a special full roller
      motion shoe to facilitate breakover and to reduce stress and thus
      pain from the ligaments and the joint capsule while adapting to the
      breakover path of the particular horse, using a similar principle as
      Van Heel et al. (2006b).
                                                                                    A
      Spavin
      Bone spavin is an aseptic osteoarthritis on the dorsomedial aspect
      of the distal intertarsal joint or the tarsometatarsal joint (Stashak,
      1987). The rationale behind treating bone spavin by lowering the
      medial side of the hoof or elevating the lateral heel is that it may
      relieve pressure from the medial side (Firth et al., 1988; Colahan
      et al., 1991). Indeed, Back et al. (2003) proved that when using
      lateral heel wedges in the hind limb, the tarsal joint becomes more
      abducted just before the end of the stance phase, in fact a more ‘cow
      hocked’ position of the tarsal joints. Conceivably, lateral heel
      wedges decrease pressure on the medial side of the tarsal joint. It
      has also been suggested that heel wedges and rolled toes prevent
      the hind limb from hyperextending the distal intertarsal and/or
      tarsometatarsal joints. Trailers have been used in selected cases to
      reduce rotation of the distal limb, but this can also exacerbate the
      symptoms (Stashak, 1987; Balch et al., 1997; Martinelli & Ferrie,             B
      1997).
      Patellar fixation
      In horses with patellar fixation, lateral heel wedges and rolled toes
      prevent hyperextension and outward rotation of the stifle and thus
      avoid locking the patella (Stashak, 1987). Most affected horses are
      aged 3–5 years. When corrective trimming and shoeing are com-
      bined with training of the appropriate muscles, symptoms often
      disappear. Back et al. (2003) confirmed that practical experience in
      his study on the effect of lateral heel wedges on sagittal and trans-
      verse plane hind limb kinematics. It was found that by using lateral
      heel wedges the stifle joint becomes more adducted, and thus these
      lateral heel wedges would relieve tension from the medial patellar            C
      ligament. Empirically, some horses, especially trotters, respond
                                                                                  Fig 8.24  Shoeing principles for flexural deformities in foals. (A) Toe
      better to a medial wedge than a lateral wedge, as this would also
                                                                                  extension for contracted deep digital flexor tendon (left) treated with a
      prevent them from interfering.
                                                                                  raised heel (right). (B) Contracted superficial digital flexor tendon. (C) Flaccid
                                                                                  flexor tendons (left) treated with a heel extension and appropriate hoof
      Flexural limb deformities                                                   trimming (right).
      The greatest threat to the young foal’s locomotor system is the foal
      itself. In the first 4–5 months of its life a foal grows as much as         can be supported by shoes with longer heels (Curtis, 1992a; Ellis,
      during the rest of its life. Just recently, it has been hypothesized that   1998).
      foals from older mares, that are poorly developed at birth because
      of the smaller placenta but then receive a surplus of milk, are prone
      to develop pathology in their locomotor system. Asynchronous
                                                                                  Angular limb deformities
      bone–tendon growth results in flexural deformities.                         In the rapidly growing young foal asymmetric bone growth, caused
         Contraction of the DDFT is responsible for a hyperflexed coffin          by congenital or acquired factors can lead to angular limb deformi-
      joint found at 1–6 months of age, while at 1 year of age SDFT               ties. They should be corrected at the fetlock joint before 3 months
      contraction leads to a hyperflexed fetlock joint (Fig. 8.24). Treat-        of age, while in those at the carpus/tarsus region this should be
      ment options depend on the severity of the contraction. Possible            corrected before 6–8 months of age (Table 8.3). At that time the
      treatments for DDFT contraction include lowering the heels,                 growth plates start to close. Treatment options of first choice are
      extending the toe of the shoe using a cast, and desmotomy of the            corrective wall/toe rasping, a medial/lateral extension shoe (Dallric,
      distal accessory (check) ligament. For SDFT contraction a wedged            Dallmer Salzhausen-Putensen, Germany; Baby Glu, Mustad Hoof-
      pad would be an option. So-called ‘weak’ flexor tendons are often           care SA, Bulle, Switzerland) and a limited exercise regime (Curtis,
      seen in premature foals and lead to hyperextension of the distal            1992b, 1999). The objective is to center the hoof-bearing surface
      limb. If this does not have a traumatic origin, the initial treatment       under the fetlock joint (Fig. 8.25).
168
                                                                                                                                              References
Conclusion
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174
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                                                                                                                                                   175
        9       Gait adaptation in lameness
176
                                                                                                                                                       Kinematics of lameness
                                                                                                                0.50
 Table 9.1  Mean and standard deviation of stride variables in 11
 horses evaluated when sound and with two degrees of induced
 forelimb lameness in the hoof at the trot (3.5 m/s)
                                   0                 1                  2
                                                                                                                0.10   *
 Stride duration (ms)                                                                                                                                          *
                                   715 (36)          707 (42)           693 (53)c
                                                                                                            -0.10
 Stance duration (ms)                                                                                            -25   -15         -5            5           15            25
 Lame forelimb                     312 (17)          313 (15)           318 (16)                                             R/protraction (degrees)
 Sound forelimb                    307 (16)          306 (15)           312 (15)c        Fig 9.2  Hoof trajectory of a lame forelimb during different degrees of
                                                                                         forelimb lameness. (blue line) Lameness degree 0 (sound); (red line)
 Ipsilateral hind limb             291 (20)          287 (25)           290 (22)
                                                                                         lameness degree 1; (green line) lameness degree 2.
                                                                    a
 Diagonal hind limb                291 (17)          284 (20)           285 (19)c        Reprinted with permission from: Buchner, H.H.F., Savelberg, H.H.C.M., Schamhardt, H.C.,
                                                                                         Barneveld, A., 1996. Limb movement adaptations in horses with experimentally induced fore
 Relative stance duration (%)                                                            or hind limb lameness. Equine Vet J 28, 63–70.
 Lame forelimb                      43.7 (2.4)        44.3 (2.4)        46.0 (2.8)bc
 Sound forelimb                     43.0 (2.4)        43.4 (2.8)        45.3 (3.4)bc
                                                                                         step duration without lameness (Table 9.1) as a result of the clearly
 Ipsilateral hind limb              40.7 (3.1)        40.7 (3.7)        42.0 (3.8)bc     shortened suspension between the lame and sound diagonals.
 Diagonal hind limb                 40.7 (2.9)        40.3 (3.3)        41.3 (3.2)          An interesting pattern is seen in the diagonal advanced place-
                                                                                         ment. As already mentioned, during forelimb lameness, the stance
 Advanced placement (ms)                                                                 phases of the forelimbs tend to increase, with the fore hooves being
                                                                                         placed earlier and lifted later. This results in an earlier placement of
 Lame diagonal                          0 (18)            −9 (19)a      −16 (26)c        the forelimbs in relation to the diagonal hind limbs. Sound horses
 Sound diagonal                         3 (22)            −2 (24)       −10 (24)bc       place their diagonal limb pairs almost synchronously or even place
                                                                                         the hind limbs earlier than the forelimbs (positive diagonal
 Lame to sound forelimb            360 (20)          358 (26)           341 (28)bc       advanced placement). The latter sequence may be indicative of
 Sound to lame forelimb            355 (18)          350 (19)           352 (28)         superior gait quality in dressage horses (Holmström et al., 1994).
                                                                                         Lameness reverses this pattern. Similarly, horses on a treadmill
 Ipsilateral to diagonal           358 (19)          357 (20)           359 (21)         show this earlier forelimb placement, perhaps due to a need for
 hind limb                                                                               longer ground contact, possibly as a sign of a remaining insecurity
                                                                                         even after a long period of habituation to the treadmill (Buchner
 Diagonal to ipsilateral           357 (18)          351 (24)           335 (36)bc
                                                                                         et al., 1994).
 hind limb
                                                                                            During hind limb lameness, generally the same temporal pattern
 Suspension (ms)                                                                         is found in most stride variables, however, the amount of changes
                                                                                         in limb timing is much less in hind limb lameness. Stride frequency
 Lame diagonal                         36 (24)            35 (26)           14 (29)bc    increases as in forelimb lameness, but the increase in relative stance
 Sound diagonal                        39 (20)            38 (20)           32 (27)      duration is small and both diagonal advanced placement and sus-
                                                                                         pension phases do not change at all (Buchner et al., 1995a). Horses
 Significant differences between the values of a variable for different lameness         with hind limb lameness keep this variable constant and perfectly
 degrees are indicated by superscripts: a, degree 0 versus 1; b, degree 1 versus 2;      symmetrical.
 c
   , degree 0 versus 2. Diagonal advanced placement is positive when the hind limb          There are two possible explanations for this temporal stability.
 precedes the forelimb and vice versa.                                                   Firstly, load damping may be more effective in the hind limbs as a
 Reprinted with permission from: Buchner et al. (1995).                                  result of greater tarsal flexion during loading of the lame limb. And
                                                                                         secondly, a lower percentage of the body weight is carried by the
                                                                                         hind limbs (46.8%, trot) compared with the forelimbs (53.2%)
                                                                                         (Merkens et al., 1993), which may facilitate the management of a
   In forelimb lameness, a real asymmetry due to lameness can be                         supporting limb lameness.
found in the suspension phase at the trot (Table 9.1) (Clayton,
1986a; Buchner et al., 1995a; Weishaupt et al., 2006). The suspen-                       Summary
sion phase following the lame diagonal stance phase, which means                         Horses with supporting limb lameness tend to have longer stance
the time when none of the limbs is on the ground after the stance                        durations in both, lame and contralateral sound limb, but provide
phase of the lame forelimb and diagonal hind limb, is significantly                      less propulsion during the stance phase of the lame limb, so that
shortened in lame horses. This is a sign of reduced propulsion                           the following suspension phase is reduced. This is an important
during the stance phase of the lame limb. The suspension following                       method of reducing the peak loads on the limbs, which will be
the sound diagonal, on the other hand, is nearly unchanged. This                         discussed in detail in a later paragraph.
asymmetry can only be seen in forelimb lameness, not in hind limb
lameness. The asymmetric suspension phase in forelimb lameness
has some implications for the co-ordination of the placements of
                                                                                         Hoof movement
the different limbs. The duration of the step from the lame to the                       Hoof movement can be visualized as the hoof trajectory during the
sound forelimb is shorter than the contralateral step or than the                        stride. Figure 9.2 shows the trajectory of a fore hoof on a treadmill
                                                                                                                                                                                     177
        9      Gait adaptation in lameness
      seen from the right side. The stance phase is characterized by a            by Knezevic et al. (1982) for a horse with carpal lameness. Changes
      constant vertical position on the treadmill belt during the horizon-        in limb movement during the swing phase may also cause changes
      tal movement from right to left in the figure. After lift-off, the flight   in the hoof-landing pattern. However, a lack of quantitative data for
      arc of the hoof shows the elevation during the swing phase and ends         different lameness causes still precludes making precise conclusions
      with the hoof landing at the start of the next stance phase.                at this time. To differentiate between individual landing patterns
         Different features can be seen in this figure showing typical            and specific lameness patterns, it will be necessary to perform
      changes in the hoof trajectory due to various degrees of forelimb           studies with a number of horses that have a similar diagnosis or the
      lameness. The maximal height of the hoof during protraction of the          same induced lameness.
      limb is said to be lower during both supporting limb lameness and
      swinging limb lameness (Stashak, 1987). In supporting limb lame-            Summary
      ness, a lower flight arc might reduce pain on impact. In swinging           The hoof flight is slightly lower in the lame limb compared to the
      limb lameness, difficulties in flexing the joints may cause a lowering      sound limb. Forelimb lameness causes reduced retraction and
      of the flight arc. However, this could not be confirmed in recordings       sometimes increased protraction of the lame limb; hind limb lame-
      of horses suffering from navicular disease. Several authors investi-        ness shows a reversed pattern. The reduced swing duration also
      gated this lameness for characteristic patterns, but did not find           leads to a shorter step length from lame to sound limb but slightly
      consistent changes in maximal hoof height (Ratzlaff & Grant, 1986;          higher flight arc in the sound limb.
      Pollhammer-Zeilinger, 1996; Keegan et al., 1997). In experimen-
      tally induced forehoof lameness (Buchner et al., 1996a) as well as
      in patients with forelimb lameness (Girtler et al., 1987) a higher
      flight arc was found in the sound forelimb and an unchanged height
                                                                                  Limb movement and joint angle patterns
      in the lame limb (Fig. 9.2). During hind limb lameness, a lower             The joint movement patterns of the equine limbs are important
      flight arc was found in the lame limb, while the sound limb had an          indicators of both physiologic locomotor capacity (Holmström
      unchanged flight arc (Buchner et al., 1996a). Both patterns give the        et al., 1994; Back et al., 1994) and disturbances of the gait due to
      same impression, the hoof of the lame side is lower than the con-           lameness (Adrian et al., 1977; Ratzlaff & Grant, 1986; Back et al.,
      tralateral hoof. In induced toe pain lameness, a shift of the instant       1993; Peloso et al., 1993; Buchner et al., 1996a; Keegan et al.,
      of maximal hoof height nearer to midswing has been found (Keegan            1997). The amount of hyperextension of the fetlock joint and
      et al., 2000).                                                              flexion of the carpal and tarsal joints correlated very well with sub-
         Changes in the pro- and retraction of the limbs of lame horses           jective judgments of gait quality in the areas of suppleness and
      are visible at the walk. Retraction of the forelimbs is slightly reduced    strength (Back et al., 1994). In lame horses, the proximal (shoulder,
      during forelimb lameness. For the interpretation of this pattern a          carpus, stifle, tarsus) and distal (fetlock, coffin) joints reflect differ-
      comparison with the changes in hind limb movement during hind               ent aspects of limb motion and show different changes due to
      limb lameness is interesting. Lame hind limbs show a reduction in           lameness.
      protraction rather than retraction. Perhaps the position of the limb           During supporting limb lameness the horse tries to reduce the
      relative to the body center of mass influences this feature. During         load on the painful limb. The amount of loading can be measured
      walking vertical ground reaction forces of the forelimbs reach peak         directly using a force plate, and it can be assessed indirectly from
      values in the second half of the stance phase, when the limb is             the distal joint patterns during the stance phase. At the trot, after
      retracted, which brings it closer to the body center of mass. On the        landing the fetlock joint shows increasing hyperextension until the
      other hand, the position of the hind limbs relative to the body             moment of maximal loading in the middle of the stance phase at
      center of mass causes peak loading in the first half of the stance          (Fig. 9.3A). The hyperextension then decreases gradually until the
      phase (Merkens et al., 1986). The changes in pro- or retraction,            end of the stance phase. The fetlock joint angle during the stance
      which are more obvious during walking than trotting, might reduce           phase is determined by and resembles the pattern of the vertical
      the total load on the lame limb by shortening the period of                 ground reaction force as measured in sound horses with a force
      high load.                                                                  plate (Riemersma et al., 1988) or a force shoe (Ratzlaff et al., 1993).
         The changes in the temporal stride pattern also have implications        This relationship is valid also in lame horses, when changes in the
      for the linear stride variables. The distances between hoof place-          fetlock and coffin joint patterns correspond to a decrease in the
      ments of sound and lame limbs and vice versa, which are called the          vertical ground reaction force in the lame limb and a compensatory
      step lengths, might give information about the cause of the lame-           increase in the contralateral sound limb (Merkens & Schamhardt,
      ness. A shortening of the step length from the lame to the sound            1988b). The correlation of the ground reaction forces with the distal
      limb is said to be typical for a supporting limb lameness (Witt-            limb joint angle pattern is even used to calculate limb forces based
      mann, 1931; Stashak, 1987). Horses with sesamoiditis (Clayton,              on kinematic data of distal limb length (Bobbert et al., 2007).
      1986b) and hoof lameness (Buchner et al., 1996a) showed this                   During supporting limb lameness, both the fetlock and coffin
      feature. This shortening corresponds with the temporal variables in         joint patterns change distinctly with increasing lameness (Table 9.2)
      terms of the shorter advanced placement between lame and sound              (Buchner et al., 1996a). In the lame limb, fetlock hyperextension at
      forelimbs as well as the clearly shortened suspension phase follow-         the middle of the stance phase is reduced with each degree of lame-
      ing the lame diagonal. The linear stride variables offer further proof      ness (Fig. 9.3A). In contrast, fetlock hyperextension in the contra-
      of reduced propulsion during the stance phase of the painful limb.          lateral sound limb shows increased maximal values (Fig. 9.3B). This
         Few studies have described specific changes in the hoof-landing          asymmetry indicates a compensation of the reduced loading of the
      pattern due to lameness. Toe first or heel first might give informa-        lame limb by the contralateral sound limb. Similarly, coffin joint
      tion about the localization of the pain, in the heel or toe region          flexion is reduced, but the effects are a little less obvious and occur
      (Ratzlaff & Grant, 1986; Stashak, 1987; Clayton, 1988; Tietje, 1992;        earlier in the stride cycle (Fig. 9.3C,D). Based on this strong correla-
      Wilson & Keegan, 1995). Measurements of induced hoof lameness,              tion, the fetlock joint pattern can be used as indicator of a support-
      caused by pressure-inducing screws on the sole, did not influence           ing limb lameness or the supporting limb component of a mixed
      the hoof-landing angle (Buchner et al., 1996a), which may have              lameness (Back et al., 1993). However, the range of fetlock joint
      been due to the position of the screws in the middle between toe            motion proved to be less sensitive in detecting slight lameness
      and heel. The study of Keegan et al. (2000) inducing the hoof pain          (Peloso et al., 1993), probably due to the higher variability in swing
      at the toe showed an increased protraction of the lame limb, but            phase flexion. Therefore, maximal fetlock hyperextension during
      the hoof-landing pattern could not be distinguished. Differences in         stance, which resembles the clinical assessment of fetlock sinking,
      the hoof position and motion just before landing were described             is a sensitive measure of a supporting limb lameness. The
178
                                                                                                                                                                                      Kinematics of lameness
70 70
                          50                                                                                                    50
Flexion angle (degrees)
10 10
-10 -10
                          -30                                                                                                   -30
                                0   20           40              60            80              100                                    0          20         40           60       80          100
        A                                     Time (% of stride)                                              B                                           Time (% of stride)
30 70
20 20
10 10
0 0
-10 -10
-20 -20
                          -30                                                                                                   -30
                                0   20           40              60            80              100                                    0          20         40           60      80           100
                                              Time (% of stride)                                              D                                           Time (% of stride)
        C
Fig 9.3  Joint angle pattern of the fetlock (A) and coffin (C) joints of a lame forelimb, and the fetlock (B) and coffin (D) joints of the contralateral sound
forelimb during different degrees of forelimb lameness. (blue line) Lameness degree 0 (sound); (red line) lameness degree 1; (green line) lameness degree 2.
Arrows indicate hyperextension (fetlock joint) or flexion (coffin joint) during the middle of the stance phase.
Reprinted with permission from: Buchner, H.H.F., Savelberg, H.H.C.M., Schamhardt, H.C., Barneveld, A., 1996. Limb movement adaptations in horses with experimentally induced fore or hind
limb lameness. Equine Vet J 28, 63–70.
                                                                                                                                                                                                               179
                           9              Gait adaptation in lameness
                                70                                                                                     70
      Flexion angle (degrees)
30 30
10 10
                                -10                                                                                    -10
                                      0           20        40           60    80     100                                    0         20         40           60       80         100
              A                                           Time (% of stride)                          B                                         Time (% of stride)
70 70
                                50                                                                                     50
      Flexion angle (degrees)
10 10
-10 -10
                                -30                                                                                    -30
                                      0           20        40           60    80     100                                    0         20         40           60       80        100
      Fig 9.4  Joint angle pattern of the tarsal (A) and fetlock (C) joints of a lame hind limb and tarsal (B) and fetlock (D) joints of the contralateral sound hind limb
      during different degrees of hind limb lameness. (blue line) Lameness degree 0 (sound); (red line) lameness degree 1; (green line) lameness degree 2. Arrows
      indicate flexion (tarsal joint) or hyperextension (fetlock joint) during the middle of the stance phase.
      Reprinted with permission from: Buchner, H.H.F., Savelberg, H.H.C.M., Schamhardt, H.C., Barneveld, A., 1996. Limb movement adaptations in horses with experimentally induced fore or hind
      limb lameness. Equine Vet J 28, 63–70.
                                                                                                                             head movement pattern (Girtler & Floss, 1984; Peloso et al., 1993;
      Head and trunk movement                                                                                                Buchner et al., 1996b; Keegan et al., 1997). The lowering and lifting
      The simplest, most sensitive, and most frequently used indicator for                                                   of the head during the stance phase of the lame limb decreases, with
      the clinical diagnosis of lameness is the characteristic vertical move-                                                a compensatory increase in both movements during the stance
      ment of the horse’s head and trunk (Stashak, 1987; Wyn-Jones,                                                          phase of the contralateral sound forelimb (Fig. 9.5). These changes
      1988). A more or less asymmetric pattern of head movement is the                                                       are proportional to the degree of lameness and in severe lameness
      starting point for each student to diagnose a forelimb lameness and,                                                   the first wave may not be visible, there is no lifting of the head
      similarly, croup or hip movement is used to diagnose a hind limb                                                       anymore. The sinusoidal pattern with two cycles per stride then
      lameness. Sound horses at a trot show a perfect sinusoidal pattern                                                     changes to show a single cycle during each stride (Girtler & Floss,
      for all midline body locations including the head, withers and                                                         1984). Vertical velocity of the head changes in accordance with the
      croup (Girtler & Floss, 1984; Buchner et al., 1996b). During one                                                       vertical movement. Both minimal and maximal vertical velocity
      stride, two symmetric waves can be seen (Fig. 9.5A), which occur                                                       during the lame stance phase decrease. During the sound stance
      almost synchronously in all three body parts. The height of these                                                      phase both values increase, which also results in a more positive
      structures falls from the beginning of the diagonal stance phase                                                       velocity of the head at the start of the subsequent lame stance phase.
      reaching the lowest position at midstance, then rising to their                                                        This means that, at impact, the head shows less downward move-
      highest level at or shortly after the end of the stance phase. During                                                  ment with increasing lameness. During severe forelimb lameness,
      the suspension phase, the body starts to fall again into the next                                                      the head may even be lifted slightly at the instant of impact of the
      diagonal limb stance phase. These sinusoidal cycles are repeated                                                       lame limb. Finally, vertical acceleration of the head also changes
      twice in each stride. The derivatives of this vertical movement, verti-                                                from a symmetrical pattern to an asymmetrical pattern (Fig. 9.5C).
      cal velocity and vertical acceleration of the head or withers, show                                                    For a quantitative analysis of the lameness, the acceleration values
      similar sinusoidal patterns, but shifted by 12.5% per derivative to                                                    are even more useful than the head movement pattern, since vertical
      the left (Fig. 9.5B, C). Vertical velocity reaches minimal values                                                      acceleration is less sensitive to changes in absolute head height.
      shortly after the beginning of the stance phase and maximal values                                                     Furthermore, changes in the acceleration peaks quite accurately
      shortly before the end of stance. Acceleration is maximal in the                                                       represent changes in the vertical forces acting on the limbs, since
      middle of the stance phase and minimal during the suspension                                                           forces (F) are determined by the mass (m) of a body and its vertical
      phase when it falls to its minimum value which is equal to gravita-                                                    acceleration (a): F = ma. Therefore, reduced vertical acceleration of
      tional acceleration. All midline body locations, head, withers and                                                     the head and trunk during the stance phase of the lame limb results
      croup raise and sink simultaneously, they are in phase.                                                                in a lower vertical force, or less loading of the lame limb.
         During lameness, characteristic changes in the patterns of all                                                         During forelimb lameness the withers and croup show the same
      these body segments occur. The most obvious of these is the vertical                                                   vertical movement pattern and the same timing as the head, but the
180
                                                                                                                                            Kinematics of lameness
                                                                                              instants of maximal pain, e.g. after landing and the first half of the
                                                                                              stance or before breakover, may lead to these four different patterns
                        1.65                                                                  of head movement. This specific head movement pattern would
                                                                                              lead to a more specific local lameness diagnosis than only limb and
                                                                                              lameness degree, but has still to be proven by the analysis of a
                        1.60
                                    Lame limb                              Sound limb         number of horses with known lameness cause.
                                                                                                 The locomotion patterns of the head, withers and croup during
                        1.55                                                                  hind limb lameness are similar to those of a forelimb lameness, but
                               0     20          40           60             80         100   show some distinctive characteristics. The os sacrum, which lies on
                                                                                              the midline, shows a perfectly sinusoidal up and down motion in
      A                                         Time (% of stride)
                                                                                              sound horses. During lameness, it shows less lowering and lifting
                        1.00                                                                  during the stance phase of the lame limb, which is exactly the same
                                                                                              as the motion of the withers during forelimb lameness (Buchner
                                                                                              et al., 1996b). The tuber coxae, however, which is more laterally
                        0.50                                                                  placed, has an asymmetric locomotion pattern even in sound horses
                                                                                              (Buchner et al., 1993). The amplitude of motion, which is mea-
Velocity (m/s)
                        0.00                                                                  sured as the distance between lowest and highest positions of the
                                                                                              tuber coxae, is smaller during the stance phase of the ipsilateral hind
                        0.50                                                                  limb, than during the contralateral stance phase (Fig. 9.6A). Rota-
                                                                                              tion of the croup around the sagittal axis through the hip joint
                    -1.00           Lame limb                         Sound limb              causes different displacements in the ipsilateral and contralateral
                                                                                              tuber coxae. The sum of the rotational movement and the vertical
                    -1.50                                                                     translational movement of the whole trunk causes this typical asym-
                                0     20         40           60             80         100   metric vertical movement pattern of the tuber coxae even in sound
                                                Time (% of stride)                            horses. In hind limb lameness, the asymmetry on the lame side of
        B
                                                                                              the body increases. This means that vertical motion of the left
                          20                                                                  tuber coxae during left hind limb lameness is diminished or
                                                                                              absent during the left hind limb stance phase (Fig. 9.6B) and
                                                                                              increased during the right hind limb stance phase (May & Wyn-
                          10                                                                  Jones, 1987; Buchner et al., 1996b). These large motion amplitudes
  Acceleration (m/s2)
                                                                                              of the tuber coxae are more easily detected by many people com-
                                                                                              pared with midline movements of the os sacrum. However, the
                           0                                                                  pattern of the os sacrum is similar to head and withers movement
                                                                                              and is, therefore, easier to describe.
                                                                                                 Movement of the withers during hind limb lameness is similar
                          -10       Lame limb                         Sound limb              to, but less pronounced, than os sacrum movement. Head move-
                                                                                              ment, on the other hand, shows a different pattern and different
                                                                                              timing than withers or sacrum movements. While the head move-
                          -20
                                0     20          40           60            80         100   ments are unchanged or even increased during the stance phase of
                                                                                              the lame hind limb, the displacement amplitude of the head
            C                                    Time (% of stride)
                                                                                              decreases during the stance phase of the sound hind limb. This
                                                                                              means that head and trunk motion is out of phase, the small verti-
Fig 9.5  Head movement pattern during different degrees of forelimb
                                                                                              cal amplitude of the croup during the stance of the lame hind
lameness: (A) vertical displacement, (B) vertical velocity, (C) vertical
                                                                                              limb is associated with a large head amplitude and vice versa. In
acceleration. The horizontal bars indicate the stance phases of the limbs.
(blue line) Lameness degree 0 (sound); (red line) lameness degree 1;
                                                                                              other words, in moderate-to-severe hind limb lameness the head
(green line) lameness degree 2.                                                               drops on the diagonal forelimb. This is to allow the horse to
Reprinted with permission from: Buchner, H.H.F., Savelberg, H.H.C.M., Schamhardt, H.C.,
                                                                                              reduce some of the load on the lame hind limb due to the
Barneveld, A., 1996. Head and trunk movement adaptations in horses with experimentally
                                                                                              changed moment of head and neck. This load redistribution
induced fore or hind limb lameness. Equine Vet J 28, 71–76.
                                                                                              mechanisms will be discussed in more detail in a subsequent
                                                                                              section.
                                                                                              Compensatory lameness
oscillations are less pronounced (Buchner et al., 1996b). This                                Dropping of the head as a compensating mechanism for a hind
means less lowering of the croup simultaneously to the withers and                            limb lameness mimics the head movements in a supporting limb
head during the lame diagonal stance and more lowering during                                 lameness of the ipsilateral forelimb and, consequently, is described
the sound stance phase. Looking from behind the horse with mod-                               as sagittal compensatory forelimb lameness (Uhlir et al., 1997). A
erate forelimb lameness this resembles a slight lameness of the                               compensatory or false lameness is an apparent lameness in the
diagonal hind limb, a diagonal ‘compensatory’ lameness (see later                             opposite end of the body in a quadrupedal animal due to the kine-
in this chapter). Nevertheless, there is a large decrease in the vertical                     matic changes caused by pain in one limb, the primary lameness
acceleration of the trunk depending on the degree of lameness. Due                            (Uhlir et al., 1997; Kelmer et al., 2005). During a moderate hind
to the mass of the trunk, which accounts for about 65% of total                               limb lameness, the dropping of the head during the lame diagonal
body mass (Buchner et al., 1997), this causes a highly significant                            stance phase resembles an ipsilateral (or sagittal) forelimb lame-
decrease in limb loading.                                                                     ness. A different situation can be seen during moderate forelimb
                                                                                                                                                                        181
                            9               Gait adaptation in lameness
                                     1.65                                                                                              1.50
      Vertical displacement (m)
1.55 1.40
1.50 1.35
1.45 1.30
                                     1.40                                                                                              1.25
                                            0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2                                                 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2
                                                                 Time (s)                                                                                           Time (s)
                                      20                                                                                                20
      Vertical acceleration (m/s2)
0 0
–10 –10
                                     –20                                                                                               –20
                                            0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2                                                 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1.1 1.2
                                                                 Time (s)                                                                                           Time (s)
      Fig 9.6  Vertical displacement and vertical acceleration of the right tuber coxae in a sound horse (A) and in a horse with a moderate lameness of the right
      hind limb (B) at the trot. The horizontal bars indicate the stance phases of the hind limbs.
      Reprinted with permission from: Buchner, F., Kastner, J., Girtler D., Knezevic, P.F., 1993. Quantification of hind limb lameness in the horse. Acta Anat 146, 196–199, S Karger AG.
      lameness. In that case the croup movements change simultaneously                                                                  in this limb did not cause pain, but the limb showed hardly any
      with the head movements, dropping of both head and croup, and                                                                     flexion or extension during the entire stride. The author has observed
      resemble a diagonal hind limb lameness. A compensatory lameness                                                                   a similar locomotion pattern in horses with ankylosis of the stifle
      can be differentiated from a real or true lameness by diagnostic                                                                  or talocrural joint. In all cases, the affected limb could support the
      anesthesias. For example, a positive diagnostic anesthesia in the                                                                 body without pain, but also without any flexion or extension during
      lame hind limb reduces the sagittal compensatory forelimb lame-                                                                   the stride.
      ness too. A true forelimb lameness, on the other hand, will not be                                                                   Much more common and of clinical significance is the mixed
      significantly changed by the hind limb anesthesia.                                                                                lameness, where pain or pain reactions are obvious during both
                                                                                                                                        stance and swing phases. Typical examples are shoulder and carpal
      Summary                                                                                                                           lameness or stifle and tarsal lameness. The most extensive informa-
                                                                                                                                        tion is available for carpal lameness. Several clinical studies in
      The pattern of head and croup movements in lame horses allows                                                                     patients (Ratzlaff et al., 1982; Ratzlaff & Grant, 1986; Clayton,
      localization of the lame limb and assessment of the degree of lame-                                                               1986a, 1987a, b) as well as studies using lameness models (Morris
      ness. The asymmetric movements of head and trunk enable signifi-                                                                  & Seeherman, 1987; Back et al., 1993; Peloso et al., 1993) investi-
      cant unloading of the painful limb. Based on a knowledge of these                                                                 gated the locomotion pattern of horses with carpal joint problems.
      principles and the interactions between trunk and head movement                                                                   In these studies the various symptoms can be differentiated into
      patterns, an accurate quantification of the lameness using several                                                                signs that are typical of a supporting limb lameness and other
      mathematical methods are possible which will be discussed later in                                                                signs that are typical of swing phase problems. The temporal vari-
      the chapter.                                                                                                                      ables do not show a consistent pattern in the different studies.
                                                                                                                                        Clayton (1986a, 1987a, b) studied three horses, suffering from a
                                                                                                                                        shoulder, carpal and tarsal problems. She found in all three
      Swinging limb and mixed lameness                                                                                                  cases shorter stance phase durations in the lame limb compared
      Pure swinging limb lameness, which is caused by pain during the                                                                   to the sound limb. Ratzlaff et al. (1982), focusing on carpal lame-
      swing phase without pain during the stance phase, is extremely rare.                                                              ness, found variable results regarding stance duration and suggested
      The two major reasons for a pure swinging limb lameness are a                                                                     that a shortened stance duration occurred with a predominance of
      mechanical problem, such as an advanced ankylosis of a limb joint,                                                                the supporting limb lameness component, while a lengthened
      or a neural problem such as paresis of the radial nerve. Adrian et al.                                                            stance duration indicated a predominance of the swinging limb
      (1977) published goniograms of a 9-year-old stallion with an                                                                      lameness. Of course, the variability of the patient histories, even in
      osseous ankylosis of the metacarpophalangeal joint. Flexion testing                                                               horses suffering from carpal lameness, precludes making general
182
                                                                                                                             Kinetics of lameness
conclusions. Three studies provoked carpal lameness using toxins             phase is indicative of the swinging limb lameness component,
(Back et al., 1993), antibiotics (Peloso et al., 1993) or surgical           while reduced fetlock joint hyperextension during the stance is
manipulation (Morris & Seeherman, 1987). If trotting velocity was            indicative for the supporting limb lameness component.
checked to be constant, no significant changes were found in the
stance phase duration between the sound and lame limbs, or
between the same limb before and after lameness induction (Morris            Bilateral lameness
& Seeherman, 1987; Peloso et al., 1993). Obviously, individual left/         A special situation and a challenging task for a veterinarian is the
right differences play the major role compared with the influence            presence of a bilateral lameness. A number of orthopedic diseases,
of a mixed lameness. In most cases, a high degree of symmetry is             such as navicular disease, distal limb arthrosis and bone spavin,
maintained and the right/left differences in temporal variables do           may be present in both limbs to a more or less similar extent. The
not help to diagnose a specific lameness.                                    presence and degree of bilateral problems are often difficult to
   The characteristics of the caudal and cranial phases of the stride        assess, because of the lack of the typical asymmetric pattern associ-
might be a useful criterion to distinguish between swinging and              ated with unilateral lameness (Seeherman, 1991). The locomotion
supporting limb lameness (Wittmann, 1931; Hajer et al., 1988). In            of horses suffering from bilateral lameness has been described as
swinging limb lameness the cranial phase is said to be shorter in            stiff, short, or shuffling (Stashak, 1987). Such characteristics are
the lame limb due to pain during the swing phase and its effect on           difficult to distinguish from the normal locomotor pattern of the
protraction. Indeed, Clayton (1986a, 1987b) found shorter cranial            individual horse, which is usually unknown to the veterinarian. In
phases in shoulder and tarsal lameness, but in a horse with carpal           this situation, local diagnostic anesthesia is used to detect locomo-
lameness (Clayton, 1987a) both phases were equal. Therefore,                 tor asymmetries by eliminating pain in one limb and thus facilitate
reduction of the cranial phase is indicative of some swing phase             the detection of pain in the contralateral limb. However, this diag-
problems, but lack of such a reduction does not exclude a swinging           nostic method is complicated by gait changes seen also in sound
limb lameness.                                                               horses with desensitized limbs. In a study on the effects of local
   Equivocal results were found regarding the joint angle pattern in         anesthesia in sound horses, they showed changes in the locomotion
horses with mixed lameness. Looking at the different limb joints, a          pattern too, perhaps due to the changed proprioception in the
very clear differentiation between swing phase and stance phase              anesthetized limb (Kübber et al., 1994). Therefore, in mild cases it
problems can be made. During the swing phase, flexion of the                 is difficult to decide whether a change in locomotion pattern is due
affected joint (carpal, tarsal) was decreased in all studies. The restric-   to bilateral lameness, or just to the lost sensitivity in one limb.
tion can be seen in both the maximal flexion and the total range of             Quantitative locomotion analysis in bilaterally lame horses
motion. The limb gives the impression of moving stiffly with a               suffers from the same problems as the clinical assessment. If the
lower flight arc of the hoof. This is most obvious during carpal             horse does not show left-to-right asymmetries and if there are no
lameness (Back et al., 1993), but is also found in tarsal (Clayton,          individual control data for the horse when it was sound, it is impos-
1987b; Khumsap et al., 2004) and shoulder lameness (Clayton,                 sible to make a diagnosis of lameness (Hugelshofer, 1982). The use
1986a). This feature is clearly different from a supporting limb             of a bilateral hoof lameness model showed some gait adaptations
lameness, where the carpal joint angle during the swing phase was            that allowed the horses to reduce their discomfort, even when the
unchanged, and the tarsal joint angle was even increased (Buchner            usual transfer of weight to the contralateral limb was impossible
et al., 1996a). Therefore, the presence and degree of left/right dif-        (Buchner et al., 1995b). The adaptations were similar to those seen
ferences in flexion of a carpal or tarsal joint seem to be useful            in unilateral supporting limb lameness: stride duration was reduced,
indicators for the swinging limb component of a mixed lameness,              while relative stance duration increased. The most distinct change
as Back et al. (1993) proposed. The decreased flexion of a painful           in temporal co-ordination, however, was in the diagonal advanced
joint results from the horse’s efforts to avoid painful positions. This      placement. During slight bilateral lameness, horses placed their
effort can be detected even earlier in the stride cycle at the start of      forelimbs earlier than the hind limbs compared with the sound
the swing phase; when flexion of the carpus begins, the angular              situation. Again this variable proved to be a reliable indicator for
velocity of this joint is reduced (Ratzlaff et al., 1982).                   unilateral or bilateral locomotor problems.
   The characteristics of the supporting limb lameness component                A second variable that is indicative of bilateral pain is fetlock
of the mixed lameness have already been described. In general, all           hyperextension, which was reduced equally in both forelimbs
variables typical for a supporting limb lameness can also be seen            during an induced bilateral lameness. By changing the temporal
in mixed lameness (Clayton, 1986a; Peloso et al., 1993). The most            stride pattern and slightly reducing the vertical displacement of the
significant features are that fetlock hyperextension in the lame limb        trunk, the horse achieved the same amount of load reduction (and
is reduced as sign of less loading, which is achieved by reduced head        pain relief) as seen in unilateral lameness.
and trunk displacement. The contributions of the supporting and
swinging limb lameness components to the individual lameness                 Summary
pattern are quite variable depending on the individual condition.
   The combined angle-angle graph of both joints illustrates the             Horses are able to relieve the pain in bilateral lameness even when
changes during various lameness degrees very clearly. Fetlock hyper-         the typical asymmetric, contralateral compensation is not possible.
extension and carpal flexion give useful information about both              Adjustments in temporal stride patterns and vertical trunk move-
aspects of the lameness, but not necessarily about its location.             ment reduce the peak forces of all limbs. Diagnosis of bilateral
Though the proximal limb joints are more at risk for swinging limb           lameness remains difficult, especially in mild cases. Repeated mea-
lameness, distal limb problems more often show supporting limb               surements using diagnostic anesthesia or by screening the horses
lameness. The coupling of different joints, such as the tarsal and           over longer periods can be used to monitor fetlock joint angle and
stifle joints, impedes the ability to localize the disease. Furthermore,     diagonal advanced placement to detect mild gait deficits.
slow protraction due to joint pain causes similar decreases in the
range of joint motion in the coupled joint regardless of whether the
pain is in this joint or the neighboring joint.                              Kinetics of lameness
                                                                             If horses feel pain in a limb when moving, they adjust their locomo-
Summary                                                                      tion pattern to diminish the pain. The various kinematic changes
Carpal and tarsal or stifle lameness are typical examples of mixed           described in the previous sections are components of the overall
lameness. Reduced flexion of a proximal joint during the swing               effort to achieve pain reduction. In a supporting limb lameness,
                                                                                                                                                     183
                                  9         Gait adaptation in lameness
      pain reduction means reducing the load on the affected limb. The                                                        1988a) as well as at the trot (Morris & Seeherman, 1987; Clayton
      success of the efforts of the load-reducing strategy can be assessed                                                    et al., 2000a; Weishaupt et al., 2004, 2006). At the walk the peak
      by measuring the ground reaction forces (GRFs) using a force plate                                                      vertical force decreases, while the GRF pattern becomes smoother:
      (Gingerich et al., 1979; Morris & Seeherman, 1987; Merkens &                                                            the dip between the two vertical force peaks diminishes in mild
      Schamhardt, 1988a, b; Weishaupt et al., 2004, 2006), force shoes                                                        lameness and disappears in moderate lameness at the walk (Fig.
      (Hugelshofer, 1982) or the EGA-system (Tietje, 1992). A unique                                                          9.7) (Merkens & Schamhardt, 1988a). At the trot, the shapes of the
      technology to record continuously the vertical ground reaction                                                          vertical and longitudinal GRF force curves in the lame limb resem-
      forces of horses is the instrumented treadmill developed in Zürich/                                                     ble those of sound horses, however with characteristic decreases in
      Switzerland, which allows to measure continuously vertical forces                                                       the force amplitudes. Generally, with increasing lameness, horses
      of all four limbs independently during treadmill locomotion                                                             show a reduced impact force, a reduced rate of loading during the
      (Weishaupt et al., 2002). A synchronous view of kinetic and kine-                                                       first half os stance and a reduced peak vertical force (Fzmax).
      matic findings provides a more complete picture of how horses                                                           (Clayton et al., 2000a; Weishaupt et al., 2006). Already in only a
      manage a lameness and gives a better understanding of the mecha-                                                        subtle lameness, Fzmax is significantly reduced by 4%. This reduc-
      nisms that redistribute the load away from the lame limb without                                                        tion reached 9% in mild lameness and 24% in moderate lameness
      serious overloading of the sound limbs.                                                                                 (Weishaupt et al., 2006). Similar results are reported by Morris and
                                                                                                                              Seeherman (1987) which measured 11.5% decrease of Fzmax in a
                                                                                                                              easy observable carpal lameness, or Clayton et al. (2000a) with
      Load reduction in the lame limb                                                                                         27% less Fzmax, in horses with an induced tendinitis. However,
      As lameness increases, horses show progressive reductions in their                                                      these horses, showing moderate to severe lameness also reduced
      vertical and longitudinal deceleration forces. These differences can                                                    their running velocity by 10%, which contributes to the overall
      be seen in the GRF tracings at the walk (Merkens & Schamhardt,                                                          load reduction.
      Mediolateral force (N/kg)
                                  100                                                                             100
                                                                     Forelimb                                                                   Hindlimb
                                      0.5                                                                          0.5
                                       0                                                                            0
                                  -0.5                                                                            -0.5
                                  -1.0                                                                            -1.0
                                            0    20     40      60       80     100                                      0   20    40      60        80    100
                                                       Stance time (%)                                                             Stance time (%)
                                      1.5                                                                          1.5
      Longitudinal force (N/kg)
1.0 1.0
0 0
0 0
                                  0.5                                                                             0.5
                                  -1.0                                                                            -1.0
                                  -1.5                                                                            -1.5
                                            0    20     40      60       80     100                                      0   20    40     60         80    100
                                                       Stance time (%)                                                             Stance time (%)
                                       8                                                                             8
      Vertical force (N/kg)
6 6
4 4
2 2
                                       0                                                                             0
                                            0    20     40      60       80     100                                      0   20     40     60        80    100
                                                       Stance time (%)                                                             Stance time (%)
      Fig 9.7  Ground reaction force patterns of left fore limb (left panel) and left hind limb (right panel) at the walk during different degrees of left forelimb
      lameness. The forces are expressed in N/kg body mass during a standardized stance time. Control session (blue line); only lame at the trot (red line); mild
      lameness at the walk (green line); moderate lameness at the walk (dark green line); digital nerve block (orange line).
      Reprinted with permission from: Merkens, H.W., Schamhardt, H.C., 1988a. Evaluation of equine locomotion during different degrees of experimentally induced lameness. I. Lameness model
      and quantification of ground reaction force patterns of the limbs. Equine Vet. J. (Suppl.) 6, 99–106.
184
                                                                                                                             Kinetics of lameness
   Similar reduction of loading can be found in the braking longi-         differences in the vertical force of nearly 500 N and differences of
tudinal force, where several local peaks of the longitudinal force are     about 230 Nm in the sagittal torque acting on the trunk. Therefore,
reduced in the lame limb. The third parameter used to describe limb        the head is an effective tool for redistributing the load from the
loading is the vertical impulse (Iz) of the limb, which represents the     painful limb to the other limbs. These dynamic influences of the
time integrated force during one stance phase. While the vertical          head and neck movements should not be confused with the rela-
force decreases continuously with increasing lameness, the vertical        tively small static influences on the position of the body center of
impulse is less affected. The increase in relative stance duration is      mass (BCM) due to different head positions. If the head and neck
responsible for this smaller increase in vertical impulse. Compared        move caudally by 10 cm, the BCM shifts caudally by only 1 cm. For
to the 24% decrease of Fzmax in moderate lameness, Iz decreased only       a 500-kg horse, assuming a distance of 100 cm between fore and
by 20% (Weishaupt et al., 2006). This difference between Fzmax and         hind limbs, this means a transfer of only 50 N from fore to hind
Iz is an important feature for the lameness management of horses           limb. This assumption is substantiated by Buchner et al. (2001)
who try to maintain their normal locomotion pattern as much as             finding a caudal translation of the BCM during midstance of the
possible together with maximal pain reduction, which will be dis-          lame limb in a grade 2 lamenesss of only 9 mm. Therefore, the
cussed in the next paragraph. If lameness is more severe, the load         dynamic influences of the asymmetric head and neck movement in
is reduced progressively to zero load in a non-weightbearing               lame horses have about 10 times more effect than the static
lameness.                                                                  component.
   In lame horses, the fetlock joint angle time diagram (Back et al.,
1993; Buchner et al., 1996a) resembles the vertical force pattern
shown by Morris and Seeherman (1987) or Clayton et al. (2000a).            Summary
The reduction of the fetlock hyperextension of about 8° in a grade         Summing up all details, the body receives less vertical impulse
2 lameness might be quite comparable to the reduction of fetlock           during the stance phase of the lame limb despite the small prolon-
extension by about 10% that was reported in horses with an easily          gation of the stance duration. This smaller vertical impulse leads to
observable lameness by Morris and Seeherman (1987). Similarly,             a distinct reduction in the duration of the subsequent suspension
Clayton et al. (2000a) found a decrease in fetlock hyperextension          phase and the contralateral limb has to cope with the need for
of 11° corresponding to the decrease in the Fzmax of 27%.                  a higher vertical impulse associated with the descending trunk
                                                                           and head.
Summary
Maximal vertical force, assumed to be responsible for the pain
during loading, is effectively reduced in the lame limb. Vertical          Redistribution of the load
impulse is reduced too, but due to an increased stance duration less
than maximal vertical force.                                               The reduction of the peak load in the lame limb is not accompanied
                                                                           by equivalent increases of peak loads in the sound limbs. This
                                                                           remarkable fact has been observed both in kinematic studies that
                                                                           evaluated the fetlock joint pattern of all limbs and in kinetic studies
Mechanisms of load reduction                                               of the vertical loads on all four limbs. Using the maximal hyperex-
Based on the kinematic analyses, the reduced loading in a lame             tension of the fetlock joint as a load indicator, at the trot a decrease
forelimb can be explained by two major mechanisms: 1) a smoother           of 7.6° in the lame limb was accompanied by an increase of only
loading of the lame limb and 2) decreased vertical movements of            1.9° in the contralateral forelimb, no change in the diagonal hind
the head and trunk.                                                        limb and a 2.6° decrease in the ipsilateral hind limb (Buchner et al.,
   The loading is smoothed by small adjustments in several aspects         1996a). Simultaneous kinetic recordings of the vertical forces on
of limb timing. The swing duration of the forelimbs is reduced,            the instrumented treadmill allowed for the quantification of the
while the relative stance duration is increased. The longer ground         effective load changes in all four limbs with increasing fore or hind
contact distributes the effort required to lift the body over a longer     limb lameness (Weishaupt et al., 2004, 2006). As already seen in
period. Furthermore, the earlier placement of the lame forelimb,           the kinematic analyses, the contralateral limb does not get a higher
seen in a changed diagonal advanced placement of the lame limb             peak load at the trot. Fzmax of the contralateral limb was nearly
(Buchner et al., 1995a; Weishaupt et al., 2006), allows it to accept       unchanged during subtle or moderate lameness. Similarly, peak
the body load at a time when the trunk is at a higher point in its         load in the diagonal hind limb was nearly constant, and it was only
sinusoidal motion cycle and has a relatively low downward velocity.        during moderate lameness a slight increase of 2% could be found.
This reduces the effort required to lift the body as discussed in the      The ipsilateral limb shows more changes, but it is loaded less rather
second mechanism. Additionally, braking of the descending body             than more (6% less in moderate lameness). In fact, hardly any
is smoothed by slightly more flexion of the shoulder joint.                compensatory increase of peak load can be found in the nonlame
   The second mechanism to reduce peak load involves the vertical          limbs. This is true also for hind limb lameness, which is even more
displacement of the body. During the stance phase of the lame limb         stable: while peak load in the lame limb gradually decreases with
the head and neck and, to a lesser extent, the trunk, are not lowered      increasing lameness, no change in Fzmax could be found in the three
as normal. Keeping the body at a more constant height needs less           other limbs (Weishaupt et al., 2004).
maximal vertical acceleration and results in a decreased peak verti-          The same relationships were found by Morris and Seeherman
cal force in the lame limb. Additionally horses adjust their head and      (1987) and Tietje (1992).
neck movement to control the load distribution in all limbs. Since            Analysis of the characteristic head and trunk movements com-
the head and neck are heavy, representing about 10% of total body          bined with model calculations (Vorstenbosch et al., 1997) offer an
mass (Buchner et al., 1997), and they have a long lever arm relative       explanation for the way horses redistribute the body load. The
to the body center of mass, their position has a relatively large effect   reduction of maximal head acceleration during the lame diagonal
in loading or unloading the forelimbs. This influence of head and          stance phase reduces the load on the lame forelimb, but increases
neck movement has been evaluated using an inverse dynamics                 the load on the diagonal hind limb due to a reduced torque at the
model (Vorstenbosch et al., 1997). The dynamic forces acting on            neck-trunk connection. At the same time, reduced acceleration of
the trunk and then on the limbs were calculated from the kinemat-          the whole trunk adds to the reduction of loading of the lame fore-
ics of head and neck, their inertial properties and the geometric          limb, but counteracts and equalizes the torque effects of the head
properties. Differences of only 10 cm in vertical amplitude of the         on the diagonal hind limb. During the sound diagonal stance
head during the stance phases of lame and sound limbs caused               phase, the trunk acceleration hardly changes. Increased head
                                                                                                                                                      185
                                  9        Gait adaptation in lameness
       movements, however, slightly increase the loading of the contralat-                            These results show that a lameness in one limb will not neces-
       eral forelimb and decrease that of the ipsilateral hind limb.                                sarily increase the risk of damaging the contralateral limb or the
         The fact that the reduction of the peak load in the lame limb is                           other sound limbs. If high peak forces are responsible for compen-
       not compensated by higher peak loads in the other limbs raises the                           satory injuries, the mechanisms described above enable a maximal
       question as to where the load is going. Two phenomena are involved                           decrease of peak force in the lame limb together with a minimal
       in answering this question:                                                                  increase of risk in the sound limbs.
       1.	 A redistribution of the load within the limbs
       2.	 A decrease of total load of all four limbs during the whole                              Summary
           stride cycle.                                                                            There is no redistribution of peak load from the lame to the sound
                                                                                                    limbs and only a little redistribution in vertical impulse. A lower
       The redistribution within the limb is based on an earlier placement
                                                                                                    total stride impulse is compensated by a higher stride frequency.
       of the limb, the prolonged stance duration and the increased
       damping in the proximal limb joints. These movement adaptations
       smooth the loading of the lame limb and enable the horse to reduce                           Specific lameness
       the peak load significantly more than the vertical impulse. As
       already mentioned for a moderate forelimb lameness, peak vertical
       load reduction was 24% compared to a reduction of vertical impulse                           The most ambitious aim in the use of locomotion analysis for the
       of only 20%. Similar results were found for a carpal lameness by                             diagnosis of lameness in horses is the exact localization of the
       Morris and Seeherman (1987) whose results showed 11.5% reduc-                                ailment within a limb thus making the diagnosis of a specific
       tion in peak force, but only 8.4% reduction in impulse in the lame                           disease (Leach & Crawford, 1983; Clayton, 1986a). A precondition
       limb. In severe induced tendonitis, a decrease of 27% in Fzmax cor-                          for such a specific diagnosis is a database that includes kinematic
       responded to 15% reduction in the vertical impulse (Clayton et al.,                          patterns of various specific diseases, based on sufficient measure-
       2000a) (Fig. 9.8). The same principle works in the contralateral                             ments to eliminate the variation due to individual locomotion
       limb. More or less unchanged peak loads during a prolonged stance                            patterns. Recordings have been made in small groups of horses with
       phase led to increases in vertical impulse in the contralateral limb                         specific ailments, and studies have been performed in groups of
       of 7% (Weishaupt et al., 2006) or 4.7% (Morris & Seeherman,                                  horses with equal, induced lameness. Analysis of the results of these
       1987).                                                                                       studies showed two major problems that impede formulation of a
          The remaining difference in impulses between lame and sound                               definition of characteristic lameness patterns in specific lameness:
       limbs can be explained by the second phenomenon, the reduction                               •	 The individual locomotion pattern: Several studies found a
       of the sum of the load of all four limbs, the total load or total stride                        high level of reproducible individuality in the locomotion
       impulse. This has already been suggested by Morris and Seeherman                                pattern of horses (Drevemo et al., 1980; van Weeren et al.,
       (1987) and is later confirmed by results of kinematic and kinetic                               1993) seen as a low intraindividual variation compared to
       studies. When forced to keep a constant velocity on the treadmill,                              the high interindividual variation. The low intraindividual
       horses increase their stride frequency by reducing the duration of                              variation allows for repeated, reliable assessments of
       the swing phase. In this way the horses reduce the load within one                              the locomotion pattern after diagnostic or therapeutic
       stride by distributing it over a larger number of strides.                                      manipulations. The accurate measurement techniques enable
                                                                                                       the detection of really small, but significant, differences
                                                                                                       due to the various kinds of lameness. However, these
                                                                                                       differences are often smaller than differences between horses
                                                                                                       due to their individual locomotion pattern.
                                  180                                                               •	 The wide variety of orthopedic diseases: Many horses suffer
                                                                                                       from more than one disease. Even horses suffering from very
                                                                         Sound
                                                                                                       similar diseases or syndromes, such as navicular disease or
                                  160                                    Lameness left forelimb        carpal lameness, show a variety of orthopedic and radiological
                                                                                                       findings. In two studies analyzing seven horses with carpal
      Vertical impulse (G msec)
186
                                                                                                                                                                 Specific lameness
Comparing their results with those from other lameness studies, the                           SDF tendonitis could be found especially at the beginning of the
same general characteristics as described for supporting limb lame-                           stance phase. These very promising results for a specific lameness
ness can be found. There is a tendency to longer stance durations,                            diagnosis, however, are based on a quite sophisticated analytic
but this feature is not shown by all horses (Pollhammer-Zeilinger,                            method that has not been pursued.
1996). Fetlock joint hyperextension is reduced and vertical head
movement shows some of its characteristic asymmetric pattern,
which depends on the degree of asymmetry of the pathologic                                    Laminitis
process in both limbs. Even hoof landing, as described by Ratzlaff                            A similar inverse dynamic study as for navicular disease was per-
and Grant (1986), does not show a consistent pattern in all horses                            formed in ponies with chronic laminitis (McGuigan et al., 2005).
(Hütter, 1997). Keegan et al. (1997) found also a reduced maximal                             These ponies all had rotations of the distal phalanx of 6–13° and
flexion in the carpal joint during the swing phase, which he explained                        a stilted gait at the trot. Ground reaction forces (GRF) showed
as a general symptom of a reduced loading followed by a less ener-                            similar typical signs of bilateral lameness, with lower Fzmax and
getic protraction of the limb. Therefore, no really specific kinematic                        a prolonged stance duration. The most interesting detail was
patterns for navicular disease could be found to differentiate navicu-                        the change in the moment arm of the GRF at the coffin joint. The
lar disease from other types of supporting limb lameness.                                     moment arm was below zero until about 40% of the stance phase,
   However, locomotion analysis studies using the advanced meth-                              and in the later part of stance was still significantly shorter than the
odology of inverse dynamic analysis, which combines kinetic and                               moment arm in sound ponies. As a consequence of this situation
kinematic measurements, offered additional insights into the spe-                             there was no tension in the DDFT until nearly midstance. In the
cific locomotion pattern of horses suffering from navicular disease                           second half of the stance phase, DDFT force gradually increased,
(or low palmar foot pain) (Wilson et al., 2001; McGuigan & Wilson,                            but reached only 64% of the peak values in sound ponies at heel-off
2001). These studies calculated the moment arm of the coffin joint                            (Fig. 9.10). This shows nicely how displacement of the distal
and the compressive force of the deep digital flexor tendon (DDFT)                            phalanx reduces tension in the DDFT, which means that rotation
on the navicular bone. The most surprising and significant finding                            of the distal phalanx during the laminitis is a self-limiting process.
was an increase in compressive force shortly after landing and                                When the rotation reaches a critical amount around 15–20°, there
during the whole stance phase in horses suffering from navicular                              is no tension in the DDFT and therefore no rotational force on the
pain. Sound horses start with a low DDFT force and a low navicular                            distal phalanx.
compressive force, which increases during the stance phase reaching
a peak shortly before heel-off. The lame horses with navicular pain
show a paradoxical increase in this force, which is expected to
increase their pain too (Fig. 9.9). Obviously, while they try to
                                                                                              Carpal and tarsal lameness
decrease heel loading by tension in the DDFT, they increase pressure                          Carpal lameness is the most intensively studied orthopedic syn-
on the navicular bone and thereby even contribute to a progression                            drome using locomotion analysis techniques. Both patient studies
of the disease. This obvious inability of the horse to unload the                             (Ratzlaff et al., 1982; Clayton, 1987a) as well as studies of induced,
diseased structure might explain the bad prognosis of navicular                               uniform carpal lameness (Auer et al., 1980; Morris & Seeherman,
disease and also the positive effects of mechanical support offered                           1987; Back et al., 1993; Peloso et al., 1993) serve as a database for
by orthopedic shoeing, such as raised heels, facilitation of break                            a detailed analysis. As in navicular disease, there are reliable general
over, or protection from overextension of the coffin joint by                                 signs of lameness, including reduced fetlock hyperextension and
extended heels (egg bar shoes).                                                               a head movement pattern that are indicative of the supporting
   Another interesting approach was described by Williams et al.                              limb lameness component. Reduced carpal flexion is a consistent
(1999) using the pattern of the GRF. When they performed a prin-                              sign of the swinging limb lameness component. Ratzlaff et al.
cipal component analysis of the vertical and longitudinal forces                              (1982) also described changes in the angular velocity as a good
specific differences between sound horses and horses suffering from                           indicator to differentiate swinging and supporting limb lameness.
7 12
                            6                                                                                    10
Compressive stress on the
                            5
  navicular bone (MPa)
                                                                                                                  8
                            4
                                                                                                                  6
                            3
                                                                                                                  4
                            2
                                                                                                                  2
                            1
                                                                                                                  0
                            0                                                                                         0   20        40            60               80             100
                                0   20     40            60           80             100                                           Time (% of stance)
                                         Percentage of stance
                                                                                              Fig 9.10  Mean force in the deep digital flexor tendon (N/kg body mass)
Fig 9.9  Compressive stress on the navicular bone by the DDFT during trot                     during the stance phase in normal horses (blue lines) and horses with
in normal horses (red lines) and horses with navicular disease (blue lines).                  navicular disease (red lines). Values are mean (solid lines) and SD (broken
Values are mean (solid lines) and SD (broken lines).                                          lines).
Reprinted with permission from: Wilson A.M., McGuigan M.P., Fouracre L., et al., 2001. The    Reprinted with permission from: McGuigan M.P., Walsh T.C., Pardoe C.H., et al., 2005. Deep
force and contact stress on the navicular bone during trot locomotion in sound horses and     digital flexor tendon force and digital mechanics in normal ponies and ponies with rotation
horses with navicular disease. Equine Vet J 33, 159–165.                                      of the distal phalanx as a sequel to laminitis. Equine Vet J 37 (2), 161–165.
                                                                                                                                                                                            187
        9      Gait adaptation in lameness
      Clayton (1987a) described a specific detail in the vertical movement       the population. Clayton et al. (2000a) also found a significant dif-
      pattern of the carpal region in a horse with a fracture of the third       ference in the slope of the vertical ground reaction force that was
      carpal bone. This involved lowering of the lame limb at lift-off and       indicative of a greatly reduced loading rate in the lame limb and a
      during the early swing phase. This pattern is visible also in the horse    more rapid loading rate in the compensating limb. It coincided with
      recorded by Ratzlaff and Grant (1986) as well as in one horse of           a divergence between the angles of the coffin and fetlock in the two
      Girtler (1988b). Another horse in the study of Girtler (1988b), that       limbs as a consequence of the differences in loading. However, the
      was suffering from tendinitis, showed the same carpal pattern,             large variations in the force curves between and within horses are
      which might point to a common phenomenon of pain during                    likely to preclude their use as a diagnostic tool.
      maximal extension of the carpal joint and the wish to flex and
      unload the lame limb as early as possible.
         Several studies analyzed the gait in induced arthritis of the distal    Ataxia
      tarsal joints (Clayton, 1987b; Kramer et al., 2000; Khumsap et al.,        Several attempts were made during recent years to find an objective
      2003; Khumsap et al., 2004). Osteoarthritis of the distal tarsal joints    documentation for ataxic movements, which are symptoms of neu-
      is known as bone spavin, a very common degenerative joint disease          rological disturbances in horses. The diagnosis of this gait pattern
      in the horse. Like carpal lameness, characteristics of both supporting     is based primarily on subjective gait changes, like in coordination,
      limb lameness as well as swinging limb lameness were found.                weakness or dysmetria. Clayton et al. (2003) and Bialski et al.
      Typical load reduction, seen as reduced vertical force and impulse         (2004) introduced the force plate as a tool to assess postural sway
      or reduced fetlock joint hyperextension was measured. Tarsal flexion       as an indicator of neurological disease. The horses stood with both
      was reduced during midstance as well as midswing. Furthermore, a           fore or both hind feet on the force plate, without and with a blind-
      net power analysis revealed reduced negative joint work during early       fold and movements of the center of pressure were tracked over a
      stance and reduced positive work at push-off at the tarsal joint           period of time. Variables that were measured include the radius and
      (Khumsap et al., 2003). Another study by Khumsap et al. (2004)             velocity of the movements of the center of pressure, and the cranio-
      offered even more insight reporting from three-dimensional joint           caudal and mediolateral range of motion. The findings are plotted
      movement pattern in tarsal synovitis. These results pointed to move-       graphically as a stabilogram (Fig. 9.11). Increases in the measured
      ments like proximodistal or craniocaudal translation of the meta-          variables have been detected in horses with various neurological
      tarsus, which, while coupled to tarsal flexion and extension to a          diseases including cervical vertebral stenosis (wobblers), equine
      major part, show some additional movements.                                protozoal myelitis and vestibular disease. The agreement boundary
                                                                                 of the center of pressure movement was described to be a sensitive
                                                                                 parameter to distinguish between sound horses or those having
      Tendinitis                                                                 balance deficiencies. Keegan et al. (2004) used the kinematics of 21
                                                                                 markers on the trunk and limbs together with a sophisticated math-
      An integrated study of the kinematics and GRFs before and after the        ematical procedure using a fuzzy clustering to distinguish between
      induction of superficial digital flexor (SDF) tendinitis in one fore-      sound and spinal ataxic horses. They found the movement
      limb (Clayton et al., 2000a) showed typical signs of a supporting          pattern of one body marker on the back together with one marker
      limb lameness, e.g. a lower peak vertical GRF in the lame limb             each at on a fore and hind limb sufficient to achieve a correct clas-
      together with less flexion of the coffin joint and less hyperextension     sification of the horses. Another kinematic method was used by
      of the fetlock joint in the lame limb during midstance compared            Strobach et al. (2006), which used the autocorrelation and cross
      with the compensating limb. Carpal joint kinematics did not                correlation of hoof movement successfully to evaluate the consis-
      change. At the lame evaluation the compensating limb had a more            tency of the gait.
      protracted orientation throughout its stance phase, though its total
      range of limb rotation from ground contact to lift-off did not
      change. This facilitated a smooth transfer of body weight from the         Peculiar lameness
      lame to the compensating limb without the need to raise the body
      mass into a suspension. In association with its more protracted            There are some rare orthopedic diseases in which the locomotion
      orientation, the compensating limb had a higher braking longitu-           pattern is so unique that it will be recognized by everybody who
      dinal force and impulse than the lame limb, while the propulsive
      components of the longitudinal ground reaction force did not differ
      between limbs. The center of pressure began to move rapidly toward
      the toe relatively early in the stance phase in the lame limb, which                                   0.4
      was interpreted as a consequence of the lower GRFs in the lame                                         0.3                                            Neurological
                                                                                Craniocaudal movement (cm)
      limb. The lame limb also showed significant reductions in the peak                                                                                    Normal
      values for the net joint moments on the palmar aspect of the fetlock,                                  0.2
      carpal and elbow joints, which are the joints crossed by the SDF
                                                                                                             0.1
      musculotendinous unit. The total mechanical energy absorbed was
      significantly lower at every joint in the lame limb compared with                                      0.0
      the compensating limb (Clayton et al., 2000b).
                                                                                                             -0.1
         In the early stance phase, oscillations in the longitudinal force
      peaks correspond approximately with changes in the vertical                                            -0.2
      loading pattern of the limb, and it has been suggested (Dow et al.,
      1991) that changes in the slope of the vertical ground reaction force                                  -0.3
      during phase periods corresponds to a reduced rate of loading of                                       -0.4
      the fetlock as this joint reaches its full extension. Unfortunately,                                          -8   -6   -4      -2      0         2   4      6       8
      findings from the lame and compensating limbs were not differenti-
                                                                                                                                   Time (% of stride)
      ated by Dow et al. (1991), but all horses whose values for the verti-
      cal force slope for one or both limbs were outside the 95%                 Fig 9.11  Stabilogram showing craniocaudal and mediolateral movements
      confidence limits of the population under study had an SDF injury.         of the center of pressure of the two forelimbs in a normal horse (red line)
      Clinical lameness was only apparent when the deviation of the              and a horse with vestibular disease (blue line). Measurements were made
      vertical force slope was outside the 99% confidence limits of              over a period of 10 s at a sampling frequency of 2000 Hz.
188
                                                                                                                            Clinical use of locomotion analysis
Fig 9.12  Typical high elevation of the hind limb during the swing phase in   Fig 9.13  Typical movement pattern of a hind limb in a horse at the walk
a horse at the walk suffering from stringhalt.                                suffering from fibrotic myopathy of the semitendinosus muscle. The foot
                                                                              jerks backward and downward just before landing.
                                                                              Reprinted from Stashak, T.S., 1987. Adam’s Lameness in Horses, with permission from John
                                                                              Wiley and Sons, Inc.
has seen it previously. Two of these specific lamenesses have been
described kinematically in detail.
                                                                              84% of the swing phase and the hoof contacted the ground toe first
Stringhalt                                                                    after being lowered almost vertically rather than being retracted
                                                                              prior to contact. Consequently, the diagonal distance was shorter
This extraordinary locomotion pattern can be seen in horses often
                                                                              for the affected diagonal limb pair. These differences were found
without a known underlying cause (idiopathic stringhalt), probably
                                                                              even at the trot, in which the characteristics are less obvious than
due to a neurologic impairment with disturbed spinal motorneuron
                                                                              at the walk, because at the walk more hind limb protraction is seen
regulation. This pattern is characterized by the exaggerated lifting
                                                                              than at the slow trot (Buchner et al., 1996a).
of one or both hind limbs during the swing phase (Fig. 9.12).
Girtler (1988c) presented the flight arc and temporal data of such
a patient. The hoof was lifted to a maximum height of nearly 60 cm            Summary
instead of the normal height of 15–20 cm, with the peak of the                Kinematic or kinetic analyses of lameness in different ailments show
flight arc being reached quite late during the swing phase and                patterns that allow for a reliable classification into supporting or
the hoof then being lowered nearly vertically to the ground. In the           swinging limb lameness. More specific patterns could not be detected
affected limb, the stance phase was shortened and the swing phase             using these techniques alone, probably as a consequence of the quite
was prolonged, whereas the sound limb showed the opposite                     uniform way horses react to pain in a limb, due to the limited degree
changes. Step duration from the sound to the lame limb was longer             of freedom in their locomotion patterns. Inverse dynamic analyses
than the contralateral step. This strange locomotion pattern is much          allow more specific characteristics of a lameness to be identified,
more obvious at the walk than at the trot, even at very slow veloci-          including changes in functional units like the deep digital flexor
ties. Recently, both kinematic as well as surface EMG techniques              tendon (including its check ligament and the navicular bone). There-
were used to document these typical gait characteristics of horses            fore, specific lameness diagnosis using gait analysis techniques is still
with stringhalt and the effects of an intramuscular botox therapy             a hot topic and field for further research in the future.
(Wijnberg et al., 2009).
                                                                              Clinical use of locomotion analysis
Fibrotic myopathy
Like stringhalt, the typical locomotion pattern of fibrotic myopathy          Accurate and objective assessments of locomotor disturbances using
is more obvious at the walk than at the trot. Fibrosis of torn muscle         locomotion analysis techniques provide the veterinarian with valu-
fibers of the semitendinosus muscle impedes protraction of the                able tools for advanced diagnostics in a clinical setting. Both quali-
hind limb at its most cranial position, when the muscle is maxi-              tative and quantitative methods can be used to assess lameness
mally stretched. At the walk, the hind hoof jerks backward and                objectively, to augment diagnostic procedures or to verify therapeu-
downward just before landing instead of a smooth forward move-                tic effects. Qualitative assessments use slow motion video-recordings
ment to impact (Fig. 9.13). Clayton (1988) analyzed a typical                 to detect changes in hoof motion and landing as well as locomotor
example of a horse with this ailment and described some kinematic             asymmetries (Seeherman, 1991, 1992). The big advantage of quali-
details for the trot. The flight arc stopped its forward movement at          tative gait analysis is the low technical effort and the simplicity of
                                                                                                                                                                         189
        9       Gait adaptation in lameness
      interpretation of the slow motion video images by veterinarian and              The HAAS index is zero in sound horses with symmetric head move-
      horse owner. The same criteria as during a standard orthopedic                  ments during the left and right forelimb stance phases. The index
      examination are assessed, but with a higher temporal resolution                 tends to −1 if the left limb is lame and it tends to +1 if the right
      and with as many replays as necessary.                                          limb is lame. This simple equation has also been applied to loca-
        Quantitative assessments need more sophisticated methods and                  tions other than the head, giving rise to WAAS (Withers Acceleration
      can measure all kinematic or kinetic details described in the previ-            ASymmetry) (Kübber et al., 1994) or SAAS (sacral acceleration
      ous sections. For clinical applications, however, the need for a rapid          asymmetry) (Uhlir et al., 1997). Similarly, using slightly different
      turnaround time usually restricts the analysis to localization of the           calculation methods, the hip acceleration can be recorded and ana-
      lame limb and quantification of the lameness degree. Several                    lyzed (Buchner et al., 1993) or the vertical displacements in both
      methods and variables are available to define symmetry indices for              hips can be compared (May & Wyn-Jones, 1987). These symmetry
      lameness quantification (Table 9.3). These indices have to meet                 indices perform very well, but still need considerable effort during
      several criteria to be of practical, diagnostic value. Firstly, they must       recording and analyzing.
      be sufficiently sensitive to lameness that even small disturbances in              More sophisticated calculation methods were used by Peham
      the locomotion pattern are reflected by distinct changes in the sym-            et al. (1996) to reduce the influence of unsteady head movements.
      metry index. Secondly, an index value should be indicative of a                 After processing the data using a system-matched filter, the sym-
      certain degree of lameness, and the interindividual variation in this           metry of the vertical head movement pattern was analyzed by deter-
      variable should be smaller than the differences between lameness                mination of the Fourier series. The symmetry of the horse’s
      degrees. Thirdly, the variable should be easy to measure and inter-             movements can then be calculated by comparing the values of the
      pret. These criteria can be fulfilled to a variable extent by variables         Fourier coefficients and presented as symmetry percentage (Table
      derived from both kinetic and kinematic analyses. However, the                  9.3) (Peham et al., 1995). Similar methodology was used by Keegan
      third criterion is still especially difficult to achieve and is the subject     et al. (2001) and Audigie et al. (2002), where Audigie et al. (2002)
      of further technical development.                                               only used a trunk marker to determine fore or hind limb lameness
                                                                                      as well as lameness degree.
                                                                                         A different kinematic method was reported by Pourcelot et al.
      Kinematic lameness indicators                                                   (1997). They applied an intercorrelation method to analyze the
      The typical asymmetric pattern of head, withers or croup move-                  contralateral symmetry of both the vertical joint motion and the
      ments in lame horses enable their use for the calculation of sym-               joint angle changes during one stride. The results of these calcula-
      metry indices that are similar to the traditional, subjective                   tions are presented as kinematic indices for the comparison of each
      assessment by the veterinarian. Kastner (1989) first used the vertical          pair of markers or limb joints, or as an averaged fore or hind limb
      accelerations of the head to calculate a symmetry index named                   index. In contrast to the HAAS, these symmetry indices have the
      HAAS: head acceleration asymmetry. He used the following                        value 1 in perfectly sound and symmetric horses and tend to zero
      equation:                                                                       in severe lameness.
                                       LAA − RAA
                              HAAS =
                                          BAA                                         Accelerometer
      HAAS:  Head acceleration asymmetry                                              Acceleration can be calculated by double differentiation of the dis-
      LAA:  Left vertical head acceleration amplitude                                 placement of a point, or it can be measured directly using an accel-
      RAA:  Right vertical head acceleration amplitude                                erometer. Conversely, acceleration data can be integrated to calculate
      BAA:  Bigger vertical head acceleration amplitude.                              velocity or displacement. Barrey et al. (1994) used accelerometers
190
                                                                                                                                       Clinical use of locomotion analysis
                                                                                                                                                                                                        191
        9      Gait adaptation in lameness
192
                                                                    Biomechanical studies of diagnostic or therapeutic aids in equine orthopedics
assumption using different methods. All the studies of diagnostic        mat. They measured local peak pressures up to 14.4 N/cm2 at the
anesthesia in sound horses found slight gait changes, but they dif-      gallop and maximal total forces up to 235 N under the bandage.
fered in quality and quantity. Kübber et al. (1994) and Drevemo          They concluded that even when no kinematic effect can be seen,
et al. (1999) found some kinematic changes that were indicative of       the pressure under the bandage might impede blood flow in the
a slight increase in weight bearing on the anaesthetized limb.           distal limb, which could be counterproductive in terms of protec-
Kübber et al. (1994) reported increased asymmetry in the symmetry        tion and performance of the horse. Furthermore, if bandages were
variables of the head and withers after the nerve block in 9 out of      applied tightly enough to support the tendons during locomotion,
12 sound horses, while Drevemo et al. (1999) found an increased          the forces applied to the limb at different locations under the
range in the joint angle pattern of the fetlock joint. The changes       bandage, for example the metacarpal skin, are likely to cause prob-
were very small and some were very close to the border of statistical    lems that would outweigh any positive effects at the tendons or
significance. Looking at the loading of the limbs using a force plate,   fetlock joint.
however, Keg et al. (1996b) could not find differences in the vertical
load before and after local nerve blocks. Only one variable, the time
of change from a decelerative to an accelerative horizontal force
                                                                         Analgesia, NSAIDs, ESWT
changed significantly. This indicates a change in the proprioceptive     The effectiveness of various pharmaceuticals for the therapy of lame-
information and a consequent slight change in the locomotion             ness has been quantified in terms of changes in the lameness degree
pattern of the horses. This change in proprioception was also pro-       or loading of the limbs. Mostly the peak vertical force was used to
posed by Kübber et al. (1994) and Drevemo et al. (1999) and leads        follow the effects of an anti-inflammatory therapy, like phenylbuta-
to the conclusion that sound horses do indeed show small changes         zone, flunixin, etodolac, cox-2 inhibitors (firocoxib) or combina-
in their gait pattern after a local nerve block. However, these          tions with intrasynovial corticocoids and orthopedic shoeings (Back
changes are very small and there might be a gray zone in which it        et al., 2009; Hu et al., 2005; Erkert et al., 2005; Schoonover et al.,
is impossible to differentiate between the responses to desensitiza-     2005; Symonds et al., 2006). Similarly, the immediate analgesic
tion of the limbs in horses with a slight or subclinical, bilateral      effect of extracorpral shock wave therapy (ESWT) was tested and
lameness from the reactions of sound horses.                             found to be negligible in horses suffering from navicular disease
                                                                         using the simple parameter peak vertical force (Brown et al., 2005).
Therapeutic aids
                                                                         Desmotomy
Bandages                                                                 A study of the therapeutic effects of desmotomy of the accessory
Bandages on the limbs of horses are a widely used tool and serve         ligament of the deep digital flexor tendon (also known as the distal
several different functions. They have important medical uses in         check ligament, DCL) took a step further and used inverse dynamic
wound management or immobilization, and therapeutic uses for             analysis to assess the consequences of this procedure for the digital
applying pressure, cold, heat, water or various medical agents           joints and tendons (Buchner et al., 1996c; Becker et al., 1998a).
(Stashak, 1987). Another important use of bandages is to protect         Desmotomy of the DCL is usually performed in young, growing
against injuries of the distal limbs due to interfering, overreaching,   horses suffering from flexural deformity of the distal interphalan-
hitting a fence or any other cause of skin trauma (Dyson, 1994).         geal joint (McIlwraith & Fessler, 1978). Recently, desmotomy of the
The most controversial use of bandages is to prevent tendon strains      DCL has also been proposed as a possible therapy for DCL desmi-
or joint injuries associated with loading during locomotion. The         tis, similar to desmotomy of the accessory ligament of the superfi-
distal limbs are often bandaged to prevent or support tendinitis or      cial digital flexor tendon to treat SDF tendinitis (Becker et al.,
arthritis of the fetlock joint. There are some studies, however, which   1998a). In a long-term study all clinical, ultrasonographical, histo-
disprove this protective function or even indicate possible adverse      logical and biomechanical aspects of the desmotomy were assessed
effects of bandages for this purpose. The effects of bandages on         to evaluate the advantages or disadvantages of the desmotomy for
tendon strain can be evaluated directly using invasive methods,          treating chronic desmitis of the DCL. A combination of kinetic,
such as strain gauge implants into the tendons, or indirectly, using     kinematic and radiologic techniques was used to study the function
non-invasive, kinematic methods. Keegan et al. (1992) implanted          of the DCL for normal locomotion and to follow the changes in
strain gauges into the suspensory ligament of 9 horses. They com-        joint moments, tendon forces and limb kinematics at intervals of
pared ligamentous strain while standing and walking with two types       10 days and 6 months after DCL desmotomy in sound horses.
of casts and four types of supportive bandaging materials as well as        Ten days after desmotomy the horses had no visible lameness or
different bandaging techniques. The results clearly showed that sig-     changes in limb loading, but alterations in the locomotion pattern
nificant support can only be expected for the full cast and the dorsal   were clearly indicative of the loss of biomechanical function of the
fetlock splint. There was no effect of any bandage on suspensory         DCL (Buchner et al., 1996c). During the whole stance phase a
ligament strain.                                                         caudad shift of the point of force application at the hoof (center of
   Kobluk et al. (1990) applied the close relationship between           pressure) reduced the moment arm of the GRF and, consequently,
fetlock joint angle and suspensory ligament strain to evaluate the       the net joint moment at the coffin joint. Despite the loss of DCL
supporting capacities of bandages. They measured the kinematics          function, the joint motion pattern at the beginning and in the
of galloping horses that had been wrapped with different types of        middle of the stance phase was not changed. An increase in function
support bandages. Some horses showed slightly decreased fetlock          of the SDFT compensated for the loss of the DCL, so the fetlock
hyperextension with bandages, but others showed no decrease or           joint angle was unchanged during maximal vertical loading at mid-
even had increased fetlock joint angles. In general, there was no        stance. At the end of the stance phase, it was primarily the deep
proof for a protective effect of supporting bandages on fetlock joint    digital flexor tendon (DDFT), rather than the SDFT, that took over
angle or tendon strain during loading of the limbs. There might be       the function of the deficient DCL (Fig. 9.16). However, the DDFT
a physical restriction of the amount of flexion during the swing         could not fully compensate the DCL function. Consequently, some
phase, but this is unlikely to prevent injuries associated with limb     kinematic changes occurred in the later part of the stance phase: the
loading.                                                                 fetlock joint remained hyperextended for a longer time before
   On the other hand, bandages cause pressure on the limb, with          flexing rapidly at the end of the stance phase, whereas the carpal
the amount of pressure being dependent on the type of bandage            joint started to flex earlier in the stride cycle. The increased loading
and the speed of locomotion. Morlock et al. (1994) quantified the        of SDFT and DDFT was found to be within the normal range of
pressures on the metacarpal skin using a small pressure-sensitive        loading at the walk and the trot. Therefore, it was concluded that
                                                                                                                                                    193
                        9      Gait adaptation in lameness
                        0.60                                                                          (1989). By using a computer model to simulate the loss of the DCL,
                                                SL + SDFT
                                                                                                      the increase in the DDFT force, as well as the change in the position
                        0.50
                                                                                                      of the point of force application, were predicted correctly, but the
      Moments (Nm/kg)
                        0.40                                                                          increase in the force of the suspensory ligament (SL) was overesti-
                                                                      DDFT + DCL                      mated. Obviously, the SDFT could compensate for the DCL des-
                        0.30
                                                                                                      motomy by maintaining the normal midstance angle of the fetlock
                        0.20                                                                          joint so that SL loading was unchanged.
                        0.10                                                                             Six months after the desmotomy, the function of the DCL was
                                                                                                      partly restored by scar tissue formation, which restored 80% of the
                        0.00                                                                          original tensile strength of the DCL, while its length had increased
                               0    10     20      30       40   50      60       70
                                                                                                      by 1 cm (Becker et al., 1998b). This healing process restored its
                                          Time (% of stride)                                          biomechanical function to a certain extent and reduced the typical
       Fig 9.16  Tendon moments at the fetlock joint of suspensory ligament and
                                                                                                      locomotor changes seen 10 days after the desmotomy. However,
       superficial digital flexor tendon (SL + SDFT), deep digital flexor tendon and                  most of the locomotor changes persisted, especially the caudad shift
       its distal check ligament (DDFT + DCL) averaged over six horses at the walk                    of the point of force application, and it was assumed that healing
       before and after desmotomy of the DCL. Solid lines, before desmotomy;                          would continue for a longer period of time.
       dashed lines, after desmotomy.                                                                    In conclusion this study documented the biomechanical
       Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M., Becker, C.K., 1996. Load redistribution   changes due to DCL desmotomy and quantified the consequences
       after desmotomy of the accessory ligament of the deep digital flexor tendon in adult horses.   for the net joint moments and the loading of the tendons. Even
       Veterinary Quarterly 18, S2, S70–74, with permission from Taylor & Francis Ltd, http://www.    6 months after desmotomy, healing was still in progress and DCL
       informaworld.com.                                                                              function was not fully restored. These experimental and model
                                                                                                      studies of DCL function show the potency of non-invasive
                                                                                                      methods for assessing the biomechanical effects of therapeutic
       there is no risk of damage to the compensating tendons after DCL                               procedures on the internal forces in limb joints and tendons.
       desmotomy, provided locomotion is controlled during the recovery                               Similar studies have been performed to assess the effects of
       period.                                                                                        various types of orthopedic shoes and to enable an objective
         These experimental findings nicely confirmed most of the details                             assessment of the benefit of these therapeutic measures for the
       that had been predicted by a model analysis of van den Bogert et al.                           health of the horse.
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   1987. Early development of gait                      bewegung eines stützbeinlahmen pferdes               1992. Evaluation of support bandaging
   asymmetries in trotting Standardbred colts.          vor und nach diagnostischen                          during measurements of proximal
   Equine Vet. J. 19, 189–191.                          leitungsanästhesien dargestellt in weg-zeit-         sesamoidean ligament strain in horses by
Drevemo, S., Johnston, C., Roepstorff, L., et           diagrammen. Wiener Tierärztliche                     use of a mercury strain gauge. Am. J. Vet.
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                                                                                                                                                              195
        9      Gait adaptation in lameness
      Keegan, K.G., Pai, P.F., Wilson, D.A., et al.,         tarsometatarsal joints on sagittal plane           Merkens, H.W., Schamhardt, H.C., 1988a.
         2001. Signal decomposition method of                kinematics and kinetics of trotting horses.           Evaluation of equine locomotion during
         evaluating head movement to measure                 Am. J. Vet. Res. 64 (12), 1491–1495.                  different degrees of experimentally induced
         induced forelimb lameness in horses              Knezevic, P.F., 1982. Untersuchung auf                   lameness. I. Lameness model and
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      Keegan, K.G., Wilson, D.A., Smith, B.K., et al.,       pferdekrankheiten für wissenschaft und                6, 99–106.
         2000. Changes in kinematic variables                praxis. S.Karger, Basel, pp. 40–53.                Merkens, H.W., Schamhardt, H.C., 1988b.
         observed during pressure-induced                 Knezevic, P.F., Floss, F.N., Girtler, D., 1982.          Evaluation of equine locomotion during
         forelimb lameness in adult horses                   Erste klinische ergebnisse rechnergestützter          different degrees of experimentally induced
         trotting on a treadmill. Am. J. Vet. Res.           kinematographischer bewegungsanalyse                  lameness. II. Distribution of ground
         61, 612–619.                                        beim pferd. Proceedings of the 14.                    reaction force patterns on the concurrently
      Keegan, K.G., Wilson, D.J., Wilson, D.A., et al.,      Conference of the European Society of                 loaded limbs. Equine Vet. J. Suppl. 6,
         1997. Effects of anesthesia of the palmar           Veterinary Surgery, Istanbul, pp. 89–94.              107–112.
         digital nerves on kinematic gait analysis in     Kobluk, C.N., Martinez del Campo, L.,                 Merkens, H.W., Schamhardt, H.C., Hartman,
         horses with and without navicular disease.          Harvey-Fulton, K.A., et al., 1990. A                  W., et al., 1986. Ground reaction force
         Am. J. Vet. Res. 58, 218–223.                       kinematic investigation of the effect of a            patterns of Dutch warmblood horses at
      Keegan, K.G., Yonezawa, Y., Pai, P.F., et al.,         cohesive elastic bandage on the gait of the           normal walk. Equine Vet. J. 18, 207–214.
         2004. Evaluation of a sensor based system           exercising Thoroughbred racehorse.                 Merkens, H.W., Schamhardt, H.C., Hartman,
         of motion analysis for detection and                Proceedings of the.annual Convention of               W., et al., 1988. The use of H(orse) INDEX:
         quantification of forelimb and hind limb            the American Association of Equine                    a method of analysing the ground reaction
         lameness in horses. Am. J. Vet. Res. 65,            Practitioners Lexington, pp. 135–148.                 force patterns of lame and normal gaited
         665–670.                                         Kramer, J., Keegan, K.G., Wilson, D.A., et al.,          horses at the walk. Equine Vet. J. 20,
      Keg, P.R., Barneveld, A., Schamhardt, H.C., et         2000. Kinematics of the hind limb in                  29–36.
         al., 1994. Clinical and force plate                 trotting horses after induced lameness of          Merkens, H.W., Schamhardt, H.C., van Osch,
         evaluation of the effect of a high plantar          the distal tarsal and tarsometatarsal joints          G.J.V.M., et al., 1993. Ground reaction
         nerve block in lameness caused by induced           and intraarticular administration of                  force patterns of Dutch warmblood horses
         mid-metatarsal tendinitis. Vet. Q. 16,              anesthetic. Am. J. Vet. Res. 61 (9),                  at normal trot. Equine Vet. J. 25, 134–137.
         S70–S75.                                            1031–1036                                          Morlock, M.M., Kobluk, C.N., Jones, J.H., et
      Keg, P.R., Schamhardt, H.C., van Weeren, P.R.,      Kübber, P., Kastner, J., Girtler, D., et al., 1994.      al., 1994. Influence of bandage material on
         1996b. The effect of diagnostic regional            Erkenntnisse über den einfluss der tiefen             pressure distribution under the bandage on
         nerve blocks in the forelimb on the                 palmaranästhesie auf das gangbild des                 the distal forelimb of the galloping horse.
         locomotion of clinically sound horses. Vet.         lahmheitsfreien pferdes mit hilfe einer               Gait Posture 2, 253–260.
         Q. 18, S106–S109.                                   kinematischen meßmethode.                          Morris, E.A., Seeherman, H.J., 1987.
      Keg, P.R., Schamhardt, H.C., van Weeren, P.R.,         Pferdeheilkunde 1, 11–21.                             Redistribution of ground reaction
         et al., 1996a. The effect of high palmar         Leach, D.H., Crawford, W.H., 1983.                       forces in experimentally induced equine
         nerve block on lameness provoked by                 Guidelines for the future of equine                   carpal lameness. Equine Ex. Physiol. 2,
         collagenase induced desmitis of the lateral         locomotion research. Equine Vet. J. 15,               553–563.
         branch of the suspensory ligament. Vet. Q.          103–110.                                           Muybridge, E., 1899. Animals in motion.
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                                                          Leach, D.H., Cymbaluk, N.F., 1986.                       Republished (1957). In: Brown, L.S. (Ed.).
      Keg, P.R., van den Belt, A.J.M. , Merkens, H.W.,
                                                             Relationship between stride length, stride            Dover publications, New York.
         et al., 1992. The effect of regional nerve
                                                             frequency, velocity and morphometrics of           Peham, C., Scheidl, M., Girtler, D., 1995.
         blocks on the lameness caused by
                                                             foals. Am. J. Vet. Res. 47, 2090–2097.                Definition eines lahmheitsmaßes mit
         collagenase-induced tendonitis in the
         midmetacarpal region of the horse: a study       Leach, D.H., Drevemo, S., 1991. Velocity-                hilfe der spektralanalyse. In: Knezevic, P.F.
         using gait analysis, and ultrasonography to         dependent changes in stride frequency and             (Ed.), Orthopädie bei huf- und
         determine tendon healing. J. Vet. Med.              length of trotters on a treadmill. Equine Ex.         klauentieren. Schattauer, Stuttgart, pp.
         Assoc. 39, 349–364.                                 Physiol. 3, 136–140.                                  412–423.
      Keg, P.R., van Weeren, P.R., Back, W., et al.,      May, S.A., Wyn-Jones, G., 1987. Identification        Peham, C., Scheidl, M., Licka, T., 1996. A
         1997b. Influence of the force applied and           of hind limb lameness. Equine Vet. J. 19,             method of signal processing in motion
         its period of application on the outcome of         185–188.                                              analysis of the trotting horse. J. Biomech.
         the flexion test of the distal forelimb of the   McGuigan, M.P., Walsh, T.C., Pardoe, C.H., et            29, 1111–1114.
         horse. Vet. Rec. 141, 463–466.                      al., 2005. Deep digital flexor tendon force        Peham, C.h., Licka, T., Mayr, A., et al., 2000.
      Keg, P.R., van Weeren, P.R., Schamhardt, H.C.,         and digital mechanics in normal ponies                Individual speed dependency of forelimb
         et al., 1997a. Variations in the force              and ponies with rotation of the distal                lameness in trotting horses. Vet. J. 160,
         applied to flexion tests of the distal limb of      phalanx as a sequel to laminitis. Equine              135–138.
         horses. Vet. Rec. 141, 435–438.                     Vet. J. 37 (2), 161–165.                           Peloso, J.G., Stick, J.A., Soutas-Little, R.W., et
      Kelmer, G., Keegan, K.G., Kramer, J., et al.,       McGuigan, M.P., Wilson, A.M., 2001. The                  al., 1993. Computer-assisted three
         2005. Computer-assisted kinematic                   effect of bilateral palmar nerve analgesia on         dimensional gait analysis of amphotericin-
         evaluation of induced compensatory                  the compressive force experienced by the              induced carpal lameness in horses. Am. J.
         movements resembling lameness in horses             navicular bone in horses with navicular               Vet. Res. 54, 1535–1543.
         trotting on a treadmill. Am. J. Vet. Res. 66        disease. Equine Vet. J. 33 (2), 166–171.           Pollhammer-Zeilinger, S., 1996. Messung des
         (4), 646–655.                                    McIlwraith, C.W., Fessler, J., 1978. Evaluation          bewegungsmusters podotrochlosekranker
      Khumsap, S., Lanovaz, J.L., Clayton, H., 2004.         of inferior check ligament desmotomy for              pferde auf dem laufband mit hilfe eines
         Three-dimensional kinematic analysis of             treatment of aquired flexor tendon                    high speed videosystems. Dissertation,
         horses with induced tarsal synovitis. Equine        contracture in the horse. J. Am. Vet. Med.            Wien.
         Vet. J. 36 (8), 659–663.                            Assoc. 294, 293.                                   Pourcelot, P., Degueurce, C., Audigié, F., et al.,
      Khumsap, S., Lanovaz, J.L., Rosenstein, D.S.,       Meij, H.S., Meij, J.C.P., 1980. Functional               1997. Kinematic analysis of the locomotion
         et al., 2003. Effect of induced unilateral          asymmetry in the motor system of the                  symmetry of sound horses at a slow trot.
         synovitis of distal intertarsal and                 horse. South African J. Sci. 76, 552–556.             Equine Vet. J. Suppl. 23, 93–96.
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                                                                                                                   CHAPTER                 10 
Function                                                                    and neck changes the center of gravity, which provides means for
                                                                            changing the speed of the gaits and even movement on the same
                                                                            position. The thoracolumbar part of the vertebral column is rela-
The goal of this chapter is to present a synthesis of the current           tively stiff; it has to oppose the forces exerted by the relatively heavy
knowledge on in vivo neck and back function and dysfunction at              abdominal organs and it has to transmit the propulsive forces
walk, trot, gallop. Descriptions of equine vertebral column move-           brought about by the hind limbs.
ments are often limited to the relative displacements of different
axial regions of the horse (mainly neck versus back). These displace-
ments induced and controlled by long muscle chains have been                Bones
measured using kinematics and accelerometrics, of which in general          The first cervical vertebra, the atlas, consists of two arches (dorsal
surface EMG measures muscular activity and needle EMG muscular              and ventral), two lateral wings (enlarged transverse processes) and
functionality. An anatomical overview of the vertebral column pre-          no vertebral body. On its cranial end it carries a dorsal tubercle
cedes the locomotor data review on its function and dysfunction             (remnant of the spinous process) on its caudal end a ventral one.
(Clayton et al., 2005).                                                     The wings are an important palpable landmark, to which the head
                                                                            and neck muscles responsible for rotary movements of the head,
                                                                            attach. During development of the vertebrae in early embryonic life
Anatomy                                                                     (a part of) the body of the first vertebra fuses with the body of the
The spinal column of the horse extends from the occipital condyles          second, providing the latter with a cranial protrusion, the dens. The
to the tail and consists of approximately 50 separate short bones,          dens, resting on the floor of the vertebral foramen of the atlas,
the vertebrae. The spinal column supports the body axis and thus            provides the axis of rotation for the atlas and the head. The body
the maintenance of posture. The vertebrae are connected by short            of the axis is long and carries a ventral crest that ends on the caudal
and long ligaments, and two types of articulations, and therefore,          ventral tubercle. The high spinous process of the axis gives rise to
the spinal column also plays an important role in locomotion. The           two articular facets at its caudal extremity; these meet the cranial
typical vertebral formula for the horse is seven cervical, 18 thoracic,     facets on the third cervical vertebra. The cervical vertebrae become
six lumbar, five sacral, and 15–21 caudal vertebrae (Fig. 10.1), each       progressively shorter towards caudal. The third, fourth and fifth
with its own specific characteristics. The basic form of vertebrae (this    cervical vertebrae are long and strong and carry a sharp robust
does not account for the first cervical vertebra) consists of a ventrally   ventral crest on their body that terminates in the ventral tubercle.
placed vertebral body and a dorsally placed vertebral arch, which           The spinous processes are weakly developed. The transverse pro-
encloses the vertebral foramen. The body is composed of an outer            cesses are split into a cranioventral and a dorsocaudal tubercle,
cortex of compact bone, which surrounds trabecular bone. The                connected by a crest. The sixth cervical vertebrae is shorter, but
cranial aspect of the body is usually convex, the caudal aspect             carries an impressive ventral crest. The ventral tubercle of the trans-
concave. Both are covered with hyaline cartilage and can as such be         verse process is replaced by a ventral plate (lamina ventralis). The
regarded as the non-ossified part of the epiphysis of the vertebral         seventh cervical vertebra has the shortest body of the cervical verte-
body. The basal part of the arch is notched on both the cranial and         brae, still a weakly developed spinous process and no ventral plate.
caudal margin; the two notches of successive vertebrae form one             On its caudal aspect the body carries not only the articular process
intervertebral foramen that transmits the spinal nerves and vessels         for the cervicothoracic joint but also the fovea costalis for articula-
(Fig. 10.2). The spinous process, which is located, on top of the           tion with the first rib.
arch, varies in its shape, length and inclination. On the left and right       The 18 (range 17–19) thoracic vertebrae have short bodies, low
junctions of the body and the arch the transverse processes can be          articular processes, closely fitting vertebral arches and long spinous
found. Mamillary processes, if present, are located between the             processes. The latter increase rapidly in size with T2–T9 forming the
cranial articular process and the transverse process; accessory pro-        basis of the withers. Normally, the tip of T5 or T6 forms the highest
cesses are located between the caudal articular process and the             point of the withers. Thereafter a gradual decline in height of the
transverse process. The head and neck unit plays an important role          spinous processes can be seen. The spinous processes of the first 14
in balancing and in locomotion. Changing the position of the head           thoracic vertebrae have a backward inclination, the 15th one has an
                                                                                                                                                        199
       10         The neck and back
C1 Cervical C7
T1 Thoracic T18
L1 Lumbar L6 S1 Sacral S5
Ca1 Caudal
      Fig 10.1  The vertebral formula for the horse is seven cervical, 18 thoracic, six lumbar, five sacral, and 15–21 caudal vertebrae.
      Denoix, J.M., Pailloux, J.P., 1996. Anatomy and basic biomechanical concepts. In: Physical Therapy and Massage for the Horse, with permission from Manson Publishing Ltd.
                                                          Nerve roots                                 upright spinous process, and the processes of the remaining tho-
                                                                                                      racic vertebrae and of the loin or lumbar vertebrae have a forward
                  Spinal cord
                                                                                                      inclination. Serial features are an appearance of an additional
                                                                         Vertebral facet              mamillary process as a projection from the transverse process and
                                                                                                      its gradual migration to join the cranial articular process and a
                                                                                                      change toward the end of the number of the thoracic vertebrae in
                                                                                                      the character of the articular facets from the cervical to the lumbar
                                                                                                      pattern (Fig. 10.1). There are sternal (10) and asternal (8) ribs, the
                                                                                                      neck of the ribs become gradually shorter caudally. Costal facets are
                                                                                                      present on both extremities of the vertebral body for articulation
                                                                                                      with the rib heads and on the stubby transverse processes for the
                                                                                                      rib tubercles. The articular facets of the heads and tubercle become
                                                                                                      confluent in the caudal thoracic vertebrae which increases the
                                                                                                      mobility of the last few pairs of ribs. The head of a rib has a cranial
       A                                                                                              and a caudal facet, separated by a groove for the attachment of the
                                                                                                      intra-articular ligament of the head of the rib.
                                           Dorsal branch        Intervertebral foramen                   The average number of lumbar vertebrae is six (range five to seven).
            Dorsomedial branch
                                                                                                      Their vertebral bodies are longer than those of the thoracic verte-
                                                                                                      brae, the spinous processes shorter, and the transverse processes are
                                                                                                      long, flattened and positioned in a cranioventral direction. The
                                                                                                      transverse processes of the last two lumbar vertebrae and those of
                                                                                                      the last lumbar and first sacral vertebrae articulate with each other.
                                                                                                      Transverse processes cranial to L5 can also form articulations.
                                                                                                      Fusion of the transverse processes can occur without clinical
                                                                                                      implications.
                                                                                                         The sacrum is a completely rigid structure, constructed of five
                                                                                                      sacral vertebrae and their ossified intervertebral discs. The fusion is
                                                                                                      complete at the age of 4–5 years. The fusion increases the effective-
                                                                                                      ness of the forward thrust in locomotion from the hind limb to the
                                                                                                      vertebral column. The fused transverse processes of the sacral ver-
                                                                                                      tebrae are enlarged by the sacral wings, which project laterally and
                                                                                                      originate from the first sacral vertebra. The sacral wings form a rigid
              Dorsolateral branch                                                                     joint with the ilial wings through the oval area (facies auricularis),
                                                       Ramus communicans
                                                                                                      which is covered with cartilage. The dorsal margin of the sacral wing
        B                                                                                             (tuberositas sacralis) is roughened for the attachment of the sacro-
      Fig 10.2  The basal part of the arch is notched on both the cranial and                         iliac ligament.
      caudal margin; the two notches of successive vertebrae form one                                    The number of tail (coccygeal) vertebrae is very variable (15–21).
      intervertebral foramen that transmits the spinal nerves and vessels: (A) a                      Unlike in other species such as the cat, the biomechanical role of
      transverse view, (B) a sagittal view.                                                           the tail in horses is limited.
200
                                                                                                                                         Function
                                                                                                                                                       201
       10         The neck and back
      Fig 10.3  The nuchal ligament supports the weight of the head, when the head is held high. It is composed of two paired parts, the funiculus and
      the laminae.
      Denoix, J.M., Pailloux, J.P., 1996. Anatomy and basic biomechanical concepts. In: Physical Therapy and Massage for the Horse, with permission from Manson Publishing Ltd.
      shaking, tilting, flexing and turning the head. The m. rectus capitis                           muscle. It originates from the cranial border of the thoracolumbar
      dorsalis major is located between the spine of the axis and the                                 fascia, the spinal processes of the first three thoracic vertebrae and
      occiput–nuchal crest, lateral to the nuchal ligament; it contains a                             the median neck raphe. The cephalic parts inserts the nuchal crest
      deep and superficial part. The muscle extends the atlanto–occipital                             and mastoid process with the longissimus capitis. The cervical part
      joint and is innervated by the dorsal branch of the first cervical                              inserts on the caudal part of the alar wing and the transverse pro-
      nerve. Beneath it lies the minor rectus capitus dorsalis muscle,                                cesses of third and fifth cervical vertebrae. The muscle is a neck
      which covers the dorsal atlanto–occipital membrane and shares the                               extensor and upon unilateral action it moves the neck to the side.
      function and innervation with the major muscle. The lateral rectus                              It is thought to play an important role in maintaining balance
      capitis muscle is a small muscular band, which extends from the                                 during galloping. The muscle is innervated by the dorsal branches
      ventral arch of the atlas to the paracondylar process of the skull. It                          of the cervical nerves. The long muscle of the head (m. longus
      flexes the atlanto–occipital joint and tilts the head and is innervated                         capitis) (Fig. 10.6 (9)) is a strong muscle, which can be regarded as
      by the ventral branch of the first cervical nerve. The ventral rectus                           a cranial continuation of the long muscle of the neck. It has long
      capitis muscle between the ventral arch of the atlas and the base of                            muscles fibers, and is located on both sides next to the ventral part
      the skull near the tympanic bulla also flexes the atlanto–occipital                             of the second to fourth cervical vertebra. It unites with the contra-
      joint and has the same innervation as the lateral rectus muscle. The                            lateral muscle and ends between the guttural pouches on the base
      m. obliquus capitis cranialis extends obliquely craniolaterally over                            of the skull. It flexes the atlanto–occipital joint, draws the head
      the atlanto–occipital joint, covered by the splenius and a part of                              sideways, or the neck downward and is innervated by the ventral
      the brachiocephalic muscle. It extends the atlanto–occipital joint                              branches of the first four cervical nerves. The segmented long muscle
      and bends the head to the contracting side. It is innervated by the                             of the neck (m. longus cervicis) extends from the atlas to T6. It runs
      dorsal branch of the first cervical nerve. The m. obliquus capitis                              craniomedially to insert on the bodies of the more cranial cervical
      caudalis (Fig. 10.6 (12)) is positioned more caudally between                                   vertebrae near the midline. The muscle flexes the neck and is inner-
      the spinous process of the axis and the wing of the atlas; it receives                          vated by ventral branches of both the intercostal as the cervical
      its innervation through the dorsal branch of the second cervical                                nerves dependent on the part of the muscle. Of the scalenus muscle,
      vertebra. Unilateral action provokes rotation of the atlas and thus                             only the ventral (Fig. 10.6 (11)) and middle part are present. It takes
      the head on the dens of the axis. Bilaterally it acts as a fixator of                           its origin from the first rib, and is divided by the brachial plexus. It
      the head.                                                                                       inserts on the transverse processes of the third to seventh cervical
         A neck muscle, not belonging to the large extensor systems, is the                           vertebrae (middle part) and the seventh cervical vertebra (ventral
      splenius muscle, which is a large muscle, located at the dorsolateral                           part). The ventral branches of the fifth to eighth cervical nerve and
      part of the neck, under the cranial (cervical) parts of the rhomboid                            the first two thoracic nerves innervate both parts. It flexes the neck,
202
                                                                                                                                                 Function
                                                                                                                                                               203
       10       The neck and back
             Cerebrum                      Cerebellum
                                                        C1 to C6
                                                                         C6 to T2
                                                                                         T3 to L3       L4 to S2
                                                                                                                            S3 to S5
Brainstem
Neck
Thoracic limb
Abdomen
Pelvic limb
      Fig 10.5  A sagittal view with the different functional parts of the neurological system within the vertebral column: face and head, neck (C1–C5), thoracic
      limb (C6–T2), abdominen (T3–L3), pelvic limb (L4–S2), tail and perineum (S3–S5).
                                           12      8
                                                                                                        3
                                                               6
                                                                                         4
                                                                   7
                                                           9
                                                                                                    2
                                                                                    11
                                                                                               5
                                                                          1         10
      Fig 10.6  A sagittal view to the cervical part of the muscles around the vertebral column: 1, m. sternocephalicus; 2, m. serratus ventralis cervicis; 3, m.
      rhomboideus cervicis; 4, m. semispinalis capitis, biventer cervicis head; 5, m. iliocostali; 6, m. longissimus, capital part; 7, m. longissimus, atlantal part; 8, m.
      semispinalis capitis, complexus head; 9, m. longus capitis; 10, m. scalenus, ventral part; 11, m. scalenus, middle part; 12, m. obliquus capitis caudalis.
         Recently, the multifidous musculature has been the subject of                          the thoracic and cervical vertebrae to the spinous processes of the
      study in the horse, because it atrophies in people with lower back                        preceding vertebrae. The bundles can span up to five segments in
      pain (Stubbs et al., 2011). The muscle is composed of numerous                            the thoracic region. Cranially it unites with the cranial oblique
      short bundles, which extend from the articular or mamillary pro-                          muscle of the head, caudally with the musculature of the tail. In
      cesses of the lumbar vertebrae, and from the transverse processes of                      the neck five bundles are present at each vertebral level that are
204
                                                                                                                                                 Function
                                                                                     nerve. The psoas minor muscle, which is located between the last
                                                                                     two or three thoracic vertebrae, and the first four or five lumbar
                                                                                     vertebrae, lies ventrally on the psoas major muscle. Due to its inser-
                                                                                     tion on the ilium it stabilizes the vertebral column and rotates the
                                                                                     iliosacral joint. The muscle can be easily recognized from its shiny
                                               5
                                                                                     insertion tendon. It shares its innervation with the quadratus lum-
                                       2                                             borum muscle.
                                           4         6
                     1
                                                                                     Biomechanics
                         3
                                                                                     Several in vitro studies have been performed on the biomechanics
                                                                                     of the neck and back (Jeffcott & Dalin, 1980; Townsend et al., 1983;
                                                                                     Townsend & Leach 1984; Denoix, 1987; Clayton & Townsend,
 A                                                                                   1989a,b; Sleutjens et al., 2010), but our knowledge of these areas is
                                                                                     still incomplete. In vitro studies were mainly performed to evaluate
                                                                                     the nature and maximal amount of regional or intervertebral move-
                                                                                     ments of flexion and extension, axial rotation and lateral bending
                                                                                     (Gellman & Bertram, 2002a,b). With the different protocols used,
                                                                                     wide displacements were studied (Denoix, 1999a), but mobility of
                                       3                                             the vertebral column rarely reaches its maximal limits during loco-
                                                                                     motion and sporting performance, although back pain due to pres-
                         2                                                           sure, tension and/or shearing on vertebral structures (Denoix,
                                                                                     1999b) can alter locomotion of sport and racehorses (Jeffcott et al.,
     1                                                                               1982; Denoix, 1998; Jeffcott, 1980). These studies on cadavers
                         4                                                           found that the lumbar part of the spinal column was very rigid,
                                                                                     especially with respect to lateroflexion, with increasing mobility in
                                                                                     forward direction. The same applied to axial rotation. It should be
                                   5
                                                                                     emphasized, however, that, although this work is of great value as
                                                                                     it gives insight into the potential for movement of various parts of
                               6                                                     the equine spine, it does not represent reality, as there was obviously
 B                                                                                   no influence of any of the active structures.
                                                                                        Of special interest for the biomechanical function of the vertebral
Fig 10.7  A transverse section of (A) the thoracic (1, m. latissimus dorsi; 2, m.
                                                                                     column is head and neck movement influence the movement of the
rhomboideus thoracis; 3, m. iliocostalis; 4, m. longissimus dorsi; 5, m. spinalis;
                                                                                     back. If the head is lowered, the nuchal ligament will exert a pull
6, m. multifidi) and (B) the lumbar part (1, m. iliocostalis; 2, m. longissimus
dorsi; 3, m. multifidus; 4, m. psoas major; 5, m. psoas minor; 6, crus of            on the withers and flex the spinal column. Vice versa, lifting of the
diaphragm) of the muscles around the vertebral column.                               head will extend the back (Fig. 10.3). Understanding of this concept
                                                                                     is of great importance in the athletic training of sport horses. The
                                                                                     question of how the function of the back can best be described dates
innervated by the dorsal branches of the corresponding cervical                      back to Antiquity. Galenus (130–200 AD) developed the concept of
nerves. The attachment of the hind limb is much more stable, com-                    the ‘vaulted roof’ in which the back and the upper part of the rib
pared to the front limb, to optimize the transmission of the thrust                  cage form a roof over the abdominal and thoracic cavities. A col-
generated by the hind limbs to the back. The hind limb is connected                  lapse of this roof would be prevented by the spinous processes.
to the pelvis through the hip joint, the pelvis itself is connected with             However, the fact that the spinous processes do not make contact
the rigid iliosacral joint to the spine. Extrinsic muscles are respon-               in the normal situation makes this representation improbable. The
sible for pro- and retraction of the limb: the gluteal muscles (super-               next concept was developed by Bergmann in 1847 and further
ficial, medial, deep and piriform), the sartorius, the rectus femoris,               elaborated by Zschokke (1892). This concept implies the represen-
the biceps femoris, the semitendinosus and the semimembranosus                       tation of the back by a bridge that is resting on four piers (the
muscles.                                                                             limbs). The upper ledger represents the supraspinal ligament and
   The flexed arch of the spine is, for a large part, maintained by the              withstands tensional forces, the lower ledger, the vertebral bodies,
abdominal musculature, especially the rectus abdominis muscle.                       is loaded under compression. The smaller girders between both
The hypaxial musculature also stabilizes the vertebral column, the                   ledgers represent the spinous processes and the ligaments in
quadratus lumborum muscle, the iliopsoas muscle and the psoas                        between these. Although this concept was generally adhered to until
minor muscle.                                                                        World War II, it contains a basic error in that such a bridge will not
   The quadratus lumborum muscle is a segmented muscle posi-                         be loaded by tension dorsally and by compression ventrally, but
tioned directly ventral to the bodies, the transverse processes and                  just the other way round. It was the zoologist Slijper who, in 1946,
the intervertebral discs from the last thoracic vertebrae to the sacral              after a meticulous study of the anatomical form of the vertebrae
wings. It serves to stabilize the vertebral column: the ventral                      and especially of the inclination of the spinous processes in various
branches of the lumbar nerves and the last intercostal nerves inner-                 species, came up with the model that is still holding today. His
vate it. The psoas major muscle is located lateral to quadratus                      so-called bow-and-string concept not only takes into account the
lumborum, between the bodies and transverse processes of the last                    vertebral column and the limbs, but also the sternum and muscu-
two thoracic vertebrae and ribs and the lumbar vertebrae. The                        lature of the ventral abdomen. In this concept the vertebral column
iliacus muscle fuses at its insertion with the major psoas muscle to                 is a bow that is held under intrinsic tension by the abdominal wall
form the iliopsoas muscle. It originates from the medial side of the                 (Fig. 10.3).
ilium and is divided in a larger lateral part and a smaller medial                      Now the bony vertebral column is loaded under compression and
part. The common insertion is on the lesser trochanter and can flex                  the supraspinal ligament under tension (which is the only force it
the pelvic joint and externally rotate the femur. The muscle is inner-               can resist). Various factors determine the ultimate loading of
vated by the ventral branches of the lumbar nerves and the femoral                   the system. Contraction of the abdominal musculature, especially
                                                                                                                                                               205
          10    The neck and back
      of the rectus abdominis muscle, will tense the bow (i.e. flex the        at the beginning of the stance phase and maximal at about mid-
      back). The same effect will be achieved indirectly by retraction of      stance of both thoracic and pelvic limbs (Buchner et al., 1996). The
      the forelimbs or protraction of the hind limbs. The fusion of the        acceleration signal recorded over the sternum showed also two
      fibrous sheet of the gluteus medius muscle and the longissimus           similar dorsoventral deviations corresponding to each half-stride
      dorsi muscle as alluded to earlier may be of importance for the latter   (Barrey et al., 1994).
      mechanism. The string will be tensed (i.e. the back extended) by            A complementary analysis of the walk on a treadmill using three-
      protraction of the forelimbs and retraction of the hind limbs, but       dimensional accelerometers fixed to the front of a saddle (Galloux
      also by the considerable weight of the abdominal organs. The latter      et al., 1994) showed that, at the walk, the amplitude of movement
      effect is nicely illustrated by the appearance of many old brood         was higher in the vertical axis than in the transverse or longitudinal
      mares with their often very hollow backs. Although often misun-          axes; rotation around the transverse axis (pitching motion) was
      derstood, activity of the epaxial musculature will have an extending     higher than rotation around the longitudinal axis (rolling) and
      effect on the back as well, that makes the back hollower. Given the      vertical axis (twisting or yaw). Furthermore, the twisting movement
      fact that the vast majority of the musculature is located on top of      was greater in the walk than in the other gaits.
      the thoracolumbar vertebral column, contraction of this muscula-            Head movement adaptations associated with a supporting fore-
      ture will automatically lead to extension of the back.                   limb lameness induced by pressure on the hoof sole resembled
                                                                               those of the trot: the amplitude of the dorsoventral oscillation
                                                                               decreased during the stance phase of the lame limb and increased
      Coordination and locomotion                                              during the contralateral limb stance phase (Buchner et al., 1996).
                                                                               Similarly, the maximum acceleration amplitude over the sternum
      Considering the complete equine vertebral column, the movements          was reduced during the stance phase of the lame forelimb (Barrey
      of the neck and trunk and structural and functional description of       et al., 1994). For induced hind limb lameness, elevation of the
      the behavior of the axial muscles during different gaits and sport       tuber sacrale was slightly reduced during the lame stance phase
      exercises has been published previously (Denoix, 1987; Denoix &          while head and withers movements were not significantly altered
      Pailloux, 1996; Denoix, 1999a,b). At present, few in vivo studies        (Buchner et al., 1996).
      have been published. A kinematic method to evaluate back flexibil-          Surface electromyographic (EMG) activity of neck and trunk
      ity on standing horses was presented (Licka & Peham, 1998). Neck         muscles was performed while horses walked on a treadmill or on
      and back motion and coordination are very different according to         hard surfaces, using skin-mounted surface electrodes (Fig. 10.8).
      the gait and movement that are being performed and there is a need          It was found that the left and right splenius muscles act simulta-
      for better knowledge of the nature and amplitude of in vivo equine       neously before the landing of each forelimb (or during the second
      vertebral mobility. Neck and back flexibility and active mobility are    half of the opposite forelimb stance phase) to elevate the head and
      essential to the accomplishment of sport exercises and are the           neck and facilitate forelimb protraction by the elongated brachio-
      subject of constant observation and concern for trainers and riders      cephalicus muscle. The sternocephalicus muscles had reciprocal
      (Colborne et al., 2001; Cassiat et al., 2004).                           activity to splenius muscles and act before and during the first half
         The behavior of the osteoarticular components of the equine           of each forelimb stance phase, the longissimus dorsi muscles act
      thoracolumbar vertebral column mainly based on in vitro investiga-       during the intermediate part of each hind limb stance phase to
      tions has been performed (Denoix, 1999a). Three major move-              facilitate propulsion (Peham et al., 2001a,b; Licka et al., 2009), and
      ments take place in the equine intervertebral joints (Jeffcott, 1980;    the rectus abdominis muscles do not show any significant EMG
      Townsend et al., 1983; Clayton & Townsend, 1989a; Denoix,                activity during the walk (Tokuriki et al., 1997; Robert et al., 1998),
      1999a):                                                                  and this is correlated to the limited vertical acceleration of the
      •	 Flexion (ventral bending inducing a dorsal convexity) and             abdominal visceral mass due to the lack of a suspension phase in
         extension (dorsal bending inducing a ventral convexity)               this gait.
         movements, occurring in the median plane, around a                       A previous study performed with intramuscular fine-wire elec-
         transverse axis                                                       trodes on four horses with and without a rider reported that the
      •	 Lateral bending (lateroflexion) to the left and right sides,
         developed in the horizontal plane, around a dorsoventral axis
      •	 Left or right axial rotation (left or right deviation of a            Stance phases
         vertebral body with respect to the following one) around a                                                            LH
         longitudinal axis.                                                                                                              LF
                                                                                                                                                         RH
                                                                                                                                                              RF
      Translational movements of minor amplitude take place in a verti-
      cal transverse plane:
      •	   Vertical shearing (dorsoventral translation) is associated with      Sp
           flexion and extension movements                                      SC
      •	   Transverse shearing (left to right displacement) is associated
           with lateroflexion and rotation.
                                                                                LD
      Longitudinal compression and tension occur in some parts of the           RA                              No electromyographic activity
      intervertebral joints for every major movement of the vertebral
      column.                                                                        80          0           20          40         60          80       0    20
                                                                                                                  Percentage of stride activity
206
                                                                                                                                                                Function
multifidus lumborum muscle was active in the intermediate part of                                  stance phase, the neck and trunk rotate downward to become closer
the stance phase of the ipsilateral hind limb and the obliquus                                     to the horizontal. During the suspension phase, extension between
externus abdominis muscle had intermittent activity (Tokuriki                                      the trunk and neck occurs (Fig. 10.9).
et al., 1991). On the standing horse, in the neck region, the splenius                                A three-dimensional in vivo kinematic study of flexion and exten-
muscle showed some activity, while the sternocephalicus and bra-                                   sion movements of the thoracolumbar spine was performed at the
chiocephalicus muscles were silent (Tokuriki & Aoki, 1991). Clinical                               trot in 13 sound horses using five skin markers placed on the median
observation shows that it is probably during walking that the mobil-                               plane of the back over the 6th and 13th thoracic spinal processes
ity of the thoracolumbar vertebral column is most diversified, with                                as well as at the thoracolumbar, lumbosacral and sacrocaudal junc-
association of rotation and lateroflexion combined with limited                                    tions (Pourcelot et al., 1998; Audigié et al., 1999). This study showed
movements of flexion and extension.                                                                that maximal thoracic extension occurs near midstance (Fig. 10.10).
                                                                                                   This passive movement is produced by the visceral mass inertia. The
Trot                                                                                               maximal thoracolumbar extension occurs in the second half of each
                                                                                                   stance phase, followed by the maximal lumbosacral extension at the
Kinematic and electromyographic data of neck and trunk motion                                      end of the stance phase (Audigié et al., 1999).
and coordination have been established on sound horses with a                                         The maximal thoracic flexion takes place during the swing phase
three-dimensional kinematic analysis system allowing simultane-                                    and is concomitant with an elevation of the neck (Figs 10.10, 10.11).
ous recording of the left and right sides of the horse (Audigié et al.,                            It is followed by the maximal thoracolumbar flexion. Finally, the
1999; Robert et al., 1998; Pourcelot, 1999). Lame horses have also                                 maximal flexion of the lumbosacral junction occurs at the end of
been investigated using kinematic analysis (Buchner et al., 1996;                                  the swing phase at the time of maximal protraction of the hind limb
Audigié et al., 1999).                                                                             (Audigié et al., 1999).
   The vertical displacement versus time of the head, withers and                                     The influence of the neck orientation on the thoracic spine dor-
tuber sacrale at trot shows a sinusoidal pattern (Buchner et al.,                                  soventral mobility has been investigated in cadaver specimens
1996) with two symmetrical oscillations during a stride. The general                               (Denoix, 1987). The results showed that elevation of the neck facili-
orientation of the neck and trunk and their alignment vary during                                  tates thoracic flexion (Fig. 10.11).
the stride (Fig. 10.9). With respect to the tuber sacrale position, the                               An accelerometric device fixed over the sternum area by an elastic
withers elevate during the first and intermediate parts of each diago-                             girth (Barrey et al., 1994) showed that, for horses trotting on a
nal stance phase (upward rotation of the trunk) and descend during                                 treadmill, the dorsoventral acceleration curves had a deviation cor-
the last part of the stance phase as well as during the suspension                                 responding to each half-stride. The height of the dorsoventral accel-
phase (downward rotation of the trunk). Additionally, the croup                                    eration signal was linearly correlated with speed. Longitudinal
presents wider dorsoventral movements (lowering and elevation)                                     accelerations were less repetitive than dorsoventral ones; their mag-
than the withers.                                                                                  nitude increased with the increasing speed of the gait. Analysis of
   In sound trotting horses, the head position is highest in the first                             the trot on a treadmill using three-dimensional accelerometers fixed
half of each diagonal stance phase (Vorstenbosch et al., 1997).                                    to the saddle (Galloux et al., 1994) showed that the linear move-
During the major part of the stance phase (Fig. 10.9), the neck                                    ments along the three axes (longitudinal, transverse and vertical)
rotates downward and becomes closer to the horizontal, with the                                    were similar in amplitude. Rotation around the transverse axis
head reaching its lowest point before the end of this phase. During                                (pitching motion) was smaller in comparison with the other two
the suspension and beginning of the following stance phase the                                     gaits (walk and canter).
neck becomes more oblique (Fig. 10.9), and the head is elevated                                       The surface electromyographic activity of neck and trunk muscles
again (upward rotation of the neck).                                                               at trot has been investigated on hard track surfaces, with or without
   In early stance both the neck and trunk undergo an upward rota-                                 riders, as well as on a treadmill (Tokuriki & Aoki, 1991; Tokuriki
tion; during the middle part of the stance phase the angle between                                 et al., 1991, 1997; Robert et al., 1998, 1999, 2001, 2002; Licka et al.,
the neck and trunk flexes (Fig. 10.9) and during the last part of the                              2004).
                                                                                                                                                 +
                 6                                                              2
                                                                                     Trunk angle (o)
Neck angle (o)
4 0
                 2                                                              -2
                     0          20       40           60             80   100
                                         Time (% of stride)
Fig 10.9  Neck and trunk orientation in sound horses guided by hand on hard track at trot (3.1 m/s). Markers are placed over the zygomatic arch, withers
(6th thoracic spinal process) and tuber sacrale. The straight line between the first two markers represents the neck orientation; the line between the last two
markers represents the trunk orientation. The figure shows the angle variations occurring between these lines and the horizontal plane during one stride. A
positive angle indicates an upward angulation of the cranial marker relative to the caudal one as shown in the image on the right. Blue line: neck angle (°)
with respect to the horizontal plane; green line: trunk angle (°) with respect to the horizontal plane; diagonal stance phase: full fore hoof–ground contact.
                                                                                                                                                                              207
          10                   The neck and back
4 163
                       2                                                                             161
                           0               20            40             60            80       100
                                                         Time (% of stride)
      Fig 10.10  Coordination between the neck orientation and thoracic spine dorsoventral movements in sound horses guided by hand on a hard track at trot
      (3.1 m/s). Markers are placed over the zygomatic arch, withers (6th thoracic spinal process), 13th and 18th thoracic spinal processes. The straight line
      between the first two markers represents the neck orientation. The thoracic angle is drawn between the last three markers. The figure shows the angle
      variations occurring between the neck orientation and the horizontal plane as well as the thoracic angle variations during one stride. For the neck, an
      increasing angle indicates an upward rotation; the thoracic angle increases during flexion of the back and decreases during extension. Blue line: neck angle
      (°) with respect to the horizontal plane; green line: thoracic angle (°); diagonal stance phase: full fore hoof–ground contact.
208
                                                                                                                                                    Function
                                                                                   NAtural position
SC                                                                                                    -5E-01                 LF RH               LF RH
                                                                                                      Splenius               stance phase        stance phase
                                                                                                       3E-04
LD
RA                                                                                                    1E-04
                                                                                                      -1E-04
     80          0           20          40         60          80   0      20
                                  Percentage of stride activity                                       -3E-04
                                                                                   Neck lowered
                                                                                                      -3E-04
Fig 10.13  Electromyographic activity of neck and trunk muscles at trot
                                                                                                      Accelerometer
(4 m/s) on a treadmill (mean periods for five horses). Limbs: LF, left forelimb;                       1E-00
RF, right forelimb; LH, left hind limb; RH, right hind limb. Muscles: Sp,
splenius; BC, brachiocephalicus; SC, sternocephalicus; LD, longissimus dorsi;                         5E-01
RA, rectus abdominis.
Courtesy of Céline Robert, Maisons-Alfort, France.                                                    0E-00
                                                                                                      -5E-01
Effect of neck orientation on neck muscle activity
Lowering of the neck using the reins induces a reduction of splenius               Fig 10.14  Influence of the neck position on the electromyographic activity
muscle activity during the first half of the stance phase of each                  of the left splenius at trot (4 m/s) with reference to the left front limb.
                                                                                   Courtesy of Céline Robert, Maisons-Alfort, France.
diagonal (Fig. 10.14). These data can be explained by the lower
amplitude of the neck displacement as well as by increased tension
in passive anatomical structures that support the head and neck,
such as the nuchal ligament.
                                                                                   the back, markers indicative of neck and trunk movements were
Trunk muscle activity and thoracolumbar                                            placed over the zygomatic arch, shoulder joint and tuber coxae (Fig.
movements                                                                          10.15). The head and neck were positioned with side reins and the
                                                                                   horses were filmed under competitive conditions at a left lead canter
Comparison of trunk muscle activity and thoracolumbar move-                        from outside of the circle. The neck and trunk angle curves showed
ments shows that the rectus abdominis muscle acts during the                       that the cranial part of the neck and trunk becomes lower during
stance phase (Figs 10.12, 10.13) to limit the passive thoracolumbar                the intermediate part of the support phase (downward rotation)
extension induced by the visceral mass acceleration. The longissi-                 and elevates (upward rotation) during the leading forelimb stance
mus dorsi muscles act at the end of each stance phase and during                   phase and the suspension phase (Fig. 10.15). The orientation
the suspension phase (Figs 10.12, 10.13) to induce lumbosacral                     changes of the neck angle occur before those of the trunk. An analy-
extension and facilitate hind limb propulsion as well as to stabilize              sis of the canter using three-dimensional accelerometers fixed to the
the thoracolumbar spine as it flexes.                                              saddle (Galloux et al., 1994) showed higher amplitudes of motion
   A previous study (Tokuriki et al., 1991) showed that the multifi-               than for the other gaits (walk and trot), especially along the longi-
dus lumborum and longissimus lumborum were active before and                       tudinal and vertical axes. Rotation around the transverse axis (pitch-
after lift-off of each hind limb, with the activity being higher for the           ing motion) and around the longitudinal axis (rolling) were greater
ipsilateral hind limb. According to this study the obliquus externus               than in the other gaits, while twisting around the vertical axis was
abdominis and rectus abdominis had roughly reciprocal activity to                  lower. EMG activity of trunk and neck muscles was recorded with
these epiaxial muscles. In another study (Tokuriki et al., 1997), the              surface electrodes at the canter (Figs 10.16, 10.17). Recording of
longissimus lumborum was thought to play a role in limiting lateral                neck muscle activity showed that the splenius muscles were
bending of the trunk during symmetrical gaits.                                     active once in the stride cycle, during the trailing diagonal stance
   Dorsoventral movements of flexion and extension have been                       phase (Fig. 10.16). These muscles limit neck lowering and cause
quantified in sound horses (Audigié et al., 1999; Pourcelot et al.,                the neck to extend during the leading forelimb stance phase and
1998). The maximal range of vertical displacements occurred near                   the suspension phase. The sternocephalicus muscles had a reci
the 13th thoracic vertebra and, with respect to the tuber sacrale,                 procal activity and were active from the end of the leading forelimb
reached an average value of 1.5 ± 0.2 cm. In clinical cases with                   stance phase to the first part of the trailing hind limb stance
intervertebral osteoarthrosis a significant reduction of this range of             phase (Fig. 10.16). The brachiocephalicus muscle moving the trail-
motion was observed (Audigié et al., 1999).                                        ing forelimb was mainly active during the stance phase of the
                                                                                   leading forelimb. The brachiocephalicus muscle on the side of
                                                                                   the leading forelimb was mainly active during the suspension
Canter                                                                             phase. This left to right dissociation is correlated to the asymmetry
Kinematic analysis was performed in nine high-level vaulting horses                of the gait and to the respective chronology of each forelimb
cantering at 4–5 m/s on a circle. As no markers could be placed on                 protraction.
                                                                                                                                                                 209
          10                     The neck and back
                                 Right hindlimb
                                 stance phase
                                                 Right forelimb
                                                 stance phase
                        45                                                                            -5
35 -15 +
25 -25
                        15                                                                            -35
                             0              20            40          60              80        100
                                                        Time (% of stride)
      Fig 10.15  Neck and trunk orientation in a sound horse being lunged with side reins at left lead canter (4.5 m/s) on soft ground (sand) in competitive
      conditions (vaulting gymnastics). Markers are placed over the zygomatic arch, point of shoulder and tuber coxae. The straight line between the first two
      markers represents the neck orientation; the line between the last two markers represents the trunk orientation. The figure shows the angle variations
      occurring between these lines and the horizontal plane during one stride. An increasing angle indicates an upward rotation; a decreasing angle indicates a
      downward rotation (blue line). Neck angle (°) with respect to the horizontal plane; (green line) trunk angle (°) with respect to the horizontal plane.
                                                               LF                                                              Left frontlimb
                                             RF LH
                                       RH                                                             RF LH
                                                                                               RH
      Sp
                                                                                                                                                                      LF                        LF
                                                                                                                               Left hindlimb                  RF-LH                     RF-LH
      BC                                                                                                                                                 RH                        RH
      SC
      OI
                                                                                                                               Right longissimus dorsi
                       80          0             20        40         60         80        0           20
                                                   Percentage of stride duration
                        Muscular activity:
                                                                                                                               Left rectus abdominis
                                                 High                   Left side
                                                 Moderate               Right side
                                                 Low                    Both sides
                                                 None
                                                                                                                               Right rectus abdominis
      Fig 10.16  Electromyographic activity of neck and trunk muscles at ridden
      left lead canter (6 m/s) on hard ground (mean values on three horses).
      Limbs: LF, left forelimb; RF, right forelimb; LH, left hind limb; RH, right hind
      limb. Muscles: Sp, splenius; BC, brachiocephalicus; SC, sternocephalicus; LD,
      longissimus dorsi; RA, rectus abdominis; OI, obliquus internus abdominis.                                                Left obliquus internus abdominis
      Courtesy of Céline Robert, Maisons-Alfort, France.
210
                                                                                                                                 Neck dysfunction
   The longissimus dorsi muscles were active once per stride at the          Subsequently, there is transition from the lumbar back to the tho-
end of the leading forelimb stance phase, during the suspension              racic back that leads to a progressive (smoother) rotation of the
phase and during the trailing hind limb stance phase (Figs 10.16,            chest vertebrae. During diagonal support phases (e.g. left forelimb,
10.17). The function of these muscles was to prepare the landing of          right hind limb) in the trot and canter, the forelimb pushes the chest
both hind limbs and to extend the trunk before forelimb landing.             vertebrae in one direction while the hind limb rotates the pelvis
The rectus abdominis muscles had reciprocal activity during the              and lumbar back in the opposite direction. This twisting occurs at
support phase of the diagonal limbs; they act to support the visceral        about the same time as the maximal extension of the back. The
mass and to initiate thoracolumbar flexion during the leading fore-          strings of the back (abdominal muscles) restrain these movements.
limb stance phase (Fig. 10.18) and the suspension phase. Bursts of           The above-mentioned movements of the back were found to be very
activity were observed simultaneously in the longissimus and rectus          symmetrical. The relationship between the movement of the limbs
abdominis muscles on the side opposite to the leading forelimb               to the movement of the back is paramount to the symmetrical
during the stance phase of the trailing hind limb.                           bending of the back. The shape of the movement partly depends
   The obliquus internus abdominis muscle corresponding to the               on the gait. Flexion–extension movement has a double sinusoidal
leading forelimb was active during most of the intermediate part of          motion pattern at the walk and trot, but a single sinusoidal pattern
the support phase (Figs 10.16, 10.17), contributing to visceral              at the canter. Lateroflexion has the form of a single peak and trough
support and trunk lateroflexion. The opposite obliquus internus              at all gaits, as has axial rotation. This has to do with the symmetry
abdominis muscle had a burst of activity at the end of the support           of the gait and the effect of hind limb placement on spinal
phase and beginning of the swing phase.                                      kinematics.
   During the canter, the use of intramuscular wire electrodes has              Variability within the same horse is limited for flexion–extension
shown that the multifidus lumborum and longissimus lumborum                  and axial rotation (6–8%), but considerably more for lateroflexion
are active during the swing phase of the trailing hind limb. The             (8–18%). The variability between horses is larger, as could be
rectus abdominis and obliquus externus abdominis have reciprocal             expected, and the same applies here: lateroflexion may vary as much
activity (Tokuriki et al., 1991).                                            as 16–25% between individual horses, which is considerably more
                                                                             than the variation in the rotation around the other two axes
                                                                             (10–16%).
Walk vs trot vs canter
The horses worked at a walk, trot and canter on a treadmill and              Neck dysfunction
movement of the back and limbs was measured with a complex
series of high-speed cameras. The studies have demonstrated far less
movement of the back at trot than in the other two gaits. At the             Since the publication of Ricardi and Dyson (1993) there has been
walk, the range of motion for flexion–extension is fairly constant           a growing interest in the head and neck region as a potential source
for vertebrae behind T10 (approximately 7°), lateral bending is              of pathological locomotor disturbances and the availability of EMG
greatest in the more cranial thoracic vertebrae and in the pelvic            (Giovagnoli et al., 1998; Tokuriki et al., 1999; Van Wessum et al.,
segments (values >5.6°), but less in the lumbar region between T17           1999; Wijnberg et al., 2004) and MEP techniques (Nollet et al.,
and L5 (<4°). Axial rotation increases gradually from 4° at T6 to            2003a,b, 2004) has proven to be a great asset in investigating this
13° at the tuber coxae. At the trot the range of flexion–extension           region. These studies proved that a neuropathy in combination with
for all vertebrae does not exceed 2.8–4.9°, lateral bending is even          myelopathy and facet joint arthrosis can, like in humans, also result
less (1.9–3.6°). Axial rotation at this gait is in the order of 3°. At       in neck pain, clinical signs of incoordination or front leg lameness,
the canter flexion–extension movement is substantially larger                stringhalt and disability in horses (Schnebel et al., 1989; Moore
(maximal range 15.8 ± 1.3°). Lateral bending is maximally 5.2 ±              et al., 1992; Dunbar et al., 2008; Levine et al., 2008). Moreover,
0.7° and axial rotation 7.8 ± 1.2°. An important relationship was            different head and neck positions (HNP) have become under
demonstrated on the movement of the lumbar back and pelvis.                  debate in the equine community, especially in the disciplines of
Functionally, this part of the back essentially rotates (twists) as a        dressage and show jumping, as they might have an effect on normal,
single unit is readily observed when the walk is viewed from behind.         physiological function too (Jeffcott et al., 2006; McGreevy et al.,
                                                                             2010; Sleutjens et al., 2012; Wijnberg et al., 2010).
                                                                                The general aim of training the equine athlete is to achieve a
                                                                             well-balanced horse in harmony with its rider that is able to show
                                                                             its individual gait qualities (Weishaupt et al., 2006; Heuschmann,
                                                                             2007). The head and neck position is believed to be an important
                                                                             aid in achieving this goal, as it influences fore and hind limb kinet-
                                                                             ics and kinematics, as well as thoracolumbar movement (Denoix &
                                                                             Audigie, 2001; Rhodin et al., 2005; Gómez-Alvarez et al., 2006;
                                                                             Weishaupt et al., 2006; Rhodin et al., 2009; Waldern et al., 2009).
                                                                                The use of specific head and neck positions in training is not
                                                                             uncontested. The recent discussion in the international dressage
                                                                             world focuses on the extremely flexed head and neck position ‘hyper-
                                                                             flexion’ or ‘Rollkur’, or ‘low, deep and round’ (Jeffcott et al., 2006;
                                                                             Heuschmann, 2007; Van Bostel et al., 2009; Wijnberg et al., 2010),
                                                                             which is believed by some trainers to be a useful tool to improve
                                                                             the gymnastic ability that is asked from today’s high performance
                                                                             dressage horses and is rejected by others on the basis of presumed
                                                                             negative effects on equine welfare (McGreevy et al., 2010).
                                                                                Some recent studies on locomotion demonstrated that, although
                                                                             a flexed head and neck position induced an increase in range of
                                                                             motion in the lumbar back in the unridden horse and would imply
Fig 10.18  Leading forelimb stance phase during left lead canter while       a more animated use of the hind limbs, a longer stride length at
lunging on a circle. See the rectus abdominis contraction (red arrowheads)   walk and a more equal weight distribution between fore and hind
inducing lumbosacral flexion (white arrow).                                  limbs (Gómez-Alvarez et al., 2006), this effect could not be
                                                                                                                                                       211
       10      The neck and back
      reproduced while horses were ridden (Rhodin et al., 2009). An                model, developed from measured cervical vertebral dimensions,
      extremely elevated neck, however, caused an increase in extension            calculated centers of rotations, determined intervertebral angle limi-
      of the thoracic and lumbar back in the unridden as well as in the            tations, and earlier reported nuchal ligament properties, and subse-
      ridden horse (Gómez-Alvarez et al., 2006; Rhodin et al., 2009).              quently whether the model could be used to estimate the relative
      Furthermore, an extremely elevated neck was shown to affect the              differences in loading between the objectively quantified HNPs
      functionality of the locomotor apparatus much more than an                   (Sleutjens et al., 2010).
      extremely low neck by an increase in peak vertical force in the                 Goals were to determine the effect of dorsoventral flexion and
      forelimbs, which is, among other factors, a potential risk factor for        extension on intervertebral foramina dimensions in the equine cer-
      the development of injuries (Biau et al., 2002; Weishaupt et al.,            vical spine (Sleutjens et al., 2010, 2012), to evaluate the effect of
      2006; Waldern et al., 2009).                                                 different HNPs on single fiber (SF) and quantitative electromyo-
         Dysfunction of the vertebral column can originate from pathology          graphic (EMG) examination directly after moderate exercise (Wijn-
      of bone, cartilage, joints, ligaments, tendons, muscles or nerves and        berg et al., 2010), to evaluate the effect of different head and neck
      therefore the clinical signs can be rather diverse. Several clinical signs   positions on intrathoracic airway resistance and corresponding arte-
      can occur and vary from lameness, to less specific signs such as             rial blood gas values during a regular training exercise (Sleutjens
      paresis, muscle atrophy, decreased range of motion, expressions of           et al., 2009) and to investigate the effect of head and neck position
      pain such as resistance to perform or to position (Sleutjens et al.,         (HNP) on behavior and cortisol levels in blood and salivar in
      2012). Pathology in the nervous system can also result in clinical           Warmblood riding horses (Dierendonck et al., 2010). This study
      signs of upper motor neuron disease such as dysmetria, hypermetria,          used 7 healthy, base-level trained Dutch Warmblood riding horses
      hypometria and deficits in proprioception. A thorough and detailed           (sex: five mares, two geldings, age: 10.3 ± 3.6 years (mean ± SD),
      lameness exam and neurological exam are necessary to localize the            height at the withers: 161.2 ± 1.4 cm, weight: 531 ± 47.3 kg), with
      area of interest that can be subjected to additional diagnostic              no history of respiratory disease, cardiovascular disease, musculo-
      methods such as local blocks, radiology, ultrasound, scintigraphy            skeletal or neuromuscular disorders. Radiographic and ultrasound
      and last, but not least, EMG needle examination. A study using               examination of their spinal column showed no abnormalities.
      fone-wire EMG to localize a problem (Wijnberg et al., 2004) showed              Videos were taken at the walk on a straight line in five different
      that lesions in the segment L3–S3 were overdiagnosed and lesions             head and neck positions, which were accomplished using side rains
      in the C1–T2 region were underdiagnosed without (semi) quantita-             (Fig. 10.19). The five head and neck positions, of which HNP1,
      tive EMG examination and Motor Unit Action Potential (MUP)                   HNP2, HNP4, and HNP5 were identical to those used in an earlier
      Analysis. In addition, this study showed that if generalized muscle          experiment (Weishaupt et al., 2006; Gomez Álvarez et al., 2006;
      atrophy was present, it was more often associated with a generalized         Rhodin et al., 2009; Waldern et al., 2009), were defined as follows
      neuropathy than a myopathy. If the problem was defined as lame-              (Fig. 10.20):
      ness of unknown origin, most often the diagnosis was a neurogenic
      problem in the segment of C1-T2. Remarkably signs of hypermetria
                                                                                   •	 HNP1: Free, unrestrained, neutral position.
212
                                                                                                                           Neck dysfunction
Fig 10.20 Different HNPs evaluated in this study shown at the moment of LF midstance in an anatomical simulation model.
                                                                                                                                              213
       10      The neck and back
      •	   HNP4: Neck lowered and considerably flexed; nose pointing           accustom the horses to the experimental set-up, they were trained
           toward the chest.                                                   in the different head and neck positions on the lunge for at least 3
      •	   HNP5: Neck raised and considerably extended; bridge of the          weeks.
           nose in front of the vertical.                                         Spherical reflective markers were glued to the skin over the dorsal
      •	   HNP7: Neck lowered and flexed; nose pointing towards the            spinous process of Th6, the wing of the atlas (C1), the rostral part
           carpus.                                                             of the facial crest (CF), the suprascapular tubercle (TS) and the
                                                                               lateral styloid process of the radius (PS). Two additional markers
      In addition, they were evaluated by an international dressage team       were placed on the horse’s bridle, while the bridge of the nose (BN,
      to check for realistic and correct interpretation, and thus considered   BN′) could be identified in every video frame. The known distance
      as being currently representative and commonly used in training          between these two bridle markers was used as a calibration refer-
      and competition. HNP7 was included because two interpretations           ence for the video-frame analysis. A home-video camera was set on
      of the hyperflexion, ‘Rollkur’ or ‘low, deep and round’ training posi-   the line A-C perpendicular to the long side of the riding arena,
      tion were found to exist among riders (HNP4 and HNP7). To                where the horses were evaluated.
214
                                                                                                                              Neck dysfunction
  Video analysis was done using custom software program to deter-            The horses were acclimatized to the experimental neck positions
mine the marker coordinates. Head and neck positions were                 during a training period of at least 3 weeks, until they accepted the
described using four angles and two distances. For each HNP the           induced neck positions. Acceptance was defined as walking in the
following angles and distances were measured (Fig. 10.19):                required position with no pressure on the bit. A standardized exercise
                                                                          test was performed namely: trot1 for 10 min at a heart rate (HR) of
•	   (C1–T6-Hor): the angle between the wing of the atlas (C1),
                                                                          101 ± 8 bpm, canter for 4 min at a HR of 128 ±10 bpm, trot2 for 5 min
     the dorsal spinous process (T6) with the horizontal: angle no.
                                                                          at a HR of 104 ± 7 bpm and walk for 5 min at a HR of 73 ± 8 bpm.
     1. This angle has a negative value when the atlas is lower than
                                                                             Mean consecutive difference (MCD) of single fiber potentials and
     T6.
                                                                          motor unit action potential (MUP) variables (amplitude, duration,
•	   (CF-C1–T6): the angle between the rostral part of the facial
                                                                          area, turns and phases) were recorded in each position directly after
     crest (CF), the wing of the atlas (C1) and the dorsal spinous
                                                                          exercise at rest in a fixed HNP using commercial EMG equipment.
     process of (T6): angle no. 2.
                                                                          Muscle enzyme activity was measured before and 4, 6 and 24 h after
•	   (C1–CF-Vert): the angle between the wing of atlas (C1), the
                                                                          exercise (Wijnberg et al., 2010).
     rostral part of the facial crest (CF) with the vertical: angle no.
                                                                             Intrathoracic pressure was indirectly measured during exercise
     3. This angle is negative when the facial crest is caudal to the
                                                                          using a portable intra-oesophageal pressure (Pes) measuring device.
     atlas.
                                                                          Arterial blood samples were taken immediately after every test inter-
•	   (BN′–BN-Vert): bridge of nose with the vertical: angle no. 4.
                                                                          val from a catheter placed into the transverse facial artery. Arterial
     This angle is negative value when the bridge of the nose is
                                                                          oxygen pressure (PartO2), oxygen saturation (SartO2) and carbon
     behind the vertical.
                                                                          dioxide pressure (PartCO2) values were corrected for core tempera-
•	   (CF–TS): the horizontal distance between the rostral part of the
                                                                          ture (Sleutjens et al., 2009). Continuous telemetric ECG recordings
     facial crest (CF) and the supraglenoid tubercle (TS): distance A.
                                                                          were made using the Televet system in order to determine or exclude
•	   (CF–PS): the vertical distance between the rostral part of the
                                                                          cardiac arrhythmias that potentially could occur as a result of
     facial crest (CF) and the lateral styloid process (PS): distance
                                                                          hypoxia.
     B. For each HNP, 5 video captures were taken per horse on
                                                                             The horses performed an exercise test in each (HNP), which
     the left and right sides with the camera perpendicular to the
                                                                          consisted of warming-up at trot (15 min), canter (4 min), trot2
     line of motion. Measurements were made with the left front
                                                                          (10 min), walk (5 min) and cooling down. External influences
     limb (LF) at midstance with the left metacarpal bone vertical
                                                                          were prevented and the horses were videoed. Afterwards, predefined
     (Figs 10.19, 10.20). The four angles (angle no. 1, 2, 3 and 4)
                                                                          behavioral elements were scored by the same person in The
     and the two distances (A and B) were measured and the mean
                                                                          Observer® program. Blood and salivary samples were collected at
     and the SEM of the group of seven horses were calculated.
                                                                          8.00 am, prior to and directly at the end of the exercise test, 30 and
   For every HNP digital L/M radiographs were made of the cervical        60 min after the exercise test and at 8.00 pm, in order to determine
vertebrae C2–C7 of one horse (horse no. 1), while it was standing         basal cortisol levels and the effect of exercise in the different HNPs.
square with the head and neck in the sagittal plane to determine          Several behavioral expressions were recorded such as:
the in vivo longitudinal angles between the cervical vertebrae (C2–
C7). Cervical angles were given a negative value when the body of         •	   Head toss: The horse attempts to move or moves the head in
                                                                               a quick forward-upward motion.
the cranial vertebra sloped in regards to the body of its successive
caudal vertebra.                                                          •	   Head shake: The horse attempts to shake or shakes its head in
                                                                               a quick left to right motion.
   From an additional Warmblood horse (horse no. 8), which
was euthanized for other reasons than musculoskeletal or neuro-           •	   Head pull: The horse lets its head hang in the reins and pulls
                                                                               the reins forward.
muscular disorders, the ex vivo longitudinal angles between the
cervical vertebrae (C2–C7) were measured in five different positions      •	   Shying: The horse shies away from an object or side of the arena.
(neutral, extension 20° and 40°, flexion 20° and 40°), which              •	   Blowing: Non-pulsated sound produced by forceful expulsion
                                                                               of air through the nostrils.
according to Sleutjens et al. (2009) represents respectively the in
vivo HNP angles: HNP 1, HNP 2 and 5, and HNP 4 and 7.                     •	   Snorting: Sound of forceful exhalation through the nostrils
                                                                               with an audible flutter pulsation, while the horse attempts to
   The (ex vivo) CT images (horse no. 8) were overlaid on the (in
                                                                               lower the head (Dierendonck et al., 2010).
vivo) digital radiographical images (horse no. 1) using imaging
processing software to facilitate accurate and representative cervical       Elgersma et al. (2010) showed that mean angles were significantly
intervertebral angle measurements to feed the model. All data were        different between the 5 HNPs for C1–T6 with the horizontal ((C1–
transferred into commercially available modeling software. The            Th6-Hor): angle no. 1) and for CF–C1 ((C1–CF-Vert): angle no. 3)
model was based on the inertial properties data of Buchner et al.         and bridge nose ((BN′–BN-Vert): angle 4) with the vertical (p <
(1997), Gelmann et al. (2002) and Gelmann and Bertram                     0.05). For angle 2 ((CF-C1–Th6)) all HNP, except for HNP2 and 4,
(2002a,b).                                                                were significantly different (p < 0.05). The horizontal distance from
   The first step in building the model was to measure the cervical       CF to TS (distance A) was different only between HNP1 and all
vertebral dimensions from the ex vivo specimen (horse no. 8). For         others, while the vertical distance from CF to PS (distance B) was
this, digital images were produced of the vertebrae C1–Th2 using          significantly different between all 5 HNPs (p < 0.05).
a CT scan (Sleutjens et al., 2009) and a rectangle was projected             Sleutjens et al. (2010) showed that an extension of 20° causes a
over the vertebral body with the cranial head and the caudal tail         decrease in intervertebral foramina dimensions at segment C5/
as longitudinal, sagittal reference length. Thus, using free available    C6–C7/T1. A decrease in intervertebral foramina dimensions is
software the dimensions of the vertebrae were determined. The fol-        caused by 40° extension at segment C4/C5–C7/T1. Flexion causes
lowing values were found: C1, 4.4 cm; C2, 13.4 cm; C3, 11.0 cm;           no significant change in foramina dimensions, except for the length
C4, 11.1 cm; C5, 10.6 cm; C6, 9.8 cm; C7, 8.3 cm; T1, 5.9 cm; T2,         at segment C6/C7 at 20° flexion.
5.9 cm; T3, 5.6 cm; T4, 5.3 cm; T5, 5.1 cm; T6, 5.1 cm. Cervical CT          Wijnberg et al (2010) showed that mean MCD in all HNPs were
images of six cadaver equine cervical spines were taken in the neutral    significantly higher than in HNP1 (p < 0.05) of which HNP4 was
position, extension (20° and 40°) and flexion (20° and 40°).              highest (p < 0.05) with 39 compared to 30 in HNP2. HNP5 and 7
Images were reconstructed in the oblique plane perpendicular to           with 25 MCD were lower than the MCD in HNP 2 and 4 (p < 0.05).
the long axis of each intervertebral foramen from the C2/C3 to C7/        Odds ratio for potential pathological MCD and conduction block
T1 level. Foramina height and length were measured in each posi-          was 13 : 6 in HNP4 compared to HNP1 (p < 0.05), but there are no
tion and compared to the neutral position (Sleutjens et al., 2010).       reference values for horse patients yet. Number of turns and
                                                                                                                                                    215
       10      The neck and back
      duration followed the same pattern as MCD indicating temporal             MUP variables indicated that head positions affect neuromuscular
      dispersion of the MUP and a non-synchroneous arrival of the indi-         functionality. The meaning of this elevation of MCD, in a range that
      vidual muscle fiber action potentials that contribute to the MUP.         in humans is considered to be pathological, remains unclear as long
      Only LDH activity increased at all time points in HNP4 at time            as there is no information from patients with known nerve damage.
      points 4 (p < 0.05), 6 (p < 0.05) and 24 (p < 0.05) and in HNP5           Therefore, it would be interesting to measure patients with cervical
      and HNP7 at 4 (p < 0.05) (Wijnberg et al., 2010).                         vertebral pathology (Wijnberg et al., 2010). Especially HNP4 leads
         Sleutjens et al. (2009, 2012) proved that using HNP1 as reference,     to a higher elevation in muscle enzyme activity that caused the
      inspiratory intrathoraric pressure (IP) became more negative during       horses to develop a dynamic obstruction of the respiratory tract,
      trot1 (each HNP) (p < 0.05), canter and trot2 (HNP4) (p < 0.05) and       evidenced by an increase in intrathoracic pressure difference and a
      walk (HNP4, HNP5) (p < 0.05). Intrathoracic pressure difference           more negative pressure during inspiration. However, the authors did
      (IPΔ) increased during trot1 and walk (each HNP) (p < 0.05) and           not find a change in arterial oxygen or carbon dioxide pressure,
      canter and trot2 (HNP4) (p < 0.05). PartO2 increased during canter        respectively. In contrast, they found a significant increase in arterial
      (HNP4) (p < 0.05). PartCO2 (mmHg) and SartO2 (%) did not                  oxygen pressure in HNP4 during canter. This may be explained by
      change significantly.                                                     the fact that the horses were by no means working at maximal
         Van Dierendonck et al. (2010) demonstrated that head tossing           capacity, leading to a lot of reserve capacity that prohibits a measur-
      and head shaking were increased during exercise in HNP2 (p < 0.05)        able decline or increase in arterial oxygen or carbon dioxide pressure,
      and head pulling in HNP2 (p < 0.05). During detaching of the side         respectively. Further research is needed to elucidate the origin of
      rains, head shaking was increased in all HNPs (p < 0.05), but most        this effect on arterial blood gases and to evaluate the effect of an
      in HNP2, holding the head low was increased in HNP5 (p < 0.05).           extremely flexed head and neck position (HNP4) in patients with
      During cooling down, holding the head low was increased in HNP5           upper/lower airway disease (Sleutjens et al., 2009, 2012). HNP2 and
      (p < 0.05), HNP2 (p < 0.05) and HNP4 (p < 0.05). During exercise,         HNP5 cause more resistance behaviors during exercise and attach-
      helper encouragement was increased in HNP2, HNP4 and HNP7                 ment of the side rains. After detaching the side reins (HNP5) and
      (p < 0.05), helper slow down was increased in HNP2 and HNP5               during cooling down after HNP5, 2 and 4, the horses displayed a
      (p < 0.05), shying was decreased in HNP7 (p < 0.05), blowing was          lower head and neck position, possibly to compensate pain in the
      increased in HNP2 and HNP4 (p < 0.05), snorting was increased in          exhausted neck muscles. Cortisol levels are needed to further com-
      HNP7 (p < 0.05) and swishing of the tail was increased in HNP2            plete the knowledge of the effect of HNP on the mental state of the
      (p < 0.05). During attaching and detaching of the side rains, tail        equine athlete (Van Dierendonck et al., 2010).
      swishing was increased in respectively HNP2 (p < 0.05) and HNP2,
      7 (p < 0.05, p < 0.05).
                                                                                Back dysfunction
216
                                                                                                                                                                         Back dysfunction
visual inspection, palpation and observation of movement when in                                   markers, a camera system consisting of six cameras was used. The
hand, on a lunge, and ridden. Individual limbs were flexed to reg-                                 system is based on passive markers and infrared cameras. Data were
ister reaction and lameness. Only horses that were clinically sound                                captured during steady state locomotion during walking and
and did not demonstrate abnormal reaction to palpation, flexion                                    trotting. Movement of the back was described in terms of
tests nor abnormal movement (behavior) during the riding or                                        extension–flexion, lateral bending, lateral excursion and axial rota-
lunging tests, were used. The clinical examination in the asymptom-                                tion. The range and symmetry of movement were calculated. Addi-
atic, normal horse illustrated the importance of the normal appear-                                tionally, characteristics of the horses’ back, height at withers, and
ance of well functioning horses. Still, in the majority of the horses                              weight were determined. The characteristics that were derived from
some reaction to palpation was apparent. Furthermore, the location                                 marker data were length of the thoracic back (horizontal distance
of reaction to palpation seemed to be dependent on the main use                                    T6–T17), length of the lumbar back (horizontal distance L1–L5),
of the horses. This could be explained by the differences in training                              length of whole back (horizontal distance T6–S3), width (i.e. the
these horses were subjected to, in their respective discipline. Dres-                              distance between the tubera coxae), and curvature of the mid-
sage horses and show jumpers in this study were also ridden with                                   thoracic back.
different types of saddles, which might influence how the back is                                     Walk and trot are symmetric gaits and the movements of the back
loaded. The dressage rider normally sits ‘deeper’ on the horse, while                              in these trained animals were also highly symmetric. Normal func-
the rider of a show jumper will sit more in a forward seat. However,                               tion and symmetry are apparently highly related both in gait and
this should not lead to a pathological reaction upon palpation, as                                 movement in the back. The only difference in conformation that
then there might be something wrong. Horses that were reactive to                                  dressage horses had longer lumbar backs than jumpers. Dressage
palpation of the back, did not always show impaired function,                                      horses demonstrated more lateral movement than jumpers. Further-
dysfunction or lack of performance.                                                                more, dressage horses demonstrated less symmetry in the mid-
   The horses were trained four times on a treadmill (Johnston                                     thoracic region than did the jumpers at the walk. Suppleness is
et al., 2004). The dorsal spinous processes were identified by palpa-                              thought to be associated with increased back length and may there-
tion and spherical, reflective markers were placed over the identified                             fore explain a conformational preference toward the dressage horse.
landmarks (Fig. 10.21). For collecting the position data of the                                    Because the musculature of the back is passive during the walk,
                                                                                      T6
                                                                                                                                 L5                 S3
                                                                                               T10 T13       T17 L1       L3
                                                                               1
2 4
Fig 10.21  Marker placement on back and limbs. Lumbar vertebrae 1, 3 and 5 (L1, L3, L5); sacral vertebra 3 (S3). 1, Proximal spina scapula; 2, lateral collateral
ligament of the metacarpophalangeal joint; 3, cranial part of the trochanter major of the femur; 4, lateral collateral ligament of the metatarsophalangeal joint.
Reprinted from De Cocq, P., van Weeren, P.R., Back, W., 2004. Effects of girth, saddle and weight on movements of the horse. Equine Vet. J. 36, 758–763, with permission of the Equine Veterinary
Journal.
                                                                                                                                                                                                    217
       10      The neck and back
      lateral movement may be greater and less symmetric in the dressage           reactions like bolting or rearing, tail swishing, unruliness, rapid
      horse. Gender was found to be an important factor in the lateral             caudal movement of the ears or stiff, jerky movements.
      movement of some of the segments of the back while working at                   Horses with back pain show an aberrant pattern of the movement
      the trot. Mares demonstrated greater lateral excursion (displace-            of the back, which, with the aid of objective measurement tech-
      ment of the back to each side) in the cranial back than did geldings,        niques, makes it possible to classify a horse with back dysfunction.
      and greater movement symmetry. The functional significance is not            It is reasonable to believe that a horse with a sore back will try to
      known, however mares show increased occurrence of bony changes               move in a way that, if possible, may alleviate the pain. Apparently,
      on the underside of the vertebrae (spondylosis) when compared to             this will best be accomplished by a stiffer dorsoventral (flexion-
      geldings and stallions. Perhaps excessive lateral movement is a con-         extension) movement in the caudal thoracic back and at the thora-
      tributing factor in the degenerative processes between the vertebral         columbar junction, at both the walk and trot. The abnormal lateral
      structures of this part of the mid-thoracic back that is most suscep-        movement seen at the withers and decreased rotation (AR) of the
      tible to spondylosis. Age was also a determinant in the movement             pelvis, results in a side-to-side swaying walk as seen from behind.
      of the back. Older horses had decreased flexion–extension at the             Presumably, the symptomatic horse has altered the neuromuscular
      transition between thoracic and lumbar back at the trot. Perhaps             control of the walk and trot to cope with back pain. Acquired
      wear and tear due to age in this area of high shearing is an important       pathological limitations could also be an initial source of the
      factor in the pathogenesis of certain disorders. These trained riding        problem and therefore crucial factors to the decreased range of
      horses demonstrated highly symmetrical movement of the back,                 movement (ROM) of the back.
      which is in contrast to research horses used in an earlier study                Apparently, flexion of the back is reduced to limit the relative
      (Faber et al., 2000, 2001a,b,c, 2002). Training and perhaps quality          displacement of the individual segments of the thoracolumbar
      of horse may influence movement symmetry and function of the                 back, perhaps due to excessive muscular activity as aggravated by
      back. Factors such as gender and age, thus are important in the              nociception. The normal movement of the back is more controlled
      function of the back. The effect of gender is intriguing and requires        by muscle activity at the trot than at the walk, where the movement
      further investigation, while age is more intuitive as it is likely related   is more passive with greater amplitude for the lateral and twisting
      to the wear and tear of use. Perhaps the most influential factor (not        movements. This may be the reason why the ROM for the AR of the
      related to use) for the function of the back is the perceived confor-        pelvis is decreased in a horse with back pain at the walk, but not at
      mation for the respective disciplines (Johnston et al., 2002). Further       the trot.
      investigation on the relationship of back conformation and func-                The reduction in the ROM for the flexion and extension (FE) and
      tion to orthopedic health is warranted as to determine the most              AR movements has earlier been observed in another study – a case
      appropriate conformation and function for the different sporting             study of one horse with increased responsiveness to palpation of
      disciplines.                                                                 the lumbar and sacral back (Faber et al., 2003). The shorter stride
         There were no statistically significant associations between the          length observed in the horses with back pain at the walk, coinciding
      clinical, kinematic, radiographic and scintigraphic results (Erichsen        with the decreased FE movement of the back, is well in accordance
      et al., 2003a,b, 2004). The age, gender, use, weight and height of           with the findings of Jeffcott (1980) and Faber et al. (2003). It is also
      the horses did not influence, the presence or absence of clinical or         in agreement with the positive relationship between the pro- and
      radiographic and scintigraphic changes nor the classification of pos-        retraction of the hind limbs and the FE movement of the back that
      sible outliers in the range of movement and the symmetry of move-            has been established in clinically sound horses at the walk (Faber
      ment. However, there was a statistically significant positive                et al., 2000) and trot (Faber et al., 2001). In the present study, the
      association between the total number of times a horse was graded             expected reduction in stride length in the patients was not seen at
      as a possible outlier in the range of movement and the symmetry              the trot though. The explanation for this is not obvious, but it is
      of movement and increased isotope uptake (IRU) during a scinti-              possible that the muscle activity in the hind limbs was altered and
      graphic examination (Erichsen et al., 2003a,b, 2004). The number             may have influenced the stride length. The slight difference in stride
      of times a horse was graded as a possible outlier in the range of            velocity at the trot is not likely to have caused the decrease in the
      movement was significantly associated with the presence of coincid-          ROM (Robert et al., 2001).
      ing radiographic changes, IRU and lunging abnormalities respec-                 Since all horses showed muscle soreness on palpation of the back,
      tively. Deviation from the normal function of the back is related to         and more than half of them had pathological skeletal reactions, it
      clinical, radiological and scintigraphic abnormalities. Consequently,        is reasonable to believe that this was the main reason for the
      the objective determination of function may indeed suggest sub-              decreased dorsoventral FE movement at both gaits and the changed
      clinical structural and functional abnormalities. Kinematic studies          lateral movement at the walk.
      on the treadmill (Licka et al., 2001a,b; Johnston et al., 2004;                 This study supports the use of objective measurements of the
      Johnson & Moore-Colyer, 2009) and overground (Audigie et al.,                back kinematics as a valuable tool to help identify horses with back
      1999; Gomez Alvarez et al., 2007, 2009) provide a viable means of            dysfunction. Before using it more extensively it is necessary to
      determining difficult performance problems that are related to the           further evaluate the method, including measurements on patients
      back.                                                                        whose diagnoses can be confirmed, and long-term follow-up of
                                                                                   back patients after treatment.
218
                                                                                                                              Back dysfunction
criterion between horses with back pain and horses without prob-          diagnosed back problem was much higher than in horses without
lems is their function. Despite many changes in the radiographs and       such a problem (Landman et al., 2004).
scintigraphy, the horses in the healthy group managed to maintain            The diagnosis of back pain is elusive and complex. Single factors
their normal work. Imaging techniques are important in the isola-         such as conformation, lameness, equipment, and way of riding are
tion of horses with back problems, but do not seem to be predictive,      likely to contribute to the clinical manifestation. Consequently,
at least at this point in time, in determining if horses will become      function or dysfunction is ultimately the determining factor in the
dysfunctional. Encouraging, however, is a clear separation of             diagnosis. Indiscriminate uses of imaging or palpation do not seem
patients from normal, as horses with back pain have more outliers         to be accurate determinants of back pain. A complete clinical evalu-
than the fully functional horses. In other words, horses with back        ation is paramount and in this study an objective measure of func-
pain move significantly differently from the fully functional horse       tion may certainly contribute to an accurate diagnosis. Techniques
as determined from kinematic data. Thus, kinematic studies are            in the diagnosis of back pain, such as local anesthesia, need to be
valuable in the definition of clinical and perhaps subclinical clas-      evaluated to appreciate their correct usage and interpretation. It can
sification of horses with dysfunction of the back.                        be anticipated that, notwithstanding the limitations all kinematic
   The results from the clinical, kinematic, radiographic and scinti-     gait analysis systems suffer (Van Weeren, 2002), computerized anal-
graphic examinations are likely to overlap between horses with and        ysis of spinal kinematics will become more popular as an aid in
those without back pain or back dysfunction. The sensitivity and          diagnosis and to monitor recovery and/or the success of chosen
specificity of these, as well as other tests or examinations, depend      therapies. Understanding back pain requires a fundamental under-
on the cut-off points set in order to determine the presence or           standing of the normal function of the back and how normal
absence of a change. Cut-off levels of changes set so low, that           intervention can affect its function. The biomechanical concept of
changes would be present in a majority of asymptomatic horses,            the action of the back is crucial too for a good understanding of
would not be helpful in the evaluation of symptomatic horses.             various riding techniques in dressage horses and how certain train-
Since mild changes were common in these studies (Erichsen et al.,         ing methods could affect the musculoskeletal system (Van Weeren,
2003a,b, 2004), they are not likely to be good indicators of clini-       2005). It should be emphasized, however, that this matter is
cally significant pathology in symptomatic horses. Therefore, mild        extremely complex, as there are many factors that may influence
changes were grouped together with no changes to allow some               performance. Of these, use of the horse, the quality of the rider and
variation in the lower range of the classification system and to make     the tack are among the most important.
the criteria less sensitive. The level from which the changes should
be considered significant, is also important if changes are early signs
of later clinical problems. This can only be determined by perform-       The effect of head and neck position on the
ing a longitudinal study.                                                 movement of the back
   It may be that the examinations used in this study are not the
optimal or final combination for the detection or description of          Head and neck positions have been standardized by the use of side
symptomatic or asymptomatic horses in terms of back pain or               reins (Fig. 10.22). Flexion–extension movement of the back at walk
dysfunction. Data on the ultrasonographic and thermographic or            with the head and neck in the high position was significantly lower
quantitative electromyographic appearance of the back of the              as compared to the movement with the head and neck in a free or
asymptomatic horse have not been published extensively and, few,          in a low position at the caudal part of the back (Biau et al., 2002;
if any, other practically useful tests would contribute significantly     Weishaupt et al., 2006; Gómez-Alvarez et al., 2006; Rhodin et al.,
in a general evaluation of the equine back.                               2009; Waldern et al., 2009). The same tendency was seen with the
   A major advantage of the protocol used in these studies is the         head and neck in the low position as compared to the free position
broad and complementary approach of the examinations. The                 but probably because of the low number of observations, no sig-
detailed clinical examination is quintessential to identify and clas-     nificant differences were found. At trot only flexion–extension
sify the signs of reduced or impaired performance. The kinematic          movement of segment T17 was lower at the high position.
examination is functional, objective, and relatively easy to perform.        At walk the stride length was shortest with the head in the high
The radiographic and scintigraphic examinations are indicative of         position but this was not seen at trot where the stride length was
specific anatomic lesions within the relative context. In the study of    constant. It is, however, known that the movement of the back is
asymptomatic horses, none of the examinations by themselves is            related to stride length. Horses with longer strides extend and flex
sufficiently specific to describe these horses as asymptomatic. Kine-     their backs in the caudal saddle region to a greater extent at walk
matics and radiographic and scintigraphic results support the clini-      (Johnston et al., 2002). Faber et al. (2000, 2001) found that an
cal examination suggesting that these horses are asymptomatic.            increasing stride length of the hind limb was correlated with an
   The examination of the equine back remains a complicated and           increasing flexion–extension range of movement for most of the
interesting challenge but with information gained in this study used      vertebrae both in the walk and in the trot. This is in accordance
for comparison, the combined results from clinical, kinematic and         with our findings but the stride length was also associated with the
radiographic and scintigraphic examinations of the back in symp-          head and neck position.
tomatic horses can be used to decrease the risk of excessive false           The different results at walk and trot may be due to the different
positive results. In addition, muscle pathology of the back is not        characteristics of the gaits (Roepstorff et al., 2002; Bystrom et al.,
reflected by an increase in muscle enzyme activity and therefore          2006). At walk the horse moves the head and neck to a greater
needle EMG can often be helpful in detecting underlying muscle            extent as compared to trot, where the head and neck position is
fiber loss.                                                               more constant. When the head and neck are fixed, as with side reins,
   It can be concluded that the equine back is a very complex struc-      this impedes the natural movement at walk more than at trot. At
ture that takes a central position in the entire equine musculoskel-      trot, speed influences movement of the back (Robert et al., 2001),
etal system and hence can be decisive for performance. A good             but in this study the speed at trot was constant.
knowledge of how the back works is therefore essential. The close            It seems probable that the decreased flexion–extension move-
interrelationship between the limbs and the back (and neck) is            ment of the back in the high head position is directly caused by the
often underestimated. In a recent survey a group of orthopedic            shorter stride length, which in turn is caused by the head and neck
patients and a control group of animals presented for a prepurchase       position. The lateral bending movement of the lumbar back with
exam were subjected to a full lameness examination as well as a full      the head and neck in the high position was at walk significantly
back examination, irrespective of their eventual complaints. In that      lower as compared to the movement with the head and neck in a
study it appeared that the prevalence of lameness in horses with a        free position, which was similar for flexion–extension. On the other
                                                                                                                                                   219
       10       The neck and back
                                                                                        General conclusions
      Fig 10.22  The six different head positions measured in the study. From
      right to left and top to bottom, the positions are designated free, FEI like      Research on the function and dysfunction of the neck and back has
      position, FEI like position but head slightly behind the vertical, deep           been of great academic and public interest. The popularity of the
      overrolled or ‘Rollkur’ position, the extremely high and stressed position, the   research is due to the fundamental understanding of the central roll
      relaxed low position.                                                             of the neck and back in the riding horse, but as well as the lack of
                                                                                        in-depth insight into the function of the neck and back. Restricting
                                                                                        and restraining the position and movement of the head and neck
      hand the thoracic region of the back had a significantly larger lateral           alter the movement of the back. The flexion–extension movement
      bending movement. The lower movement in the lumbar back may                       of the caudal back, with the head and neck in the high position
      have been due to the shorter stride length and the larger movement                at the walk, has the most pronounced reduction; most likely
      in the thoracic region of the back can be compensation or the direct              depending on the significantly shorter stride length. There are only
      cause of the head and neck position.                                              small difference between long reins and side reins with regard to
        The axial rotation was significantly lower with the head in a high              the movement of the back at the walk and trot. Consequently, long
      position as compared to the free and low position at walk. For axial              reining and free movement (with or without side reins) on a tread-
      rotation at the walk, there is a high degree of synchronization                   mill are similar. Considering the intention and normal use of long
      between the vertebrae T13 through the pelvis; only T10 moved                      reining, proper technique is thus essential as the positioning of the
      independently and there is no significant correlation with the stride             head (use of hand) is central in the movement of the horse.
      length. For pro- and retraction of the hind limb there is a positive                 Movement and forces are not necessarily similar in all cases as
      correlation with the stride length. In this experimental set-up we                demonstrated by the use of draw reins. Similarly, more extreme
      did not have the possibility to encourage the horses forward and                  movement does not induce similar and more extreme differences
      thereby affect the hind limbs. If a constant stride length could be               in forces. To induce a shift in weight (though only slight) from the
      achieved, for example by long reining, together with variable head                forelimb to the hind limb draw reins with normal reins are required.
      and neck positions the causal relationship between the head                       Extreme bending of the head and neck by use of the draw rein did
      and neck position and the movement of the back could be proven                    not lead to the same result. As in long reining proper equipment
      (Fig. 10.22).                                                                     and technique when using for example draw reins is required to
                                                                                        achieve the intended result.
                                                                                           The head and neck positions (HNP) in sport horses, however, are
      The effect of local analgesia in the movement                                     under debate in the equine community, as they would interfere
                                                                                        with equine welfare (Jeffcott et al., 2006). These HNPs have, until
      of the back                                                                       recently, never been objectively quantified and no information used
      Diagnostic infiltration of local aesthetic solution is commonly used              to be available on their head and neck loading.
      in cases of equine back pain. The evaluation is subjective and it is                 To quantify in vivo HNPs in horses and develop a model to esti-
      not known how local analgesia affects an asymptomatic back. Holm                  mate loading on the cervical vertebrae in these positions, videos
      et al. (2006) evaluated the effect of infiltration of local anesthetics           were taken of seven Warmbloods at walk on a straight line in five
220
                                                                                                                                General conclusions
 Table 10.1  Mean ± SEM in vivo measured angles and distances defining different head and neck positions (HNP) commonly used in
 training and competition evaluated in a group of horses (n = 7)
positions, representing all HNPs during Warmblood training and                 neck position. The results on the cortisol test are needed to define
competition. Markers were glued at five anatomical landmarks.                  whether the horse does indeed feel more relaxed in these positions,
Two-dimensional angles and distances were determined from video                or just does not have the ability to behave in an adverse manner.
frames for the five HNPs (p < 0.05).                                           This is probably also influenced by the character of the indi-
   Thus, Elgersma et al. (2010) was able to objectively quantify the           vidual and its tendency to submissive behavior. A temporary
different head and neck positions by angles and distances, which               decreased conduction velocity indicating a decreased neuromuscu-
were significantly different from each other (Table 10.1). Therefore,          lar transmission is an unwanted, negative effect, although not
it was possible to induce repeatable and reproducible the desired              per se a pathological effect, but the question remains how these
head and neck position in different experimental circumstances by              values will be when some degree of facet joint arthrosis is present,
using side rains. Sleutjens et al. (2010) found from ex vivo data that         thereby pressing to some extent on peripheral nerve roots, like
extension of the cervical spine could have an adverse effect on                is experienced in humans (Yoo et al., 1992; Farmer & Wisneski,
neuromuscular functionality with the most profound effect on the               1994; Humphreys et al., 1998; Lu et al., 2000; Muhre et al., 2001;
segment C6–C7. The concommittant in vivo study of Wijnberg et al.              Nuckley et al., 2002; Kitagawa et al., 2004; Ebraheim et al., 2006;
(2010) on neuromuscular transmission showed that compared to                   Morishita et al., 2006; Tanaka et al., 2006; Abbed & Coumans,
HNP1, each head and neck position had a potentially adverse effect             2007; Hubbard et al., 2008; Down et al., 2009). Nevertheless,
on neuromuscular functionality. The greatest adverse affect was seen           trainers/riders insisting on using HNP4 in the base-level trained
in HNP4, though based upon reference values for humans. This                   horse for a longer period of time should at least realize the possible
effect could be even more profound in patients with cervical pathol-           consequences. There are still several remaining questions, which
ogy. HNP 7, another interpretation of a flexed HNP from the                    need to be answered in order to complete our understanding of the
induced neck positions, had the least affect on neuromuscular func-            effect of head and neck position on the well-being of the equine
tionality. This effect might be caused by another factor than a                athlete. It would for example be interesting to repeat the study in
decrease in intervertebral foramina dimensions. Furthermore, espe-             elite dressage horses, to see if there is a difference between horses
cially HNP4 leads to an increased intrathoraric pressure difference            trained at different levels. Additionally, the training circumstances
and a more negative inspiratory pressure. These effects may be                 could be expanded. Although it could possibly pose a greater chal-
caused by a dynamic upper airway obstruction and are possibly                  lenge on standardization and safety, it would be interesting to
even more profound in patients with upper airway disease. Last but             measure in the ridden horse or the horse working on a treadmill.
not least, HNP4 caused a shift to sympathetic dominance during                 Furthermore, besides the healthy horse, there are many patients
walk, based on heart rate variability, possibly indicating (exercise)          with some sort of upper/lower airway disease or a more or less
stress. HNP2 and HNP5 caused more active resistance behavior                   advanced stadium of cervical arthrosis, which are still used in
during exercise and applying of the side rains. Cortisol levels are            training/competition on various levels.
under examination to further complete the knowledge of the effect                 The following logical question is which head and neck position
of HNP on the mental state of the equine athlete, and the type of              would be advisable. HNP1 is the natural position of the horse
stress detected using heart rate variability.                                  during exercise. However, it is unreasonable to believe that in the
   These results justify to conclude that training with an extreme             opinion of trainers/riders this position would be sufficient to
flexed head and neck position (HNP4) has an effect on the healthy,             prepare the horses for competition at any level. As stated above
base-level trained Warmblood riding horse during moderate exer-                HNP4 is questionable as is HNP5 because of its effect on the back,
cise for a longer period (± 30 min) of time and during lunging                 locomotor apparatus and behavior (Gómez-Alvarez et al., 2006;
exercise. However, it remains a challenge to judge for another                 Rhodin et al., 2009; Weishaupt et al., 2006; Waldern et al., 2009).
subject than yourself to which extent this effect is necessarily nega-         HNP2 is still the position desired during competition by the
tive. For example, we could argue that an organism needs to have               national (KNHS) and international (FEI) organizations and pre-
some degree of stress in order to perform. However, the resistance             ferred above HNP 4 for gymnastic training of a horse on the lunge
behavior we observed in HNP2 and HNP5 is not desirable during                  and for shorter times, although we demonstrated that it affected
training/competition. This behavior was not seen in HNP4 and                   neuromuscular transmission and increased resistance behavior
HNP7, our impression is that the horses showed more submissive                 during exercise. After all, HNP7 looks at a position which could be
behavior during these positions which is in agreement with the                 used during training, since round and deep posture is trained with
argument that riders feel that their horse is more under control and           less effect measured so far. In the end, variation is probably the key
more sensitive to the riders input while trained in a flexed head and          word while adapting the training strategy to the level of the
                                                                                                                                                        221
       10      The neck and back
      individual horse, rider and training goal while being cautious with        appreciate these pathological changes thus limits our ability to
      extreme flexed head and neck positions in the base-level trained           identify them as factors in the orthopedic function of the horse. The
      Warmblood riding horse. All this information will be of potential          back offers thus a considerable challenge for the clinician. Presently,
      help in better understanding the occurrence, and eventually in             the diagnosis of back pain is often through exclusion of sources of
      improving treatment and prevention of locomotor disturbances in            reduced performance. Back pain is thus a functional diagnosis and
      sport horses, induced by suboptimal head and neck positions                requires considerable experience to understand and properly
      during training and competition. In this way, this approach may            manage. The interaction between lameness and back dysfunction is
      contribute to equine welfare and indirectly to promotion of the            apparent in the clinics, though the interrelationship to the success-
      equine industry (McGreevy et al., 2010).                                   ful treatment of lameness and back dysfunction is not as apparent.
         The back is a complex entity that provides stability and flexibility.   In many cases horses need only to be treated for the lameness and
      Normal movement is highly symmetrical and specific. The thoracic           any symptom from the back is resolved. Not uncommon are lame-
      back is an extension of the flexible neck to allow for rotation and        nesses that are readily isolated but do not respond to therapy until
      lateral bending (Stubbs et al., 2006). As the forelimb is loaded, the      combined therapies for the lameness and back pain are initiated.
      back will need to accommodate for the strut like system. The scapula       Finally, some clinical cases are overtly lame and the lameness is first
      will assumedly impose bending of the forward segments of the               resolved (isolated) to the back. Subsequently, back pain is likely a
      thoracic back. On the other hand, the stable lumbar back-pelvis            symptom and a source of other injuries and performance problems,
      complex transfers the propulsive energy of the hind limb to lift and       as well as being a primary cause of locomotor disturbance. The
      propel the rest of the body. Intersegmental movement of the lumbar         information gained to date reveals that clinical and potentially
      back is slight to provide the needed stability. Consequently,              kinematic examinations are fundamental to the diagnosis of back
      the lumbar back, with the exception of the joint between the last          dysfunction. Aids such as radiology, scintigraphy, and diagnostic
      lumbar vertebra and sacrum, acts as a functional unit transferring         anesthesia are only helpful when the functional (clinical) diagnosis
      the movement through the joints of the back and supported by               is established. Knowing the characteristic way of walking can
      the muscles and ligaments that surround these bony structures. The         provide a strong indication for back dysfunction as indicated from
      muscles of the lumbar back (longissimus dorsi) limit flexion while         the kinematic studies. A protocol might become a basis for a clinical
      the muscles of the abdomen limit extension of the lumbar and later         examination of horses with performance problems that may be
      thoracic back. A more complex system of muscles function about             related to the back, and thus documentation for further studies. The
      the thoracic back to aid in lateral movement and limit extension,          correct evaluation of therapies and rehabilitation programs can also
      while the large ligament of the neck causes extension or limits            be established through this protocol. Potentially, a preferably lon-
      flexion of the part of the back. In equine sports, engagement of the       gitudinal study using a protocol can offer a golden standard of
      hind limbs and manipulation of the head and neck are thus impor-           diagnosis determination. However, many details on interrelation-
      tant features in training and competition. Our use of the horse has        ship of lameness and back pain, involvement of difficult areas of
      a central role on the function of the back. Perception of conforma-        clinical evaluation such as the lumbar back, and interaction of
      tion, riding technique, equipment, and training will impinge on the        riding/training/equipment/tradition affect the orthopedic health of
      normal function of the back and consequently function of the horse         the back are needed to successfully apply the information gained
      as a whole. The manipulation of the head and neck alters the move-         in this study. Because of their limited mobility and heavy muscles,
      ment specific regions of the back. The use of reins is frequently used     the axial regions of the horse are probably the most difficult to
      to aid in this manipulation and thus education of the horse. Raising       investigate with biomechanical techniques and diagnostic proce-
      the head and neck extends and limits the amount of movement of             dures. Nevertheless, in the recent years a lot of information has been
      the back, while lowering the head and neck tends to flex the back.         gained on the biomechanics of the neck and back, especially with
      In the ridden condition, the back becomes extended due to the              kinematic analysis and quantitative (needle) electromyographic
      weight of the rider (De Cocq et al., 2004, 2006) and stride length         studies (Wijnberg et al., 2004, 2008, 2010). However, detailed
      decreases. Consequently, raising or lowering of the head and neck          knowledge of the functional behavior of the different structures of
      would exacerbate or mitigate this condition. Training with weights         the axial regions is still incomplete. Further research is required to
      may help to mobilize and strengthen the muscles of the back and            understand the pathogenesis of the different pathological condi-
      limbs to help prepare the horse for loading as engendered by riding.       tions of the back as well as to identify the sources of pain in back
      Intriguingly interesting and important to recognize is that move-          problems. These data are essential for application of the different
      ment of the limbs (as induced by increased weight) has also a sig-         methods of physical therapy on equine athletes. Further investiga-
      nificant effect on the back. The innate movement pattern, lameness,        tions are needed to establish a rational basis for the training of sport
      and shoeing practices can potentially induce changes that may affect       and racehorses in order to develop their neck and back athletic
      the normal function of the back. A direct relationship between             capabilities as well as to identify physical exercises helpful for the
      shoeing and movement of the back is difficult to appreciate. We            management of back problems.
      know that horses respond to similar farrier techniques similarly in           Studies on the effect of lameness from limbs on the movement
      the hoof capsule and bony segments of the distal limb (under the           of the back found a changed posture and a reduced mobility of the
      carpus and tarsus), but quite differently when taking into consider-       caudal back (Gomez Alvarez et al., 2007, 2008). Perhaps the most
      ation of the movement of the whole body.                                   difficult anatomical region of the horse to understand, from a vet-
         Draw reins used with normal reins resulted in lowering the neck         erinary perspective, is indeed the caudal back. The caudal back is
      and placing the head more vertical or behind the vertical and              the lumbar back and the connection between the back and the
      increased propulsion from the hind limbs. Interestingly, exaggera-         pelvis. The caudal back is constructed to support and transmit the
      tion of this condition with draw reins only did not exaggerate             hind limb’s energy to the forelimb (Van den Bogert et al., 1994;
      engagement of the hind limb; on the contrary the hind limbs                Spadavecchia et al., 2002, 2004). Indeed, considerable pathological
      reduced their driving function. Function of the horse (and back)           changes are found in this part of the back at pathological examina-
      is thus the complex interaction of rider-horse that is influenced          tion (Jeffcott, 1980; Haussler et al., 1999) that would assumingly
      by training, equipment, and tradition; this interaction having             affect the function of the horse as a whole. We therefore need to
      the most potential influence on the orthopedic health of the horse         address this area of the horse in a methodical manner to better
      (and back). The close proximity of these bony structures as well           understand the changes to these structures that may be important
      as other structures of the back is subsequently site for many              to the normal function of the athletic horse.
      pathological changes that may or may not limit performance                    Perhaps the single most important factor to the orthopedic health
      through dysfunction/pain. The bulky muscles limit our ability to           of the riding horse is the interaction with the rider. The weight of
222
                                                                                                                                                                     General conclusions
the rider is known to induce extension of the lumbar back and alter                                confused and indeed in some cases horses are being treated with
the way of moving. While we do not exactly know what these altera-                                 methods that are not efficacious and perhaps injurious. A systematic
tions may result in the health of the horse, it is plausible to suggest                            approach in the evaluation of therapies and rehabilitations pro-
that if the horse is not properly prepared for this task than injury                               grams is required to assure the proper care of horses with back-
will assuredly ensue. In the studies with high level dressage horses                               related problems.
walking and trotting on a force measuring treadmill with and
without their normal rider we could measure the three-dimensional
movement of the rider and horse as well as the pressure from
the rider and saddle on the back of the horse, and the forces at all
four hooves simultaneously (Fig. 10.23). Follow-up studies in this
area would be aimed at the effect of rider position and education
on the movement and forces in the high-level dressage horse. The
effect of the saddle on the movement of the horse is very poorly
understood and is subject to considerable speculation. Recent
studies using modeling (Schlacher et al., 2004; Peham & Shobes-
berger, 2004, 2006) have also contributed considerably to our
present understanding, Considering the relationship of the rider
and horse, the saddle is supposed to be important in the orthopedic
health of the horse (De Cocq et al., 2004, 2006; Back, 2013)
(Fig. 10.24).
   Having these measurements techniques available there is a
great need on the objective evaluation of different therapies
and rehabilitation programs on horse with dysfunction and/or
pain of the back. Currently, most of our therapies are based
on experience and conjecture (Marks et al., 1999; Xie et al., 2005;
Haussler et al., 2007; Van de Weerd et al., 2007; Gomez
Alvarez et al., 2008; Sullivan et al., 2008). Animal owners are often                              Fig 10.23  Horse ridden on the force measuring treadmill.
A B
C D
Fig 10.24  Pictures of all four situations: (A) unloaded; (B) with lunging girth; (C) with saddle; (D) with saddle and 75 kg lead.
Reprinted from De Cocq, P., van Weeren, P.R., Back, W., 2004. Effects of girth, saddle and weight on movements of the horse. Equine Vet. J. 36, 758–763, with permission of the Equine Veterinary
Journal.
                                                                                                                                                                                                    223
       10      The neck and back
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         equine back. J. Biomech. 39, 2845–2849.           Sleutjens, J., Smiet, E., Van Weeren, P.R., Van        activity in horses during locomotion with
      Pourcelot, P., 1999. Développement d’un                  der Kolk, J.H., Back, W., Wijnberg, I.D.,          and without a rider. Equine Exerc. Physiol.
         système d’analyse cinématique 3-D.                    2012. Effect of head and neck position on          3, 146–150.
         Application à l’étude de la symétrie                  intrathoracic pressure and arterial blood       Tokuriki, M., Nakada, A., Aoki, O., 1991.
         locomotrice du cheval au trot. PhD thesis,            gas values in Dutch Warmblood riding               Electromyographic activity of trunk muscles
         Université Paris XII -Val de Marne.                   horses during moderate exercise. Am. J. Vet.       in the horse during locomotion and
                                                               Res. 73, 522–528.                                  synaptic connections of neurons of trunk
      Pourcelot, P., Audigié, F., Degueurce, C.,
         Denoix, J.M., Geiger, D., 1998. Kinematics        Sleutjens, J., Voorhout, G., Van der Kolk, J.H.,       muscles in the cat. Proceeding of the First
         of the equine back: a method to study the             Wijnberg, I.D., Back, W., 2010. The effect of      (ESB) Workshop on Animal Locomotion,
         thoracolumber flexion-extension                       ex vivo flexion and extension on                   Utrecht.
         movements at the trot. Vet. Res. 29,                  intervertebral foramina dimensions in the       Tokuriki, M., Ohtsuki, R., Kai, M., Hiraga, A.,
         519–525.                                              equine cervical spine. Equine Vet. J. 42           Oki, H., Miyahara, Y., et al., 1999. EMG
                                                               (Suppl. 38), 425–430.                              activity of the muscles of the neck and
      Rhodin, M., Gomez Alvarez, C.B., Bystrom, A.,
         Johnston, C., van Weeren, P.R., Roepstorff,       Slijper, E.J., 1946. Comparative biologic-             forelimbs during different forms of
         L., et al., 2009. The effect of different head        anatomical investigations on the vertebral         locomotion. Equine Vet. J. Suppl. 30,
         and neck positions on the caudal back and             column and spinal musculature of                   231–234.
         hind limb kinematics in the elite dressage            mammals. Proc. K. Ned. Acad. Wetensch.          Tokuriki, M., Ohtsuki, R., Kai, M., Hiraga, A.,
         horse at trot. Equine Vet. J. 41, 274–279.            42, 1–128.                                         Oki, H., Miyahara, Y., et al., 1999. EMG
      Rhodin, M., Johnston, C., Holm, K.R.,                Sloet van Oldruitenborgh-Oosterbaan, M.M.,             activity of the muscles of the neck and
         Wennerstrand, J., Drevemo, S., 2005. The              Blok, M.B., Begeman, L., Kamphuis,                 forelimbs during different forms of
         influence of head and neck position on                M.C.D., Lameris, M.C., Spierenburg, A.J.,          locomotion. Equine Vet. J. 30 (Suppl.),
         kinematics of the back in riding horses at            et al., 2006. Workload and stress in               231–234.
         the walk and trot. Equine Vet. J. 37, 7–11.           horses: comparison in horses ridden             Tokuriki, M., Otsuki, R., Kai, M., et al., 1997.
                                                               deep and round (‘Rolkür’) with a draw              Electromyographic activity of trunk muscles
      Ricardi, G., Dyson, S.J., 1993. Forelimb                 rein and horses ridden in a natural
         lameness associated with radiographic                                                                    during locomotion on a treadmill (5th
                                                               frame with only light rein contact.                WEVA Congr. Abstracts: Padova). J. Equine
         abnormalities of the cervical vertebrae.              Tijdschrift voor Diergeneeskunde 131,
         Equine Vet. J. 25, 422–426.                                                                              Vet. Sci. 17, 488.
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      Robert, C., Audigié, F., Valette, J.P., Pourcelot,                                                       Townsend, H.G., Leach, D., 1984. Relationship
                                                           Spadavecchia, C., Andersen, O.K., Arendt-
         P., Denoix, J.M., 2001. Effects of treadmill                                                             between facit joint morphology and
                                                               Nielsen, L., Spadavecchia, L., Doherr, M.,
         speed on the mechanics of the back in the                                                                mobility in the equine thoracolumbar
                                                               Schatzmann, U., 2004. Investigation of the
         trotting saddlehorse. Equine Vet. J. 33                                                                  spine. Equine Vet. J. 16, 461–465.
                                                               facilitation of the nociceptive withdrawal
         (Suppl.), 154–159.                                    reflex evoked by repeated transcutaneous        Townsend, H.G.G., Leach, D.H., Fretz, P.B.,
      Robert, C., Valette, J.P., Degueurce, C., Denoix,        electrical stimulations as a measure of            1983. Kinematics of the equine
         J.M., 1999. Correlation between surface               temporal summation in conscious horses.            thoracolumbar spine. Equine Vet. J. 15,
         electromyography and kinematics of the                Am. J. Vet. Res. 65, 901–908.                      117–122.
         hind limb of horses at trot on a treadmill.       Spadavecchia, C., Spadavecchia, L., Andersen,       Van Breda, E., 2006. A nonnatural head-neck
         Cells Tissues Organs. 165, 113–122.                   O.K., Arendt-Nielsen, L., Leandri, M.,             position (Rolkür) during training results in
      Robert, C., Valette, J.P., Denoix, J.M., 1998.           Schatzmann, U., 2002. Quantitative                 less acute stress in elite, trained, dressage
         Surface electromyographic analysis of the             assessment of nociception in horses by use         horses. J. Appl. Anim. Welfare Sc. 9, 59–64.
         normal horse locomotion: A preliminary                of the nociceptive withdrawal reflex evoked     Van den Bogert, A.J., Jansen, M.O., Deuel,
         report. Proc. Conf. Equine Sports Med.                by transcutaneous electrical stimulation.          N.R., 1994. Kinematics of the hind limb
         Science, Cordoba, pp. 80–85.                          Am. J. Vet. Res. 63, 1551–1556.                    push-off in elite show horses. Equine Vet. J.
      Robert, C., Valette, J.P., Pourcelot, P., Audigié,   Stubbs, N.C., Clayton, H.M., Hodges, P.W.,             Suppl. 17, 80–86.
         F., Denoix, J.M., 2002. Effects of trotting           Jeffcott, L.B., McGowan, C.M., 2010.            Van Dierendonck, M.C., Sleutjens, J.,
         speed on muscle activity and kinematics in            Osseous spinal pathology and epaxial               Tiggelman, S.L., Van Denderen, J.G.,
         saddlehorses. Equine Vet. J. 34 (Suppl.),             muscle ultrasonography in Thoroughbred             Wijnberg, I.D. Back, W., et al., 2010. The
         295–301.                                              racehorses. Equine Vet. J. 42 (Suppl.), s38,       effect of head- and neck position on
      Roepstorff, L., Johnston, C., Drevemo, S.,               654–661.                                           behaviour and cortisol levels in blood and
         Gustas, P., 2002. Influence of draw reins on      Stubbs, N.C., Hodges, P.W., Jeffcott, L.B.,            salivary. Proceedings ISES, in press.
         ground reaction forces at the trot. Equine            Cowin, G., Hodgson, D.R., McGowan,              Van Weeren, P.R., 2002. The clinical
         Vet. J. Suppl. 34, 349–352.                           C.M., 2006. Functional anatomy of the              applicability of automated gait analysis
      Rooney, J.M., 1982. The horse’s back:                    caudal thoracolumbar and lumbosacral               systems. Equine Vet. J. 34, 218–219.
         Biomechanics of lameness. Equine Pract. 4,            spine in the horse. Equine Vet. J. 36           Van Weeren, P.R., 2005. Equine ergonomics: a
         17–27.                                                (Suppl.), 393–399.                                 new era? Equine Vet. J. 37, 4–6.
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   Oosterbaan, M.M., Clayton, H.M., 1999.            Holm, K., Erichsen, C., Eksell, P., Drevemo,        (Over)training effects on quantitative
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   medicine and in veterinary research–a             in the sport horse with back pain. Equine           activities in standardbred horses. J. Applied
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Vandeweerd, J.M., Desbrosse, F., Clegg, P.,       Wijnberg, I.D., Back, W., De Jong, M., Zuidhof,     Wijnberg, I.D., van der Kolk, J.H., Franssen,
   Hougardy, V., Brock, L., Welch, A., et al.,       M.C., Van den Belt, A.J.M., Van der Kolk,           H., Breukink, H.J., 2003a. Needle
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   study. Equine Vet. J. 39, 59–63.                  locomotor problems in the horse. Equine             Vet. J. 35, 9–17.
Von Borstel, U.U., Duncan, I.J.H., Shoveller,        Vet. J. 36, 718–722.                             Wijnberg, I.D., Van der Kolk, J.H., Sleutjens, J.,
   A.K., Merkies, K., Keeling, L.J., Millman,     Wijnberg, I.D., Back, W., van der Kolk, J.H.,          Back, W., 2010. Effect of head and neck
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   Behav. Sc. 116, 228–236.                          of classic springhalt in a Dutch                    moderate exercise. Equine Vet. J. 42 (Suppl.
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   Gomez Alvarez, C.G., Roepstorff, L.,              Equine Veterinary Association, Glasgow,             Assoc. 15, 281–286.
   Johnston, C., et al., 2009. Influence of          UK. September 2002. Proceedings, p. 205.         Yoo, J.U., Zou, D., Edwards, W.T., Bayley, J.,
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   ground reaction forces, linear and time           Back, W., van der Kolk, J.H., 2003b.                motion on the neuroforaminal dimensions
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                                                                                                                CHAPTER                11 
                                                                                                                                                    229
       11         The effects of conformation
       gender:                                                 name:
       height at withers:                                      reg. no.:                                         cat. no.:
       markings:                                               sire:                                             dam:
       markings not allowed:                                   reg. no.:                                         reg. no.:
       judging location:                                       date:                                             jury member:
       element                    characteristic   groep         5       10   15      20   25          30   35    40       45 characteristic
       head                       plain            racial                                                                     noble
       head-neck connection       heavy            frame                                                                      light
       neck                       short            rac/frame                                                                  long
                                  horizontal       racial                                                                     vertical
       shoulder                   steep            frame                                                                      sloping
       back                       weak             frame                                                                      tight
       loins                      weak             frame                                                                      tight
       croup                      straight         frame                                                                      sloping
                                  short            frame                                                                      long
       body                       downhill         frame                                                                      upstanding
       length forearm             short            frame                                                                      long
       frontlegs                  straight         feet&legs                                                                  standing under
       hindlegs                   sickled          feet&legs                                                                  straight
       pasterns                   short            feet&legs                                                                  long
       hooves                     small            feet&legs                                                                  large
       quality of legs            course           feet&legs                                                                  hard
       hair                       little           racial                                                                     much
       color                      faded black      racial                                                                     jet black
       frontlegs                  toeing-in        feet&legs                                                                  toeing-out
       walk                       short            walk                                                                       long
                                  weak             walk                                                                       powerful
       trot                       short            trot                                                                       long
                                  weak             trot                                                                       powerful
                                  unbalanced       trot                                                                       balanced
                                  not supple       trot                                                                       supple
                                      racialtype     frame      feet & legs        walk         trot
      Fig 11.1  Typical example of a linear scoring form to judge a Friesian sport horse.
      Data from http://www.kfps.nl.
      Quantitative analysis                                                                 further developed and refined for use in the Thoroughbred race-
                                                                                            horse industry in the USA (M Holmstrom and D Lambert, unpub-
      Quantitative methods for measuring conformation can be used for                       lished work, 2004). The method was originally based on reference
      an objective evaluation (Rossdale & Butterfield, 2006). Several studies               points marked on the horse with small paper dots glued to the skin
      have been carried out, especially on riding horses. The results do often              (Fig. 11.2), and when first used all measurements were registered
      show a great deal of conformity, but in most cases it is impossible to                ‘by hand’ from a picture projected on a wall using a simple measur-
      directly compare such parameters as angle measurements from dif-                      ing band and a protractor. Later the whole procedure was computer-
      ferent studies, due to differences in methods of measurement.                         ized and the measurements were obtained from a digital photo on
         Quantitative conformational analysis, as a complement to the                       a laptop computer. The measurements were registered by clicking
      traditional evaluation, has been proven to increase the accuracy in                   with the mouse on the white markers. The computer then calculates
      the prediction of performance potential in young riding horses                        all length and angle measurements (Fig. 11.3). In the most recent
      (Holmström & Philipsson, 1993). However, applying this knowl-                         version joint angles and length and proportional measurements can
      edge in practice, i.e. in breeding evaluation programs, talent scout-                 be obtained from a picture with just one paper dot on the hip.
      ing, etc., has been very difficult. Much of the resistance to quantitative
      analysis is due to the deeply rooted tradition of subjective evalua-
      tions in the horse industry, combined with a lack of familiarity with
      the new methods. In addition, there are some shortcomings in the
                                                                                            Conformation and growth
      method itself. Obtaining quantitative measurements has, until                         Conformation evaluation in young growing horses calls for an
      recently, been a slow procedure – too slow to be incorporated into                    understanding of the effect of age, i.e. the effect of growth on the
      stallion tests and other similar events. New computerized methods                     conformation. The accuracy of quantitative methods applied to
      have now been developed that will speed up the process and make                       foals and yearlings, with the aim of predicting future performance
      it possible to measure many horses in a short time.                                   and soundness, are dependent on age adjustments according to
         In recent years an objective method, developed in Sweden by                        reliable growth curves for each individual measurement. Growth
      Magnusson (1985a) for a study of Standardbred trotters, has been                      curves for some body measurement such as height at the withers
230
                                                                                                                                  The study of equine conformation
2 9
10
4 11
5 12
                                                                                                                      13
                                                             6
                                                             7                                                        14
8 15
Fig 11.2  Standard position and reference points used in conformation analysis of Thoroughbred racehorses. Head and forelimbs: 1, the cranial end of the
wing of the atlas; 2, the proximal end of the spine of the scapula; 3, the posterior part of the greater tubercle of the humerus; 4, the transition between the
proximal and middle thirds of the lateral collateral ligament of the elbow joint; 5, the lateral tuberosity of the distal end of the radius; 6, the space between
the fourth carpal and the third and fourth metacarpal bones; 7, the proximal attachment of the lateral collateral ligament of the fetlock joint to the distal end
of the third metacarpal bone; 8, the proximal attachment of the lateral collateral ligament of the pastern joint to the distal end of the first phalanx. Hind
limbs: 9, the proximal end of the lateral angle of the ilium; 10, the center of the anterior part of the greater trochanter of the femur; 11, the proximal
attachment of the lateral collateral ligament of the stifle joint to the femur; 12, the attachment of the long lateral ligament of the hock joint to the plantar
border of the calcaneus bone; 13, the space between the fourth tarsal and the third and fourth metatarsal bones; 14, the proximal attachment of the lateral
collateral ligament of the fetlock joint to the distal end of the third metatarsal bone; 15, the proximal attachment of the lateral collateral ligament of the
pastern joint to the distal end of the first phalanx.
b 5
                                                 1                                                  6
                                             2                                                           g
                                         c
                                                                                                         7
                                             3
d h
                                                                                                             8
                                                     e                                                            i
                                             4
                                                                                                         9
                                                 f
Fig 11.3  Length measurements: a, neck; b, shoulder; c, humerus; d, radius; e, fore cannon; f, fore pastern; g, femur; h, tibia; i, hind cannon; j, hind pastern.
Angle measurements: 1, shoulder inclination; 2, shoulder joint; 3, elbow joint; 4, fore fetlock joint; 5, pelvis inclination; 6, femur inclination; 7, stifle joint; 8,
hock joint; 9, hind fetlock joint.
                                                                                                                                                                          231
       11       The effects of conformation
Correct Outwardly rotated Bench knee Base wide Narrow at the knees Toe-in
Buck knee Calf knee Correct Outwardly rotated Narrow at the knees Wide at the hocks
Fig 11.4 Deviations of limb and toe axes in the fore and hind limbs.
      are mainly breed specific while many other growth curves are spe-          not sufficient. Many important variables are almost impossible to
      cific for the method used for measuring a trait. Thus, growth graphs       judge correctly without objective measurements.
      obtained by one quantitative method cannot be used together with              This chapter will focus on objective measurements and subjective
      a different quantitative method.                                           conformational characteristics that are important for the function
                                                                                 of sport horses and racehorses. For those who have a specific interest
                                                                                 in the characteristics of a specific breed, that information can be
      Conformation, performance and soundness                                    obtained from the respective breeding organization.
      Searching for talented young sport horses involves evaluation of
      many different qualities. Temperament, movement and jumping
      ability are of course the most important in riding horses, but the
      significance of conformation must not be neglected. Furthermore,
                                                                                 Deviations of limb and toe axis
      dressage riders seek ‘good looking’ horses, with conformation that         One important part of the subjective evaluation is to describe devia-
      facilitates good movements, soundness and, above all, the ability          tions of limb and toe axes, if any. The most common deviations are
      to show a high level of collection. The competition results of Grand       described in Figure 11.4. Deviations from the straight (normal) limb
      Prix horses are certainly dependent on the skill of their riders and       and toe axes have traditionally been considered as a considerable
      trainers, but their conformation and movement must have the basic          weakness. However, not all deviations from what has been the
      qualities that create the necessary conditions for successful training     desired conformation should be judged as abnormal. About 80%
      of the horse. Resistance from the horse is often interpreted as poor       of all Warmblood riding horses and Standardbred trotters had out-
      temperament but might just as well be due to pain or lack of ability       wardly rotated hind limbs (Magnusson, 1985a; Holmström et al.,
      to carry weight on the hind limbs caused by inappropriate confor-          1990). The frequency of this ‘faulty conformation’ is so high that it
      mation and/or movement. Potential world class Grand Prix dres-             must be regarded as normal. Boldt (1978) maintains in his dressage
      sage horses are difficult to find because many promising young             handbook that outwardly rotated hind limbs facilitate exercises
      horses with excellent gaits fail to learn passage, piaffe and other        such as half-pass and shoulder-in. In this context, it is important to
      collected movements, resulting in years of wasted training. The            distinguish between hind limb rotation and toe-out conformation
      ability to collect and work in balance is also very important in a         as well as between rotated hind limbs and hind limbs that are
      jumping horse.                                                             narrow at the hocks (cow hocked). Confusion between these char-
         Conformation is also important in the selection of most other           acteristics should be avoided, especially as the rotated hind limb
      performance horses including Thoroughbred racehorses and Stan-             conformation should be considered normal. To judge this aspect of
      dardbreds. However, a successful use of conformation as an indica-         conformation, the observer should stand behind the point of the
      tor of performance requires good knowledge of the relationships            hock rather than behind the tail of the horse. The latter position
      between conformation and performance, as well as a reliable                makes it impossible to see if the rotated hind limb is also narrow
      method for its evaluation. In most cases a subjective evaluation is        at the hocks.
232
                                                                                                                                               The study of equine conformation
Table 11.1 Frequencies (percent) of subjectively scored deviations of limb and toe axes in different groups of riding horses
                               1         2         3          4         1         2         3            4         1         2       3     4        1         2      3      4
 Forelimbs
 Front view
 Outwardly rotated               3.0       7.1        3.0      3.7      –          3.6      –              0.6     –         –       –     –         3.0      10.7    3.0    4.3
 Bench knee                    48.4      32.5      53.0       48.4      6.1       21.4      11.0         11.8      –         –       –     –        54.5      53.6   64.0   60.2
 Base wide                     –         –         –          –         –         –           1.0          0.6     –         –       –     –        –         –       1.0    0.6
 Narrow at knees                   9.1   21.4       10.0      11.8      –         –         –            –         –         –       –     –            9.1   21.4   10.0   11.8
 Toe-in                        39.4      25.7       37.0      37.2      9.1       10.7          7.0          8.1   –         –       3.0   1.9      48.5      46.4   47.0   47.2
 Side view
 Buck knee                     18.2      35.7         6.0     13.8      3.0       10.7        2.0          3.7     6.1       –       –     1.2      27.3      46.4    8.0   18.7
 Calf knee                       9.1       7.1     21.0       16.2      3.0       –           3.0          2.5     –         –       –     –        12.1       7.1   24.0   18.7
 Hind limbs
 Rear view
 Outwardly rotated             84.9      82.1      67.0       73.3      3.0        3.6        7.0          5.6     –         –       –     –        87.9      85.7   74.0   78.9
 Narrow at the hocks           –           7.1     10.0        7.4      –         –         –            –         –         –       –     –        –          7.1   10.0    7.4
 Wide at the hocks             –         14.3         3.0      4.4      –         –           1.0          0.6     –         –       –     –        –         14.3    4.0    5.0
 Toe-out                       –           0          1.0      0.6      –         –         –            –         –         –       –     –        –         –       1.0    0.6
 Side view
 Camped under                  –           7.1        4.0      3.7      –         –           1.0          0.6     –         –       –     –        –          7.0    5.0    4.3
 1, elite dressage horses (n = 33); 2, elite show jumpers (n = 28); 3, riding school horses (n = 100); 4, total (n = 161).
 Data from Holmström et al. (1990). ©EVJ Ltd.
   Bench kneed conformation in the forelimbs together with a                                             The frequency of toe-in and/or bench knee conformation, as well
toe-in conformation is a very common type of deviation in riding                                      as of most other deviations, was the same among the elite dressage
horses, while outwardly rotated forelimbs are seldom seen in adult                                    horses and show jumpers as in a group of riding school horses
riding horses (Holmström et al., 1990). According to Magnusson                                        (Table 11.1). This indicates that mild-to-moderate deviations from
and Thafvelin (1985a) the converse is the case in Standardbred                                        the ‘normal’ limb conformation do not impair either soundness or
trotters. This difference may partly be explained by the fact that                                    performance in riding horses. However, it is important to empha-
trotters are narrower through the chest than the riding horses, even                                  size that, even though mild and moderate deviations can be
after adjustment for different height at the withers. Several other                                   accepted, severe deviations of any type should be considered as a
authors have also found that bench knee and toe-in conformation                                       major weakness. Several authors have claimed that there is an
seems to be related to weight and width of the breast (Santschi                                       increased stress to the distal parts of the limbs in horses with toe-out
et al., 2006; Firth et al., 1998). Santschi et al. (2006) studied the                                 and toe-in conformation (Churchill, 1962; Rooney, 1968; Beeman,
development of front limb deviations in foals and concluded that                                      1973; Magnusson, 1985c). This can often be noticed as synovial
calf knee conformation in foals tends to self correct and eventually                                  distensions of the fetlock and the coffin joints, as well as swelling
and it was also found that the incidence of bench knee increased                                      of the distal metacarpal growth plate.
between the age of 1 week and 18 months. Anderson et al. (2004)                                          According to Adams (1974), calf knee (back at the knee) confor-
compared conformation to injury in Thoroughbreds and found that                                       mation may predispose to lameness, whereas buck knee (over at the
calf knees were somewhat protective agains injuries. Today most                                       knee) conformation is less serious. This is probably true for Stan-
clinicians feel that mild carpal valgus is protective and is actually                                 dardbreds as well as Thoroughbred racehorses that overextend the
normal during growth.                                                                                 carpal joint considerably during the midstance phase. Steel et al.
   As in the hind limbs, there is often confusion between outwardly                                   (2006) reported that carpal lameness occurred in 28% of a group
rotated forelimbs and a toe-out conformation. Even though bench                                       of Standardbred horses and was present in 56% with forelimb lame-
knee conformation in a riding horse does not have any documented                                      ness. Of the variables studied, poor forelimb conformation and
negative effects on the long-term performance, bench kneed horses                                     more intense speed training were predisposing factors. Back et al.
have been reported to have a higher frequency of splints on the                                       (1996) proved in Warmbloods that there is a relationship between
medial side of the third metacarpal bone (Adams, 1974; Davidson,                                      a calf knee conformation at square stance and carpal hyperexten-
1970; Nordin, 1980).                                                                                  sion at trot.
                                                                                                                                                                                   233
       11       The effects of conformation
      Head, neck and body                                                       inclusion of objective measurements can minimize these discrepan-
                                                                                cies. Figure 11.5 shows two horses, one with a low set neck and the
      Many of the criteria that are used to describe the head, neck and         other with a well set neck.
      body are very difficult or impossible to analyze objectively. Such           In handbooks on evaluation of the conformation of sport horses,
      criteria are type, the setting of the neck, the shape of the withers,     some characteristics are described more consistently. A long and
      the ‘harmony’ of the horse, etc. They have to be evaluated subjec-        well-set neck are considered important for most kinds of perfor-
      tively. Other characteristics, such as length of the neck and body or     mances (Wrangel, 1911–1913; Forsell, 1927; Anon, 1940; Boldt,
      height at the withers, can be objectively measured or subjectively        1978; Bengtsson, 1983) and a long well-developed withers is said
      scored (Van der Veen, 1996).                                              to be important for horses that are working under saddle (Van der
         It is obvious that there are significant relationships between head,   Veen, 1996). In a large, cohort study of a Warmblood population,
      neck and body characteristics and performance, which are reflected        in which linear scoring results collected at studbook admission were
      in the difference between, for example, a slow, heavy draught horse       related to later performance in dressage and show jumping, it
      and a fast, elegant racehorse. Thus, differences between breeds have,     appeared that when horses were genetically selected on height at
      to a large extent, originated from different demands upon the             the withers, neck length was shorter. Longer necks were genetically
      horses. However, within a certain breed it is much more difficult to      related to a conformation more suited for dressage performance but
      correctly describe and evaluate the relatively subtle differences, and    had less impact on jumping performance (Ducro et al., 2009a).
      this difficulty has been associated with a rather large variation            In contrast, results from objective studies show that elite show
      between judges (van Vleck & Albrechtsen, 1965; Grundler, 1980;            jumpers have significantly longer necks than elite dressage horses
      Magnusson, 1985a). Long experience, a deep understanding of the           and ‘normal’ horses (Holmström, unpublished data) (Table 11.2).
      influence of conformation on performance and, when appropriate,           Other studies showed significantly shorter necks in elite dressage
                                                                                horses than in other riding horses but there was no significant cor-
                                                                                relation between the length of the neck and gaits under saddle in
                                                                                4-year-old riding horses (Holmström et al., 1990; Holmström &
                                                                                Philipsson, 1993). Available objectively obtained results indicate
                                                                                that a long neck might be an advantage for jumping horses, prob-
                                                                                ably because it makes it easier for the horse to maintain balance
                                                                                over the fence. In dressage horses, the setting of the neck is probably
                                                                                more important than its length (Van der Veen, 1996). It is generally
                                                                                agreed among riders and trainers of riding horses that a low set neck
                                                                                makes it very difficult to work the horse in a proper frame. However,
                                                                                there are no data supporting this statement, mainly because of the
                                                                                difficulties of objectively measuring the setting of the neck.
                                                                                   In Thoroughbred racehorses the length of the neck is part of the
                                                                                overall subjective conformation evaluation of young stock. The
                                                                                general opinion is that sprinters should have shorter necks than
                                                                                stayers but objective analysis of 780 grade 1 and group 1 winners
                                                                                in the USA and Europe showed that on both dirt and turf the sprint-
                                                                                ers, i.e. distances up to 7 furlongs, had slightly longer necks com-
                                                                                pared to the rest of the grade 1 and group 1 winners (M Holmstrom,
                                                                                unpublished work, 2009). The differences were small but statisti-
                                                                                cally significant.
        A                                                                          The setting of the head to the neck is also of importance (Van der
                                                                                Veen, 1996). A wide throat latch has always been considered impor-
                                                                                tant in racehorses, Standardbred trotters and Quarter Horses
                                                                                because it is said to facilitate breathing. In dressage horses, a wide
                                                                                distance between the wing of the atlas (first cervical vertebra) and
                                                                                the posterior ridge of the mandible has been considered important
                                                                                by riders. In a study of differences between elite dressage horses,
                                                                                elite jumping horses and ‘normal’ horses it was found that both the
                                                                                dressage horses and the jumpers had significantly greater width in
                                                                                this area than other horses (Holmström, unpublished data). A pos-
                                                                                sible explanation is that a small distance might cause problems,
                                                                                most likely a mechanical resistance, at higher levels of collection
                                                                                when the horse is required to perform a maximal flexion at the poll.
                                                                                   Height at the withers has been linked to jumping performance in
                                                                                several studies (Neisser, 1976; Langlois et al., 1978). Müller and
                                                                                Schwark (1979) found that show jumpers were taller at the withers
                                                                                than dressage horses. Even though there is a positive correlation
                                                                                between height at the withers and jumping performance up to a
                                                                                certain limit (around 172 cm), it must be remembered that there
                                                                                is a great variation among elite show jumpers. The range of the
                                                                                height at the withers was between 158 cm and 178 cm in a study
                                                                                of the World Cup finalists in 1997 (Holmström, unpublished data).
                                                                                According to Ducro et al. (2009a) height at the withers was geneti-
                                                                                cally related to dressage ranking but not to jumping ranking.
        B                                                                          It is generally agreed that height at the withers is not related to
                                                                                stride length in different gaits (von Wagener, 1934; Krüger, 1957;
      Fig 11.5  Horses with (A) low set neck and (B) well set neck.             Dušek et al., 1970; Dušek, 1974). However, Holmström and
234
                                                                                                                               The study of equine conformation
 Table 11.2  Comparison of adjusted means for length and angle                              Table 11.3  Significant conformational differences between
 measurements*                                                                              horses treated for recurrent lameness and other insured horses
 Variable            4-year           Dressage            Jumping            Injured        Variable                     Lame horses           Sound horses
                     olds                                                                                                mean (SD)             mean (SD)
 Length measurement (cm)                                                                    Height at the withers        165.4 (4.2)           163.5 (3.60)*
                              a                ab                  c                  bc
 Neck                 70.51            71.55               74.02              72.87         Femur inclination             86.7 (1.7)            85.4 (2.3)**
                              a                c                   a                  ab
 Scapula              40.07            42.00               40.51              41.00         Hind fetlock joint angle     156.6 (6.2)           153.8 (6.4)*
                              a                b                   a                  a
 Humerus              32.10            33.07               32.14              32.01         *p < 0.05; **p < 0.01.
                              a                b                   a
 Radius               37.15            37.64               37.69              37.58ab
 Fore                 20.92a           21.56b              21.37b             21.14ab
 cannon
                                                                                              In Standardbred trotters many authors have found a positive cor-
 Fore                   9.12a            9.52b               9.51b              9.16a      relation between height at the withers and performance (Bantoiu,
 pastern                                                                                   1922; Richter, 1953; Magnusson, 1985d), while a negative correla-
                                                                                           tion between height at the withers and soundness was found by
 Femur                40.24a           41.20b              40.36a             40.09a
                                                                                           Magnusson (1985c). In Thoroughbred racehorses no significant
 Tibia                48.52   a
                                       49.14   ab
                                                           49.74   b
                                                                              49.40ab      effect of the height at the withers on performance has been found
                                                                                           by Holmström (unpublished work, 2004) but the height at the
 Hind                 26.83a           27.36b              26.68a             26.55a
                                                                                           withers is likely to have a similar negative correlation to soundness
 cannon
                                                                                           as in Standardbred trotters. In a study of relationships between
 Hind                   8.74a            9.01ab              9.34b              9.07ab     conformation and soundness in insured riding horses in Sweden,
 pastern                                                                                   horses with recurrent lameness problems were significantly taller at
                                                                                           the withers than the sound horses (Table 11.3) (Holmström, unpub-
 Angle measurements (°)                                                                    lished data). This was confirmed by a (UK) study among owners of
 Shoulder             64.5a            66.3b               67.0b              66.5b        registered dressage horses, in which it was reported that 33% of the
 inclination                                                                               horses had been lame at some time during their career, 24% of these
                                                                                           within the previous 2 years (Murray et al., 2010). A number of
 Shoulder            126.3a           124.5b              126.2a             126.0a        factors were associated with the occurrence of lameness including
 joint                                                                                     increased risk for older and bigger horses.
                                                                                              Swedish Warmblood riding horses (Holmström et al., 1990)
 Elbow joint         152.4a           148.5b              151.1a             150.7a
                                                                                           and Hannovarian stallions (Dušek, 1974) seemed to have a rectan-
 Fore fetlock        148.7a           149.9ab             151.3b             148.2a        gular body shape, i.e. the length of the body is greater than the
 joint                                                                                     height at the withers. Oldenburg and East Friesian breeds have also
                                                                                           been shown to have this body form (Degen, 1953; Weferling,
 Pelvis               31.0a            27.5b               28.2b              31.0a        1964). At the Royal Dutch Warmblood selections, stallions are
 inclination                                                                               selected for ‘rectangular’ body proportions in contrast to a ‘square’
 Femur                85.4a            84.7b               84.5b              87.8c        body (Van der Veen, 1996). Müller and Schwark (1979), on the
 inclination                                                                               other hand, measured 687 horses competing in dressage, show
                                                                                           jumping and 3-day events and found them to have a rather short
 Stifle joint        154.1a           155.6b              154.0a             153.4a        body form. The horses had about the same height at the withers as
 Hock joint          159.4a           160.4a              159.2a             157.0b        Swedish Warmbloods but it was not clear how the body length was
                                                                                           measured. Neisser (1976) and Schwark et al. (1977) found nega-
 Hind                154.6a           153.4a              155.7a             156.1a        tive correlations between body length and performance in show
 feltlock                                                                                  jumping.
 joint                                                                                        The average body length of 780 grade 1 and group 1 winners in
                                                                                           the USA and Europe analyzed by Holmström (unpublished work,
 *Between elite dressage horses (n = 40), elite show jumpers (n = 51), 4-year-olds
                                                                                           2009) was 108% of the height at the withers, i.e. the Thoroughbred
 tested at quality events (n = 217) and horses with back problems or recurrent
                                                                                           racehorses had, on average, a long body form. No significant cor-
 lameness problems (n = 52). Differences in sex, and, for the stifle angle, differences
 in femur inclination, have been taken into consideration.                                 relation between body length and performance has been found but
                                                                                           a short body form is very rare among top class racehorses. No sig-
 Values with different superscripts differ significantly from each other.
                                                                                           nificant differences in body length between grade 1 and group 1
                                                                                           winners on dirt and turf were found. The influence of body length
                                                                                           on performance is still somewhat unclear but a majority of the
                                                                                           available studies indicate that a somewhat long body form is
Philipsson (1993) found positive correlations between height at the                        preferable.
withers and subjective scores for the canter in 4-year-old riding                             There is not much objective data available on the effect of the
horses. However, elite dressage horses have not been found to be                           length of the body on soundness but Magnusson (1985c) found
larger than other riding horses (Barrey et al., 2002). Ducro et al.                        that Standardbred trotters with a short back had fewer problems
(2009a) found that height at the withers was positively genetically                        with back pain then those with a long back. On the other hand,
correlated to conformation grades for sports performance. The                              horses with short backs showed more scalping problems. This con-
results above indicate that judges might be positively influenced by                       firms the statement that a short back is a strong back but predis-
the size of the horse, while in reality it has just a marginal impact                      poses to interference, such as over-reaching, forging and scalping
on elite performance in dressage and show jumping.                                         (Pritchard, 1965; Nordin, 1980; Van der Veen, 1996).
                                                                                                                                                                   235
       11       The effects of conformation
         Scope, as defined by Holmström and Lambert, i.e. the relationship              Subjectively, it is very difficult to correctly estimate the real slope
      between the length of the back and the distance between the fore-              of the shoulder. The problem is that in some horses there is a con-
      limbs and hind limbs, has shown to have a significant impact on                siderable discrepancy between the external outline of the shoulder
      the performance of Thoroughbred racehorses on dirt tracks in the               and the real inclination of the scapula (Fig. 11.7). To be able to
      USA (Holmström, unpublished work, 2004). The study, including                  judge the slope of the shoulder correctly, it is necessary to palpate
      2600 racehorses in the USA and Europe, showed that the scope, as               the position of the scapula. On the other hand there is one impor-
      with most other conformational traits, had a non-linear correlation            tant aspect of the shoulder that might have been underestimated.
      to performance on a mile and longer, while it was of less importance           A seemingly long and sloping shoulder in combination with a long
      for sprinter performance. It was also less important for the perfor-           and well-developed withers will place the rider more to the rear on
      mance on European tracks. The optimal scope increased with race                the horse, resulting in better balance. As a result of the better
      distance, i.e. the longer the race distance, the longer the horse’s back       balance, the horse will be able to move its forelimbs more freely,
      relative to the distance between the forelimbs and hind limbs.                 and reach higher and more forward. Thus, the effect of a ‘subjec-
                                                                                     tively’ sloping shoulder on the forelimb movements might be more
                                                                                     important than the real or ‘objective’ slope.
      Forelimbs                                                                         Of the forelimb conformational details, the length of the humerus
      A long and sloping shoulder has always been considered as advanta-             showed the strongest correlation to good gaits in 4-year-old riding
      geous for the movements of the forelimbs (Ehrengranat, 1818; Van               horses (Table 11.4) (Holmström et al., 1993; Holmström, unpub-
      der Veen, 1996). Sellet et al. (1981) suggested that a long sloping            lished data). Elite dressage horses have been shown to have a sig-
      scapula was associated with ergonomic efficiency in 2-year-old                 nificantly longer humerus than both show jumpers and ‘normal’
      pacing fillies. In a study of conformational characteristics of elite          horses (Table 11.2). In the older literature, the importance of a long
      dressage horses and show jumpers, both groups had significantly
      more sloping shoulders (Holmström et al., 1990). There was also
      a significant correlation between high gait scores and a sloping
      shoulder in 4-year-old riding horses (Holmström et al., 1993). Nev-
      ertheless, in a recent study (Table 11.2), the opposite result was
      found (Holmström, unpublished data). Apparently, the slope of the
      shoulder, objectively measured, does not have to be directly con-
      nected to elite performance in riding horses. Sport horses can
      perform at top level with a less sloping shoulder because other
      qualities are more important. The Royal Dutch Warmblood stud-
      book uses the criterion that horses should have a functional, but
      nonetheless ‘eye-catching’ conformation, that would allow and
      preferably facilitates sports performance at the highest level (Van
      der Veen, 1996). Henninges (1933), however, found a positive cor-
      relation between a sloping shoulder and stride length in walk.
      Theoretically, a more sloping shoulder might facilitate the forward
      and upward movement of the forelimbs during the last part of the
      swing phase in trot (Fig. 11.6). Back et al. (1996) correlated the
      joint angles at square stance to their kinematics at trot in a group
      of young adult Warmbloods (n = 24) and proved that a sloping
      scapula was correlated to a more protracted forelimb.
                               Shoulder
                               inclination = +5°
                                                                                       B
      Fig 11.6  Possible effect of different shoulder conformation on forelimb
      orientation at the beginning of the swing phase retraction: 5° difference in   Fig 11.7  (A,B) Horses with different slopes of the shoulders and scapula.
      shoulder inclination and all other angles unchanged.                           Note the discrepancy between the real slope and the outer contour in (B).
236
                                                                                                                                            The study of equine conformation
 Table 11.4  Results from multiple regression analyses of the effects of conformation measurements and scores on gaits under saddle and
 jumping abilitya
 Subjective scores
 Type                                         –                              0.11                  –                          −0.04                       0.40                   0.02
 Head, neck and body                          –                              0.12                  –                              0.11                  −0.13                    0.18
 Extremities                                  –                          −0.08                     –                              0.02                    0.18                 −0.28
 Walk                                         –                              0.98***               –                              0.25***                 0.08                   0.05
 Trot                                         –                              0.19**                –                              0.45***                 0.16                   0.11
                                                                                                                                                                                         237
       11      The effects of conformation
      Hind limbs
      The importance of the hind limbs for sport horse performance is
      obvious (Back et al., 1995). The hind quarters constitute the ‘engine’
      of the horse that, depending on the type of performance, should
      lift the horse over a fence, push it forward at a high speed or over
      long distances or, as in dressage horses, carry a lot of weight.
      Both horsemanship handbooks and many scientific studies indi-
      cate that good conformation of the hind limbs is essential for good
      performance and soundness (Van der Veen, 1996).
         A small angle of the pelvis to the horizontal plane has been              B
      reported to have a positive effect on performance in dressage and
      jumping horses. In a recent study, elite dressage and jumping horses       Fig 11.9  Horse with large discrepancy between (A) the slopes of the pelvis
      had significantly flatter pelvises than ‘normal’ riding horses (Table      and the croup, compared to a horse (B) with rather good correspondence
      11.2). The same results were found in a similar study in 1988 (Hol-        between pelvis and croup.
      mström et al., 1990). Holmström et al. (1993) also found a positive
      correlation between the slope of the pelvis and scores for the walk
      at 4-year-old tests for riding horses. Ehrengranat (1818) states that      position of the pelvis and a more horizontal position of the femur
      a flat croup is desirable for good movements. However, there is not        at square stance. Furthermore, the more vertical position of the
      always a good correspondence between the slope of the croup and            pelvis was correlated to a less retracted hind limb providing a more
      pelvis. Many horses have a flat croup combined with a steep pelvis         collected appearance. This does not, however, mean that a more
      (Fig. 11.9). This must be taken into consideration when evaluating         sloping pelvis has a positive correlation to real gait quality or dres-
      conformation subjectively. In analyses of high-speed films it has          sage performance. The majority of studies on dressage horses and
      been found that dressage horses classified as good movers had a            show jumpers lead to the conclusion that these horses’ perfor-
      larger rotation of the pelvis during the stride than those classified      mances are facilitated by relatively flat pelvises. Thus, it is important
      as poor movers (Holmström et al., 1994). Pelvic rotation is one of         to evaluate pelvis slope correctly in riding horses.
      the biomechanical parameters that contribute to elastic gaits in              In Thoroughbred racehorses Holmström (unpublished work,
      good dressage horses, while a non-rotating pelvis results in short         2004) found strong correlations between a smaller angle between
      and inelastic gaits. A flat pelvic conformation facilitates pelvic rota-   the pelvis and horizontal plane (flatter pelvis) and top performance.
      tion. Rotation of the pelvis during the stride is more pronounced          As mentioned earlier a flat pelvis facilitates pelvic rotation, which
      in passage than in the other paces, and the degree of change in the        very important part of an efficient stride in the racehorse.
      pelvic movement pattern from trot in hand to passage is approxi-              In Standardbred trotters a steeply sloping pelvis has been reported
      mately the same in all horses, irrespective of the initial pattern         to be related to synovial distention in the femoropatellar joint and
      (Holmström et al., 1995a,b). Pelvic rotation in the trot might be a        the medial synovial sac of the femorotibial joint, and also to have
      determinant of passage performance. Back et al. (1996) found that          a negative effect on the soundness of the hock joints (Magnusson,
      a flexed hip joint at movement was correlated to a more vertical           1985c). On the other hand, a flat pelvis is significantly correlated
238
                                                                                                                    The study of equine conformation
with pain on palpation of the croup muscles. The length of the                 (Bourgelat, 1750; Magne, 1866), which is very much the result of a
pelvis has been reported to have a positive correlation to jumping             forward sloping femur.
ability (Langlois et al., 1978) and to stride length in the walk (Kro-             The femur slope is also important in Thoroughbred racehorses
nacher & Ogrizek, 1931).                                                       and shows a significant non-linear correlation to top performance
   Probably the most important individual conformational detail                (Holmström, unpublished data). There are different optimal femur
for most sport horses is the femur. A long and forwardly sloping               slopes depending on distance and type of track. The optimal femur
femur places the hind limb more under the horse, which allows the              in a sprinter is a bit less forward sloping than in a stayer. Further-
horse to keep its balance more easily and carry more weight on the             more, horses with a femur slope close to the vertical have a better
hind limbs, since the hind limb position is closer to the center of            chance for top performance on turf. A combination of a very sloping
gravity. Van der Veen (1996) has suggested that optimally the stifle           pelvis and a vertical femur has been shown to disqualify racehorses
joint at square stance should be situated below the tuber coxae. In            from top performance. In a study of approximately 17 000 Thor-
a study of Brandenburg horses, Kronacher and Ogrizek (1931)                    oughbred racehorses with quantitative conformation data (Holm-
showed a positive correlation between stride length in walk and the            ström, unpublished data) there were no grade 1 or group 1 winners
length of the pelvis and femur. The slope of the femur has been                with this type of proximal hind limb conformation. The vast major-
reported by many authors to be related to performance. Langlois                ity of the horses with a combination of very sloping pelvis and verti-
et al. (1978) showed that good jumping performance was signifi-                cal femur had below average performance records. The reason for the
cantly correlated to a forwardly sloping femur, i.e. a small angle of          large negative effect on performance is probably that the very sloping
the femur to the horizontal plane (Fig. 11.10). In 4-year-old riding           pelvis limits the rotation of the pelvis during gallop and also together
horses the forward sloping femur has been shown to have the                    with the vertical femur limits the range of motion of the femur,
strongest correlation to gait quality of all studied variables (Holm-          especially retraction, resulting in a short and inefficient stride.
ström et al., 1993). In a recent study both elite dressage and                     A forwardly sloping femur has also been shown to have a positive
jumping horses had significantly more forward sloping femurs than              effect on soundness. In a study of riding horses with recurrent lame-
‘normal’ horses (Table 11.2). More than 150 years ago this correla-            ness and back problems attending one of the major horse clinics in
tion was stated by Hörman (1837). Other authors claimed that                   Sweden, the femur was significantly more vertical than in ‘normal’
horses intended for dressage work should be well camped under                  horses and elite horses (Table 11.2). Going through insurance
                                                                               company records of riding horses that were measured at quality
                                                                               events as 4 year olds, horses with recorded recurrent lameness and
                                                                               back problems had a significantly more vertical femur than the
                                                                               sound horses (Table 11.3) (Holmström, unpublished data).
                                                                                   In riding horses, the stifle angle should not be too small. Elite
                                                                               dressage horses have been shown to have a significantly straighter
                                                                               stifle angle than elite show jumpers and ‘normal’ horses (Table
                                                                               11.2). A small stifle angle results in a lot of strain to the quadriceps
                                                                               femoris muscle, i.e. the muscle that extends the stifle. The quadri-
                                                                               ceps femoris probably is the most strained group of muscles when
                                                                               a horse works in collected gaits. If the muscles cannot ‘lock’ the stifle
                                                                               in an extended position when maximum load is put on the hind
                                                                               limbs, the horse must transfer weight to its forelimbs and it is then
                                                                               no longer working in balance. In Standardbred trotters a positive
                                                                               correlation has been found between stifle angle and performance
                                                                               (Magnusson, 1985d). The same has been found in Thoroughbred
                                                                               racehorses but again, there is a non-linear correlation to perfor-
                                                                               mance and an optimal stifle angle, which vary depending on the
                                                                               conformation of the rest of the hind limb (Holmström, unpub-
  A                                                                            lished data). Generally a very small stifle angle leads to a weak hind
                                                                               limb and poor performance. The hind limb has to be able withstand
                                                                               the huge load at high speed and at the same time store elastic
                                                                               energy, which not possible with a very small stifle angle.
                                                                                   Comparing the hock angles of elite dressage and jumping horses
                                                                               with ‘normal’ horses (Fig. 11.11), it has been found that the dressage
                                                                               horses in general had larger hock angles or, more correctly, there were
                                                                               no sickle hocked dressage horses (Holmström et al., 1990). However,
                                                                               it could not be proved that the gaits improved with larger hock angles
                                                                               (Holmström et al., 1993). A more recent study failed to show any
                                                                               differences in the hock angle between elite horses and others, mainly
                                                                               because the mean hock angle in the ‘normal’ horses had increased
                                                                               from 155.4–159.4°, which was almost the same as in the elite horses
                                                                               (Table 11.2). Horses with lameness and back problems had signifi-
                                                                               cantly smaller hock angles than sound horses (Table 11.2).
                                                                                   Magnusson (1985c) found that small hock angles (sickle hocks)
                                                                               were related to more synovial distentions in the stifle and hock joints
                                                                               as well as to more curbs. This has also been reported by several other
                                                                               authors (Smythe, 1963; Pritchard, 1965; Davidson, 1970; Beeman,
                                                                               1973; Adams, 1974). Rooney (1968) and Hickman (1977) were of
  B                                                                            the opinion that sickle hocked horses more frequently experienced
                                                                               bone spavin. Icelandic Toelter horses show a significant correlation
Fig 11.10  Comparison of horses with (A) a forward sloping femur and (B) a     between small hock angles and bone spavin according to Eksell
vertical femur. Note the effect on the overall replacement of the hind limb.   et al. (1998). Axelsson et al. (2001) found that Icelandic horses with
                                                                                                                                                           239
       11       The effects of conformation
B B
      Fig 11.11  Horses with (A) small hock joint angle and (B) large hock joint   Fig 11.12  Horses with (A) good and (B) poor hind limb conformation.
      angle.
      a larger tarsal angle had a lower prevalence of radiographic signs of        It is concluded that sickle hocked horses, or horses with small hock
      degenerative joint disease (DJD) in the distal tarsus confirming that        joint angles, should be avoided.
      the tarsal conformation is associated with OA in the distal tarsus,             The slope of the hind pastern is, to some extent, influenced by
      probably by altering the biomechanics of the distal tarsal joints. In        the rest of the hind limb conformation. A straight hock is signifi-
      addition, Björnsdóttir et al. (2004) examined Icelandic horses at            cantly correlated to a more sloping pastern (Magnusson, 1985b).
      young age by high detail radiography and histology and concluded             Riding horses with soundness problems had a significantly steeper
      that the development of OA in the centrodistal tarsal joint of young         pastern. This might be an effect of a smaller hock angle in these
      Icelandic horses seems to be due to poor conformation or joint               horses; however, the difference in hock angle was not statistically
      architecture rather than trauma or overloading.                              significant (Table 11.3) (Holmström, unpublished data). In contrast
         A small hock angle generally has a negative effect on performance         to the forelimb, a straighter hind fetlock joint has been shown to
      in Thoroughbred racehorses (Holmström, unpublished work). The                be correlated to a longer stride and swing duration at the trot (Back
      negative correlation between hock angle and performance is stron-            et al.1996). A straighter hind fetlock is more efficient in storing
      ger on dirt tracks than on turf. All these findings confirm what was         elastic energy, which contributes to more power from the hind limb.
      said by Schmidt (1928), that a horse with a small hock angle will               Generally, the hind limb conformation should be regarded as one
      be able to step underneath itself but will not be able to carry weight       unit when evaluated. There are many different combinations of
      on the hind limbs due to decreased resistance and strength in                angles that result in a ‘good hind limb conformation’, but it is
      the hock.                                                                    generally characterized by a somewhat flat pelvis, a forwardly
         Studies using high-speed films have shown that in good dressage           sloping femur, a normal to straight stifle and a normal to straight
      horses there is considerable compression of the hock joint (~15°)            hock (Fig. 11.12). If the horse is weak in one part this can be com-
      during the midstance phase in trot and even greater compression              pensated by strength somewhere else. The overall result is a strong
      in passage and piaffe (Holmström et al., 1995a). In jumping horses           hind limb that can endure stress, carry weight and store elastic strain
      and racehorses, the compression is larger than in dressage horses.           energy. Thus, looking at one characteristic at a time is not sufficient.
240
                                                                                    Predicting performance and soundness by conformation analysis
Fig 11.13 Laterality and uneven feet: demo of a clinical provocation test.
All aspects of hind limb conformation must be taken into account.             Thoroughbreds differed from other breeds, not only with regard to
This makes it more difficult to do an accurate evaluation subjec-             segment lengths but also with regard to joint angles and deviations.
tively, and that is why inclusion of objective measurements improves          The results from these studies illustrate the difficulties scientists face
the accuracy of the evaluation (Holmström et al., 1993).                      when designing conformational studies in horses. First of all subjec-
   Preliminary studies on riding ponies and Icelandic Toelter horses          tive evaluation of the conformation has limitations mainly because
indicate that the most favorable conformation for each type of                of the difficulties to accurately and consistently register the subtle
performance is almost the same as that described above in sport               differences between good and poor conformation within a breed
horses. The differences found are variations on the same theme                with relatively homogeneous conformation and secondly quantita-
(Holmström, unpublished data). These variations are nevertheless              tive analysis of the conformation has great potential as a predictive
important to investigate, and further studies will be carried out in          tool only if used with the right approach. Quantitative studies
the future.                                                                   of smaller groups of horses or random samples without inclusion
   Extensive studies of the Thoroughbred racehorse conformation               of a sufficient number of top performers might give the wrong
have shown that there are surprisingly small differences in confor-           answers to the questions asked. Holmström (unpublished data)
mation between elite sport horses and top class racehorses. The               has found that there are very small and subtle conformational
optimal hind limb shape for top performance is very similar, while            differences between top class Thoroughbred racehorses and Warm-
there are some subtle differences in the forelimb conformation.               blood sport horses when comparing grade 1 winners and Grand
                                                                              Prix dressage horses and show jumpers, while when comparing
                                                                              horses of lesser quality significant differences could be found.
Predicting performance and soundness by                                          It is also very important to understand that conformation analysis
                                                                              as a selection tool can only work as a negative predictor, i.e. sorting
conformation analysis                                                         out horses with conformation that gives them a significantly lower
                                                                              chance of being successful in the sport or a significantly higher
There is no doubt that there are significant correlations between             chance of injuries. The latter information however, would give
conformation and performance and soundness. The efficiency of a               insurance companies an opportunity to improve their risk
selection procedure based on conformation evaluation is, however,             evaluation.
highly dependent on the method used. Love et al. (2006) analyzed                 Applying conformation analysis as a negative predictor to wean-
a limited number of conformational traits assessed by a single vet-           lings, yearlings and 2 year olds within the Thoroughbred racehorse
erinary observer against pedigree and racing records of 3916 Thor-            business in the USA has proven that quantitative conformation
oughbred yearlings sold at public auctions during a 7-year period.            analysis is a very useful tool in the selection of young horses
Only a weak association was found between performance and con-                intended for top class performance. Between 75 and 80 % of the
formation. In the study by Santschi et al. (2006) the validation              horses analyzed as weanlings or yearlings, and that subsequently
portion of their study showed that the coefficient of variation for           won grade 1 races, at 8 furlongs or longer, were categorized as horses
subjective assessment of conformation was greater than 10%, which             with ‘grade 1 conformation’ (Holmström, unpublished data).
is well below a clinically useful tool. Weller et al. (2006a,b,c) objec-         There are many studies on the relationship between conforma-
tively evaluated the conformation of a group of 108 National Hunt             tion and soundness in different breeds showing the complexity of
racehorses using a digital motion analysis system. It appeared that           the problem. For example, Gnagey et al. (2006) evaluated the effect
                                                                                                                                                           241
       11      The effects of conformation
                                                                                   Survival
      the risk of plantar ligament desmitis, illustrating the delicate balance                0.5
      between conformation, kinematics and kinetics of the tarsal joint                       0.4
      in relation to soundness (Baird & Pilsworth, 2001).                                     0.3
         Recently, the ‘grassfoot’ phenomenon has been unraveled, as                          0.2
      foals with relatively longer limbs and shorter neck and head length
                                                                                              0.1
      seem to have a preference in forelimb position when grazing leading
      to an asymmetric development of their front feet, the so-called                           0
                                                                                                    0   1     2         3       4       5          6        7        8          9
      uneven feet (Van Heel et al., 2006; Kroekenstoel et al., 2006; Ducro         A                                          Years in sport
      et al., 2009a). The steep foot is habitually positioned behind and
      the sloping foot is positioned more forward (Fig. 11.13). Studbooks
      tend not to select horses that have this asymmetry. The effect of this                    1
      phenomenon has been evaluated at a population level comparing                           0.9
      studbook admission data, scoring the existence of uneven feet, with                     0.8
      what horses have delivered in sports (Ducro et al., 2009b). Length                      0.7
      of competitive life was shorter for jumping than for dressage. A                        0.6
                                                                                   Survival
      different set of risk factors was found for each level and discipline,
                                                                                              0.5
      e.g. height at withers was a risk factor at basic level in dressage and
      jumping, while pastern angle was a risk factor at the elite level of                    0.4
      jumping and dressage. The trait ‘uneven feet’ tended to shorten the                     0.3
      competitive life in dressage, but was a significant risk factor at the                  0.2
      elite level of jumping (Fig. 11.14). Davies and Watson (2005)                           0.1
      proved that there is also such a laterality asymmetry in the third                        0
      metacarpal bone and midshaft dimensions in Thoroughbred race-                                 0   1     2         3       4       5          6        7        8          9
      horses (n = 40). They proposed that racehorses with longer right             B                                          Years in sport
      MC3 bones were more able to control the loading of the right MC3
      than the left during fast exercise. In Warmbloods, this phenomenon          Fig 11.14  Survival curves for (A) dressage: basic dressage (n = 12 776):
      has led to a locomotor asymmetry at a young adult age, possibly an          even feet (n = 11 940; blue); uneven feet (n = 836; green); elite dressage
      explanation for the so-called ‘natural asymmetry’ in the perfor-            (n = 684): even feet (n = 657; orange), uneven feet (n = 27; red); and
      mance of a horse at the beginning of their career that is a challenge       (B) jumping performance: basic jumping (n = 8738): even feet (n = 8221;
                                                                                  blue), uneven feet (n = 517; green); elite jumping (n = 756): even feet
      for every rider (Van Heel et al., 2010).
                                                                                  (n = 725; orange), uneven feet (n = 31; red); and the number of years
         Further studies of conformational effects on soundness is neces-
                                                                                  horses were registered as being in competition.
      sary but at the moment there are no data available that contradict
                                                                                  Reprinted from Ducro, B.J., Gorissen, B., van Eldik, P., Back, W., 2009b. Influence of foot
      that belief that a conformation that facilitates top class performance
                                                                                  conformation on duration of competitive life in a Dutch Warmblood horse population.
      and longevity of the horses’ careers in general also is positive for
                                                                                  Equine Vet. J. 41: 144–148, with permission from the Equine Veterinary Journal
      the horses’ soundness.
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244
                                                                                                                CHAPTER               12 
                                                                                                                                                   245
       12      Genetic contributions to exercise and athletic performance
246
                                                                                                            Selection for locomotor performance
Dierks et al., 2006; Goh et al., 2007; Gustafson-Seabury et al., 2005;   (Gu et al., 2009). This work involved a genome scan of genetic
Lee et al., 2004; Perrocheau et al., 2006; Raudsepp et al., 2004a,b),    variation at 394 autosomal and X chromosome microsatellite loci
have been contributed to by collaborations among international           in four geographically diverse horse populations (Connemara,
laboratories.                                                            Akhal-Teke, Tuva and Thoroughbred). Positively selected loci were
   A major breakthrough in equine genomics was the selection of          identified in the extreme tail-ends of the distributions for popula-
the horse for genome sequencing by the US National Human                 tion genetic parameters and test statistics that identified departures
Genome Research Institute (NHGRI). The full length sequencing of         from patterns of genetic variation expected under neutral genetic
the horse genome began in February 2006, and was performed at            drift (Gu et al., 2009). Within the outlier loci there was a statistically
The Broad Institute, Massachusetts Institute of Technology and           significant enrichment for genes involved in phosphatidylinositol
Harvard University in collaboration with the Equine Genome               3-kinase (PI3K) mediated signaling, insulin receptor signaling and
Sequencing Consortium. A single female Thoroughbred horse was            lipid transport – biochemical pathways with well-characterized
chosen for sequencing using the whole genome shotgun approach.           roles in adaptation to exercise. Furthermore, the importance of
The 6.8× coverage of the initial assembly (EquCab1.0) was released       muscle function in the recent evolution of the Thoroughbred was
in January 2007, and the current assembly (EquCab2.0) was                highlighted by a significant overrepresentation of sarcoglycan
released in September 2007 (Wade et al., 2009).                          complex and focal adhesion pathway genes located within the
   In addition to whole genome sequencing, a single nucleotide           selected regions. In summary, these data indicate that recent selec-
polymorphism (SNP) database (EquCab 2.0) containing >1 million           tion in the ancestors of the present-day Thoroughbred population
SNPs (~1 per 1500 bp) was constructed by comparing sequences             principally targeted genes associated with fatty acid oxidation,
from horses of disparate geographic origin, including Akhal-Teke,        increased insulin sensitivity and muscle strength, highlighting the
Andalusian, Arabian, Icelandic, Quarter Horse, Standardbred and          central role for muscle function and integrity in the Thoroughbred
Thoroughbred. Stemming from the horse genome sequencing                  athletic phenotype. More recently, using the Illumina® EquineSNP50
project new technologies such as the Illumina® EquineSNP Bead-           BeadChip platform, the Equine Genetic Diversity Consortium, led
Chip (McCue et al., 2012) and various gene expression microarrays        by researchers at the University of Minnesota, investigated signa-
(Bright et al., 2009) have been designed and may be used to under-       tures of selection in over 30 horse breeds that had been selected for
stand trait association and gene function.                               different phenotypic traits (Petersen et al., 2013). In this study, the
   The recent completion of the draft sequence of the horse genome       most significant signature of selection in the Thoroughbred was
(Wade et al., 2009), combined with technological and method-             found on ECA17, which was previously implicated as having selec-
ological advances in the analysis of complex genetic traits in humans    tive importance in the Thoroughbred (Gu et al., 2009). Among all
(Steemers & Gunderson, 2007) has provided veterinary genetic epi-        breeds, the strongest signature of selection was identified in the
demiologists with an array of tools for the study of diseases with a     Paint and Quarter Horse; a 5.5-Mb region of ECA18, which centered
heritable component. Specifically, the advent of high-density single     on the myostatin (MSTN) gene.
nucleotide polymorphism (SNP) based genotyping arrays and the               To date, three genes with molecular functions relevant to physi-
concomitant growth in knowledge of the haplotypic structure of           ological processes important for exercise have been reported to be
mammalian genomes has led to the adoption of genome-wide                 associated with racing performance, including the myostatin gene
association studies (GWAS) for disease gene mapping (Frazer et al.,      [MSTN] (Hill et al., 2010b,; Tozaki et al., 2010a,b), the cytochrome
2007; Orr & Chanock, 2008). These studies, which have recently           c oxidase, subunit 4, isoform 2 gene [COX4I2] (Gu et al., 2010) and
been successful in the identification of large numbers of genetic loci   the pyruvate dehydrogenase kinase isozyme 4, mitochondrial gene
contributing to disease in humans, exploit the high degree of cor-       [PDK4] (Hill et al., 2010c). A variant in the genomic sequence for
relation between genetic variants at any particular region of a chro-    PDK4 is the first example of a statistically significant association of
mosome to efficiently interrogate the entire genomes of large            a SNP with elite race winning performance (Hill et al., 2010). In a
numbers of samples using a minimally redundant set of so-called          set of n = 278 Thoroughbred samples, segregated by retrospective
‘tagging-SNPs’ (Howie et al., 2006). The GWAS paradigm in human          racetrack performance into elite performers and non-winners, a SNP
studies has been to genotype hundreds of thousands of SNPs in            at the PDK4 gene locus (g. 38973231A>G) was significantly associ-
many thousands of affected and unaffected individuals. These large       ated with elite racing ability (p = 0.0004, odds ratio = 1.97, C.I. (95)
numbers are a result of the hypothesis that multiple loci with a         = 1.35–2.87), with the A : A and A : G genotypes more common
range of effect sizes contribute to the etiology of complex diseases;    among elite (70%) than non-elite (47%) racehorses. On average,
large numbers of samples are thus required to attain the requisite       the A : A and A : G genotypes had a 16.2–16.6 lb handicap advantage
statistical power for unambiguous detection of such loci. Charlier       over G : G horses. As the PDK4 gene locus was identified among a
et al. (2008) and Karlsson et al. (2007) have demonstrated that          set of positively selected loci in Thoroughbreds (Gu et al., 2009),
association based mapping can be effective in the detection of single    has functions known to be relevant to exercise (Wende et al., 2005;
locus recessive traits in animals using much smaller numbers of          Scarpulla, 2008; Pilegaard & Neufer, 2004), and in horse skeletal
individuals.                                                             muscle is significantly differentially regulated post-exercise (Eivers
   The advances in equine genomics have also rapidly enabled the         et al., 2010; Hill et al., 2010) this gene variant represents a promis-
identification of genomic sequence variation associated with ath-        ing opportunity to integrate molecular genetic information in selec-
letic performance phenotypes in Thoroughbreds (Gu et al., 2009;          tion and decision-making processes in the Thoroughbred.
Hill et al., 2010b,d; Tozaki et al., 2010a,b). Thoroughbred horses          The locus that has been most extensively studied in regard to an
represent a unique opportunity to identify genomic contributions         athletic performance trait contains the gene encoding myostatin
to exercise adaptation and athletic performance as Thoroughbreds         (MSTN). Three studies have identified variation at this locus associ-
have been selected for exceptional racing performance for 300 years      ated with optimum race distance in European, North American and
and stem from a small number of founder animals. Intense selec-          Australasian Thoroughbreds (Hill et al., 2010; Binns et al., 2010)
tion for elite racing performance in the Thoroughbred has resulted       and with performance rank and lifetime earnings among Japanese
in a number of adaptive physiological phenotypes relevant to exer-       Thoroughbreds (Tozaki et al., 2010a,b). Myostatin is a growth and
cise; however, the underlying molecular mechanisms responsible           differentiation factor that functions as a negative regulator of skel-
for these characteristics are not yet well understood.                   etal muscle mass development. In several mammalian species,
   The first report of genes and functional groups of genes contribut-   including cattle, sheep, dogs and mice, muscle hypertrophy pheno-
ing to the athletic phenotype in the Thoroughbred employed a             types are associated with sequence variants in the MSTN gene
population genetics-based approach to identify regions of the Thor-      (Grobet et al., 1997; McPherron et al., 1997; McPherron & Lee,
oughbred genome that have been selected for exercise-relevant traits     1997; Schuelke et al., 2004; Mosher et al., 2007).
                                                                                                                                                      247
       12      Genetic contributions to exercise and athletic performance
         Employing a candidate gene approach, Hill and colleagues identi-           microarrays and through the use of next-generation sequencing
      fied a sequence polymorphism in intron 1 of the MSTN gene                     technologies. Using equine-specific cDNA microarrays McGivney
      (g.66493737C>T) that may be used to predict sprinting ability and             and colleagues (2009) identified novel genes and key regulatory
      racing stamina in Thoroughbred horses (Hill et al., 2010). In a set of        pathways responsible for exercise adaptation in skeletal muscle.
      n = 197 elite race winning Thoroughbreds, a very strong association           Skeletal muscle biopsy samples were collected from a cohort of
      with best race distance has been observed (p = 3.28 × 10−13). Two             Thoroughbred horses at rest (T0) and at two time points following
      alleles were observed at this biallelic SNP: a ‘C’ allele and a ‘T’ allele,   a single bout of treadmill exercise (immediately post-exercise (T1),
      with the ‘C’ allele more than twice as frequent in the short distance         and 4 h post-exercise (T2) (Fig. 12.1)). While only two genes had
      (≤7 furlongs) cohort of animals compared to the long distance (>8             increased expression at T(1) (p < 0.05), by T(2) 932 genes had
      furlongs) group (0.75 and 0.34 respectively), corresponding to an             increased (p < 0.05) and 562 genes had decreased expression
      odds ratio of 5.81 (Hill et al., 2010d). It was observed that C : C horses    (p < 0.05). Functional analysis of genes differentially expressed
      are suited to fast, short-distance races; C : T horses compete favorably      during the recovery phase (T2) revealed an over-representation of
      in middle-distance races; and T : T horses have greater stamina. Evalu-       genes localized to the actin cytoskeleton and with functions in the
      ation of retrospective racecourse performance (n = 142) and stallion          MAPK signaling, focal adhesion, insulin signaling, mTOR signaling,
      progeny performance predict that C : C and C : T horses are more              p53 signaling and type II diabetes mellitus pathways (Table 12.1).
      likely to be successful 2-year-old racehorses than T : T animals. His-        At T(1), using a less stringent statistical approach, an over-
      tological analysis of gluteal muscle biopsies in Quarter horses               representation of genes involved in the stress response, metabolism
      showed that the C-allele was associated with higher Type 2B and               and intracellular signaling was observed (Table 12.2). These find-
      lower Type 1 muscle fiber proportions, demonstrating a functional             ings suggested that protein synthesis, mechanosensation and muscle
      consequence for selection this locus. Each copy of the C-allele               remodeling contribute to skeletal muscle adaptation towards
      increased Type 2B muscle fibres by 4.79% (Petersen et al., 2013).             improved integrity and hypertrophy.
         The importance of this locus in determining the type of racing                To evaluate changes in gene expression following multiple exer-
      an individual is most suited to, was confirmed in a genome wide               cise bouts (i.e. conditioning or training) McGivney et al. (2010)
      SNP association study (GWAS) using the Illumina® EquineSNP50                  used digital gene expression (DGE) mRNA tag profiling, which is
      BeadChip. A study using a set of n = 118 elite Thoroughbreds identi-          based on the high-throughput sequencing by synthesis technology
      fied the genomic region on chromosome 18 containing the MSTN                  available from Illumina Inc. (Mardis, 2008; Fox et al., 2009; Moro-
      gene as the highest ranked region for optimum race distance and a             zova et al., 2009), to characterize the assembly of genes expressed
      set of seven SNPs within a 1.7 Mb region that reached genome-wide             in equine skeletal muscle and to identify the subset of genes that
      significance (Hill et al., 2010d). A comparison of trait association          were differentially expressed following a 10-month period of exer-
      in the same set of samples demonstrated the superior power of the             cise training. Skeletal muscle biopsies were collected from the
      g.66493737C>T SNP (Punadj. = 1.02 × 10−10) for the prediction of best         gluteus medius of seven Thoroughbred horses at rest at two time
      race distance when compared with the best marker on the array:                points: T(1)-untrained (9 ± 0.5 months old) and T(2)-trained (20
      BIEC2-417495 (Punadj. = 1.61 × 10−9). A genetic test is now available         ± 0.7 months old). This study found that the most abundant mRNA
      to horse breeders and trainers for this polymorphism. The Equi-               transcripts in the muscle transcriptome were those involved in
      nome Speed Gene Test may be used to make a prediction about the               muscle contraction, aerobic respiration and mitochondrial func-
      optimum race distance for an individual and may be used to                    tion. A previously unreported over-representation of genes related
      improve decision-making in selection, breeding and training.                  to RNA processing, the stress response and proteolysis was observed.
         Functional genomics studies provide a mechanism to further                 Following training 92 tags were differentially expressed of which 74
      understand the importance of genes and gene functions in exercise             were annotated. Sixteen genes showed increased expression, and
      adaptation. Gene expression studies in an exercise context in the             among the 58 genes with decreased expression, tags representing
      horse are growing (Eizema et al., 2005; Jose-Cunilleras et al., 2005;         the gene encoding myostatin (MSTN), had the greatest decrease
      Barrey et al., 2006; Mucher et al., 2006; McGivney et al., 2009;              (−4.2-fold, p = 0.0043). This demonstrates the key role of the myo-
      Eivers et al., 2010; Hill et al., 2010a; Martin et al., 2010; McGivney        statin protein in the adaptive response and its function as a negative
      et al., 2010). The products of many genes are likely to influence             regulator of muscle development. Functional groups displaying
      system-wide physiological responses. However, the protein products            highly significant increased expression included mitochondrion,
      of two genes have been identified as key regulators of the adaptive           oxidative phosphorylation and fatty acid metabolism, while func-
      response to exercise in humans and model species. These are the               tional groups with decreased expression were mainly associated
      hypoxia inducible factor 1, alpha subunit (basic helix-loop-helix             with structural genes and included the sarcoplasm, laminin complex
      transcription factor) gene (HIF1A), which encodes HIF-1α and the              and cytoskeleton. Recently, the Illumina® EquineSNP50 BeadChip
      peroxisome proliferator-activated receptor gamma, coactivator 1               platform was used in a GWAS to identify a gene having a major
      alpha gene (PPARGC1A), which encodes PGC-1α (for reviews                      effect on gaitedness in horses. Andersson and colleagues (Anders-
      Bonen, 2009; Gibala, 2009; Lundby et al., 2009; Yan, 2009; Lira               son et al., 2012) identified a premature stop codon in the doublesex
      et al., 2010; Olesen et al., 2010). Eivers and colleagues (2010) have         related mab transcription factor gene 3 (DMRT3 gene), which influ-
      reported the gene expression responses of a panel of HIF-responsive           enced the pattern of locomotion in Icelandic breeds. The presence
      genes in skeletal muscle biopsies collected from the gluteus medius           of the mutation allows for the performance of alternate gaits, i.e.
      before and after a standardized incremental-step treadmill exercise           instead of the two-beat contralateral gait of the trot, some horses
      test in untrained Thoroughbred horses. Analyses of mRNA profiles              perform the pace, a two-beat ipsilateral gait. Other natural varia-
      revealed significant transcriptomic differences 4 h post-exercise (T2)        tions in movement include four-beat ambling gaits characteristic of
      for the CKM, COX4I1, COX4I2, PDK4, PPARGC1A, and SLC2A4                       the Tennessee Walking Horse, Peruvian Paso, Paso Fino, and others,
      genes relative to pre-exercise levels. The observed relationships with        with unique variations in rhythm between breeds. This finding
      measured physiological variables (VHRmax and [La]peak) indicated              was validated in an investigation of genomic regions under selec-
      that local transcriptional microadaptations influence the overall             tion in gaited breeds (Petersen et al., 2013). A 186kb region on
      athletic phenotype. Also, the data highlighted the roles of genes             ECA23 spanning the DMRT3 gene locus was found to have been
      responsible for the regulation of oxygen-dependent metabolism,                targeted by selection in breeds with the ability to perform alterna-
      glucose metabolism, and fatty acid utilization in equine skeletal             tive gaits. Together these studies provide strong evidence that
      muscle adaptation to exercise.                                                DMRT3 is a major effect gene for locomotion/gait phenotypes;
         Employing global approaches to gene expression studies is now              however specific variations in gait among breeds may be modified
      possible with the availability of equine-specific gene expression             by other loci.
248
                                                                                                                                                 Selection for locomotor performance
                                    1000
                                    800
                                    600
                                  T0                      T1                                     T2
                           ~10 min exercise      <10 min post-exercise                  4 hrs post-exercise
                                                          T1                                      T2
                                                Ribosome
                                                                                    Intramolecular                             Return to homeostasis,
     Metabolic due to                           Oxidative phosphorylation
                                                                                    oxidoreductase activity                     enhanced response to
    endurance exercise                          Proton-transporting ATP
                                                                                    Insulin signaling pathway                  future bouts of exercise
                                                synthase complex
                                                                                    Actin cytoskeleton
                                                                                    Stress fiber
    Mechanical due to                                                                                                              Muscular repair,
                                                                                    Cell cycle
    resistance exercise                                                                                                           muscle hypertrophy
                                                                                    Focal adhesion
                                                                                    mTOR signaling pathway
Fig 12.1  Skeletal muscle biopsy samples collected from a cohort of Thoroughbred horses at rest (T0) and at two time points following a single bout of
treadmill exercise (immediately post-exercise (T1), and 4 h post-exercise (T2)).
Reprinted from McGivney, B.A., Eivers, S.S., MacHugh, D.E., MacLeod, J.N., O’Gorman, G.M., Park, S.D., Katz, L.M., Hill, E.W., 2009. Transcriptional adaptations following exercise in thoroughbred
horse skeletal muscle highlights molecular mechanisms that lead to muscle hypertrophy. BMC Genomics 10, 638, http://www.biomedcentral.com/1471-2164/10/638 ©McGivney et al; licensee
BioMed Central Ltd.
  Table 12.1  Over-represented functional groups of differentially expressed genes relative to all genes expressed in muscle were obtained
  using the online tool DAVID. Subsequent clustering of functional groups was aided by the functional group clustering tool in DAVID
Mt, mitochondrial.
                                                                                                                                                                                                      249
250
      Table 12.2  Differential gene expression between pre and post-exercise time-points in a panel of exercise-relevant genes located in positively selected (Dh/SD and FST) genomic regions
                                                                                                                                                                                                 12
      in Thoroughbred horses
                                                                                        T0 Vs T1                   T0 Vs T2
      Molecular function                                    Gene symbol      FC               P value   FC               P value   Chr      Locus         Dh/sd       P         FST      P
      Angiogenesis                                          ANGPT2            1.29            0.051      4.35            0.001     27       VHL150        −2.863      0.017     0.309    0.038
      Carbohydrate/Glucose metabolism                       PDK2                 1.24         0.234      1.51            0.033     11       TKY033        −2.916      0.002     0.392    0.013
                                                            PDK3                 1.07         0.583     −1.16             0.486    X        Lex026        −3.890      0.006     0.020    NS
                                                            PDK4              1.80            0.010      2.19            0.001      4       TKY222        −6.117      0.000     0.450    0.005
      Fatty acid metabolism/Gluconeogenesis/Glycolysis      ADHFE1            1.54            0.020      1.51            0.060      9       COR008        −9.436      0.000     0.258    NS
      Fatty acid biosynthesis/Insulin signaling pathway     ACACA            −1.1             0.379     −1.18             0.342    11       TKY033        −2.916      0.002     0.392    0.013
                                                            ACACB            −1.05            0.821     −1.02             0.929     8       AHT025        −1.360      NS        0.319    0.023
      Insulin signaling pathway                             FOXO1A            2.17            0.008      3.69            0.002     17       NVHEQ079      −3.602      0.007     0.380    0.018
                                                            GRB2             −1               0.985     −1.06             0.517    11       NVHEQ040      −3.848      0.007     0.170    NS
                                                            IRS1             –                –         –                –          6       UMNe197       −2.571      0.014     0.315    0.028
                                                            PRKAR2B          −1.05            0.714     −2.04            0.040      4       NVHEQ029      −0.272      NS        0.305    0.041
                                                            PTPN1            −1.01            0.949     −1.1              0.707    22       HMS047        −4.444      0.004     0.135    NS
                                                                                                                                                                                                 Genetic contributions to exercise and athletic performance
Selection for locomotor soundness                                                          comprising 23 116 records of horses for which their conformation
                                                                                           scores and duration of their sports career were available. Survival
                                                                                           analysis was used to determine which of the conformation traits
A discrimination should be made between inherited conforma-                                had a significant effect on duration of sports career in dressage and
tional traits that may predispose to lameness or other aberrations                         jumping at basic and elite level. Duration of competitive life was
of the locomotor system and genetically determined disorders of                            shorter for jumping than for dressage. A different set of risk factors
the musculoskeletal system that will affect performance.                                   was found for each level and discipline. The trait ‘uneven feet’
                                                                                           tended to shorten the competitive life in dressage, but was a signifi-
Conformational lameness-causing disorders                                                  cant risk factor at the elite level of jumping. Thus, limb conforma-
                                                                                           tion and, in particular, the conformation of the distal limb, are
Stashak (1987a) describes conformation of the horse as ‘the key to                         important for duration of competitive life. From the prevalence of
its method of progression’. He then elaborates on a number of faulty                       uneven feet in sports disciplines, it may be concluded that this is
conformations that may predispose to various pathologic condi-                             an undesirable trait, particularly at the elite level of jumping, since
tions of the musculoskeletal system: for instance a toe-out confor-                        uneven feet have a detrimental effect on the duration of competitive
mation results in a greater likelihood of limb interference and                            life in a sport horse population. This study provided evidence that
plaiting; a palmar deviation of the carpal joints (‘calf knees’) may                       the conformation trait uneven feet has a negative effect on Warm-
predispose to slab fractures of the carpal bones; and the commonly                         blood jumping performance and, therefore, breeders should be
seen cow hocked conformation may lead to bone spavin. Apart                                encouraged to avoid this phenomenon at foal age. Moreover, Ducro
from these conformation-related disorders, there are direct geneti-                        et al. (2009b) assessed the prevalence and heritability of uneven
cally determined aberrations of the musculoskeletal system, which                          feet and its genetic relationship to other conformation traits as well
are much rarer than conformational imperfections. Some of these                            as to sporting performance later in life in Warmblood riding horses.
have been known for a long time to have a genetic basis, but have                          Warmblood horse studbooks aim to breed horses with a conforma-
only recently been elucidated using modern molecular genetic tech-                         tion that will enable elite future performance, but reduce the risk
niques. Ducro et al. (2009a) investigated the significance of foot                         of injuries and lameness. Negative conformational traits, such as
conformation at young age to duration of the career of sport horses.                       asymmetrical or ‘uneven’ forefeet would possibly diminish perfor-
Warmblood horse studbooks aim to breed horses with a conforma-                             mance. The databases of the Royal Dutch Warmblood Studbook
tion that will enable elite future sports performance, but reduce the                      (KWPN, n = 44 840 horses) and Royal Dutch Equestrian Sports
risk of early retirement due to lameness. Negative conformational                          Federation (KNHS, n = 33 459 horses in dressage and n = 30 474
traits, such as asymmetrical or ‘uneven’ forefeet may possibly                             horses in show jumping) were linked through the unique number
shorten the career of sport horses. Databases of the Royal Dutch                           of each registered horse (Table 12.3). Therefore, heritabilities and
Warmblood Studbook (KWPN) and of the Royal Dutch Equestrian                                genetic and phenotypic correlations could be estimated from the
Sports Federation (KNHS) were matched and resulted in a dataset                            scores of the jury at studbook admission and the sports
 Table 12.3  Means and description of lower and upper value of traits scored at studbook entry (n = 44 480) and graded in sports
 (n = 33 459 in dressage, n = 30 474 in jumping)
 Grade in sports
 Dressage ranking*                              0                       Bad                                200                        Good                                52.5
 Jumping ranking                                0                       Bad                                200                        Good                                43.0
                                                                                                                                                                                   251
       12       Genetic contributions to exercise and athletic performance
       Table 12.4  Heritabilities (diagonal, bold and underlined) and genetic (below diagonal) and phenotypic (above diagonal) correlations
       between traits scored at studbook entry (n = 44 480) and graded in sports (n = 33 459 dressage (Dre), n = 30 474 jumping (Jum))
                                        HW           NL           UF           FC        PA          HS          HH           LQ          BC           CG          Jum          Dre
       Height at withers                 0.67        −0.12         0.01         0.04     −0.05         0.19        0.03       −0.17         0.12         0.19      −0.02           0.14
       Neck length                      −0.44         0.23        −0.01        −0.12      0.08       −0.03         0.04         0.10      −0.01        −0.30         0.02          0.04
       Uneven feet                      −0.03         0.10         0.12        −0.01     −0.06       −0.17         0.05       −0.03         0.04       −0.06       −0.01        −0.01
       Forelimb conformation            −0.06         0.16        −0.05         0.16      0.00       −0.04         0.01         0.10        0.00         0.08      −0.01        −0.08
       Pastern angle                    −0.03         0.01        −0.30         0.21      0.17         0.13      −0.16          0.10      −0.04        −0.04       −0.12        −0.04
       Hoof shape                        0.28         0.01        −0.49        −0.12      0.27        0.27         0.07         0.00        0.25         0.03        0.09       −0.07
       Heel height                      −0.01         0.15         0.47        −0.19     −0.42       −0.41         0.16         0.08        0.06         0.15        0.20          0.04
       Limb quality                     −0.29         0.22        −0.12         0.22      0.22         0.04       −0.01        0.19       −0.25          0.33        0.04          0.05
       Bone circumference                0.35         0.02         0.20        −0.17     −0.16         0.50        0.18       −0.58         0.24       −0.13         0.09          0.03
       Conformation grade                0.35        −0.59        −0.04         0.25      0.15         0.08        0.28         0.67      −0.23         0.30         0.04          0.19
       Jumping ranking                   0.01         0.14        −0.12         0.07      0.01         0.11        0.19         0.20      −0.09          0.29        0.14            ne
       Dressage ranking                  0.33         0.32        −0.09        −0.01      0.07       −0.01         0.15         0.36      −0.13          0.67         ne           0.14
       BC, bone circumference; CG, conformation grade; FC, forelimb conformation; HH, heel height; HS, hoof shape; HW, height at withers; LQ, limb quality; NL, neck length; PA,
       pastern angle; UF, uneven feet (%).
       Standard errors of estimates were below 0.03; ne, not estimated.
       Reprinted from Ducro, B.J., Bovenhuis, H., Back, W., 2009, Heritability of foot conformation and its relationship to sports performance in a Dutch Warmblood population. Equine
       Vet. J. 41, 139–143, with permission from the Equine Veterinary Journal.
       Table 12.5  Least square means of traits scored at studbook entry for level (basic and elite) and for sports discipline (n = 33 459 dressage,
       n = 30 474 jumping)
                                                                           Dressage                                                                  Jumping
                                                    Basic                    Elite                 Prob                      Basic                   Elite                    Prob
       Uneven feet (%)                                 6.20                     5.78                0.78                        6.43                    5.32                   0.32
       Height at withers                            165.6                    166.1                 <0.0001                   165.6                   165.6                     0.4
       Neck length                                  −18.36                   −17.90                <0.0001                   −18.55                  −18.00                   <0.0001
       Forelimb conformation                        −20.02                   −19.97                 0.14                     −19.91                  −19.98                    0.43
       Pastern angle                                −20.71                   −20.42                 0.006                    −20.61                  −20.71                    0.05
       Hoof shape                                   −18.99                   −18.91                 0.62                     −18.97                  −18.85                    0.02
       Heel height                                  −19.38                   −19.28                 0.05                     −19.47                  −19.14                    0.005
       Limb quality                                 −19.66                   −19.10                <0.0001                   −19.62                  −19.28                   <0.0001
       Conformation grade                            67.62                     69.27               <0.0001                    67.53                    68.33                  <0.0001
       Prob, probability of equal means of basic and elite level in each discipline.
       From Ducro et al., 2009b.
      performance of that population in dressage and jumping over the                            mean prevalence in the offspring of registered breeding stallions
      period 1990–2002. The prevalence of uneven feet was 53% on                                 (Fig. 12.2). Because of weak genetic correlations, the increased
      average, and increased from under 4.5% during the first 3 years of                         prevalence is not directly associated with selection for better sports
      recording to over 8% in the years from 2000 onwards. Heritability                          performance or higher conformation grade. If the trait ‘uneven feet’
      estimates of foot conformation traits were moderate and ranged                             arises from a disproportionate relationship between height at the
      from 0.16 for heel height to 0.27 for hoof shape (Table 12.4). The                         withers and neck length, then selection on conformation grade
      genetic correlation between the trait of uneven feet and perfor-                           might result in development of uneven feet (Fig. 12.3). In general,
      mance in competition was negative but weak: −0.09 with dressage                            limb conformation has a moderate genetic relationship to confor-
      and −0.12 with show jumping (Table 12.5). Predisposition to                                mation grade and foot conformation traits have a genetic relation-
      uneven feet can be reduced by selection, as there is a difference in                       ship to sporting performance. Reducing occurrence of uneven feet
252
                                                                                                                                                 Selection for locomotor soundness
 by selection is possible, without limiting progress in sport                                      breeding, illnesses, and concurrent myopathies. Valberg et al.
 performance.                                                                                      (1996) gave evidence for a familial basis for polysaccharide storage
                                                                                                   myopathy and associated exertional rhabdomyolysis in Quarter
                                                                                                   Horse-related breeds, the pattern of inheritance of which resembled
 Neuromuscular lameness-causing disorders                                                          an autosomal recessive disorder.
 Many monogenic anomalies in the horse have been described, a                                         Some disorders are inherited as dominant traits. An example that
 minority of which are related to the locomotor system (Galizzi Vec-                               has been known for centuries in both animals and man is hereditary
 chiotti Antaldi, 1980a,b). Most of these disorders are inherited as                               multiple exostoses (Li et al., 1989; Leone et al., 1987). In the horse
 autosomal recessive genes. Björck et al. (1973) described progres-                                the condition is generally inherited as a single autosomal dominant
 sive congenital cerebellar ataxia in the Gotland pony breed as being                              gene (Gardner et al., 1975; Shupe et al., 1979), though some report
 inherited as an autosomal recessive gene with full penetrance. In                                 that, as in man, three genes are involved, two autosomal and one
 Arabs a clinically similar condition described by Gerber et al.                                   X-linked (Monteiro & Barata, 1980). The American Association of
 (1995) caused almost total hypoplasia or atrophy of the Purkinje                                  Equine Practitioners (AAEP) has listed genetic tests for nine single
 cell layer. A lethal form of arthrogryposis (‘muscle contracture’)                                gene diseases (Nollet & Deprez, 2005; Finno et al., 2009) and
 associated with polydactylia in the Norwegian Fjord horse was                                     this number is likely to increase in the coming years as the new
 described by Nes et al. (1982) as an autosomal recessive mutation,                                genomics tools are utilized to identify the genetic variants underly-
 whereas Buoen et al. (1997) suggested a possible relation to auto-                                ing key equine disorders. ‘Autosomal dominant’ disorders include
 somal trisomy. Collinder et al. (1997) found for the equine                                       hyperkalemic periodic paralysis (HYPP) in the Quarter Horse, type
 rhabdomyolysis syndrome (RHA) in Standardbreds that gene fre-                                     1 polysaccharide storage myopathy (PSSM) in different breeds, and
 quencies for several markers in the RHA groups differed signifi-                                  malignant hyperthermia in Quarter Horse-related breeds (Aleman
 cantly from those estimated for the total population. A                                           et al., 2009; Magdesian, 2009). ‘Autosomal dominant’ disorders
 rhabdomyolysis risk group could be characterized using 4 or 5                                     include overo-lethal-white syndrome in the Paint Horse (McCabe
 genetic marker loci. Beech and Haskins (1987) described a neuroax-                                et al., 1990; Blendinger et al., 1994), combined immunodeficiency
 onal dystrophy in the Morgan. Aleman et al. (2009) proved that                                    in Arabian Horses (McGuire et al., 1974; Mottironi et al., 1981;
 Malignant Hyperthermia (MH) is a potentially fatal disease of                                     Bernoco & Bailey, 1998), glycogen branching enzyme deficiency
 Quarter Horses that could be triggered by halogenated anesthetics                                 (GBED) in Quarter Horse-related breeds (Stockham et al., 1994,
 and other nonanesthetic factors that may include exercise, stress,                                Wagner et al., 2006), junctional epidermolysis bullosa (JEB) in Bel-
                                                                                                   gians (Johnson et al., 1988; Frame et al., 1988; Milenkovic et al.,
                                                                                                   2003; Mömke & Distl, 2007) and in Saddlebred horses (Lieto et al.,
                  300                                                                              2002; Lieto & Cothran, 2003; Graves et al., 2009), and hereditary
                                                                                                   equine regional dermal asthenia (HERDA) in Quarter Horse-
                  250                                                                              related breeds (White et al., 2004; Tryon et al., 2005; Graves et al.,
                                                                                                   2009).
                  200                                                                                 Jamison et al. (1987) described a congenital form of myotonia
Number of sires
                                                                                                             -19
                   164
                                                                                                       9.4   -19.5
                  163.5                                                                    9.0
                                                                              7.3   7.5          8.1         -20
                                                                        7.2
                   163                                     5.5   5.9
                                4.5          5.0     4.7                                                     -20.5
                          3.8         3.7
                  162.5                                                                                      -21
                   162                                                                                       -21.5
                          1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
                                                                                                                                                                                                253
       12      Genetic contributions to exercise and athletic performance
      significantly better in halter classes than did unaffected horses         (2009) fine mapped a quantitative trait locus on horse chromosome
      (Naylor, 1994b). The mean total performance points were not sig-          2 associated with radiological signs of navicular disease in Hanove-
      nificantly different. He stated that selection of Quarter Horses          rian Warmblood horses. Németh (1974) demonstrated a pheno-
      affected with HYPP was enhanced by show judges. It has been               typic correlation between navicular disease and sesamoiditis. For
      demonstrated that the disease manifests as a result of a defect in        sesamoiditis a relatively low heritability of 0.11–0.17 has been esti-
      the sodium channel subunit gene (Rudolph et al., 1992; Zhou               mated (Barneveld, 1996). For osteoarthritis or degenerative joint
      et al., 1994; Cannon et al., 1995). A mutation in glycogen synthase       disease of the fetlock joint, which can also be graded using a radio-
      1(GYS1) has been shown to be associated with equine PSSM and              logical scale, heritability was found to be comparable (0.13–0.26;
      exertional rhabdomyolysis (Valberg et al., 2001; Ward et al., 2003,       Barneveld, 1996). Degenerative joint disease (DJD) of the distal
      2004; McCue et al., 2008a,b, 2009a; Herszberg et al., 2009). The          tarsal joints, often called bone spavin, is commonly associated with
      GYS1 mutation is an important cause of exertional rhabdomyolysis          poor conformation in which sickle hocks and cow hocks are pre-
      but does not account for all forms of PSSM. However, a significant        disposing factors (Stashak, 1987b). It is therefore not surprising that
      proportion of horses with histopathological evidence of PSSM and/         the disease to a certain extent is thought to have a genetic basis.
      or exertional rhabdomyolysis have different diseases (Valentine           Barneveld (1983) studied 168 3- and 4-year-old Warmblood off-
      et al., 1997; Valberg et al., 1998; Stanley et al., 2009). Tryon et al.   spring of 11 stallions and concluded that bone spavin indeed had
      (2009) estimated the allele frequencies of HYPP, lethal white foal        a hereditary basis and was related to the conformation of the hind
      syndrome (LWFS), glycogen branching enzyme deficiency (GBED),             limb. In the study by Van der Veen et al. (1994) bone spavin was
      HERDA, and PSSM genes in elite performance subgroups of Ameri-            found to have a heritability of 0.20–0.35. Radiographic examina-
      can Quarter Horses (AQHs). Accurate estimates of disease-causing          tion is considered essential for diagnosis of bone spavin (Butler
      alleles in AQHs and APHs may guide the use of diagnostic genetic          et al., 1993) but palpation of the distal tarsus and hind limb motion
      testing, aid management of genetic diseases, and help minimize            evaluation before and after the flexion test of the tarsus have also
      production of affected foals.                                             been shown to be of importance. In German riding horses, the
                                                                                heritability of bone spavin, based on radiographic diagnosis, has
                                                                                been estimated to be low, 0.02–0.04 on an observed scale (Winter
      Degenerative lameness-causing disorders                                   et al., 1996). In Icelandic horses the heritability for bone spavin in
      Frequently encountered lameness-causing disorders of the locomo-          the distal tarsal joint was 0.1 (Björnsdóttir et al., 2000) whereas
      tor system that are not developmental in origin, but are more of a        heritability for hind limb lameness after the flexion test was 0.47.
      degenerative nature, include navicular disease, sesamoiditis, osteo-      The flexion test is regarded as a less specific method for the diagnosis
      arthritis of the fetlock joint and bone spavin.                           of bone spavin. They suggest to select against bone spavin based on
         Navicular disease is a degenerative disorder of the podotrochlea       flexion test of the tarsus followed by radiographic diagnosis, since
      including the navicular bone, the navicular bursa, the distal sesa-       the combined trait has a considerable higher heritability than only
      moid impar ligament, the collateral sesamoid ligament and the             considering radiography. This is an interesting example of combin-
      distal part of the deep digital flexor tendon, has been known as an       ing two methods of diagnosis to develop a more accurate measure
      important cause of lameness for ages (Youatt, 1836). An inherited         of the phenotype, resulting in a higher heritability of the disorder.
      basis for the disease has been suggested (Numans & van de Water-
      ing, 1973).
         Using a radiological classification of the navicular bone as a
                                                                                Developmental lameness-causing disorders
      measure for the disease, Bos et al. (1986) found variation between        Hermans et al. (1987) investigated the genetic background of con-
      daughter groups consisting of 3-year-old mares from different sires,      genital luxation of the patella in Shetland ponies. Hermans (1970)
      supporting the theory that navicular disease has, to a certain extent,    described ulnar and tibial malformation (persistence) in the Shet-
      a genetic basis. However, they also concluded that the results of the     land pony with associated locomotor problems. Vertebral compres-
      radiological evaluation of the sires did not have predictive value for    sive myelopathy or ‘wobbler disease’ is a pathological disorder of
      the progeny.                                                              the spinal cord rather than of the locomotor system. However, as it
         In a large study that included 590 female offspring from 30 sires,     produces ataxia the condition may severely affect locomotor perfor-
      the heritability of the radiographic classification of the navicular      mance. An early report on Wobbler disease stated that the syndrome
      bone was estimated as 0.26–0.34 (Van der Veen et al., 1994) and           was familial (Dimock, 1950). However, this could not be confirmed
      were in agreement with heritability estimates ranging from                in a later large-scale retrospective study (Falco et al., 1976), nor in
      0.20 to 0.31 found by Willms et al. (1999) on 492 Holstein horses.        a prospective study in which clinically and radiographically con-
      Winter et al. (1996) analyzed 3566 German Warmblood horses                firmed ‘wobbler’ mares and stallions were mated (Wagner et al.,
      selected for auction sale without clinically manifest navicular           1985). In the latter study the high incidence of a number of devel-
      disease. The heritability estimate was 0.06 on the observed scale and     opmental orthopedic diseases (OC, physitis, contracted tendons)
      no transformation to liability scale was performed. The study of          was remarkable.
      Stock and Distl (2006) gave estimates varying from 0.10 to 0.34.
      From these studies it can be concluded that radiological changes of
      the navicular bone are genetically influenced. An explanation might
                                                                                Complex chondrodysplasia: osteochondrosis
      be the shape of the proximal articular border of the navicular bone       Osteochondrosis (OC) can be defined as a disturbance of the
      has been found to be inherited and to predispose the pathogenesis         process of endochondral ossification as this occurs in the growing
      of navicular disease; the more concave or undulating, the higher the      individual. Irregular ossification leads to the formation of thick
      risk for the disease (Dik et al., 2001). Selection against navicular      cartilage plugs and areas of focal necrosis, eventually resulting in
      disease was successfully performed by the Dutch Warmblood stud-           flattened bone contours and loose fragments, commonly referred
      book. In 1997 selection was started by excluding from breeding the        to as osteochondrosis dissecans (OCD) (Jeffcott, 1997; van de Lest
      stallions with severest grade (grade 4) of the disease has resulted in    et al., 1999). Of the group of so-called developmental orthopedic
      a considerable decrease of the two worst grades (3 and 4). From           diseases it is by far the most common (McIlwraith, 1986). Epide-
      1997 to 2002 the prevalence of the two most severe grades (3 and          miological data suggest that the disorder is present in many breeds
      4) decreased from 11 to 2% (Van den Belt et al., 2003). Diesterbeck       of horses in 10–25% of the population (Jeffcott, 1997). The exact
      and Distl (2007) reviewed the genetic aspects of radiological altera-     pathogenesis of the disease is still unclear and subject to investiga-
      tions in the navicular bone of the horse and found Genome-wide            tion (Jeffcott, 1991; Jeffcott & Henson, 1998). However, there is
      significant QTL were on ECA2 and on ECA10, whereas Lopes et al.           universal agreement that the disease is multifactorial (Hurtig &
254
                                                                                                             Selection for locomotor soundness
Pool, 1996) and that genetics play a role. Therefore, like many            often are converted afterwards to the underlying scale, using appro-
diseases and performance characteristics, the phenotypic expression        priate formulas (e.g. Dempster & Lerner, 1950).
of OC is influenced by the environment plus a genetic component               The analysis is commonly performed using a sire or an animal
consisting of many genes in the genome (Gerber & Bailey, 1995).            model. The animal model better accounts for the state of selection
   Van Weeren and Barneveld (1999) showed that osteochondrosis             in females, whereas the assumption underlying a sire model is that
is a very dynamic process in which lesions develop, but may also           females are unselected. In horse breeding in which assortative
regress spontaneously. They also demonstrated the presence of              mating is common. As a result of poor data quality and treatment,
osteochondrotic lesions in many joints other than the commonly             genetic differences between joints and breeds might be
affected hock and stifle. These findings shed a different light on this    compromised.
condition and ask the question of whether there is a genetic differ-          OC/OCD in the stifle seems to have low heritability with esti-
ence between animals that show the condition at 3 years of age and         mates around 0.08 and not significantly different from zero (Tables
animals that have shown the condition since foals, but in which the        12.6 and 12.7). Measuring OC in the stifle is probably more difficult
lesions subsequently regressed spontaneously. In addition to this,         than in the hock, which introduces random noise. The heritability
when considering the stifle joint, they found significant difference       estimate for OC in the stifle might therefore be lower than for the
in the prevalence of the condition in foals that were the offspring        hock, although the prevalence is comparable. This is supported by
of OC-free parents compared with foals whose parents were suffer-          the significant effect of sedation during radiography (Van Grevenhof
ing from the condition in the same joint. This was not the case with       et al., 2009a). OC/OCD in the FP more often leads to lameness
respect to oseteochondrotic lesions in the hock joint and might be         than OC/OCD in the TC (Auer & Stick, 2006), but OC/OCD in the
an indication of a different genetic background in these two joints        hock joint is more frequently investigated. When only considering
(Van Weeren et al., 1999).                                                 OC, heritability lies mostly in the area of 0.15, whereas OCD is
   Osteochondrotic lesions are found in different joints and joints        somewhat higher at 0.27 (Stock & Distl, 2006; Van Grevenhof et al.,
primarily affected are the tarsocrural (TC), femeropatellar (FP), gle-     2009b). OC in trotters might be somewhat higher as indicated by
nohumeral (GH), metacarpophalangeal, (MCP), metatarsophalan-               studies of Grondahl and Dolvik (1993) and Philipsson et al.
geal (MTP) and the cervical intervertebral (CI) joints (Radiostits         (1993). Grondahl and Dolvik suspected an overestimation in their
et al., 2007). Most of the genetic studies are considering only one        result, because of a very high incidence of OC in one group of
or a few of the joints, of which the stifle, hock and fetlocks are the     offspring. OC/OCD in the fetlock has a heritability of 0.10 (Schober
most frequent ones (Table 12.6). The large range in prevalence and         et al., 2003; Van Grevenhof et al., 2009b); whereas heritability of
heritability reported may be attributed to: use of field data, defini-     OCD was somewhat higher at 0.17–0.18 (Stock et al., 2005; Phil-
tion of OC, and statistical model of analysis in relation to the scale     ipsson et al., 1993), which was accompanied by a higher prevalence
of OC-scoring. As radiographic examinations are expensive and              of 25%. Van Grevenhof et al. (2009b) found only a value of 0.09
labor intensive, datasets collected at other occasions (auctions and       when clearly separating fragments from flattenings. They argued
presale purchases) are often subject to genetic studies. There is a        that only osseous fragments seen at the proximodorsal parts of the
serious risk that these datasets are too small or preselected, leading     sagittal ridge of the third metacarpal and metatarsal bone can be
to inaccurate and/or biased estimates. The heritability estimates          considered as caused by the same etiology as other OC and not by
may also vary as a result of different definitions of OC, in particular    mechanical injuries (Hurtig & Pool, 1996).
with respect to bony irregularities at different predilection sites in        Genetic correlations reflect to what extent traits are affected by
the joints. Depending on the predilection site, lesions are assumed        the same genetic complex and therefore contribute to unraveling
to have either a traumatic origin or an osteochondrotic origin (Jef-       the etiology of traits. Sandgren et al. (1993) found genetic correla-
fcott, 1991). For example, Philipsson et al. (1993) and Grøndahl           tions between hock and fetlock close to zero and this corresponds
and Dolvik (1993) only regarded bony fragments at the intermedi-           to the findings of Grondahl and Dolvik (1993) and Van Grevenhof
ate ridge of the distal tibia and at lateral/medial trochlear ridge of     et al. (2009b). Stock et al (2005) estimated a moderate positive
the talus as OC, whereas McIlwraith (1993a,b) additionally regarded        genetic correlation between hock and fetlock OCD. Genetic correla-
the lateral/medial malleolus of the tibia as a predilection site. Preva-   tion of stifle with hock was moderately positive, and of stifle with
lence and heritability are likely affected by the number of predilec-      fetlock was low. Although standard errors in most of the studies
tion sites considered. Similarly, fragments and flattening might have      were too high to make significant statements, the genetic correla-
a different genetic basis and it is questionable whether these two         tions between joints did not indicate that OC as manifested in the
forms should be treated alike in a genetic study. Scoring of OC is         various joints are the same traits (or solely regulated by the same
mostly on binary scales (yes/no OC), which does not give the               genes). This is supporting the hypothesis of Van Weeren and Van
opportunity to record further details with respect to form and             Barneveld (1999) of a different genetic background in the different
degree of severity of OC. Instead Van Grevenhof et al. (2009b) used        joints (Van Weeren et al., 1999). Additionally, genetic correlations
a 5-point scale in their study on which form as well as severity of        between the joints are not high enough to rely on measuring in
disorder could be recorded. In most joints heritability-estimate           only a part of the joints to set up a selection program to eradicate
improved when using the 5-point scale, compared to a binary scale          OC in all joints. Whether the two forms of OC are genetically
(Table 12.7). In contrast, Ricard et al. (2002) propagated a binary        related was investigated by van Grevenhof et al. (2009b). Genetic
scale, because heritabilities based on multipoint scales were lower,       correlation between flattenings and fragments over joints was high
due to introduction of random noise in the data when using a               (0.80) and not significantly differing from one. This finding sup-
multipoint scale. This illustrates that the extra categories should be     ports the hypothesis of a common genetic background of both
useful differentiators.                                                    forms of OC.
   After data collection, further differences in heritability estimates       Genetic correlations of OC with conformation and performance
could arise from different models of analysis. The binary trait could      could aid to understanding the etiology as well, and reveals how
be treated accordingly using a threshold model, although often an          selection against OC can be implemented in a horse breeding
ordinary linear model is used. A linear model reveals the heritability     program. There are only a few studies on the relation with perfor-
on the observed scale, which is an underestimation of the true             mance and expectations are based on phenotypic observations.
frequency because of its dependence on the prevalence in the popu-         Affected horses suffering from pain and distress are likely to show
lation. A threshold model estimates heritability on the underlying         reduced performance in sports. However, given the high preva-
scale, which can be interpreted as the sensitivity to or risk of devel-    lence of radiographic findings in horses without signs of lameness
oping the disorder (irrespective of having OC), and better reflects        or stiff joints, the relevance of particular radiographic findings,
the genetic potency. Therefore, estimates on the observable scale          especially with respect to sport performance, is being questioned.
                                                                                                                                                   255
       12        Genetic contributions to exercise and athletic performance
       Table 12.6  Prevalences and heritabilities (h2) of osteochondrosis (OC) and fragments (OCD), by joint, for different populations of
       warmblood (WB) horses
       ATM, animal threshold model; DL, Dempster-Lerner transformation; GS, Gibbs sampling; LAM, linear animal model; LSM, linear sire model; REML, restricted maximum likelihood;
       SB, Standardbred; STM, sire threshold model; WB, Warmblood.
       *I, der Kinderen (2005); II, Ricard et al. (2002); III, Pieramati et al. (2003); IV, KWPN (1994); V, Schober et al. (2003); VI, Grøndahl and Dolvik (1993); VII, Philipsson et al. (1993); VIII,
       Stock et al. (2005); IX, Stock and Distl (2006); X, Schougaard et al. (1990).
       Adapted from Van Grevenhof, E. M., B. J. Ducro, P. R. van Weeren, J. M. F. M., van Tartwijk, A. J. van der Belt, and P. Bijma, 2009. Prevalence of various radiographic manifesta-
       tions of osteochondrosis and their correlations between and within joints in Dutch Warmblood horses (KWPN). Equine Vet. J. 41, 11–16, with permission from the Equine
       Veterinary Journal.
      Reduced sports performance was found in trotters (Grøndahl &                                          make inferences on whether sires that inherit potential for a suc-
      Engeland, 1995) and osteoarticular findings were directly respon-                                     cessful sport career also inherit high or low susceptibility to OC.
      sible for failure to qualify in 31% of the horses participating                                       In the study of Stock and Distl (2006) hock-OCD showed high
      (Robert et al., 2006). In contrast, no significant differences were                                   negative genetic correlation to sports performance in both disci-
      found in racing performance of Standardbred trotters with radio-                                      plines whereas fetlock-OCD was only negatively related to show
      graphic signs of OCD, relative to their contemporaries (Brehm &                                       jumping. Negative genetic correlations are favorable because they
      Straecker, 2000; Storgaard Jørgensen et al., 1997). These results are                                 point out that breeding for lower prevalence of OC coincides with
      indicative for phenotypic correlations, but do not allow us to                                        breeding for higher sport performance. The authors suspected
256
                                                                                                                              Selection for locomotor soundness
                                                                                                                                                                    257
            12             Genetic contributions to exercise and athletic performance
                       4
      -log10 P-Value
                              1      2    3    4      5    6     7     8     9    10   11 12 13   14   15           16           17   18   19    20   21 22 23 24 25 26 27 28 29 3031
                                                                                 Chromosome
      Fig 12.4  Manhattan plot of P-value in the Friesian horse dwarfism GWAS. Association of 34 429 SNPs with dwarfism represented by –log10 P-values from a
      two degree of freedom x2 test plotted by chromosome and sorted by chromosomal position. No SNP in the GWAS remained statistically significant after
      correction for multiple testing.
      Reprinted from Orr, N., Back, W., Gu, P., et al., 2010. Genome-wide SNP association based localization of a dwarfism gene in Fresian dwarf horses. Animal Genetrics 41 (Suppl. 2), 2–7, with
      permission from John Wiley and Sons.
258
                                                                                                                                          References
Hanson et al., 2006). In the Friesian dwarf horses, however, a dis-             Finally, both FGFR1 and FGFR2 are included within the critical
proportional growth disturbance is seen, which would imply a                 region of chromosome 14 flanked by BIEC2-249929 and BIEC2-
local defect or disturbance in one of the regulatory systems for             250663 based on the equine build from UCSC Broad Institute
growth plate development. Growth plate development is under the              (UCSC Genome Browser: http://genome.ucsc.edu). Both fibroblast
control of many autocrine and paracrine factors (Kronenberg,                 growth factor receptors play key roles in skeletal development and
2003). Recently, de Graaf and colleagues investigated the function-          mutations have been related to skeletal dysplasia and dwarfing syn-
ing of the hypothalamic-pituitary growth axis in three Friesian              dromes (White et al., 2005; Eswarakumar et al., 2002). Profound
dwarfs. No evidence of hypothalamic-pituitary dysfunction or                 effects on bone elongation have been shown through supposed sup-
failure of IGF-1 production was found, suggesting that the cause of          pression of chondrocyte and osteoblast function. However, in con-
the congenital growth abnormality was located distal or peripheral           trast to the relative normal head proportions seen in the Friesian
to the level of the GH receptor in the liver and may have been a             dwarf syndrome, FGFR1 and FGFR2 mutations seem to have a sig-
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tant with this observation, no coding polymorphisms in PROP1                 ism in Friesian horses has been identified on ECA14. Validation of
were detected that were associated with dwarfism in the Friesian             this finding in a larger group of animals and segregation analysis in
horse samples. When the normal bone remodeling process is dis-               known pedigrees is warranted before further localization of the
turbed in horses, abnormal defects in the growth plate may result.           causative mutation is conducted. This may prove extremely chal-
A local defect or disturbance in one of the regulatory systems for           lenging given the strong linkage disequilibrium in the region. The
growth plate development potentially can result in a dispropor-              study suggests that with the advent of new genomic tools, studies
tional growth disturbance typically seen in Friesian dwarf horses            of equine diseases may yield important new insight into pathogen-
(Vaughan, 1976; Jeffcott & Henson, 1998; Gee et al., 2005).                  esis and may be translatable to orthologous human traits.
Further screening of the OMIM database for genes in the chromo-
some 14 region that could be linked to a disturbed bone remodel-
ing process in abnormal growth plate development identified
ZNF346, COL23A1 and B4GALT7 as candidate genes. ZNF346 is                    Conclusions
proposed to play a role in apoptosis (cell death), a process crucial
for the normal transition of cartilage into bone seen during normal          The recent completion of the horse genome sequence and the com-
physeal growth (Gibson, 1998; Ballock & O’Keefe, 2003). It could             mercial availability of an equine SNP genotyping array will facilitate
be speculated that disturbed apoptosis plays a role in the physeal           an acceleration in the mapping of disease genes in the horse during
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COL23A1 and B4GALT7 are proposed to play a role in collagen                  and training play an important role in shaping the equine athletic
network formation. Although a disturbed collagen network is                  phenotype, it is likely that genetic testing for conformation, disease
known to effect calcification and subsequent transformation of car-          and performance traits will become mainstream and that this infor-
tilage into bone (Wassen et al., 2000), the specific role of both            mation will enhance decision-making processes in the selection and
genes in collagen formation is highly speculative and largely                breeding of horses. A crucial step in the success of developing gene
unclear. B4GALT7 is also proposed to play a role in connective               tests is the phenotyping. Poor phenotyping will severely compro-
tissue disorders and has been related to disturbed fibril organiza-          mise the success of genotyping. For a set of diseases this is less
tion and proteoglycan synthesis. Both processes could play a role            relevant as the phenotype is clear, but for complex multi-factorial
in abnormal development of bone and subsequent retardation of                diseases the phenotype is less clear. Defining accurate phenotypes
growth in the growth plate seen in Friesian dwarfism (Kvist et al.,          for performance and conformation, in which subjective measure-
2006; Burdan et al., 2009).                                                  ments are involved will be the challenge in the near future.
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   draught horses. Equine Vet. J. 29, 220–225.         Exterieurgesamtbeurteilungen und                  Wittwer, C., Chowdhary, B.P., Distl, O., 2005.
Van Bergen, H.M.J.M., van Arendonk, J.A.M.,            Beziehungen zu Körpermaβen bei                       Radiation hybrid mapping of equine
   1993. Genetic parameters for linear type            Trakehner Stuten. Züchtungsk. 64, 92–100.            CDK2, DGKA, DNAJC14, MMP19,
   traits in Shetland ponies. Livest. Prod. Sci.                                                            CTSL and GAS1. Anim. Genet. 36 (6),
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   36, 273–284.                                                                                             536–537.
                                                       M., Gnerre, S., Imsland, F., et al., 2009.
Van de Lest, C.H., van den Hoogen, B.M., van           Genome sequence, comparative analysis,            Wittwer, C., Dierks, C., Hamann, H., Distl, O.,
   Weeren, P.R., Brouwers, J.F., van Golde,            and population genetics of the domestic              2008. Associations between candidate gene
   L.M., Barneveld, A., 1999. Changes in bone          horse. Science 326, 865–867.                         markers at a quantitative trait locus on
   morphogenic enzymes and lipid                                                                            equine chromosome 4 responsible for
                                                    Wagner, M.L., Valberg, S.J., Ames, E.G., Bauer,
   composition of equine osteochondrotic                                                                    osteochondrosis dissecans in fetlock joints
                                                       M.M., Wiseman, J.A., Penedo, M.C., et al.,
   subchondral bone. Equine Vet. J. Suppl.                                                                  of South German Coldblood horses.
                                                       2006. Allele frequency and likely impact of
   (31), 31–37.                                                                                             J. Hered. 99, 125–129.
                                                       the glycogen branching enzyme deficiency
Van Den Belt, A. J., Dik K. J., Van Den Broek          gene in Quarter Horse and Paint Horse             Wittwer, C., Hamann, H., Distl, O., 2009. The
   J., 2003. The use of radiography as a tool          populations. J. Vet. Intern. Med. 20,                candidate gene XIRP2 at a quantitative
   for the efficacy of selective breeding of a         1207–1211.                                           gene locus on equine chromosome 18
   poor radiographic navicular bone                                                                         associated with osteochondrosis in fetlock
                                                    Wagner, P.C., Grant, B.D., Watrous, B.J.,               and hock joints of South German
   condition (grade3 and 4). In: Proceedings
                                                       Appell, L.H., Blythe, L.L., 1985. A study of         Coldblood horses. J. Hered. 100,
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   Radiological Society, Midrand, South
                                                       horses. Proc. Am. Assoc. Equine Pract. 31,
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                                                       43–50.
Van der Veen, G., Kingmans, J., van                                                                         Distl, O., 2007b. Genetic parameters for the
                                                    Ward, T.L., Valberg, S.J., Adelson, D.L., Abbey,        prevalence of osteochondrosis in the limb
   Veldhuizen, A.E., et al., 1994. The
                                                       C.A., Binns, M.M., Mickelson, J.R., 2004.            joints of South German Coldblood horses.
   frequency and heritability of navicular
                                                       Glycogen branching enzyme (GBE1)                     J. Anim. Breed Genet. 124, 302–307.
   disease, sesamoidosis, fetlock joint
                                                       mutation causing equine glycogen storage
   arthrosis, bone spavin, osteochondrosis of                                                            Wittwer, C., Lohring, K., Drogemuller, C.,
                                                       disease IV. Mamm. Genome 15, 570–577.
   the hock: a radiographic progeny study.                                                                  Hamann, H., Rosenberger, E., Distl, O.,
   Koninklijk Warmbloed Paardenstamboek             Ward, T.L., Valberg, S.J., Lear, T.L., Guérin, G.,      2007a. Mapping quantitative trait loci for
   Nederland, Zeist, p. 47.                            Milenkovic, D., Swinburne, J.E., et al.,             osteochondrosis in fetlock and hock joints
Van Grevenhof, E. M., Ducro, B. J., van                2003. Genetic mapping of GBE1 and its                and palmar/plantar osseous fragments in
   Weeren, P. R.,van Tartwijk, J. M. F. M., van        association with glycogen storage disease IV         fetlock joints of south German Coldblood
   der Belt, A. J., Bijma, P., 2009a. Prevalence       in American Quarter Horses. Cytogenet.               horses. Anim. Genet. 38, 350–357.
   of various radiographic manifestations of           Genome Res. 102, 201–206.                         Yan, Z., 2009. Exercise, PGC-1alpha, and
   osteochondrosis and their correlations           Wassen, M.H., Lammens, J., Tekoppele, J.M.,             metabolic adaptation in skeletal muscle.
   between and within joints in Dutch                  Sakkers, R.J., Liu, Z., Verbout, A.J., et al.,       Appl. Physiol. Nutr. Metab. 34 (3),
   Warmblood horses (KWPN). Equine Vet. J.             2000. Collagen structure regulates fibril            424–427.
   41, 11–16.                                          mineralization in osteogenesis as revealed        Yang, D.E., Zhang, C.L., Zhang, D.S., Jin, D.M.,
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   J., van Weeren, P. R., van Tartwijk, J. M. F.       J. Bone Miner Res. 15 (9), 1776–1785.                Genetic analysis and molecular mapping
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   various manifestations of osteochondrosis           Giguère, V., Kelly, D.P., 2005. PGC-1alpha           gene Rfg1. Theor. Appl. Genet. 108 (4),
   and their correlations between and within           coactivates PDK4 gene expression via the             706–711.
   joints in Dutch warmblood horses.                   orphan nuclear receptor ERRalpha: a               Yang, F., Fu, B., O’Brien, P.C., Robinson, T.J.,
   J. Anim. Sci. 87:1906–1912.                         mechanism for transcriptional control of             Ryder, O.A., Ferguson-Smith, M.A., 2003.
Van Weeren, P.R., Barneveld, A., 1999. The             muscle glucose metabolism. Mol. Cell Biol.           Karyotypic relationships of horses and
   effect of exercise on the distribution and          25 (24), 10684–10694.                                zebras: results of cross-species chromosome
   manifestation of osteochondrotic lesions in      White, K.E., Cabral, J.M., Davis, S.I., Fishburn,       painting. Cytogenet. Genome Res. 102
   the Warmblood foal. Equine Vet. J. 31               T., Evans, W.E., Ichikawa, S., et al., 2005.         (1–4), 235–243.
   (Suppl.), 16–25.                                    Mutations that cause osteoglophonic               Youatt, W., 1836. Animal pathology. The
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                                                                                                                 CHAPTER                 13 
                                                                          1996). Unlike most other species, horses have always been used to
General introduction                                                      increase the mobility and transport capacity of mankind, with more
                                                                          tangible products such as meat, milk and leather figuring as
There is a constant interaction between any biological entity and its     by-products only. Although the role of the horse in society has
environment, which may consist of other biological systems (such          changed dramatically in the past 50–60 years in comparison to the
as individuals from the same species, predators or invading micro-        previous five millennia, it is still its athletic capacity that gives the
organisms), or physical influences such as weather conditions. In         horse its role in present-day society.
fact, the (in)ability to respond actively to these environmental chal-       On a much shorter timescale, functional adaptation towards
lenges can be seen as a criterion for the discrimination between life     optimal locomotion capacity is also of crucial importance for the
and death. The environmental influences can be best accommo-              individual animal. The demands on the equine musculoskeletal
dated when the individual is optimally suited to cope with these          system of many modern performance horses seem likely to be sub-
challenges. In other words, when optimal functional adaptation            stantially more than those borne previously by animals principally
occurs. This is of particular interest when the environmental stimuli     used in transport, agriculture and the military, and are most prob-
are repetitive in nature, such as those generated by the locomotor        ably much heavier than under most circumstances in the wild. The
system. This concept of functional adaptation applies to widely           heavy challenges placed on the musculoskeletal system by present-
different timescales. On an evolutionary scale the capacity to adapt      day equestrian activities, together with the inevitable loss in robust-
functionally is decisive for the survival of a species; for a given       ness and sturdiness that goes with the process of domestication,
individual the ability to adapt throughout life determines whether        may well lie at the heart of the high incidence of musculoskeletal
or not vitality is retained and for how long.                             injury and elevated wastage for orthopedic reasons in the equine
   The horse has evolved from a forest-dwelling browser called            species (Rossdale et al., 1985; Williams et al., 2001).
Hyracotherium or Eohippus, which had four hoofed toes in the                 Any musculoskeletal injury can be seen as a failure of the tissues
front feet and three in the hind feet and was not more than 8–9           to respond to the (mostly biomechanical) challenges placed upon
inches (approximately 2 hands) at the withers, to the contemporary        them. Such failure may be the consequence of a high-impact single
large ungulate measuring up to 18 hands. During the evolutionary          traumatic event, but more often follows the accumulation of repeti-
process, which started in the Eocene and took some 60 million             tive micro-trauma. In the latter, training may be helpful to enhance
years, the horse changed from a typical forest inhabitant, which          the resistance of the musculoskeletal tissues to biomechanical
relied on hiding rather than flight for survival into an animal that      loading. In fact, training is the artificial and purposeful enhance-
was optimally adapted for living on the open steppe (Simpson,             ment of the degree of functional adaptation of tissues. Classically,
1951). Through this process the locomotor system underwent pro-           there has been much interest in the effect of training on cardiovas-
found change, as it became the most important factor in escaping          cular performance and on muscle strength, but other tissues respond
from predators. The morphological changes that have imparted              to training too, though it should be clear that the extent of response
advantage for high-speed locomotion include the development of            of different tissues to the same training protocol may differ vastly.
long and slender limbs with the muscles located proximally and            Another complicating factor is the age of the individual. Tradition-
close to the center of mass, reduced degrees of freedom of joint          ally, research has been done in young horses, mostly aged 2–4 years,
motion in the distal limbs, which grossly limits motion to the sagit-     because of the early onset of the athletic career in the racing breeds
tal plane, and the use of collagenous components of muscle and            and resulting commercial pressure. These horses cannot be classi-
tendon to reduce energy requirements in posture and locomotion.           fied as juvenile, nor have they yet reached full skeletal maturity
A very important athletic asset of the present-day horse is the storage   (Gabel et al., 1977; Strand et al., 2007). There has been little inter-
of kinetic energy in the form of elastic energy in the tendinous          est in the effects of exercise on older horses, but some large studies
structures of (especially) the limb flexors. This spring-like mecha-      have been conducted in the past decade on the effects of exercise
nism prevents energy loss and limits the role of the flexor muscles       in very young animals, e.g. in newborn foals. The latter research has
to dampening of these springs rather than using them to generate          made it clear that age indeed does matter. Whereas bone and muscle
propulsion, thus greatly reducing the muscle volume needed                are known to respond to exercise throughout life, articular cartilage,
(Wilson et al., 2001).                                                    tendons and ligaments are tissues that are much less, if at all,
   The potential of the locomotor system led man to begin domes-          responsive in mature individuals. However, there is mounting evi-
ticating the horse in approximately 3000 BC (Dunlop & Williams,           dence from recent research that these latter three tissues, which rank
                                                                                                                                                      267
       13      The response of musculoskeletal tissues to exercise
      among the first with respect to injury prevalence and are notorious       Articular surface
      for their poor healing tendency, might be much more responsive to
      exercise in juvenile animals. This might open up new avenues for             Proteoglycan
      better adapting the equine musculoskeletal system to athletic chal-           aggregates
      lenge through programs of conditioning exercise at young age.              Collagen fibrils
      However, such programs could be developed only if the exact effects
                                                                                       Tidemark
      of exercise on the diverse musculoskeletal tissues are known, if the
      exercise regimen to effect adaptation is known, and the appropriate         Calcified layer
      time window in which to apply it. In the following chapter the               Subchondral
      major constituting tissues of the musculoskeletal system: bone,                 boneplate
      articular cartilage, tendons and muscle, are discussed with respect       Fig 13.1  Schematic drawing of articular cartilage showing the arcade-like
      to their responsiveness to exercise. Discrimination is made between       architecture of the collagen fibrils as first described by Benninghoff (1925).
      the effect of exercise in mature individuals and in the growing and       Typically, the collagen fibrils emerge from the calcified layer perpendicular
      still developing juvenile animal.                                         to the tidemark and start to arch in the intermediate zone, to become
                                                                                aligned with the articular surface in the superficial zone.
Articular cartilage
268
                                                                                                                                          Articular cartilage
A D
B E
amount of proteoglycans (PG) and high water content (Aydelotte         percentage of water of any zone, and chondrocytes arranged in
et al., 1988; Aydelotte & Kuettner, 1988). The middle (transitional)   columns perpendicular to the subchondral bone (Todhunter,
zone has lower water content, a higher concentration of PG, and a      1996).
lower concentration of collagen fibrils that are less organized, and      Articular cartilage is, like any living tissue, not a static entity but
rounded chondrocytes dispersed irregularly in the extracellular        undergoes constant remodeling through anabolic and catabolic
matrix. The deep zone has collagen fibrils oriented perpendicular      processes. The chondrocyte, the only cell type found in normal
to the articular surface, the highest concentration of PG, lowest      articular cartilage, produces all ECM components. Collagen
                                                                                                                                                                   269
       13         The response of musculoskeletal tissues to exercise
Site 1 Site 1
A Proximal phalanx
                                                                                                       Site 1
                                                                                                       Site 2
                                                                                                                                           Site 1
Site 2
        B                                                                                        Fig 13.4  Differently loaded sites at the proximal articular surface of the
                                                                                                 proximal phalanx. Site 1 is located at the medial dorsal margin of the joint
                                                                                                 surface. This site is not loaded when standing still or in a slowly moving
                                                                                                 animal, but it is subject to high intermittent peak loading in overextended
                                                                                                 joints at high speeds and during jumping. Site 2 is located in the central
                                                                                                 fovea of the articular surface and is continually loaded when the limb is
                                                                                                 weight bearing, but the site experiences lower absolute forces than site 1.
270
                                                                                                                                                            Articular cartilage
                                                                                                     1.25
The effect of exercise on articular cartilage
                                                                          Collagen ratio site I/II
                                                                                                                                                                                  271
        13      The response of musculoskeletal tissues to exercise
         Another interesting observation was made in the boxed/sprinted                  metacarpal cartilage (Kawcak et al., 2010). However, the exercised
      animals that had been subjected to a combination of short bouts                    horses had more viable chondrocytes in the more heavily loaded
      of high-intensity exercise with a sedentary lifestyle. The degree of               sites than in the less loaded sites of the same metacarpal cartilage
      development of topographical heterogeneity in this group was com-                  (Dykgraaf et al., 2008). Also, a detailed study of contiguous approx-
      parable to the pastured animals, which were regarded as controls.                  imately 100-µm thick slices taken from the proximal articular
      However, when culture experiments were carried out with chondro-                   surface of the proximal phalanx down to the tidemark at differently
      cytes harvested at age 11 months from animals from the former                      loaded sites (see above) showed not only obvious site differences,
      exercise groups, it appeared that chondrocytes from the former box/                but also exercise-related changes. There was no exercise effect on
      sprinted group could not be stimulated to increase metabolic activ-                proteoglycan content, indicating that the exercise level had not been
      ity, in contrast to samples from both other groups. This was inter-                strenuous and confirming the work by Nugent et al. (2004) and
      preted as a deleterious long-term effect of the combination of                     Kawcak et al. (2010); but at 18 months old the normal physiological
      sedentarism with bouts of high intensity exercise, possibly repre-                 increase in collagen at the site located at the joint margin was less
      senting a kind of cellular exhaustion that might be due to over-                   in CONDEX animals (Brama et al., 2009a). This was interpreted as
      stimulation during the first 5 months of life (van den Hoogen et al.,              a precocious cessation of collagen remodeling at this site due to
      1999). Similar phenomena were observed in other tissues from                       advancement in time of the normal maturation process. The bio-
      these animals (Barneveld & van Weeren, 1999). Also, forced exercise                chemical analysis of similar slices from the same site in the meta-
      (box/sprinted) had a negative effect on collagen turnover, as mea-                 tarsophalangeal joint pointed in the same direction: in the CONDEX
      sured by serum markers CPII and Ctx1, when compared to pastured                    animals, hydroxylysine, HP cross-links and pentosidine cross-links
      foals (Billinghurst et al., 2003).                                                 were all higher, all indicative of advancement of the normal process
         Another large-scale exercise study concerning foals was conducted               of functional adaptation (van Weeren et al., 2008). The increased
      by the Global Equine Research Alliance (GERA, a consortium of the                  pentosidine levels in the CONDEX animals are of particular inter-
      equine orthopedic research groups from Massey University, New                      est, because they indicate a lower metabolic activity in this group,
      Zealand, Colorado State University, USA, Royal Veterinary College,                 confirming more rapid progression of the physiological age-related
      UK and Utrecht University, the Netherlands). This study became                     decrease in matrix turnover and thus indicative of an advanced
      known under the acronym GEXA. In the GEXA study, 33 Thorough-                      degree of maturation compared to the PASTEX animals (Fig. 13.8).
      bred foals were raised from 0–18 months under different exercise                      Other evidence for the difference in maturation rate came from
      conditions. One group (PASTEX, n = 15) had free pasture exercise                   ultrastructural and biomechanical studies. Polarized light micros-
      all year round, in agreement with common New Zealand practice;                     copy techniques were used to investigate the spatial arrangement of
      the second group (CONDEX, n = 18) was raised under similar                         the fibrils of the collagen network throughout the depth of the
      conditions, but subjected to an additional exercise program as well.               cartilage, measured as parallelism index (PI, a measure of the degree
      The exercise program consisted of cantering and sprinting on a track               to which the collagen fibrils are aligned with each other) and ori-
      which increased overall workload by a moderate, but significant,                   entation index (OI, a measure of the average angle of collagen fibrils
      30% (Rogers et al., 2008a). At age 18 months, 12 animals (six from                 with respect to the articular surface). Parallelism index was higher
      each group) were sacrificed and their tissues harvested for detailed               in CONDEX animals, again indicating advanced maturation (Brama
      analyses. The remaining animals were broken in and trained and                     et al., 2009b) (Fig. 13.9). An interesting observation was that ori-
      raced as 2- and 3-year-olds (Rogers et al., 2008b) (Fig. 13.7).                    entation of collagen fibrils in the deep zone of the cartilage was less
         The articular cartilage of the metacarpophalangeal and metatar-                 perpendicular than expected, which is possibly an adaptation of the
      sophalangeal joints from the GEXA animals harvested at 18 months                   direction of collagen fibers to high shear forces in the equine meta-
      was meticulously researched using a variety of techniques. Bio-                    carpophalangeal joint, which is a heavily loaded joint with an
      chemical and biomechanical analyses of full-thickness samples                      exceptionally high range of motion where an oblique insertion of
      from the distal metacarpal bone showed site-related differences, but
      no exercise effect (Nugent et al., 2004). The same applied to the
      metabolic rate of chondrocytes (measured by 35S-uptake) from third
                                                                                                                         2
                                                                                                                                                                      Pastex
      Months
                                  33 foals                                                                                                                            Condex
                                                                                       Pentosidine (mmol/triple helix)
      18         15 Pasture                     18 Pasture
               without training               without training                                                           1
                                  20 racing
      35
                     6†                             6†
                                                                                                                         0
      Fig 13.7  Schematic diagram of the experimental set-up of the so-called                                                1   2   3   4        5       6   7   8      9
      GEXA study. Thirty-three Thoroughbred foals were divided into 2 different                                                          Slice from surface
      exercise groups from average age 3 weeks until age 18 months. Exercise
      regimens consisted of 24 h/day pasture exercise (PASTEX, n = 15), or pasture       Fig 13.8  Mean values for pentosidine cross-link content (expressed as
      exercise with additional track training that increased workload by 30%             millimole per mole triple helix) for the slices produced at site 1 and 2 for
      (CONDEX, n = 18; for details of training protocol see Rogers et al. 2008a). At     both PASTEX and CONDEX animals. The most superficial layer (slice 1) is
      age 18 months, six animals from each group were euthanized and their               located at the joint surface; the deepest layer (slice 9) is adjacent to the
      tissues harvested. One PASTEX animal was lost due to an accident and the           calcified cartilage.
      remaining 20 animals were trained for racing as 2- and 3-year-olds. Cross          Reproduced from van Weeren et al, Equine Veterinary Journal 40, 128–135, 2008, with
      symbol indicates euthanasia.                                                       permission.
272
                                                                                                                                             Articular cartilage
                            70%
                                                                                         treadmill, trotting in a mechanical horse walker three times weekly
                            60%
                                                                                         and 40 min walking exercise six times weekly. The control group
                            50%                                                          was only walked for 40 min six times per week during the same
                            40%                                                Trained   period (Murray et al., 1999b). In the MUGES study (Massey Uni-
                                                                               Pasture   versity Grass Exercise Study), a group of 2-year-old Thoroughbreds
                            30%
                            20%                                                          was trained for 13 weeks on grass and sand tracks, after which their
                                                                                         musculoskeletal tissues were analyzed (Firth et al., 2004a).
                            10%
                                                                                            Cartilage taken from the proximal articular surface of the radial,
                             0%                                                          intermediate and 3rd carpal bone from exercised animals that had
                                  0   90   180   270 360 451 541 631         721   811
                                                                                         participated in the Bristol study had a thicker calcified, but not
                                                   Thickness (micrometers)
                                                                                         hyaline cartilage layer than from non-exercised animals (Murray
 Fig 13.9  The average degree of collagen parallelism (PI; mean ± SD) over               et al., 1999a). The cartilage of the strenuously trained animals was
 the entire depth of the cartilage, measured with quantitative polarized light           biomechanically less stiff, showed more fibrillation and more chon-
 microscopy at points 9 µm apart from each other from the cartilage surface              drocyte clusters than the gentler trained animals, suggesting that
 to the osteochondral junction. A PI of 0% indicates random course of fibrils            strenuous exercise may lead to deterioration of cartilage (Murray
 and 100% complete parallelism. Pastured animals (PASTEX) compared to                    et al., 1999b). Also fibronectin (Murray et al., 2000) and cartilage
 exercised animals (CONDEX).                                                             oligomeric matrix protein (COMP) distribution (Murray et al.,
                                                                                         2001b) appeared to be influenced by exercise. When cartilage from
                                                                                         animals of the 19-week Bristol study was cultured to measure chon-
                                                                                         drocyte metabolic activity, proteoglycan synthesis rates were higher
 the collagen fibers in the calcified cartilage layer may yield better                   in the trained animals than in the controls, confirming the overall
 resistance to repeated shear forces than would a perpendicular con-                     effect of strenuous exercise on the proteoglycan component of
 figuration. Based on this observation it was hypothesized that the                      articular cartilage ECM (Bird et al., 2000). There were no overall
 Benninghoff arcade model may be more flexible than commonly                             effects on collagen levels, but sites predisposed to clinical signs
 thought and that local adaptation includes a predominantly non-                         contained significantly less collagen in horses undergoing the exer-
 perpendicular direction of the collagen fibrils in the deep zone.                       cise program; also, strenuously exercised animals had higher glycos-
 Biomechanical analysis of samples from different sites showed that                      aminoglycan content than horses from the more gently trained
 in CONDEX animals site-related differences known to develop with                        group, which was most marked in the cartilage from the dorsal
 age (Brommer et al., 2005) were less marked than in PASTEX                              radial and dorsal intermediate carpal surfaces, sites known to be
 animals with respect to Young’s modulus (ratio of axial stress and                      heavily loaded during exercise (Murray et al., 2001a). Mechanisti-
 strain in unconfined compression) and dynamic modulus (propor-                          cally, the hypothesis that the degrading enzymes Cathepsin B and
 tional to the elastic and viscous energy dissipated in the loading                      D might be involved in the exercise-induced alterations could not
 process and essentially a measure of dynamic stress and strain                          be confirmed, but it was demonstrated that the two enzymes were
 (Palmer & Bertone, 1996)). This may have been caused by earlier                         regulated differently by mechanical loading (Bowe et al. 2007). In
 down regulation of collagen metabolism in trained animals, as                           contrast to the Bristol study, the MUGES study found a significant
 signaled earlier (van Weeren et al., unpublished results). The                          increase in thickness of (hyaline) cartilage after 13 weeks of training
 quicker maturation of the collagen matrix and associated other                          (Firth & Rogers, 2005), compared to pasture-raised controls, in
 pattern of topographical heterogeneity need not necessarily be del-                     particular in sites within the intercarpal joint. At these sites there
 eterious, as the same study showed that the cartilage degeneration                      was no patho-anatomical damage, leading to the conclusion that
 index (CDI) as described by Brommer et al. (2003) was significantly                     the response of the tissue was adaptive and not degenerative in
 less in the CONDEX animals, indicating better surface integrity in                      nature. However, there was a difference between joints, because in
 this group (van Weeren et al., unpublished results).                                    the metacarpophalangeal (MCP) joints of the same animals wear
    There is also evidence from other species that the exercise regimen                  lines and fibrillation were present and water content was increased
 at early age may affect cartilage properties and that this effect need                  while HP cross-links had fallen compared to the controls, which
 not always be reversible. Kiviranta et al. (1987) showed in young                       was interpreted as signs of loosening of the collagen network due
 Beagles in which one of the hind limbs was immobilized for 11                           to micro-damage (Brama et al., 2000a). The metacarpophalangeal
 weeks that GAG content may be reduced by almost 50% in the                              joint is known to be the equine joint most susceptible to damage
 non-weight-bearing limb, whereas cartilage thickness and GAG-                           (Pool, 1996) and predilection for patho-anatomical damage in the
 content was increased in the contralateral limb. When the study was                     MCP joint has been shown in both treadmill-exercised horses
 repeated, but now followed by a 15-week rehabilitation program,                         (Kawcak et al., 2000) and in wild horses (Cantley et al., 1999). Also
 the normal situation was not fully restored; the authors concluded                      the study by Little et al. (1997) showed that there is a level at which
 that immobilization of skeletally immature joints may affect carti-                     exercise may become deleterious. In an ex vivo study in which mate-
 lage development such that recovery is very slow or alterations are                     rial from the dorsal radial facet of the third carpal bone, an area
 permanent (Kiviranta et al., 1994).                                                     well-known to be subjected to high contact stresses in galloping
                                                                                         horses, was cultured that came from horses having undergone a
                                                                                         strenuous exercise regimen, a significant reduction in aggrecan syn-
 The effect of exercise on articular cartilage in                                        thesis and a concomitant increase in decorin synthesis could be
                                                                                         determined compared to less vigorously trained controls. The sug-
 young adult animals                                                                     gestion was made that this alteration in articular cartilage metabo-
 No large studies have been conducted on the effect of exercise on                       lism could be a predisposing factor for cartilage degeneration and
 cartilage from completely mature or elderly horses, but work has                        OA at a later stage.
 been performed on 2-year-old Thoroughbreds. These animals can                              An effect of exercise on the biomechanical properties of cartilage
 be classified as ‘young adult’, although they cannot be considered                      was shown in a relatively short (6 weeks) treadmill study (Palmer
 as fully skeletally mature yet because they are still growing (Green,                   et al., 1995a), in which the permeability constant increased at all
 1976), although at a much lower rate than the foals that were                           sites investigated, but the Poisson’s ratio increased only at specific
                                                                                                                                                                   273
       13      The response of musculoskeletal tissues to exercise
      sites, stressing the topographical variation in response to biome-         mean for the horse that it might be better to start athletic training
      chanical stimuli, which is most probably related to local differences      rather than later, as has been suggested (Smith et al., 1999).
      in joint architecture and geometry.                                        However, long-term epidemiological studies are necessary to estab-
         The overall metabolism-enhancing effect of exercise on articular        lish whether differences in the development of the biochemistry
      cartilage has been studied indirectly in several studies that focused      and ultrastructure of articular cartilage that are now known to be
      on a variety of potential biomarkers in either serum or synovial           modulated by early exercise have significant implications for the
      fluid. Plasma GAG levels, and serum keratan sulphate and COMP              orthopedic health and/or performance of the equine athlete during
      all increased after moderate to strenuous exercise (Calatroni et al.,      its career.
      2008; Okumura et al., 2002; Helal et al., 2007). Brown et al. (2007)
      looked in more detail into changes in glycosaminoglycan metabo-
      lism due to exercise and found higher chondroitin sulphate peak            Bone
      chain lengths, but shorter hyaluronic acid chain lengths in exercised
      versus rested horses. Investigating both serum and synovial fluid,         Introduction
      Frisbie et al. (2008) confirmed the increase in proteoglycan markers
      after exercise, and showed that the same was true for a number of          Bone is the tissue that confers rigidity to the musculoskeletal system
      collagen markers. However, moderate exercise did not affect MMP-1          and its intimate association with articular cartilage allows both
      activity in synovial fluid (Brama et al., 2004). There is a reciprocal     tissues to sustain the large forces generated by normal and athletic
      interaction between synovial fluid and articular cartilage and the         locomotor activity. Bone derives its resistance to deformation from
      former is not just a reflection of the status of the latter. The effects   the hydroxyapatite crystals that are laid down on a collagen matrix,
      of joint loading on cartilage are, at least in part, mediated by altera-   providing the tissue with great strength, but also reducing elasticity
      tions in the synovial fluid, as cartilage explants cultured in post-       substantially. The responsiveness of bone to biomechanical influ-
      exercise synovial fluid showed enhanced GAG synthesis and                  ences has been recognized universally since the late 19th century
      diminished release when compared to cultures using pre-exercise            when Julius Wolff proposed his law, stating that bone will adapt
      synovial fluid (van den Hoogen et al., 1998).                              both architecturally and with respect to composition to changes in
         Also in other species there is evidence for an influence of exercise    mechanical loading (Wolff, 1892). Failure of bone results in (micro)
      on articular cartilage, at least in young individuals. In young Beagle     fractures. The incidence of bone failure in equine orthopedics varies
      dogs, moderate loading levels tended to increase GAG production,           strongly with the discipline involved, but can be substantial, par-
      while strenuous exercise led to GAG depletion in high-load areas           ticularly in racing (Rossdale et al., 1985; Williams et al., 2001).
      (Arokoski et al., 1993; Kiviranta et al., 1988, 1992, 1994; Säämä-         Clinically, bone failure in the horse may vary from relatively mild,
      men et al., 1994). In man it has been shown that children not              yet economically important, micro-fractures and fissures as seen in
      undergoing programs of vigorous activity had approximately 25%             sore shins (Boston & Nunamaker, 2000), to catastrophic fractures
      less cartilage than children that had been mildly active (Jones et al.,    of long bones (Parkin et al., 2006). In the following section an
      2003).                                                                     introduction on the morphology and physiology of bone is given
                                                                                 first, followed by a discussion of the influences of exercise on bone
                                                                                 in general and more specifically for the horse. Most of the earlier
                                                                                 work has been done in young adult animals; recently the effect of
      Conclusion                                                                 exercise on foals has become an area of interest.
      There is no doubt that articular cartilage is responsive to biome-
      chanical loading and that responsiveness is highest in the youngest
      animals. In fact, there is now substantial evidence that the charac-
                                                                                 Morphology and physiology of bones
      teristic topographical heterogeneity in composition and ultrastruc-        The diaphysis of long bones has a marrow cavity, which allows a
      ture of the extracellular matrix of mature cartilage is formed under       better strength/weight ratio to resist bending and torsional forces,
      the influence of loading, i.e. through physical exercise. It has been      while positively affecting gait velocity by minimizing the weight of
      suggested, therefore, that the collagen network of juvenile animals        the distal limb. Most features of a long bone and cuboidal bone are
      that are in a phase of rapid growth might respond to loading in a          illustrated in Figure 13.10. There is a gradual transition from the
      fashion similar to that in which trabecular bone is known to               dense bone of the diaphyseal cortex to the metaphysis, in which the
      respond according to Wolff’s law (van Weeren & Brama, 2003). The           junction of the outer compact bone with the cancellous bone is
      difference with bone is that, whereas bone will continue to respond        indistinct. The epiphysis is contained within a dense shell of
      to exercise throughout life, the collagen network can most probably        compact bone, which in articulating regions is referred to as the
      do so only in the young, growing animal before the collagen remod-         subchondral bone (SCB), is regionally thickened at various sites,
      eling rate falls to the extremely low level related to the very long       and has a gradual transition into the bulk epiphyseal trabecular
      collagen turnover times in mature animals mentioned earlier.               bone (BETB). The orientation and architecture of the trabecular
      Indeed, although some studies have shown a response of the pro-            bone of the metaphysis and epiphysis is central to how load is
      teoglycan component of the ECM of cartilage to exercise in (young)         transferred from the diaphyseal cortex to the joint surface and
      adult horses, no adaptive response of collagen has ever been dem-          thence across the joint. The metaphyseal cortex is thin, and this is
      onstrated in this age group. This makes the early juvenile period the      most obvious close to the physis, and especially in the young pre-
      only window of opportunity to manipulate the collagen network              sumably because of the rapid growth rates in early life. The cross
      through modification of loading, e.g. differences in exercise. Recent      section of the whole bone is greatest at the level of the physis, and
      studies show that such manipulation is possible and may irrevers-          the contact area of the articulating surface of the bone with its
      ibly delay the normal maturation process as the result of a decreased      opposing counterpart in the close-packed position is also large. This
      exercise level or lead to accelerated maturation resulting in a differ-    maximization of the force-bearing surfaces allows articular and
      ent topographical pattern in animals subjected to more exercise            physeal cartilage and immature bone to sustain lower stress,
      than free pasture exercise. There is thus reason to believe that exer-     although the force transmitted across the joint and through the
      cise at an early age may indeed have long-lasting effects on the           physis and metaphysis equals that borne by the diaphysis, which is
      collagen matrix of articular cartilage, lending credibility to the         much more dense and much smaller in cross-section than elsewhere
      hypothesis that variations in exercise regimens of juvenile persons        in the bone.
      or animals may influence the risk for the development of degenera-            The extracellular matrix of bone is made up of a framework of
      tive joint diseases later in life (Helminen et al., 2000). This may        osteoid, consisting of about 90% collagen (type I), around and in
274
                                                                                                                                                Bone
                                                                                                                                                          275
       13      The response of musculoskeletal tissues to exercise
      to stimulate various tissues: for instance, in young rats taught to          osteochondrosis in Warmblood foals. Three groups of foals were
      jump, five cycles per day of this unusual activity produced as great         kept from birth for 5 months in one of three exercise conditions:
      a response in terms of resistance to fracture than did 40 jumps              in a box stall with the mare (boxed group), boxed but exposed to
      (Umemura et al., 1997). The effect on other tissues and species may          sprint exercise 5 days per week in a 50-m long walled enclosure
      differ, and each may have its own stimulus requirements if it is to          from a young age (boxed/sprinted), or kept at pasture continually
      adapt. Unfortunately, the number of other activities that deliver            (pastured). After euthanasia of some foals at 5 months of age, the
      these novel higher forces to tissues is not documented in either             remaining foals until 11 months of age were out of the weather in
      domesticated or wild horses. It is assumed to include the playing,           a large stall, which was always open to a small enclosure. The
      fighting, fast locomotion and other exuberant activities that young          change in exercise regimen meant that the previously boxed group
      mammals engage in habitually and adults less often. The duration             had greater opportunity for exercise, the previously boxed/sprinted
      of these high-intensity exercises need not be long. The natural              and pastured groups had less (van Weeren & Barneveld, 1999a).
      grazing and social slow movement behavior of wild horses is known               At 5 months, pQCT showed that the cross sectional area (CSA)
      to occupy ~17 h/day, whereas Dutch Warmblood foals at pasture                of the third metacarpal bone (Mc3) was significantly less in the
      did not canter more than approximately 3 min per day (Kurvers                boxed than pastured group, but the BMDv was not different between
      et al., 2006).                                                               groups, although BMDv in the dorsal cortex was significantly higher
         The animal management systems of agricultural and competition             in the boxed group, possibly due to a difference in the remodeling
      animals have been in place for some hundreds of years, so it is              rate. The between-group differences had disappeared in the foals
      perhaps understandable that some profess to know the normal                  aged 11 months, and the pooled values at 11 months for area were
      exercise requirements at all stages of a horse’s life. It is less reassur-   higher and for density were lower than at 5 months (Cornelissen
      ing that the literature contains hardly any data on how horses are           et al., 1999), although there was no decrease in other foals pastured
      managed, and much less data on how much horses move, whether                 from birth, and scanned at 6 and 9 months of age (Grace et al.,
      they be domesticated, wild or feral. It is only recently that modern         2003), possibly due to different experimental design and technique
      tracking technologies such as GPS have been applied in the equine            (Firth, 2006).
      field, and it is assuring that their price is falling to an affordable          In the proximal sesamoid bone, the trabecular BMDv was highest
      level. The upshot remains that we have no data to know how much              in the boxed/sprinted group, and lowest in the boxed group, and
      exercise a horse requires, in terms of duration, frequency, number           the value in the latter increased greatly after the exercise regimen
      of cycles, and when repetitions of different types of activity are           changed at 6 months if age. The BMDv of the previously pastured
      spread over time. In turn this implies firstly, that we may under- or        group had increased by 11 months, but that of the previously
      over-estimate how much exercise animals require physiologically,             boxed/sprinted group had not. Confinement apparently had
      secondly, the ideal amount of imposed exercise or imposed rest may           resulted in a retardation of normal development which was com-
      be doubly difficult to estimate, and thirdly, the control group of           pensated for, at least partly, when the restriction on exercise was
      some experiments may not have been ‘normal’ but rather abnor-                lifted (Cornelissen et al., 1999).
      mally inactive or sedentary, which may mean the effect of an                    The BMDv of the medial aspect of the third carpal bone was
      imposed exercise regimen appears greater than if it had been                 significantly less in boxed foals at 5 months old, with the effect of
      imposed on a normal control regimen (whatever that is).                      sprint training being similar to that of pasture exercise. By 11
         This lack of knowledge is one reason for the current interest in          months old, the reduced exercise possibility in previously pastured
      the area of exercise in the young foal. But there is also little research    and boxed/sprinted groups and the greater exercise in previously
      in the area of training for particular athletic objectives. There is close   boxed foals were associated with a significantly greater BMDv than
      similarity of equine structure and function to that in people, and           at 5 months old, but no difference between groups. The average
      there is increasing interest from the human health community in              dorso-palmar depth of the third carpal bone was not significantly
      the responses of the tissues of children to exercise, or the lack of it.     different between foals of 5 and 11 months old (Firth et al., 1999b).
      The outcome parameters that have been used to quantify a bone                BMDv was determined in the SCB of the proximal articular surface
      response include radiography, radiogrammetry, radiographic bone              of the proximal phalangeal bone of these six groups (three exercise
      aluminium equivalence, point projection radiography, dual X-ray              regimens, two ages) at 1-, 2-, 3-, 4- and 5-mm depth from the
      absorptiometry (DXA), computed tomography (CT), peripheral                   articular surface at two differently loaded anatomical sites (site 1 at
      quantitative computed tomography (pQCT), magnetic resonance                  the proximo-dorsal eminence and site 2 at the middle of the medial
      imaging (MRI) (Firth, 2004), and clinical and pathological features          articular surface; site 2 is continuously loaded, site 1 intermittently).
      associated with, for instance, cartilage and subchondral bone                At 5 months BMDv was significantly higher at site 2 than 1 with
      lesions related to imposition of exercise. The latter are not consid-        highest values and most apparent difference at depths to 3 mm. By
      ered in this chapter.                                                        11 months, site differences were less, due to a greater increase in
                                                                                   BMDv at site 1 in the previous 6 months, and BMDv was significantly
                                                                                   higher in site 2 than 1 in previously boxed/sprinted and trained
                                                                                   groups but not previously pastured foals. The significantly higher
      The response of bone to exercise in the horse                                BMDv in pasture and boxed/sprinted than boxed foals at 5 months
      The following is a summary of evidence so far available on bone              was no longer present at 11 months at site 1, and at site 2 the previ-
      tissue responses of horses, grouped in order of age when the exercise        ously boxed/sprinted foals had significantly higher BMD than previ-
      began, because there is difference in the response of the immature           ously boxed and pastured groups. Continuous loading in the central
      as opposed to the older skeleton, possibly because of the turnover           area of the metacarpophalangeal joint surface, which is present even
      time of collagen and its maturation in older subjects. The responses         during standing and slow gaits, apparently stimulated distinct and
      presented are mostly in either BETB or SCB of the epiphysis or of a          significant changes in the SCB to a greater extent than intermittent
      particular cuboidal bone, or diaphyseal cortex. Few studies mention          loading at the proximal eminence of the proximal phalangeal bone
      responses in the metaphysis, perhaps because this area is considered         (Brama et al., 2009).
      to be of less interest after a young age and because of the difficulty          In the GEXA study 18 of 33 Thoroughbred foals born and raised
      in using sensitive imaging methods to examine it, partly caused by           at pasture began gentle exercise at 3 weeks of age and continued
      the inability to separate trabecular from cortical metaphyseal bone          until ~17 months of age. The remaining 15 foals had spontaneous
      in projected radiographic images.                                            pasture exercise only. The bone parameters of the foals having only
         Several aspects of bone development became evident in an inves-           spontaneous pasture exercise (PASTEX group) were compared with
      tigation (EXOC study) of the relationship between exercise and               those of the foals subjected to additional exercise (1030 m per day,
276
                                                                                                                                                 Bone
                                                                                                                                                         277
       13      The response of musculoskeletal tissues to exercise
      et al., 2005). The results were consistent with the previous studies      Interestingly, when loading is discontinued, e.g. when horses are
      in which metacarpal cortical thickness increased in treadmill-            withdrawn from training, diaphyseal circumference will not dimin-
      trained yearlings that had galloped (McCarthy & Jeffcott, 1992).          ish, but the (relatively minor) increase in bone density will be
      Significant relationships existed between months in training and          reversed. In the epiphyses, which are for the larger part made up of
      Mc3 bone geometry and moment of inertia in 2–4-year-old race-             trabecular bone, increased loading through the intensification of
      horses (Sherman et al., 1995). It was further shown that lunging          exercise programs will lead to a substantial increase in density, which
      yearling Quarter Horses for 20 min/day for 8 weeks had no signifi-        is apparently retained after withdrawal from training exercise.
      cant effect on osteocalcin concentrations (Fenton et al., 1999), and         When assessing the effect of exercise on bone it should be realized
      that velocities >12 m/s were required to affect the Mc3 dorsal cortex     that the area is complex, with the nature of the exercise program
      dimensions (Davies et al., 1999).                                         itself being only one of the factors involved. Possible confounding
         In the Mc3 epiphysis, early training resulted in highly localized      factors include the base exercise in the subjects of study, and the
      BMDv increases, with different patterns to that in Mt3 (Firth et al.,     effects of the early environment in which they were raised. Also, the
      2005), which was described in detail (Boyde & Firth, 2005). The           background of the control group matters, as no exercise effect can
      changes in the galloped horses resembled those found in the proxi-        be assessed against a nil option. To obtain better insight into the
      mal sesamoid bone of 2-year-old racehorses, in which 5 months of          effects of exercise in the horse, it is imperative that exercise levels
      training on dirt tracks was associated with significantly higher densi-   of individual horses be recorded on a large scale, including various
      ties and greater trabecular width compared with horses at pasture         age classes over prolonged, preferably career-spanning, periods of
      (Young et al., 1991b). Similar regional adaptive changes were             time. Relating workload patterns to data on performance, orthope-
      present in the medial facet of the third carpal bone, in which the        dic health and wastage may then provide better clues regarding the
      remodeling response of the SCB was not uniform between horses,            effects of specific exercise programs under field conditions for a
      with higher densities being present in those that had galloped least.     variety of equestrian disciplines.
      The bulk trabecular bone apparently responded by formation of
      increased bone mass in an arrangement resembling pillar structures
      deep to the SCB (Firth & Rogers, 2005). Such changes are consistent       Muscles
      with indentation studies in the dorsal aspect of third carpal bones
      of 2- and 3-year-old Thoroughbred horses that had raced or trained,
      which had higher density and stiffness of the third carpal bone than
                                                                                Overview
      did untrained horses. Area fraction and stiffness were closely related,   The horse’s skeletal musculature is highly developed, particularly in
      and were higher in horses with than without pathological change           athletic breeds. In contrast to most mammals, in which 30–40% of
      (Young et al., 1991a).                                                    bodyweight consists of muscle, and to non-athletic horse breeds
         Lastly, in this cohort of 2-year-old horses, changes in subchondral    (~42%), more than half (~55%) of a mature Thoroughbred’s body
      bone were detected in subchondral bone and articular calcified            weight comprises skeletal muscle (Gunn, 1987). Low body fat and
      cartilage of the distal Mc3. The lesions were present in both trained     a large amount of muscle likely reflect adaptation and selective
      and untrained horses, and it was suggested that the forces associated     breeding of animals used for elite endurance and sprint racing
      with athletic training might be less important than factors related       (Kearns et al., 2002). Total muscle blood flow in horses that are
      to bone development (Boyde & Firth, 2008). Although it is impos-          exercising at a level when O2 consumption is at its maximum
      sible to quantify the etiological significance of either, the findings    (VO2max, 134 ± 2 mL/min/kg) has been estimated at 226 L/min,
      are mentioned here to reinforce the point already alluded to above        which represents approximately 78% of total cardiac output (Arm-
      under cartilage, namely that optimal development requires a certain       strong et al., 1992). During exercise and locomotion metabolites
      biomechanical environment to proceed optimally, and inappropri-           and oxygen reach skeletal muscle fibers via the respiratory, cardio-
      ate exercise imposed early or later in juvenile life, can negatively      vascular, and hematologic systems; in turn the muscle fibers produce
      affect bone development.                                                  energy in the form of adenosine triphosphate (ATP), which, via the
         The age at which horses are considered adult remains less than         contractile machinery, is converted into mechanical work. The struc-
      definitive, but if adulthood is accepted as being around the end of       tural arrangement of the musculoskeletal system permits the use of
      the horse’s fourth year, there are almost no studies of the effect of     this energy to move the horse’s limbs in a characteristic rhythmic
      exercise on bone of mature horses, besides studies of cumulative or       pattern that is well established for each gait.
      excessive exercise loads resulting in pathology and/or clinical signs        Equine skeletal muscle is relatively heterogeneous and has con-
      which are not considered in this text. There remains difficulty in        siderable potential to adapt during training, largely mediated by the
      assessing the effect of exercise since much of the adult response         structural and functional plasticity of muscle fibers. These long-term
      most likely is influenced by adaptive changes in earlier years, the       (weeks to months) adaptations occur independently from the
      nature of which will vary between individuals. This explains why          immediate or short-term muscular metabolic responses to either a
      the little information on adaptive responses to exercise in adult         single bout of sub-maximal or near-maximal exercise. They are
      horses is confined to cross-sectional information, such as that con-      associated with altered rates and regulation of transcription of spe-
      cerning carpal change (see above) and radial diaphyseal BMDv              cific genes and consequently a change in the amount of specific
      (Riggs, 1993b).                                                           isoforms of proteins expressed within individual fibers (Williams &
                                                                                Neufer, 1996). Depending on the basal muscle status (e.g. breed,
                                                                                age, sex, level of fitness and training history of the horse), and
                                                                                characteristics of the stimulus (e.g. nature, intensity, duration, and
      Conclusion                                                                frequency of exercise bouts, and total length of the conditioning
      This section dealt principally with the young horse and the effects       program), the adaptive response to training can take two different
      of early exercise and its possible relationship to development and        forms (Table 13.1). First, the quantitative responses, when myofi-
      readiness for later athletic endeavour. It does not deal with excessive   bers increase in size (hypertrophy) but otherwise retain their basal
      or long-duration exercise that, through supra-maximal impact or           structural, physiological, and biochemical properties. And secondly,
      wear-and-tear, may lead to (pre-) lesional change.                        the qualitative responses or remodeling without hypertrophy, where
        It can be concluded that, in compliance with Wolff’s law, the           myofibers do not change in size but acquire markedly different
      changes elicited by the forces that are applied to bone are regionally    enzymatic and structural characteristics (e.g. fiber type transitions).
      specific and consistent with the load path. Increase in strength of       In practice, the most common adaptive responses of equine skeletal
      the diaphysis is more dependent on increase in size than in density.      muscle to training is a mixed form of remodeling with discrete
278
                                                                                                                                            Muscles
                                                                                                                                                         279
       13       The response of musculoskeletal tissues to exercise
A C
B D
      Fig 13.12  Transverse serial sections of gluteus medius muscle biopsies stained with myofibrillar ATPase after acid preincubation at pH 4.45 (A and C) and
      succinate dehydrogenase (B and D) in a young adult (3-year-old) and untrained Andalusian horse (A and B), and in an adult and regularly trained (10-year-
      old) Andalusian horse (C and D). Note that the young animal has a lower proportion of type I fibers (black fibers in A and C) and a higher percentage of
      low-oxidative type IIX fibers (gray fibers in A and C) than the adult horse; furthermore, differences in fiber size are much more pronounced in the young
      animal than in the adult. This therefore may explain the broader range of adaptive responses to training in young untrained horses than in adults or regularly
      trained animals. Bar = 50 µm.
      contractile elements. Most of the natural equine gaits typically                    The unit of muscular contraction is the sarcomere, which is
      consist of stretch-shortening exercise cycle (plyometric muscular                formed by thick and thin filaments of contractile proteins. Muscle
      contractions), characterized by multi-joint actions, rapid eccentric             contraction occurs when, within each sarcomere, thin myofilaments
      phases and explosive concentric muscular contractions potentiated                slide over thick myofilaments, bringing the adjacent Z disks closer
      by the stretch reflex. More than 90% of a muscle is made up of                   together. The myosin head of thick filaments is the motor domain
      myofibers, with the rest consisting of nerves, blood vessels, and the            that contains the ATP-blinding site, and the myofibrillar ATPase
      fat and connective tissue that separate the individual fibers (endo-             enzyme. The force that is generated in sarcomeres is transmitted via
      mysium), the fascicles (perimysium), and the whole muscle (epi-                  the contractile apparatus to intermediate filament proteins that
      mysium). The connective tissue merges with both the origin and                   provide a structural link first to the sarcolemma and then to the
      the insertion tendons of the muscle, as well as with internal tendons            extracellular matrix and the connective tissues of tendons, and ulti-
      in compartmentalized muscles. Regional functional architecture                   mately to the bones of the skeleton.
      and specialization of muscles of the pelvic and thoracic limbs have                 Functionally, muscle fibers are organized as motor units. A motor
      been reported in horses (Payne et al., 2005a,b). In general, the                 unit consists of an α-motoneuron and the set of skeletal muscle
      proximal limb is characterized by muscles with large volumes, long               fibers that it innervates. The ability of equine muscle tissue to
      and parallel fascicles, and extremely short tendons/aponeuroses,                 perform efficiently in spite of very different types of exercise is
      whereas the distal lib is characterized by muscles with small                    enhanced by the muscle heterogeneity. Equine skeletal muscle is
      volumes, short, pinnate fascicles and long tendons. Hence, in                    composed of three main pure fiber types termed I, IIA, and IIX, and
      general, proximal limb musculature is specialized for work output,               a fourth hybrid phenotype termed IIAX, which express myosin
      while the distal limb musculature is specialized for generating force            heavy chain (MHC) isoforms (Fig. 13.14). There are important dif-
      economically.                                                                    ferences in the physiological, biochemical, and morphological
280
                                                                                                                                          Muscles
C D E
properties of these muscle fiber types. Hybrid IIAX fibers exist in      non-myogenic (neural input, neuromuscular activity, and extracel-
equine locomotor muscles in significant numbers (Dingboom                lular substances) in nature, regulate this percentage. Much more
et al., 1999; Linnane et al., 1999), although the co-expression of IIA   important is, however, the significance for performance of this
and IIX MHCs at the protein level seems not to be reflected by           muscle fiber type diversity. For example, endurance ability is cor-
co-transcription of the corresponding genes (Eizema et al., 2005).       related with high percentages of types I and IIA fibers (Rivero et al.,
This suggest that hybrid fibers may represent fibers that are undergo-   1993), whereas speed ability is correlated with high percentages of
ing committed fiber type switching, towards the type corresponding       fast-twitch type IIA and IIX fibers (Barrey et al., 1999), and power
to the mRNA currently being expressed, and that this conversion          generation (strength) is proportional to fiber size (Rivero et al.,
occurs spontaneously in equine muscle not subjected to any specific      2001). Interestingly, some myofibers characteristics are positively
training stimulus.                                                       correlated with both the percentages of IIA fibers (Persson et al.,
   All fibers within a single motor unit are of the same histochemical   1991) and fiber size (Rivero & Clayton, 1996), and the stance time
type. Motor units are selectively recruited in a specific pattern that   of the stride is inversely correlated with the percentage of IIX fibers
changes according to the gait and the intensity and duration of          (Ronéus et al., 1995) and fiber diameter (Rivero & Clayton, 1996).
exercise (Eto et al., 2006). For the maintenance of posture, only type   Furthermore, certain primary muscular adaptations to training
I motor units are recruited. As the intensity and duration of exercise   occur with concomitant modifications in the temporal characteris-
increase, further motor units are recruited, in the rank order:          tics of the stride (Rivero et al., 2001).
I→IIA→IIAX→IIX. Type IIX motor units are only recruited at near-            Muscle cannot contract without a source of energy provided by
maximal exercise intensity (sprint and jumping), and during              the hydrolysis of ATP that occurs at the head of the myosin mole-
extremely prolonged submaximal exercise (Valberg, 1996; Yamano           cule. As muscle (ATP) is limited and it is metabolized within a few
et al., 2006).                                                           seconds of the exercise, replacement of ATP is mandatory. There are
   The percentage of each muscle fiber type present in a muscle (e.g.    different metabolic pathways for this goal within the muscle
fiber type composition) varies from horse to horse (Fig. 13.15), and     during exercise (see Votion et al., 2007). Within mitochondria,
multiple factors, both myogenic (lineage, breed, age, and sex), and      β-oxidation of free fatty acids, the tricarboxylic cycle and oxidative
                                                                                                                                                        281
       13        The response of musculoskeletal tissues to exercise
A B C
D E F
G H I
J K L
      Fig 13.14  Serial cryosections of adult horse M. gluteus medius stained by immunohistochemistry, enzyme histochemistry and histology. (A–D) Sections were
      stained with a number of monoclonal antibodies against specific myosin heavy chain (MHC) isoforms: BA-D5 (A, anti MHC-β/slow), SC-71 (B, anti MHC-IIA),
      BF-35 (C, anti MHCs β/slow and IIA), and S5–8H2 (D, anti MHCs β/slow and IID/X). (E–G) Sections were assayed for myofibrillar actomyosin adenosine
      triphosphatase activity after acid (pH 4.45, E) and alkaline (pH 10.45, F) preincubations, and by Blanco and Sieck’s quantitative histochemical procedure. (H–J)
      Sections assayed for succinate dehydrogenase and (H), glycerol-3-phosphate dehydrogenase activities (I) and periodic acid-Schiff (PAS) for selective staining
      of glycogen (J). (K–L) PAS with α-amylase digestion, for visualizing capillaries (K) and hematoxylin and eosin for visualizing myonuclei (L). The fibers labeled 1,
      2, 3, 4 and 5 are types I, IIA, IIAx (e.g. a hybrid fiber with more MHC-IIA content than MHC-IIX), IIaX (e.g. a hybrid fiber with less MHC-IIA content than
      MHC-IIX), and IIX, respectively. Bar = 50 µm.
      (G) Reproduced from Blanco & Sieck (1992).
282
                                                                                                                                                    Muscles
Fig 13.15  Transverse sections of M. gluteus medius specimens (equivalent depth) stained with myofibrillar adenosine triphosphatase after acid preincubation
(pH 4.4), removed at the same depth, from four different breeds of athletic horses. Note how the percentage of type I (oxidative) fibers (black fibers) and the
fiber size increases from the fastest breed (Thoroughbred) towards the slower, more endurance-suited breed (Arabian). Bar = 150 µm.
phosphorylation (via the electron transport chain) combine to                    point when the increased rate of lactate production can be detected
produce ATP aerobically (aerobic pathways). Two additional anaer-                in the plasma is known as the anaerobic threshold. This threshold
obic mechanisms (anaerobic pathways) exist: the high-energy phos-                varies and depends on several factors, including the muscle’s
phate pathway and glycolysis. Aerobic production of ATP is a                     fiber type composition and the level of fitness. In practice (and
relatively slow but efficient process, while anaerobic pathways                  henceforth in this chapter), aerobic capacity is defined as the
produce energy rapidly but relatively inefficiently. Although both               maximum amount of energy provided by aerobic pathways, whereas
pathways are active during exercise, the relative contribution                   anaerobic capacity is the maximum amount of energy provided
depends on the nature, intensity, duration and frequency of the                  by anaerobic pathways (Hinchcliff et al., 2002).
exercise, the muscle’s fiber type composition, the availability of                  At the beginning of the sub-maximal exercise (<85% of VO2max),
oxygen and substrates, and the presence of intermediary metabo-                  muscle glycogenosis is the main mechanism for providing acetyl-
lites that may potentially activate or inhibit selected enzymes.                 CoA from pyruvate. Either intramuscular glycogen or blood glucose
   In exercise of low or moderate intensities, the main energy provi-            are the substrates for this pathway. But as energy demands increase,
sion for muscular functions comes from aerobic pathways. As exer-                higher rates of pyruvate oxidation tend to cause a shift towards free
cise intensity increases, a greater proportion of the energy is supplied         fatty acids β-oxidation. The overall effect is that muscle glycogenesis
by the anaerobic pathway. At the point where the availability of                 declines over time during sub-maximal exercise, whereas free fatty
oxygen becomes a limiting factor in mitochondria, pyruvate from                  acids β-oxidation increases. Although lipids are the predominant
the anaerobic glycolysis cannot be converted into acetyl-CoA (the                fuel utilized during prolonged sub-maximal exercise, fatigue occurs
substrate for the Krebs’ cycle), but it is converted to lactate. The             by intramuscular glycogen depletion, as the main cause.
                                                                                                                                                                  283
       13      The response of musculoskeletal tissues to exercise
         During maximal exercise (>85% of VO2max), the high functional           et al., 1996). When considered together, the only explanation for
      demands require recruitment of most motor units. At this time,             an increase in muscle mass, despite either no change or a reduction
      intramuscular glycogen and blood glucose act as the predominant            in fiber size, is a parallel increase in the number of muscle fibers
      fuels to replenish ATP through anaerobic glycolysis. Limitations           (hyperplasia), as previously demonstrated in humans (Sjöström
      imposed by this high-intensity exercise result in greater amounts of       et al., 1991).
      pyruvate being converted to lactate rather than acetyl-CoA. As a
      consequence, muscle (lactate) increases in a rate proportional to the
      percentage of type II fibers. Initially, intracellular lactate accumula-   Muscle fiber type transitions
      tion is removed from the cell by active transport into the blood, but      Muscle fiber type distribution and MHC composition are strongly
      saturation of this mechanism results in a sudden exponential rise          influenced by training (Figs 13.12, 13.16, 13.17). Studies on endur-
      in intracellular lactate accumulation (anaerobic threshold), that          ance training in horses have demonstrated (by myofibrillar ATPase
      generally occurs when the plasma (lactate) reaches about 4 mmol/L.         histochemistry, immunohistochemistry and electrophoresis),
      The rise in intracellular lactate results in a significant reduction in    increases in the fraction of type IIA fibers and a concomitant
      cytoplasmic pH, the main cause of fatigue during maximal exercise.         decrease in the proportion of IIX fibers (Essén-Gustavsson & Lind-
      Local acidosis leads to impairment of both muscle structure and            holm, 1985; Essén-Gustavsson et al., 1989; López-Rivero et al.,
      function. A fall in cytoplasmic pH is partially overcome by a buffer-      1991; Sinha et al., 1993; Rivero et al., 1995a, 2001, 2007; Rivero,
      ing system within myofibers.                                               1996; Tyler et al., 1998; Miyata et al., 1999; Rivero & Letelier, 2000;
         From the biochemical perspective, the main goal of muscle con-          Serrano & Rivero, 2000; Serrano et al., 2000; Yamano et al., 2002;
      ditioning is to increase performance by: (1) increasing aerobic and/       D’Angelis et al., 2005; Gondim et al., 2005; Kim et al., 2005; Riet-
      or anaerobic capacities, (2) reducing the major causes of fatigue          broek et al., 2007b). In addition, several endurance training studies
      during sub-maximal (e.g. heavy intramuscular glycogen depletion)           in horses have reported fiber transitions beyond type IIA fibers, e.g.
      or near-maximal (e.g. intramuscular acidosis) exercise, or (3) both        an increase in hybrid I+IIA fibers and pure type I fibers (Henckel,
      situations.                                                                1983; Ronéus et al., 1987; Rivero et al., 1995a; Serrano et al.,
                                                                                 2000). Fiber type transitions during resistance training appear to
      Muscular adaptations to training                                           resemble qualitatively, those observed in endurance training. Hence,
                                                                                 strength training in horses has been shown to result in both
      Muscle fiber size                                                          increased IIA : IIX fiber ratio (Gottlieb et al., 1989; Rivero & Serrano,
                                                                                 1999) and, when training is long enough, the I : II fiber ratio
      The effects of training on equine muscle fiber size are still contro-      (Serrano et al., 2000). Similarly, sprint training in horses results in
      versial. In general, the adaptive response of equine skeletal muscle       increased numbers of type IIA and decreased numbers of type IIX
      to early and long-term exercise training takes the form of remodel-        fibers (Lovell & Rose, 1991), with a corresponding change in their
      ing with minimal, if any muscle fiber hypertrophy (see Snow &              respective MHC content (Miyata et al., 1999; Rivero et al., 2002).
      Valberg, 1994; and Rivero, 1997 for reviews). However, specific            In contrast to endurance and strength training, a specific decrease
      muscle fiber hypertrophy can be stimulated with bursts of high             of type I fibers has been reported as an early and probably transitory
      resistance muscle activity (Heck et al, 1996; Serrano & Rivero,            response to high-intensity training (Lovell & Rose, 1991; Rivero
      2000) and by prolonged stretch beyond normal resting length                et al., 2002).
      (Tyler et al, 1998; Serrano et al, 2000). Weight bearing, as a form           When these various training studies are considered in combina-
      of progressive resistance exercise training, has been investigated in      tion, it is reasonable to assume that fiber type transitions occur in
      ponies for improving strength, and resulted in increased muscle            a graded and orderly sequential manner and typically change from
      power, muscle size, and increased (though not statistically signifi-       faster, more glycolytic fibers to slower and more oxidative fiber
      cant) type II fiber cross sectional area, without parallel changes in      types, e.g. IIX → IIAX → IIA → IIA+I → I (Pette & Staron, 1997). A
      MHC composition (Heck et al, 1996). Six months of conventional             dose–response relationship between the duration (in total) of the
      jump training in competitive show jumpers also induced a selective         training program and the magnitude of induced changes has
      hypertrophic growth of type II fibers, with minimal switching              recently been demonstrated at the molecular level (Serrano &
      between myofiber phenotypes (Rivero & Letelier, 2000). Other lon-          Rivero, 2000; Serrano et al., 2000). This relationship can be explained
      gitudinal studies have also reported significant and early (less than      more readily in terms of a threshold for the type IIX → IIA transition
      3 months) increases in the mean cross-sectional areas of type I and/       during the early phase of training, and then a further threshold for
      or IIA fibers after training (Gottlieb et al, 1989; López-Rivero et al,    the type IIA → type I transition. Thus, a single fiber is capable of a
      1992; Rivero et al, 1995a, 2001, 2007; Tyler et al, 1998; Miyata et al,    complete fast-to-slow transformation in response to a sufficiently
      1999; Serrano et al, 2000; Yamano et al, 2002; D’Angelis et al,            long physiological training stimulus. Finally, although many reports
      2005), a result also noted in horses less than a year of age (Eto et al,   describe the training response shown by muscle fibers in terms of
      2003; Rietbroek et al, 2007b). A marked and generalized fiber              the MHC component, it is important to remember that many other
      hypertrophy (~50%) has recently been documented in endurance-              protein isoforms of the sarcomere (such as the regulatory proteins
      trained Arabians performing moderate intensity exercise (~80% of           of the thin filaments) and the calcium regulatory proteins of the
      VO2max) of long duration (50–80 min/day), 4 days/week for 3                sarcoplasmic reticulum, change in parallel (Pette, 1998).
      months (D’Angelis et al, 2005). Even though a fiber transition
      occurs towards more oxidative fibers (IIX → IIA → I) with normally
      smaller cross sectional area, the hypertrophy may represent either         Metabolic changes and increased
      the new fiber’s retaining size characteristics of its previous type, or
      generalized increased protein production (or both). In contrast,
                                                                                 capillary density
      other studies of Standardbreds and Thoroughbreds reveal minimal            Perhaps the most commonly detected and earliest muscular adapta-
      changes (Henckel, 1983; Lindholm et al, 1983; Foreman et al,               tion to training is an increase in the activity of enzymes of aerobic
      1990; Rivero et al, 1996b) or even a reduction in fiber cross-             metabolism, such as selected enzymes of the TCA cycle, the
      sectional area (Essén-Gustavsson & Lindholm, 1985; Essén-Gustavs-          electron transport chain and fat oxidation (Lovell & Rose, 1991;
      son et al., 1989; Ronéus et al, 1992, 1993; Rivero et al, 2002). These     Ronéus et al., 1991; Rivero et al., 1995b, 2007; Eaton et al., 1999;
      observations are hard to reconcile with the prominent increase in          Miyata et al., 1999; Rivero & Letelier, 2000; Serrano et al.,
      muscle mass, especially in the hindquarters, generally observed in         2000; Yamano et al., 2002; McGowan et al., 2002; Eto et al., 2003;
      horses after most training programs (Snow & Valberg, 1994; Heck            Kim et al., 2005; Rietbroek et al., 2007b). These changes are
284
                                                                                                                                                   Muscles
A C
B D
Fig 13.16  Transverse serial sections of M. gluteus medius biopsies (depth, 6 cm) of the same horse before (A and B) and after (C and D) a long-term
endurance training program (9 months in total). (A and C) Sections are stained by immunohistochemistry with a monoclonal antibody to types I or IIA
myosin heavy chain isoforms; note that almost all muscle fibers express either or both of these isoforms after training. (B and D) The same sections stained
by immunohistochemistry with a monoclonal antibody specific to type IIA myosin heavy chain isoform; note the significant increase in the number of fibers
expressing this isoform after 9 months of training. Bar = 50 µm. Details of the training program are described in Serrano et al. (2000).
associated with increased mitochondrial and capillary densities                 high-intensity, short duration exercise (~100–140% of the speed
(Fig. 13.18) (Sinha et al., 1993; Misumi et al., 1995; Rivero et al.,           that results in a blood lactate of 4 mmol/L, (or V4) for 15 min, or
1995a, 2007; Ronéus et al., 1995; Tyler et al., 1998), the latter               moderate intensity, long duration exercise (~65% of V4, 60–90 min)
response promoting improved oxygen diffusion and more expedi-                   exercise for a total of 5 weeks (Rivero et al., 2002). Similar results
tious removal of waste products (such as CO2). A recent study in                have recently been reported in adolescent Thoroughbreds after 3
growing foals has reported, however, that exercise training had a               weeks of high-intensity training (Rivero et al., 2007). Although
negative effect on both the capillary supply and oxidative capacity             training also causes increased AMP deaminase activity along with
of skeletal muscle in horses (Rietbroek et al., 2007a).                         other purine nucleotide cycle enzymes, such as creatine kinase (dis-
   The activities of key anaerobic enzymes, such as phosphofructo-              cussed in Snow & Valberg, 1994), the concentration of total nucleo-
kinase and lactate dehydrogenase, either do not change or decrease              tide stores is usually not affected by training (Lovell & Rose, 1991).
following training (Snow & Valberg, 1994; Rivero et al., 1995b;                 Nevertheless, moderate intensity (~55% of VO2max) and long dura-
Geor et al., 1999; Miyata et al., 1999; Serrano et al., 2000). However,         tion (60 min, over ~13–14 km) exercise for 10 consecutive days,
high-intensity training (~80–100% of VO2max, 5 min × 2, 5 days/                 increases muscle phosphocreatine concentration and reduces
week for 12–16 weeks) for both young (Yamano et al., 2002) and                  muscle creatine content at the point of fatigue (Geor et al., 1999).
adult (Eto et al., 2004). Thoroughbreds did result in increased gly-               Training has also been shown to result in a modest increase in
colytic phosphofructokinase enzyme activity. Histochemical assess-              muscle glycogen storage (Foreman et al., 1990; Gansen et al., 1999;
ment of glycerol-3-phosphate dehydrogenase enzyme activity, an                  Serrano et al., 2000; McGowan et al., 2002; Rivero et al., 2002) that
enzyme well correlated with other glycolytic enzymes, was also                  may well be associated with reduced activities of glycolytic enzymes,
increased by exercise consisting of alternating days of either                  since the capacity to mobilize endogenous glycogen is partially
                                                                                                                                                               285
       13       The response of musculoskeletal tissues to exercise
                                                                                         Overtraining
      influenced by the absolute activity of anaerobic enzymes expressed                 Overtraining is a syndrome that has been recognized as a cause of
      within muscle fibers (Booth & Baldwin, 1996). In experimental                      poor performance in racehorses over the course of a high intensity
      animals training is known to increase the sensitivity of glucose                   and prolonged (more than 4 months) training (Bruin et al., 1994;
      uptake across the sarcolemma via increased GLUT-4 expression                       Tyler et al., 1998; McGowan et al., 2002; Rivero et al., 2008).
      (Rodnick et al., 1992). In horses, moderate-intensity exercise train-              However clinical signs of overtraining are accompanied by relatively
      ing increases middle gluteal muscle GLUT-4 protein content, but                    few characteristic changes in skeletal muscle. In the study by Tyler
      this change is not reflected by increased sarcolemmal glucose trans-               et al. (1998), overtraining caused significant type IIA fiber atrophy
      port in post exercise muscle samples (McCutcheon et al., 2002).                    (~8%), a decrease in type IIA : IIX mATPase fiber ratio, and increased
      Finally, the transfer of FFAs from the vascular to the intracellular               mitochondrial volume in type I (~16%) and type II (~39%) fibers
      compartment is also enhanced with endurance training, and is                       accompanied by an increase in VO2max (~8%). As a consequence,
      promoted by increased extracellular (interstitial) albumin concen-                 muscle fibers of overtrained horses are generally highly oxidative
      tration (Heilig & Pette, 1988).                                                    (Karlstrom & Essén-Gustavsson, 2002). Additional metabolic adap-
                                                                                         tation of overtrained muscle includes ATP depletion (Bruin et al.,
                                                                                         1994), and reduced resting glycogen concentration (McGowan
      Physiological adaptations and buffering capacity                                   et al., 2002), though this latter finding may relate to delayed glyco-
      Training results in increased motor unit action potential amplitude                gen replenishment seen in normal horses, particularly given that
      indicative of recruitment of larger motor units and synchronization                glycogen utilization during exercise itself, is not influenced by over-
      when analyzed by quantitative electromyography (Wijnberg et al.,                   training (McGowan et al., 2002).
      2008). An increase of muscle force as a result of training can be,
      among others, the result of increased muscle fiber hypertrophy and/
      or motor unit synchronization (Gabriel et al., 2006). Thus, the
                                                                                         Detraining
      significant increase in motor unit potential amplitude seen after                  Maintenance of the trained muscle signature during inactivity is
      training (Winjberg et al., 2008) is most likely the result of an                   more prolonged in horses than other athletic species, lasting
286
                                                                                                                                                        Muscles
A C
B D
Fig 13.18  Transverse serial sections of muscle biopsy samples from the M. gluteus medius from the same horse taken before (A, B) and after (C, D) 9 months
of prolonged endurance training. (A, C) Sections are stained with succinate dehydrogenase to demonstrate the oxidative capacity of individual muscle fibers;
note the increase in the number of fibers with dark staining after training. (B, D) Sections are stained with the α-amylase PAS to visualize capillaries; note the
increased capillary density (e.g. number of capillaries per mm2) after the training program. Bar = 75 µm.
throughout 5–6 weeks of inactivity (Essén-Gustavsson et al., 1989;                 phenotype parallel a reversion of the muscle’s size and return of the
Foreman et al., 1990; Tyler et al., 1998) although not beyond 12                   muscle’s metabolic and capillary characteristics to pre-training
weeks (Rivero et al., 1995a; Serrano & Rivero, 2000; Serrano et al.,               levels (Serrano et al., 2000). In summary, fiber sizes decrease,
2000). Researchers have suggested that expression of the MHC-IIX                   together with a decline in mitochondrial density, aerobic enzyme
gene constitutes a default setting that may be altered (decreased) by              activities and glycogen content and normalization of anaerobic
chronic increased contractile activity (e.g. training), and compen-                enzyme activities.
sated for, by increased expression of MHC-IIA (Goldspink et al.,
1992). In line with this hypothesis is the observation that a return               Possible mechanisms underlying muscular
to sedentary activity levels following a prolonged endurance train-                adaptations to training
ing period normalizes the expression of MHC-IIX, via a slow-to-fast
fiber type transformation in the order I → IIA → IIX (Fig. 13.17)                  Skeletal muscle responds to altered functional demands by specific
(Serrano et al., 2000). These detraining-induced changes in MHC                    quantitative and/or qualitative alterations in gene expression
                                                                                                                                                                     287
       13       The response of musculoskeletal tissues to exercise
                                       Muscle fiber
                                                                                   Box 13.1  Steps in cascade of events by which exercise and
                                                                                   increased neuromuscular activity lead to physiologically
                                       Assembly                                    relevant changes in the characteristics of skeletal muscle
                       Protein                           Sarcomere
                                                                                   •	   Exercise
                                                                                   •	   Contractile activity
                                                                                   •	   Messengers and signal transduction pathways
                            Synthesis        Degradation
                                                                 Amino acids       •	   Regulatory genes
          Nucleotides                                                              •	   Structural genes
                                               Translation                         •	   Muscle fiber characteristics
                       Degradation                                                 •	   Muscle tissue characteristics
                                           mRNA
           Stability
                                          Transport                  storage
                                           control
                                                                                  requirement and energy supply is possibly the most important
                                 DNA                                              signal that triggers appropriate adjustment of contractile and meta-
                                            Processing                            bolic protein expression (Green et al., 1992). Finally, recent years
                          Transcription
                                                         mRNA                     have seen significant advances in our understanding of the signaling
                                          Nucleus                                 mechanism by which the information contained in specific action
                                                                                  potential patterns alters transcription within muscle fiber nuclei
                                                                                  (Yan et al., 2001). For example, Ras-mitogen-activated protein
      Fig 13.19  Schematic diagram showing different steps in the regulation of   kinase (Murgia et al., 2000) and calcineurin (Serrano et al., 2001)
      gene expression in skeletal muscle associated with increased contractile    signaling are implicated in the α-motor neuron induction of slow
      activity.                                                                   muscle fiber phenotype, but not muscle growth. Conversely, a
                                                                                  protein kinase β-dependent and rapamycin-sensitive pathway con-
                                                                                  trols myofiber growth but not fiber type specification (Pallafacchina
                                                                                  et al., 2002).
      (Fig. 13.19) provided the stimuli are of sufficient magnitude and
                                                                                     Specific genes known to undergo altered expression following
      duration (Pette, 1998). Repeated or persistent elevation of neuro-
                                                                                  contractile activity include those encoding sarcomeric and cytosolic
      muscular activity (e.g. during exercise and training) induces a series
                                                                                  proteins and enzymes of the glycolytic pathway, TCA cycle, the
      of concerted changes in gene expression, evoking either myofiber
                                                                                  electron transport chain and fat oxidation (Williams & Neufer,
      hypertrophy or myofiber remodeling, or both (Williams & Neufer,
                                                                                  1996). Additionally, signals inducing the expression of proteins
      1996). Myofiber hypertrophy is generally characterized by a coor-
                                                                                  derived from mitochondrial genes are coordinated with the activa-
      dinated increase in abundance (per fiber) of most protein constitu-
                                                                                  tion of the various nuclear genes that encode mitochondrial
      ents. To some extent this process includes the selective and transient
                                                                                  proteins.
      activation of specific genes immediately following the onset of work
                                                                                     The factors that promote angiogenesis in skeletal muscle in
      overload. The major events, however, underlying muscle hypertro-
                                                                                  response to training have not been clarified although they may be
      phy involve a general and non-specific augmentation of protein
                                                                                  related to a chronic increase in muscle capillary blood flow and the
      synthesis within cells. Remodeling of myofiber phenotype, with
                                                                                  corresponding endothelial shear stress, as well as increased capillary
      minimal or no hypertrophy, is the typical muscular response to
                                                                                  wall tension (Hudlicka et al., 1992). Hudlicka and colleagues spec-
      prolonged training in the horse (Serrano et al., 2000). During this
                                                                                  ulated that endothelial stress might disturb the luminal surface,
      type of adaptation, myofibers undergo striking reorganization, with
                                                                                  resulting in the release of bound proteases that damage the base-
      selective activation and repression of many genes, and switching
                                                                                  ment membrane and contribute to an increase in basic fibroblast
      between different myofibrillar isoproteins occurring in a graded and
                                                                                  growth factor release (Hudlicka et al., 1992). Subsequently, growth
      orderly sequential manner (Pette, 1998). These changes occur in
                                                                                  factors may enhance vascular growth and satellite cell proliferation
      parallel, but not simultaneously over time, and correspond to the
                                                                                  (Morrow et al., 1990). Still unclear, however, is the influence of
      changes observed in enzymatic profiles, cytosolic proteins and
                                                                                  training intensity and duration on neovascularization and the
      membrane receptors and transporters.
                                                                                  mechanisms that underlie the increase seen in intramuscular sub-
         The complexity and pleiotropic nature of the physical and meta-
                                                                                  strates in response to long-term endurance training. These latter
      bolic stimuli presented to myofibers during contraction that ulti-
                                                                                  adaptations may be related to either 1) increased glucose and FFA
      mately results in altered gene regulation were reviewed by Williams
                                                                                  availability (via GLUT-4 and albumin respectively), 2) a lower uti-
      and Neufer (1996). Acetylcholine released from motor neurons and
                                                                                  lization of these substrates for energy production or 3) possible
      other signaling molecules of neural origin, bind to cell surface
                                                                                  artifacts imposed by experimental design (e.g. they may be a reflec-
      receptors on myofibers, triggering intracellular events that may be
                                                                                  tion of increased dietary intake of soluble starches and fat from a
      linked to altered gene expression (Box 13.1). Additional signals are
                                                                                  parallel change in diet in horses in training (Snow & Valberg,
      probably derived from contraction-induced mechanical stress per-
                                                                                  1994)).
      turbing the sarcolemma and extracellular matrix, thus exerting
      tension via intermediate filaments on the cytoskeleton, organelles
      and the nucleus (Milner et al., 1999). Changes in the intracellular         Implications of training-induced changes to
      concentrations of ions and metabolites during repeated muscle
      contraction are also implicated in the activation of signaling path-
                                                                                  the physiologic response to exercise
      ways (Booth & Baldwin, 1996). These signals include intracellular           The main physiologic consequence of increased muscle mass in
      calcium, hydrogen ions produced during anaerobic exercise, the              response to training is to produce a muscle with a greater peak force
      marked reduction in phosphorylation potential of the adenylate              capacity, because force output is proportional to total cross-sectional
      system (ATP/ADPfree), a depletion of the redox state (NADH/NAD)             area of the fiber mass recruited (Bottinelli & Reggiani, 2000). At
      and hypoxia. Among all these factors, an imbalance between energy           slow speeds, this adaptation has an impact on gait, causing a
288
                                                                                                                                                        Muscles
                                                                                                                                                                  289
       13       The response of musculoskeletal tissues to exercise
         As stated earlier, the response of equine muscle to training                              very high (~165% of VO2max) intensity and short duration or dis-
      depends on two sets of factors: 1) the basal status of the muscle,                           tance (1.6–5.3 min; 1 600–3 600 m) 5 days/week for 16 weeks
      (determined by the breed, age, sex and level of fitness of the                               (Yamano et al., 2002).
      horse) and 2) the stimulus applied (e.g. type, intensity, duration,                            In general though, it seems clear that improved stamina through
      frequency and volume of the training exercise). Unfortunately,                               enhanced aerobic capacity is the most common response of equine
      little is known about the relative influence of most of these factors.                       skeletal muscle to training, regardless of either the basal status of
      For example, only a few studies compare muscular adaptations                                 the muscle or the training-exercise program. Given that many
      that occur with different training programs. Of these, two studies                           equestrian disciplines, including Thoroughbred racing, are largely
      (with contradictory results), examine the influence of different                             aerobic in nature, this underlies the likely benefit of training to the
      exercise intensity (Sinha et al., 1993; Eaton et al., 1999), and only                        equine athlete.
      one study has examined the combined influence of intensity and
      duration (Gansen et al., 1999). This latter study concluded that
      low intensity exercise (~50% of V4) for long duration (45 min)                               Tendons and ligaments
      was, after 6 weeks, more effective in improving aerobic capacity
      exercise than high-intensity exercise (~100% of V4) of moderate
      duration (25 min). Recent years, however, have seen the publica-
                                                                                                   Introduction
      tion of several experimental studies with well-documented exer-                              A great proportion of locomotor injuries in equine athletes involve
      cise protocols (Table 13.3). From these it seems that moderate to                            the flexor tendons, accessory ligaments and the suspensory liga-
      high intensity (~80–100% of VO2max) exercise of short duration                               ment. The injuries occur both in training and during athletic com-
      (5–10 min) improves both stamina and strength in racehorses fol-                             petition, resulting in significant wastage, with consequent financial
      lowing 12–16 weeks of training (Tyler et al., 1998; Miyata et al.,                           and welfare implications (Rossdale et al., 1985; Williams et al.,
      1999), whereas anaerobic capacity, can only be increased in the                              2001).
      short to mid term (up to 16 weeks), by introducing supramaximal                                 The extent of clinical pathological change can range from a minor
      intensity exercise (~100–150% of either VO2max or V4) of short                               disruption of a small number of fibrils to complete catastrophic
      (2 min) to moderate (15 min) duration (Rivero et al., 2002;                                  rupture of the tendon. However, the last event is unlikely to occur
      Yamano et al., 2002; Eto et al., 2004). Interestingly, adaptation                            without preceding preclinical injury and changes to the matrix at a
      occurs more readily in younger (~2 year old) than in mature race-                            molecular and ultrastructural level occur before clinical injury is
      horses, e.g. muscular adaptations compatible with a combination                              evident, making tendon damage from frequent cumulative micro-
      of improved stamina, strength and speed were reported in young                               trauma into the most frequent cause for tendon injury (Kannus &
      Thoroughbreds following exercise of high (~100% of VO2max) to                                Josza, 1991; Selvanetti et al., 1997).
Table 13.3 Physiological implications of muscular adaptations in various training programs scientifically evaluated in horses
       Intensity is expressed as a fraction of either VO2max (velocity at maximal aerobic capacity) or V4 (velocity inducing a blood lactate concentration of 4 mmol/L). The symbols + and
       − indicate that either the muscular adaptations to training had a positive or negative effect respectively towards the particular characteristic; the number of symbols is
       proportional to the magnitude of the adaptation; Ne, no effect; Ni, not investigated.
290
                                                                                                                        Tendons and ligaments
   Lesions in the superficial digital flexor tendon (SDFT) of the         collagen and minimal concentrations of several other types can be
horse are very similar to injuries seen in the human Achilles tendon,     found (Riley, 2004). The basic structural unit of collagen is tropo-
in the quadriceps tendons of jumping athletes and also the degen-         collagen, a triple-helix of polypeptide chains. Five tropocollagen
erative changes occurring in the rotator cuff of the shoulder. Thus,      molecules pack together forming collagen microfibrils, which are
the horse may provide a natural model of tendon degeneration              organized into the larger structural units of the tendon: fibrils,
from which the underlying biological mechanisms and pathologi-            fibers, sub-fascicles (primary fiber bundle), fascicles (secondary
cal processes of a number of tendon and ligament lesions, resulting       fiber bundles), tertiary fiber bundles and the tendon itself (Kastelic
from both exercise and aging, may be elucidated.                          et al., 1978; Wang, 2006) (Fig. 13.20).
   Recovery from tendon injury is protracted and incomplete; once            In the relaxed state the fascicles show a planar wave form or
injured, the tendon is permanently compromised to a greater or            ‘crimp’, which can be well demonstrated using plane polarized light
lesser extent (Watkins, 1999). Treatments are numerous and,               microscopy (Gathercole & Keller, 1991). It is the crimp that, by
although recent cell-based therapies have shown encouraging               flattening out, causes the initial, nonlinear load/deformation
results (Smith, 2008), not one approach thus far has resulted in          behavior of the tendon. Intra- and interfibril collagen cross-links
completely restoring the functional capacity of an injured tendon.        can be formed after enzymatic transformation, such as hydroxyly-
Rehabilitation is thought to be one of the most important compo-          sylpyridinoline (HP) and lysylpyridinoline (LP) cross-links or via
nents of the treatment regimen. Consequently, an appreciation of          non-enzymatic glycation (NEG), of which pentosidine cross-links
the mechanisms involved in the response of normal tendon to               are the best-known examples. Cross-linking is essential for the sta-
physical training could have implications for developing rehabilita-      bility of collagen fibrils and HP cross-links contribute significantly
tion strategies in the management of tendon injuries.                     to the biomechanical properties of a tendon (Parry, 1988; Tsuzaki
   In most competition- and racehorses there is a high predisposi-        et al., 1993). The level of NEG products is closely related to the
tion to injury in the SDFT and, to some extent, the suspensory liga-      remodeling rate of tendon tissue. NEG products are formed in a
ment of the forelimb. In dressage horses many injuries in the             time-dependent fashion via the so-called Maillard reaction (Sell
suspensory ligament of the hind limb are seen. In addition to bio-        et al., 1991; Vlassara et al., 1994). In metabolically active tissues
mechanical predisposition resulting from individual conformation,         they are broken down in the process of tissue turnover and thus
external mechanical influences such as track surface contribute to        remain at a constant level. However, in tissues with a very low
injury risk. In some racetracks in Japan a change in track surface has    turnover rate they will accumulate and can therefore be used as an
led to a great increase in tendon injury, while reducing the influence    estimate of tissue age (Verzijl et al., 2000).
of bone fractures.                                                           The major non-collagenous constituents of tendons are water
   The methods used in training to condition tendons are for the          (~65% of wet weight) and proteoglycans (PGs, ~1% of dry weight).
most part based on a traditional empirical approach. Trainers often       PGs are composed of a core protein to which one or more sulphated
describe the effect of training as ‘hardening’ the tendons, yet changes   glycosaminoglycans (GAGs) are covalently attached. The strongly
do not appear to be related to biological events within the tendon        negatively charged and therefore hydrophilic GAGs attract water
structure. The response of tendons to load and thus to training may       molecules and the collagen network prevents the tissue from
also differ between specific tendons that have different biological       expanding beyond its limits, thus giving the tissue an intrinsic
functions (Birch et al., 1997a; Goodman et al., 2004). The inci-          tension and its characteristic viscoelastic properties (Scott, 1995).
dence of injury being related to particular tendons suggests that the     Besides this direct effect PGs are also known to have an effect on
predisposition is associated with a specific function. The extensor       fibrillogenesis and matrix architecture (Iozzo, 1998), thus indirectly
tendons, together with the deep digital flexor tendons (DDFT) have,       influencing tensile strength (Garg et al., 1989). The content and
in general, a low incidence of failure in equine athletes (apart from     types of proteoglycans vary between biomechanically differently
the navicular area of the DDFT that has received much attention in        loaded areas within the SDFT (Micklethwaite et al., 1999).
recent years because of the advent of sophisticated diagnostic               Fibroblast-like cells account for 90–95% of all cells in tendons.
methods such as high-field magnetic resonance imaging (MRI) and           They have been histologically classified as tenoblasts and tenocytes
contrast-enhanced computed tomography (CECT) (Dyson &                     and are important for the production, organization and mainte-
Murray, 2007; Puchalski et al., 2007), whereas the SDFT and the           nance of the extracellular matrix (Kannus, 2000). Tenoblasts are
suspensory ligament have a very high incidence of injury.                 immature, ovoid to spindle-shaped tendon cells, with a high meta-
   With exercise, and particularly elite athletic performance, the dif-   bolic activity. As they mature, tenoblasts transform into tenocytes
ferent functional requirements will result in the need for changes        with a more flattened, slender appearance. Tenocytes show a lower
in the composition and structure of tendons. It is this relationship      metabolic activity, due to their lower nucleus-to-cytoplasm ratio,
and the mechanisms controlling it that are important in condition-        than tenoblasts (Kannus, 2000). Tenocytes are able to adjust their
ing horses for peak performance while minimizing injury risk. In          shape and metabolic activity with respect to the production of
the following part first a brief overview of structure and function of    extracellular matrix components (Robertson, 1994). Different types
tendons will be given with special attention to the reaction              of loading (compression, tension) elicit different types of metabolic
of tendons to mechanical challenge. After that, sections will follow      response (Arnoczky et al., 2007; Gillard et al., 1979). The whole
on the response of tendon tissue in juvenile and older horses to          tendon is surrounded by the paratenon, a layer of loose connective
imposed exercise.                                                         tissue that allows movement of the tendon in relation to the sur-
                                                                          rounding tissues. The tendon itself is encapsulated in a fine connec-
                                                                          tive tissue sheath called epitenon that contains vascular, lymphatic
                                                                          and nerve supplies to the tendon. This layer penetrates deep into
Tendon composition and structure                                          the tendon as the endotenon covering the tertiary fiber bundles
Tendons consist of a relatively small cellular fraction and a corre-      (Kastelic et al., 1978). Tendons can be covered by a synovial sheath
spondingly large extracellular matrix (ECM), which is composed of         in areas where the mechanical loading is not parallel to the longi-
densely packed and hierarchically arranged collagen filaments,            tudinal axis of the tendon (Jozsa & Kannus, 1997).
embedded in a hydrophilic, proteoglycan rich matrix that provides            Blood vessels enter tendons at three main sites: the so-called
tendons with characteristic viscoelastic properties (Goodship et al.,     intrinsic system at both the myotendinous junction and the osteo-
1994). Collagen is the main component of the ECM (60–85% of               tendinous insertion and the extrinsic system via the paratenon or
the dry mass of a tendon), of which type I is predominantly present,      the vincula within synovial sheaths (Carr & Norris, 1989). The ratio
accounting for 95% of the total collagen content (von der Mark,           of blood supply from these sources differs between different
1981; Williams et al., 1980). Collagen type III represents 3% of total    tendons, but the extrinsic route is usually the most important,
                                                                                                                                                   291
       13          The response of musculoskeletal tissues to exercise
Fibroblast
Endolenon Paratenon
Crinp wave
      especially in areas distal from the myotendinous junction and close                         depicted in a so-called stress–strain curve (Fig. 13.22) (Jozsa &
      to the insertion on the bone (Carr & Norris, 1989). The blood                               Kannus, 1997). This curve has four distinct regions. The initial
      supply of tendons, which is already scarce, decreases further with                          concave portion of the curve (toe region) (I) represents the straight-
      increasing age and mechanical loading (Astrom, 2000).                                       ening of the crimp wave, where minor loading results in a consider-
                                                                                                  able elongation until about 3% strain (Evans & Barbenel, 1975).
                                                                                                  Beyond this point, tendons deform in a linear fashion as a result of
      Tendon biomechanics                                                                         sliding of collagen molecules and fibrils and the fibers become
      During the stance phase of the stride cycle flexor tendons are loaded                       arranged in a more parallel fashion. If the strains do not exceed
      under tensile stress with loads that may attain easily two times body                       4–5% the tendon behaves in an elastic fashion and changes are
      weight, depending on the gait (Schryver et al., 1978). The tendons                          still completely reversible. The gradient of this almost linearly
      are able to store much of the kinetic energy when they are loaded                           elastic part of the curve (II) represents the tensile stiffness or elastic
      during the first half of the stance phase as elastic energy and release                     modulus (EM) of the tendon (EM = Δstress/Δstrain). In the third
      it during the second half of the stance phase where it aids in propul-                      region (III) higher strains, up to 8%, will result in dissociation of
      sion. In fact, flexor tendons act basically as energy saving elastic                        fibrils due to interfibrillar bond failure, which causes a plastic defor-
      springs, while the main function of the flexor muscles is to damp                           mation and microscopic failure (Evans & Barbenel, 1975; Jozsa &
      this spring-like action (Wilson et al., 2001). This energy saving role                      Kannus, 1997). With further increasing strains larger tendon
      of tendons is also utilized in other species and is perhaps most                            bundles start to fail and macroscopic failure occurs (region IV)
      evident in the kangaroo, which is able to increase speed without an                         (Jozsa & Kannus, 1997). The strain at which each phase occurs
      associated increased oxygen uptake (Morgan et al., 1978), by utiliz-                        differs in functionally distinct tendons; tendons with a spring-like
      ing the large Achilles tendons as springs.                                                  function experience higher strains before plastic deformation
         Optimization for this role results in very low failure safety                            occurs.
      margins compared with other less mass-critical structures of the                               Cyclical loading of a tendon, to a level not reaching yield, in a
      musculoskeletal system; consequently, at peak performance levels,                           materials testing machine over a period of time shows two phenom-
      functional strains are close to failure strains (Fig. 13.21). Functional                    ena that are relevant to the effects of exercise in the short term. First,
      tensile strains in equine flexor tendons have been recorded in vivo.                        as shown in Figure 13.23, there is a shift of the load–deformation
      Tensile strains measured were approximately 3% at the walk, 6–8%                            curve to the right with each successive loading cycle until eventually
      at the trot and 12–16% at the gallop (Stephens et al., 1989). Labo-                         a steady state is reached. This is known as ‘preconditioning’ and,
      ratory testing showed that the SDFT of horses will rupture at a level                       although it is a feature seen in laboratory testing of tendon; it may
      of 12–16% in the Thoroughbred (Wilson, 1991) and at approxi-                                have in vivo relevance in relation to ‘warming up’ prior to peak
      mately 12.5% in the Warmblood (Riemersma & Schamhardt,                                      athletic performance. Secondly, as illustrated, the plot of loading
      1985).                                                                                      followed by unloading of the tendon forms a loop, starting and
         The relationship between load (stress) and deformation (strain)                          finishing at the same point. The loop, termed hysteresis, is formed
      of elastic structures, such as flexor tendons can be graphically                            as a result of the elastic recoverability of the tendon being less than
292
                                                                                                                                                               Tendons and ligaments
                                                                                                              6
Stress (N/mm2)
                                                                                                              0
                                                                                                                  0   2   4    6      8     10       12   14    16   18   20
                                                                                                                                          % Strain
                 0            3            6                9        12              Fig 13.23  Cyclical loading of a tendon within the elastic range. After the
                                               Strain (%)                            first cycle, the tendon will be longer at zero force than originally. In the
                                                                                     following cycles this phenomenon repeats, but to a much smaller extent
Fig 13.22  Stress–strain curve; the relationship between stress generated by         until a steady state is reached. This is called preconditioning. The loops are
a certain force applied to a tendon and the resulting elongation (strain).           open because of hysteresis: more energy is required to stretch the tendon
                                                                                     (left arm of the loop) than is released when relaxing (right arm). The deficit
                                                                                     is dissipated as heat.
100%. The area of the loop represents loss of energy, largely in the
form of heat, which occurs during stretch and release of the tendon.
It has been shown that the internal temperature of the SDFT may
rise to 45–47°C during 7–10 min of peak performance (Wilson &                        occur. Furthermore tendon injury will lead to significant local
Goodship, 1994). Although this level and duration of hyperthermia                    changes in tissue properties and thus in non-homogeneous bio
would normally result in the death of most cell types, tenocytes                     mechanical behavior.
within the inner core of the SDFT are able to withstand much higher
temperatures than most other fibroblast-like cells (Birch et al.,
1997b). It is possible, however, that hyperthermia, although being
                                                                                     Effects of exercise
not lethal for these cells, still plays a role in the initiation of degen-           Tendon tissue is responsive to loading, giving the biomechanical
erative processes as often seen in the core region of the SDFT.                      environment an important role in the determination of tendon
   It is clear that the biomechanical characteristics of the tendon are              composition and structure. This is best shown by the regional dif-
determined by tendon composition and ultra-structure, as outlined                    ferences in molecular composition of the SDFT. The mid-metacarpal
above. As long as the tissue is homogeneous, deformation (strain)                    area, which is exclusively subjected to tensional loads, has a high
will occur evenly. Riemersma and Schamhardt (1985) showed that                       collagen content and typically has a resident population of slender,
the strain at different levels of the SDFT is uniform, despite differ-               elongated tenocytes, whereas the area that wraps around the fetlock
ences in cross-sectional area. As a function of both age and exercise                and sustains compressive loads in addition to tensile forces, con-
changes in matrix composition and associated functional properties                   tains relatively less collagen, more glycosaminoglycans and rounded
                                                                                                                                                                                       293
       13      The response of musculoskeletal tissues to exercise
      tenocytes, taking a more chondrocyte-like appearance (Lin et al.,                             Comparison of the stress–strain curves
      2005a). Also, the content of cartilage oligomeric matrix protein                                 of central and peripheral fibers
      (COMP) is higher in this region. Cells in tensional regions of
      tendons thus synthesize predominantly collagen, whereas cells in                                                            C      P
      regions of tendons that wrap around bone produce collagen type II
      and other matrix components typical of the fibrocartilaginous                         F/CSA
      matrix seen in these areas of compression. Interestingly, this appears
                                                                                   Stress
      to be a dynamic and reversible process. In a study where the com-
      pression region of the deep digital flexor tendon was released from
      compression and subjected to tensile forces, the nature changed                       F/CSA
      from fibrocartilaginous to fibrous type I collagen (Gillard et al.,
      1979).
         The horse is a precocial animal that loads its musculoskeletal
      system within a few hours after birth and will remain doing so
      throughout its life. This, together with the responsiveness of tendon
      tissue to loading, makes it difficult, if not impossible, to discrimi-
      nate between the effects of growth, maturation and eventually
      ageing, and exercise, especially with respect to the energy-storing                                                   DL% Strain
      tendons and ligaments that are the subject of most studies, as they
                                                                                   Fig 13.24  A load/deformation plot of collagen fibers from central and
      sustain by far most injuries and in fact are the only ones that are
                                                                                   peripheral regions of the superficial; digital flexor tendon in an old horse,
      clinically relevant. However, there have been a number of studies
                                                                                   illustrating the effect of a lower toe limit strain on the greater increase in
      focusing specifically at ageing or the effect of well-controlled exer-       stress with extension experienced by the central fibers.
      cise protocols that have increased our insight in the complex inter-         Reproduced from Wilmink et al. (1992).
      action of the equine tendon with its biomechanical environment.
294
                                                                                                                                    Tendons and ligaments
Fig 13.25  (A) Electron micrograph of biopsy from a foal in the pasture group at age 2 months. Note the predominance of thick fibrils. (B) Electron
micrograph of peripheral sample from the same foal as in Fig. 13.25B after euthanasia at age 5 months. There is an increase in small-diameter fibrils.
(C) Electron micrograph of biopsy from a foal in the pasture group after euthanasia at age 11 months. The number of small fibrils has further increased.
This appeared to be not the case in both other groups, indicating that additional exercise did not lead to full restoration of the normal situation.
Reproduced from Cherdchutham et al. (2001b).
deleterious for tendon function as overloading (Arnoczky et al.,                 (CDET) were increased in the trained horses compared to the con-
2007). In the case of young animals, the amount of this background               trols (by 8 and 16% respectively). In the SDFT (but not the CDET)
exercise may be an important factor determining the effect of                    this increase in size was accompanied by a decrease in tissue density.
the exercise regimen.                                                            Because no evidence of pathology could be detected, this response
   The largest exercise effect on SDFT CSA has been measured in the              was seen as adaptive. There were no changes in mechanical proper-
EXOC study that has been referred to earlier (van Weeren &                       ties of the tendon (maximal load and stress at failure) (Firth et al.,
Barneveld, 1999a). In this study pasture exercise was compared to                2004b).
box rest and box rest with additional sprint exercise in 0–5 month-                 In the long-term Bristol study young Thoroughbreds were exer-
old foals. The CSA of the SDFT of foals kept at pasture was signifi-             cised for 18 months on a treadmill and compared to controls
cantly greater (by a mean of almost 50%) than of the confined foals              undergoing a much less intensive exercise regimen. There were no
and of the foals that were confined and sprinted for a few minutes               differences in collagen content or CSA of the SDFT, but there was a
per day (Cherdchutham et al., 2001a). This means that the back-                  distinct difference in collagen fibril diameter parameters with col-
ground loading as provided by free pasture exercise is an important              lagen fibril mass average diameter in the central core region of the
factor in tendon development in the juvenile animal. This conclu-                trained animals lower than in the control horses (Patterson-Kane
sion was supported by a study on collagen fibril characteristics in              et al., 1997c). By determining the level of glycosylation it was
the same foals. The change from a unimodal to a bimodal fibril                   evident that the collagen was not newly formed, but a degradation
diameter distribution was most advanced at age 5 months in the                   of larger fibrils. Further, mean collagen crimp angle and crimp
pastured foals and least in the box-rested foals. Additional exercise            length were less in the exercised group (Patterson-Kane et al.,
from 5–11 months led to only partial recovery (Cherdchutham                      1997d, 1998). In contrast to the findings in the SDFT, no exercise-
et al., 2001b) (Fig. 13.25).                                                     related changes in collagen mass average diameter or collagen fibril
   Further support came from a study in which Thoroughbred foals                 index were found in the CDET of these same horses. This observa-
were exercised on a treadmill from age 2 to 15 months where there                tion supported the concept of the functionally distinct nature of the
was a greater rate of increase in SDFT CSA in the trained animals                CDET and SDFT, resulting in fundamentally different responses to
compared to the controls, but no significant difference at the end               high-speed exercise (Edwards et al., 2005). It was initially suggested
of the study due to high variance (Kasashima et al., 2002). Bio-                 that the changes in the SDFT might not be adaptive in nature, but
chemically, COMP was significantly increased in the positional                   more indicative of micro-trauma and thus detrimental to tendon
CDET, but not in the energy-storing SDFT. Other matrix compo-                    function (Birch et al., 1998). In later work the same research group
nents and mechanical properties were not significantly changed                   performed detailed biomechanical and biochemical analyses of
(Kasashima et al., 2008). In that study foals did not have continu-              both CDET and SDFT tissue specimens from animals pertaining to
ous access to pasture and the exercise effect was against a back-                the long-term Bristol study in which no signs of degeneration were
ground of ‘partial’ confinement.                                                 found. They concluded that high-intensity long-term exercise on
   In the GERA study that has been mentioned earlier (Rogers et al.,             skeletally mature individuals results in changes that suggest acceler-
2008a,b) there was no difference in SDFT CSA between the trained                 ated aging in the SDFT and adaptation in the CDET (Birch et al.,
CONDEX and the untrained (but pasture exercised) PASTEX                          2008).
animals after an experimental period lasting from age 3 weeks to
age 18 months, although there was a trend (p = 0.058) towards a
larger CSA in the CONDEX group (Moffat et al., 2008).
                                                                                 Conclusion
   Whereas there are no data on the effects of exercise on tendons               The adaptive response of tendon tissue to exercise is limited. It is
of old horses, various experiments have investigated the exercise                clear that the possibility to exercise is crucial to young foals, as lack
effect on tendon characteristics of young-mature horses, often                   of exercise in juvenile animals may lead to the development of
2-year-old Thoroughbreds.                                                        biomechanically inferior tendons, but little seems to be gained by
   In the MUGES study alluded to earlier (Firth et al., 2004a) CSA               imposing additional training above a baseline of free pasture exer-
of both the SDFT and the Common Digital Extensor Tendon                          cise. The time window in early life in which the constitution of
                                                                                                                                                             295
       13      The response of musculoskeletal tissues to exercise
      tendons can be influenced by exercise is short. Already at an age of        musculoskeletal system (in the mature individual) as a fact, the
      11 months the juvenile tendon has biomechanical properties that             question becomes, what would the optimal exercise load be? It has
      are similar to those of mature animals (Cherdchutham et al.,                been shown that the amount of voluntary exercise in foals raised
      2001). This supports the opinion that early competition at young            with 24 h/day access to pasture is surprisingly similar to what has
      age is not detrimental to horses (Smith et al., 1999). In young-            been observed in foals from entirely free living populations (Kurvers
      mature animals the adaptive response of flexor tendons is minimal.          et al., 2006). This, together with the fact that in the EXOC study
      In the MUGES study a small increase in CSA was observed, but                mentioned earlier the pasture exercised foals developed much better
      together with a decrease in tissue density and without improve-             than the foals in the other exercise groups, which were deprived of
      ment of biomechanical characteristics. Further, the division line           exercise or were subjected to a combination of box rest with bouts
      between adaptive response, if any, and degenerative effects is              of high-intensity exercise, makes it safe to proclaim that, based on
      extremely thin. This can be explained by the facts that flexor              present-day knowledge, free exercise for 24 h/day is the baseline or
      tendons are known to operate very close to their physiological limit        gold standard for growing foals. This does not mean, however, that
      during strenuous athletic activity and that, as energy-storing struc-       this exercise level is by definition optimal for raising all foals, irre-
      tures, flexor tendons cannot adapt by a simple increase in size (and        spective of future use. There is now evidence that the development
      thus strength) as other tendons and ligaments and most other                of the musculoskeletal system can be manipulated beyond the
      tissues of the musculoskeletal system would do. The accurate deter-         effects produced by ‘natural’ exercise through the imposition of
      mination of the delicate balance between the training load that is          additional exercise in the young animal. In the case of articular
      needed for an optimal preparation of the horse for competition              cartilage such intervention led to advancement (and earlier
      and the load that can be sustained by the SDFT and suspensory               cessation) of the natural process of functional adaptation (van
      ligament, as perhaps the most vulnerable structures of the equine           Weeren et al., 2008). No immediate clinical effects were seen
      musculoskeletal system, will remain the best prevention against             in that study, which led to the conclusion that the imposed exercise
      tendon injury and the greatest challenge for the trainer. This              level was safe (Rogers et al., 2008a). However, the long-term
      endeavor would be greatly facilitated if suitable biomarkers or             effect on morbidity in the later athletic career could not be estab-
      hyper-sensitive quantitative ultrasonographic techniques would              lished due to low numbers (Rogers et al., 2008b). Later work
      become available that would permit the timely detection of immi-            strongly suggests an overall positive influence of early exercise: epi-
      nent tendon injury.                                                         demiological data from Thoroughbreds have shown that horses in
                                                                                  training or racing as 2-year-olds had better musculoskeletal health
                                                                                  throughout life than horses starting their career later (Tanner et al.,
                                                                                  2013).
      General conclusion                                                             In the mature horse attention has focused on the adaptive
                                                                                  response provoked by exercise and the thin borderline between
      The musculoskeletal system is the organ system that generates loco-         these adaptive responses and early damage. No work has been done
      motion and is, therefore, together with the cardiovascular and respi-       on the establishment of a baseline workload needed for optimal
      ratory systems, likely to be influenced by the exercise regimen an          maintenance of the musculoskeletal system. It is the question
      individual is subjected to. The actual response of the system is            whether this lack of interest is justified given the increasing insight
      complex, however, and depends on the type of tissue and in some             that lack of exercise may have an adverse effect on some structures
      cases even on the specific structure involved. Age is a crucial factor,     in mature individuals (Arnoczky et al., 2007) and the deleterious
      as exercise may have a different effect on the young, growing animal        effect of a combination of exercise restriction and bouts of heavy,
      than in the mature individual. There is enough evidence now to              high-intensity loading, an exercise regimen that is all too common
      state that physical exercise in young individuals is pivotal for correct    for many sports and leisure horses.
      development of the musculoskeletal system, which is of great                   It can be concluded that exercise is a must for both the correct
      importance for those tissues known not to remodel or to show                development and maintenance of the musculoskeletal system.
      minimal remodeling at adult age (and related to this have a very            Restriction of space and of time spent on them means that many
      limited healing capacity after injury), such as articular cartilage and     horses kept under modern management conditions most probably
      possibly also tendons (van Weeren et al., 2010; Rogers et al., 2012).       exercise too little rather than too much. Apart from a severe impact
      However, there is evidence that also in bone, a tissue that is known        on well-being, this situation is likely to also affect musculoskeletal
      to respond to exercise and to retain its healing ability throughout         morbidity rates. Meticulous monitoring and administration of
      life, exercise-induced structural changes may be retained even long         workload and wastage due to illness or injury in the relevant eques-
      after the cessation of exercise (Karlsson, 2007), possibly because of       trian disciplines in large cohorts of horses over prolonged periods
      an effect on the underlying collagen skeleton.                              of time and adequate epidemiological processing of these data is
         Taking the need for exercise for either correct development              the way forward to establish optimal training and conditioning
      (in the young animal) or for adequate maintenance of the                    protocols for sport horses.
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304
                                                                                                                  CHAPTER                14 
Introduction                                                                   Within any gait, speed is the product of stride length and stride
                                                                            frequency. In sprinting races, a high stride frequency is the prime
                                                                            requirement; the ability to take longer strides becomes increasingly
The use of horses for different occupations resulted in selective           important as the distance of the race increases (Deuel & Park, 1990).
breeding to produce different morphological types in accordance             Stride length has been reported to show a rapid and fairly linear
with specific intended uses. Massive draught horses could haul              increase with speed, whereas stride frequency increased more slowly
heavy guns and carry medieval knights with their cumbersome and             and in a non-linear manner (Dušek et al., 1970; Leach & Cymbaluk,
bulky armor, whereas slender, more agile Arabians and Thorough-             1986). In Thoroughbreds galloping at 13.7–19.8 m/s which is
breds displayed greater speed and endurance. Today, horses compete          approaching maximal speed, Seder and Vickery (2003) reported a
is a diverse range of sports each requiring specific athletic talents.      linear increases in stride length and stride frequency.
For sprinting sports the prime requirements are rapid acceleration
and the ability to generate a high maximum speed. Middle distance
racing and endurance racing call for stamina to maintain submaxi-           Stride length
mal speed over a longer distance. Other sports depend on different          Stride length increases with effective limb length. The forelimbs are
degrees of technical skills, visual acuity, fast reflexes or esthetics of   generally considered to rotate around a point close to the tuber
movement.                                                                   spinae scapulae and the attachment of serratus ventralis, though the
   Over the past half-century, breeders have produced performance           precise point of rotation may vary between individuals. The hind
horses with highly specialized athletic abilities, such as elegant gaits    limbs rotate around the hip joint in the symmetrical gaits (walk,
and efficient jumping technique. Consequently, today’s sport horses         trot, pace) and around the lumbosacral joint in the asymmetrical
can truly be described as ‘equine athletes’, which emphasizes the           gaits (canter, gallop). The advantage of moving the rotation point
importance of their locomotor apparatus. This chapter will consider         to the lumbosacral joint is that it increases the effective limb length
the mechanical factors involved in different types of equine athletic       (Fig. 14.1). Interestingly, a necropsy study showed that 32% of
performance under the general headings of racing sports, sport              Thoroughbreds had maximal range of motion in flexion–extension
horses and Western sports.                                                  at the joint between the fifth and sixth lumbar vertebrae rather than
                                                                            at the lumbosacral joint, and 8% had evidence of sacralization of
                                                                            the sixth lumbar vertebra (Stubbs et al., 2006). Moving the effective
Racing sports                                                               lumbosacral articulation more cranially might confer an advantage
                                                                            in terms of further lengthening the hind limb. In the symmetrical
Racing encompasses a broad spectrum of sports that occur over               gaits, particularly the walk, lateral bending of the vertebral column
distances from as short as 200 m to greater than 160 km. The                may enhance stride length, whereas in the asymmetrical gaits dor-
common denominator in all these sports is that the winner main-             soventral flexion and extension make a larger contribution to stride
tains the highest average speed over the distance of the race. In           length (Hildebrand, 1962). In horses, the thoracolumbar spine is
sprinters, generation of high stride rates is of prime importance.          fairly rigid to provide support for the large body mass and facilitate
Stride length assumes greater significance for horses racing over           transmission of propulsive forces from the hind limbs. The need
middle distances. Economy of movement and energy efficiency are             for spinal stability is a priority in gaits that have a suspension
prime considerations in endurance racing competitors.                       phase, which include the racing trot, pace and gallop. Thus, the
                                                                            need for stabilization predominates and intervertebral motion
                                                                            makes a relatively small contribution to stride length in racehorses
Speed                                                                       with the exception of the lumbosacral joint. This is in contrast
Speed is the determining factor in racing, and is also a desirable          to smaller animals, such as cats, that make use of a more flexible
characteristic in many other sports. Horses change speed by altering        thoracolumbar spine to increase stride length. For more informa-
the spatial and temporal relationships between the limbs to produce         tion on vertebral kinematics, the reader is referred to the chapter on
different gaits and to vary the extension within a gait. Each horse         neck and back movements (Chapter 10).
has an optimal speed within a gait at which the metabolic cost
is minimized; slower and faster speeds both result in a higher meta-
bolic cost (Hoyt & Taylor, 1981). It has been suggested that transi-        Stride frequency
tions between gaits may be triggered by energetic cost (Hoyt &              Stride frequency describes the rate at which the limbs are protracted
Taylor, 1981) or musculoskeletal forces (Farley & Taylor, 1991).            and retracted. The ability to cycle the limbs rapidly is favored by
Whatever the reason, horses naturally select particular speeds at           having a high percentage of fast-twitch fibers in the extrinsic
which to make transitions between gaits.                                    muscles, which influences both the rapidity with which the limbs
                                                                                                                                                      305
       14        Performance in equestrian sports
      Fig 14.1  Rotation points of the fore and hind limbs are represented by asterisks for the trot (left) and the gallop (right). The forelimb rotates around a point
      in the upper part of the scapula. The hind limb rotates around the hip joint in trot (left) and around the lumbosacral joint in asymmetrical gaits (right).
      Reprinted from The Dynamic Horse with permission of Sport Horse Publications, Mason, MI, USA.
      are moved and the ability to generate large forces and impulses
      during the stance phase. Stance duration is negatively correlated                                            0.12
      with the diameter of the muscle fibers (Rivero & Clayton, 1996),
      whereas stride length is positively correlated with the percentages
      of type I and type IIa muscle fibers, and negatively correlated with
      the percentage of type IIb muscle fibers in Standardbreds. Stride
      frequency is positively correlated with the percentage of type IIa
      muscle fibers (Persson et al., 1991). Stance duration has a negative                                         0.08
                                                                                                      Height (m)
      correlation with the percentage of type IIb muscle fibers (Roneus
      et al., 1995) that is indicative of an ability to generate high ground
      reaction forces (GRFs) and so create the necessary impulse over a
      shorter period of time.
306
                                                                                                                                        Racing sports
trailing hind limb and leading forelimb, and the duration of the                   stride. Use of the whip did not change the speed, but the horses
suspension. Linear regression analysis of the data predicts that at                maintained their speed with a reduced stride length and a higher
14.9 m/s, overlap between the leading hind limb and trailing fore-                 stride frequency during urging. Also, the stance duration of the
limb approaches zero. Interestingly, at approximately this speed,                  forelimbs was reduced (Deuel & Lawrence, 1987b).
two of four horses in the study showed strides with an extended
suspension (i.e. a period of suspension between lift-off of the
leading hind limb and ground contact of the trailing forelimb) of                  Thoroughbred racing
4.0–8.0 ms duration (Deuel & Lawrence, 1986). At a constant stride                 Thoroughbreds race over short to middle distances, mostly in the
frequency, stride length is adjusted by increasing the distances                   range of one to two miles, though shorter and longer races exist.
between footfalls of the trailing and leading forelimbs and between                Over the shorter distances, the requirements for acceleration and
the leading forelimb and the trailing hind limb. In Quarter Horse                  speed are similar to those for Quarter Horse racing, but as the dis-
foals there is a significant correlation between stride length and                 tance increases stamina assumes more importance. In this breed
mass (Leach & Cymbaluk, 1986). Small foals prefer to change speed                  high maximal speeds are achieved primarily as a result of having
by adjusting stride length, whereas foals with larger dimensions                   a long stride length (Leach et al., 1987). Top class Thoroughbreds
prefer to adjust their stride frequency.                                           galloping at racing speed have had their stride lengths measured at
                                                                                   7.38 m for Secretariat and 6.66 m for Riva Ridge (Pratt & O’Connor,
Sidedness                                                                          1976). However, individual horses vary in terms of their prefer
                                                                                   ence to increase stride length or stride frequency as they approach
Two-year-old Quarter Horse fillies show a leading limb preference;                 top speed. In general, for Thoroughbreds galloping at submaxi
approximately twice as many strides were recorded on the right lead                mal speeds, stride length tends to show a decreased rate of increase
versus the left lead in spite of the horses being cued for the left and            whereas stride frequency tends to show an increased rate of
right leads an equal number of times. The horses either picked up                  increase (Yamanobe et al., 1992). Stride lengths and stride frequen-
the right lead during the transition or changed from the left to the               cies for Thoroughbreds galloping at a range of speeds are shown in
right lead (Deuel & Lawrence, 1987a). Both speed and stride length                 Table 14.1 (Ishii et al., 1989).
were significantly longer on the left lead than the right lead, but
stride frequency did not differ between the two leads. The trailing
forelimb had a longer stance duration and a shorter period of                      Stride variables
overlap with the leading forelimb on the left lead, which was inter-               A study of part-Thoroughbred horses galloping on a variety of
preted as a sign of an increased reliance on the right forelimb for                surfaces (sand, turf, woodchips, dirt) showed a linear relationship
support. The hind limbs, however, did not show any linear or tem-                  between stride length and speed, with stride length increasing from
poral asymmetries between the left and right leads.                                about 3.5 m at 6 m/s to around 7.5 m at 19 m/s. At the same time,
                                                                                   stride duration decreased from 580 ms at 6 m/s to 440 ms at
Effect of urging                                                                   19 m/s. The reduction in stride frequency was achieved through a
                                                                                   large reduction in the swing phase from 200 to 100 ms, and a
The effect of urging by the rider was studied by having the rider use              smaller reduction in the stance phase from 400 to 350 ms (Hel-
a whip on the shoulder of the leading forelimb in rhythm with the                  lander et al., 1983).
                                                                                      Stride length at the gallop comprises the sum of four inter-limb
                                                                                   distances: the hind step, the diagonal step, the fore step and the
 Table 14.1  Mean values for stride variables of galloping Quarter                 suspension distance (Fig. 14.3). Alterations in stride length are
 Horses (QH) and Thoroughbreds (TB)                                                associated with greater changes in the diagonal distance and the
                                                                                   suspension distance than in the hind and fore steps (Ishii et al.,
 Speed (m/s)          Stride               Stride frequency             Breed      1989). The suspension distance shows the greatest increase at mod-
                      length (m)           (strides/s)                             erate speeds but has a tendency to level off as maximal speed is
                                                                                   approached, whereas the diagonal step shows an increasing rate of
 13.3                 5.06                 2.62                         QH         increase at higher speeds. Lengthening of the diagonal step is a
                                                                                   consequence of an increased propulsive force from the hind limbs
   6.6                3.63                 1.82                         TB
                                                                                   but there may be an associated increase in forelimb braking force,
   9.9                4.89                 2.02                         TB         which, in turn, limits the suspension distance (Yamanobe et al.,
                                                                                   1992).
 13.8                 6.18                 2.23                         TB            The temporal variables for the gallop stride include periods of
 15.8                 6.66                 2.37                         TB         single support when one limb only is in the stance phase, periods
                                                                                   of overlap when two or more limbs are in the stance phase simul-
 19.8                 7.77                 2.55                         TB         taneously and one or more suspension phases when the horse is
                                                                                   airborne. Duration of the suspension phase is highly correlated with
 Data for Quarter Horses from Deuel and Lawrence (1986) and data for Thorough-
                                                                                   stride duration. For Thoroughbreds galloping at 15 m/s, the suspen-
 breds are from Ischii et al. (1989) and Seder and Vickery (2003).
                                                                                   sion phase occupies 28% of stride duration (Leach et al., 1987).
                                                                                                                                                          307
       14      Performance in equestrian sports
         The stance phase durations of the four limbs differ significan      (the stride in which the forelimb lead is changed) the sequence
      tly from each other, with the leading hind limb and trailing fore-      of limb placements follows a rotary sequence. Sometimes the hind
      limb having shorter stance durations than the contralateral limbs.      limb lead is not changed until several strides later, in which case
      Overlap is longest between the two hind limbs, shortest between         the rotary sequence of limb placements is maintained during the
      the two forelimbs, and of intermediate duration between the             intervening strides; this is also known as being disunited or on a
      leading hind-trailing forelimb pair. As galloping speed increases       crossed lead.
      there is a marked reduction in all the overlap durations, with
      overlap between the leading hind and trailing forelimbs decreasing
      linearly down to about 50 ms (Hellander et al., 1983). Comparison
                                                                              Acceleration
      between the extended canter of horses trained for dressage with         During acceleration, the initial increase in speed is due to a
      horses trained for racing reveals that, at the same speed, there is     rapid increase in stride frequency accompanied by a relatively slow
      no difference in stride length or stride frequency, but the race       increase in stride length (Hiraga et al., 1994). Stride frequency
      horses had significantly shorter stance durations and overlap times     peaks within a few strides after leaving the starting gate, whereas
      (Clayton, 1993), which may be a consequence of race training. Fol-      stride length requires 25–30 strides to reach its maximal value. The
      lowing 8 weeks of high-intensity training on a treadmill, the stance    diagonal distance increases relatively rapidly to reach maximal
      duration of galloping Thoroughbreds was reduced by 8–20%                length within the first few strides. The airborne distance increases
      (Corley & Goodship, 1994). These changes can be ascribed to             linearly after the first few strides until the 20th stride. Forelimb step
      greater muscular strength; the ability to generate higher ground        length and the hind limb step length tend to level off after the 20th
      reaction forces allows the necessary impulses to be created during      stride. Hind step length is very short in the initial strides during
      a shorter stance phase, and the greater forces project the horse into   which the horses use a half bound before establishing a leading
      a prolonged suspension phase. Race training also results in increases   limb for the hind limb pair. The majority of horses use a rotary
      in stride duration and stride length (Leach et al., 1987).              sequence of limb placements (crossed lead) during the initial accel-
         The advanced placements (time between footfalls) change in           eration before establishing the normal transverse sequence (Kai &
      such a manner that, at faster galloping speeds, the hind limbs act      Kubo, 1993; Hiraga et al., 1994). Horses tend to hold their breath
      more in unison with each other while becoming more dissociated          for 3–4 s immediately after leaving the starting gate after which they
      from the forelimbs. Thus the rhythm becomes more like a rabbit          settle into a breathing rhythm that is synchronized with the stride
      hop. As the advanced placement between the leading hind and the         cycle (Kai & Kubo, 1993).
      trailing forelimbs increases, the distance between placements of
      these limbs also increases. Dissociation of the actions of the hind
      limbs and forelimbs causes a greater reliance on spinal flexion and
                                                                              Ground reaction forces
      extension. Thoroughbreds traveling at speeds greater than 13.5 m/s      Vertical ground reaction forces have been studied at racing speed in
      may show a short extended suspension between lift-off of the            horses galloping round a 0.8-km track with well-banked turns and
      leading hind limb and contact of the trailing forelimb. A third         wearing instrumented shoes on all four feet (Ratzlaff et al., 1987).
      suspension, between lift-off of the trailing forelimb and contact of    On the straightaway the greatest vertical force was exerted by the
      the leading forelimb, has also been recorded occasionally. The per-     leading forelimb, followed by the leading hind limb, trailing hind
      centage of Thoroughbreds showing multiple suspension phases             limb and trailing forelimb. On the banked turns, the greatest verti-
      increases with speed from 27% of horses at 15.5 m/s, to 50% at          cal force was exerted on the leading forelimb, followed by the trail-
      17.0 m/s, and 70% at 19.5 m/s. The duration of these suspension         ing forelimb, leading hind limb and trailing hind limb. It is not
      phases also tends to increase with speed (Seder & Vickery, 2003).       surprising, therefore, that the majority of racing injuries occur in
                                                                              the leading limbs, especially the leading forelimb.
      Head and neck motion
      The head and neck, which comprise approximately 10% of body             Limb kinetics
      weight, move in synchrony with the limbs. The neck is actively          An early modeling study indicated that each forelimb would
      extended and lowered during the hind limb stance phases with the        support 170% body weight when galloping at 14 m/s (Kingsbury
      head reaching its lowest point during the propulsive phase of the       et al., 1978). Subsequent modeling studies, however, have esti-
      leading hind limb (Bramble, 1984). This movement may counteract         mated widely different forces in the superficial and deep digital
      the tendency of the forequarters to rise as a result of hind limb       flexor tendons (Brown et al., 2003; Swanstrom et al., 2005b). A
      propulsion (Pratt, 1983). Elevation of the head and neck begins         detailed musculoskeletal model for dynamic simulation of the
      as the trailing forelimb contacts the ground, continues through         Thoroughbred forelimb during the stance phase when galloping at
      the forelimb stance phases and peaks at lift-off of the leading         18 m/s (Swanstrom et al., 2005a) indicated peak vertical ground
      forelimb.                                                               reaction force of 210% body weight combined with longitudinal
                                                                              forces of 30% body weight (braking) and 63% body weight (pro-
                                                                              pulsion). This model also predicted palmar flexion angles of 148°
      Lead changes                                                            for the distal interphalangeal joint and 169° for the proximal inter-
      Horses normally use a transverse gallop in which the leading limb       phalangeal joint during the first one third of stance and 262° for
      is on the same side of the body for the fore and hind limb pairs. A     the metacarpophlangeal joint just before midstance. Angular ranges
      lead change involves a reversal in the order of placement of the        of motion for these joints were 50° (distal interphalangeal joint),
      contralateral limb pairs, and Thoroughbreds normally change leads       16° (proximal interphalangeal joint) and 54° (metacarpophalan-
      several times during a race. The most common strategy is to use the     geal joint). Peak strains in the superficial digital flexor tendon
      inside lead through the turns, and the opposite lead in the straight-   (4.9%) and suspensory ligament (8.5%) occurred prior to mid-
      aways. Racehorses usually initiate the lead change with the fore-       stance, whereas strains in the deep digital flexor tendon (2.8%) and
      limbs. During the forelimb swing phase the leading forelimb             the accessory ligament of the superficial digital flexor tendon (8.8%)
      abbreviates the cranial part of its swing phase and is placed early     peaked around midstance. The accessory ligament of the deep
      to become the new trailing forelimb. The limb that was the trailing     digital flexor tendon had peak strain of 7.1% around the start of
      forelimb increases its swing phase duration substantially to become     breakover. Transection of the accessory ligament of the superficial
      the new leading forelimb. The hind limbs then change their lead in      digital flexor tendon, which is used to treat superficial digital flexor
      a similar manner during their next swing phase. For one stride          tendonitis, resulted in increased force and strain in other soft
308
                                                                                                                                Racing sports
tissues, increases in metacarpophalangeal joint extension and distal     hoof, which increases locomotor efficiency by allowing a smoother
interphalangeal joint flexion, and a reduction in ground reaction        transition from braking to propulsion, is achieved by having a
force (Swanstrom et al., 2005a).                                         deeper cushion or by reducing the dry density of the cushion (Rat-
                                                                         zlaff et al., 2005). Hoof-mounted accelerometers (Ratzlaff et al.,
                                                                         2005) indicate wide variations in acceleration from stride to stride
Fatigue                                                                  on the same surface.
Fatigue implies a decrement in performance shown by reductions              Track surface composition and characteristics have a profound
in stride frequency and running speed. Stride length may increase        effect on the loading conditions of the horse’s limb, with the shear
or decrease depending on the horse. The absolute duration of both        strength of the granular material being particularly influential.
the stance and suspension phases of the stride increases, with sus-      Therefore, selection of soil for structure may be more important
pension occupying a greater percentage of stride duration. Footfall      than the addition of soil amendments that alter damping charac-
of the leading hind is followed more closely by that of the trailing     teristics (Reiser et al., 2001). Many racing surfaces are a composite
forelimb, and overlap between these two limbs increases during           of sand, rubber granules and fibers coated with a wax. Horses
fatigue (Leach & Sprigings, 1979). Since the stride and respiratory      trained and raced more slowly when the surface reached a tem-
cycles are synchronized in galloping horses, it has been suggested       perature of 43-46 degrees at which the lower molecular weight
that the changes in limb coordination associated with fatigue may        components of the wax melt (Peterson et al., 2010). In one study,
be related to the respiratory demands. Prolongation of the suspen-       a synthetic racing surface was shown to have lower peak accelera-
sion phase increases the duration of the inspiratory phase of the        tions, mean vibrations and peak ground reaction forces than
respiratory cycle, which may be advantageous as the horse becomes        turf or dirt surface (Setterbo et al., 2009). Track maintenance
fatigued (Leach & Sprigings, 1979).                                      also affects the mechanical properties of the track (Peterson &
                                                                         McIlwraith, 2008).
Injury
                                                                         Standardbred racing
Analysis of racetrack patrol videos (Ueda et al., 1993) has shown
that breakdown injuries often occur immediately after a lead change      Racing Standardbreds are divided into two groups according to the
(47% cases), use of the whip (38% cases) or an oblique movement          gait they perform during racing. The tendency to trot, in which the
of the horse across the track (21% cases).                               diagonally opposite limb pairs move together, or to pace, in which
                                                                         the lateral pair of limbs move together, has been shown to be geneti-
                                                                         cally determined (Andersson et al., 2012). The offspring of pacers
Training                                                                 almost always pace, whereas about 20% of the offspring of trotters
An important consideration in Thoroughbred training is the need          are pacers (Cothran et al., 1987).
to stimulate skeletal adaptation without causing injury to the bones
and joints. It has been suggested that the training regime should        Trotters
incorporate short sprints on a relatively frequent basis (every 3–6
days) to stimulate bone adaptation, especially with regard to the        Stride variables
prevention of bucked shins (Moyer & Fisher, 1991). However, the          A good trotter should have a high maximal speed with a stride
distance of the sprints must be limited because horses that accumu-      frequency in excess of 2.4 strides/s and a stride length greater
late extensive distances at high speeds are more likely to suffer a      than 5.45 m. It has been suggested that trotters achieve a high
fatal skeletal injury (Estberg et al., 1995). Many complete fractures    racing speed by selecting an optimal stride length then accelerat-
of the long bones are preceded by incomplete fractures (Stover           ing to the wire by increasing their stride frequency (Barrey et al.,
et al., 1992) indicating that they are a consequence of repeated limb    1995).
trauma during training and racing.                                          Different studies vary in their findings regarding the relationship
                                                                         between speed, stride length and stride frequency. Barrey et al.
                                                                         (1995) found that both stride length and stride frequency increase
Track surface                                                            linearly with speed, whereas Drevemo et al. (1980a) found speed
Material properties of the track surface affect both performance and     to be moderately correlated with stride length but not correlated
lameness. On a harder surface there is a reduction in stride duration,   with stride duration. The latter study also found a close correlation
whereas on a more compliant surface stride duration increases            between stride duration and swing duration. Swing duration,
(Fredricson et al., 1983). This offers at least a partial explanation    which occupied about 75% stride, had much more effect on overall
for the fact that faster race times are recorded on firmer track sur-    stride duration than stance duration, which occupied only about
faces. However, there is a price to pay in terms of soundness. The       25% of stride. The treadmill study of Weeren et al. (1993) also
incidence of lameness in Thoroughbreds that are in race training         found that stride length contributes more than stride frequency to
increases with the hardness of the track surface (Cheney et al.,         an increase in speed, with the swing duration remaining constant
1973). One of the factors that affect hardness is the composition        at all speeds.
and depth of the cushion. Hardness is reduced as the cushion gets           The temporal and linear stride variables of 30 Standardbreds
deeper, but if the cushion depth is too deep (greater than 10 cm),       trotting on a racetrack were studied using a camera car driven paral-
the footing becomes insecure. Surface moisture content tends to          lel to the horse as a pacemaker (Drevemo et al., 1980a). With the
vary, whereas the moisture content of the compacted cushion is           pacemaker car moving at 12 m/s, the actual speed of the individual
more constant (Clanton et al., 1991). There also tended to be more       strides varied from 11.3 to 12.4 m/s. The values of the stride vari-
compaction around the starting chutes than in other areas of the         ables are shown in Table 14.2. There was very little intra-individual
track. Next to the rail, track surface was softer than the surface       variation (Drevemo et al., 1980b; Kobluk et al., 1989), indicating
toward the middle of the track.                                          that each horse has a stable locomotion pattern that is repeated
   Dynamic properties of the track, such as hardness, rebound,           regularly with only minor deviations. The variation between indi-
deceleration rate, rebound rate and penetration, can be assessed         viduals was two to three times greater than that within horses.
with a track-testing instrument. Accelerometers have been attached       Depending on the variable being studied, the coefficients of varia-
to the hoof wall for dynamic testing of the track surface (Barrey        tion were of the order of 8–12%, though the variability within
et al., 1991; Ratzlaff et al., 2005). Lower peak acceleration of the     horses was about 60% less than that between horses.
                                                                                                                                                  309
       14       Performance in equestrian sports
310
                                                                                                                                 Racing sports
was lower than the right one in nine horses, and the right tuber          hoof. At racing speed the dissociation is about 30 ms, which repre-
sacrale was lower than the left one in 30 horses. The asymmetric          sents 7% of stride duration. With this amount of dissociation, the
horses had significantly larger body size than the 461 horses that        pace can be considered a four-beat gait (Wilson et al., 1988a).
did not show asymmetry. The asymmetric horses had lower total                The stride lengths and stride durations of Standardbreds pacing
earnings, a lower number of races per horse and fewer good racing         at a range of speeds between 11.5 and 14.0 m/s are shown in Table
records. It was concluded that horses in which the height of the          14.2. Pacing speed increases primarily as a result of an increase in
tubera sacrale is asymmetrical are less likely to become successful       stride length with minimal change in stride frequency (Wilson
racehorses.                                                               et al., 1988b). Lengthening of the stride is a result of covering a
                                                                          greater distance during the suspension phases, without much
Effect of track design                                                    change in the distance between the lateral pair of limbs during
Lameness is a common problem in racing horses, and gait asym-             stance. Although the overall stride rate does not show much change
metries that arise due to defects in the geometrical design of the        with speed, overlap time is reduced and single support time is
racetrack were identified as a predisposing factor. Dalin et al. (1973)   increased as a consequence of having longer diagonal advanced
showed that when horses trot on a track with under-banked semi-           placements and diagonal advanced completions. These changes in
circular turns the gait becomes asymmetrical at high speeds with          timing create a distinctly four-beat gait. The best discriminators
the horses changing to a galloping motion in the hind limbs. To           between speeds were stride length and overlap time, while the vari-
overcome the tendency to slip sideways on the turns, the horse leans      ables that limited pacing speed were stride rate and suspension time
into the turns and places the feet at an angle, using friction against    (Wilson et al., 1988b).
the track surface to overcome the centrifugal force. The left limbs          At the end of a race, a pacer is moving at a speed close to 15 m/s.
are adducted and placed on the ground closer to the horse’s midline,      When horses with different levels of ability were classified according
which is associated with a lateral landing of the left hooves and         to their finishing placing, low-order finishers were found to have
medial deviation of the fetlock throughout the stance phase. Ther-        shorter distances between the lateral pair of limbs during stance,
mographic evaluation revealed that, after the horses performed at         whereas high-order finishers had a greater range of motion in the
speed around inadequately banked turns, the left fore fetlock             fore and hind limbs. Comparing the last lap of a race with the
became warmer than the right one.                                         preceding lap, speed and stride length were reduced during the last
   The traditional racetrack design of two straights joined by under-     lap for low-order finishers but increased for high-order finishers. At
banked semi-circular turns is obviously not optimal for either per-       the end of a race, an increase in the amount of overlap expressed
formance or soundness of the horses. Fredricson et al. (1975) made        as a percentage of the stride was a sign of fatigue.
suggestions for improving the geometric design of racetracks. They
recommended the use of wide sweeping turns to reduce the horse’s          Sidedness
tendency to slide outwards and to facilitate adequate banking; on         Although the pace is generally described as a symmetrical gait, many
tighter turns the amount of banking required is so great that the         pacers show temporal asymmetries between the left and right sides.
surface material cannot be stabilized. Only the inner half of the         Gait variables that show left–right asymmetries include stance dura-
track needs to be banked sufficiently for maximal speed; the middle       tion, suspension, overlap, diagonal dissociation and single support
and outer lanes can be less steeply banked to accommodate moder-          (Crawford & Leach, 1984).
ate and slow speed training. It has also been observed that gait
asymmetries are most prevalent as the horse enters and leaves the         Conformation
turns. Therefore, the intercalation of a transitional curve between       Preliminary kinematic data of 2-year-old pacing fillies suggest that
the true curve and the straight is highly recommended (Fredricson         a long sloping scapula, substantial development of the brachioce-
et al., 1975).                                                            phalicus, a long forearm and an elastic fetlock joint are associated
                                                                          with ergonomic efficiency (Sellett et al., 1981).
Conformation of trotters
A study relating conformation to performance in Standardbred
trotters (Magnusson, 1985) showed that traits associated with supe-       Endurance racing
rior racing performance included height at the withers and large          The primary requirement for an endurance horse is economy of
girth circumference around the point of the withers, which was            movement, but the stride variables that contribute to energetic
indicative of prominent withers and a large area for attachment           economy have not yet been evaluated. During a race an endurance
of the locomotor muscles. In contrast, girth circumference at the         horse takes many thousands of strides. Horses that maximize trans-
lowest point of the back had a negative correlation with perfor-          fers of angular momentum between limb segments reduce their
mance. Outward rotation of the limb axes, which is typically              mechanical energy expenditure and so use less metabolic energy to
regarded as a conformational fault, had a positive effect on racing       cover a given distance. Prolonged endurance training of 8 months’
ability. Conformational features that had a negative influence on         duration resulted in significant reductions in stride and stance dura-
performance included tied in at the knees and hocks, narrow hooves        tions in association with an increase in the percentage of Type IIA
and greater width/circumference of the forelimbs. Overall it was          muscle fibers and a decrease in the percentage of Type IIX muscle
concluded that the better performing horse was a lightweight,             fibers, which was interpreted as an indication of more efficient
gracile type with tall withers, with open angles at the shoulder and      propulsion associated with an increase in muscle fatigue resistance
stifle joints and normal-sized hooves.                                    and strength (Rivero et al., 2001).
                                                                             In one study, stride length increased during the course of an
Pacers                                                                    82 km endurance ride. Compared with pre-race values, stride length
                                                                          at the walk increased to 115% at 41 km and 123% after 82 km. The
Stride variables                                                          length of the trot stride increased to 151% at 41 km and 149% after
The pace is a symmetrical gait in which the lateral pair of limbs         82 km compared with pre-race values (Lewczuk & Pfeffer, 1998). It
move more or less synchronously. The ability to pace is genetically       was suggested that the increase in stride length was due to warming
determined (Andersson et al., 2012). Slow motion studies have             up during the course of the race. A different study that evaluated
shown that ground contact of the hind hoof precedes that of the           the effects of fatigue found that speed decreased from 4.55 to
front hoof (Crawford & Leach, 1984; Wilson et al., 1988a), unlike         4.03 m/s during an 80 km race due to a reduction in stride length
the racing trot in which the front hoof usually precedes the hind         without any change in temporal variables (Wickler et al., 2006).
                                                                                                                                                   311
       14      Performance in equestrian sports
      This is in contrast to horses exercised to exhaustion at a similar        limbs is called diagonal dissociation, with the more specific terms
      speed (4.5 m/s) on a treadmill with 6% incline, in which the con-         diagonal advanced placement (time between fore and hind contact)
      stant speed was maintained using longer stride lengths and shorter        and diagonal advanced completion (time between fore and hind
      stride frequencies (Wickler et al., 2006).                                lift-off) also being used. Positive values are assigned if the hind limb
                                                                                acts in advance of the forelimb, and negative values are assigned if
                                                                                the forelimb acts in advance of the hind limb. A positive dissocia-
      Sport horses                                                              tion at contact is associated with good movement and a well-
                                                                                balanced horse (Holmström et al., 1994b; Morales et al., 1998a,
                                                                                1998b). The magnitude of the positive dissociation at contact tends
      The modern sport horse is elegant in appearance, usually a descen-
                                                                                to increase with training due to greater elevation of the forehand as
      dant of draft breeds crossed with hot-blooded Thoroughbreds and
                                                                                the degree of collection and self-carriage improve (Tans et al.,
      Arabians, that has been refined by many generations of selective
                                                                                submitted).
      breeding to produce the Warmblood breeds.
312
                                                                                                                                            Sport horses
Fig 14.4  A good quality trot is recognized by a long swing phase duration and a long suspension phase with more retraction of the forelimb and more
protraction of the hind limb.
Courtesy of Ellen van Leeuwen, The Netherlands.
Fig 14.5  Photograph of ‘Mythilus’ ridden by Courtney King-Dye performing the trot with good flexion of the elbow joint raising the carpus and giving
expression to the forelimb movement.
Courtesy of Jacob Melissen, The Netherlands.
   During the stance phase, horses with high gait scores show greater
inclination of the pelvis, flexion of the hock and extension of the
                                                                               Breed differences
fetlock joints as the limb accepts weight. This is associated with a           Although European Warmblood breeds currently predominate in
significantly larger angular velocity during tarsal flexion between            international dressage competitions, other breeds are competing
20 and 55% stance and during tarsal extension between 75 and 85%               more frequently. Warmbloods typically have lofty gaits with a long
stance. In the later part of the stance phase, the limb is retracted           suspension phase, which requires the generation of large vertical
faster in good movers (Holmström & Drevemo, 1997). Maximal                     ground reaction forces and impulses. Compared with Quarter
hoof height occurs soon after lift-off in the hind limb and does not           Horses, Warmbloods have been shown to have higher peak vertical
differ with gait quality (Holmström et al., 1994b).                            forces normalized to body weight (Back et al., 2007). Comparison
                                                                                                                                                           313
         14               Performance in equestrian sports
100
80
                                     n
                                   io
                                                           Fle
                 80            ens                          xio
                           Ext                                 n
                 70                                                                                                              -20
                 60                                                                                                                 -60   -40      -20       0       20   40
                 50                                                                    A                                                  Fetlock joint angle (degrees)
                 40
                      0    10        20    30   40    50    60     70   80   90 100
                                         Percent of one stride                                                                   100
      Fig 14.6  Illustration of the relationship between scapular angle to the
                                                                                                                                  80
      horizontal and protraction and retraction of the forelimb during one stride.
      Ontogeny of gait                                                                                                            80
                                                                                                  Carpal joint angle (degrees)
314
                                                                                                                                                                      Sport horses
indicative of gait quality (Back et al., 1994b) this explains why                                           0.32
astute horse breeders are said to be able to predict future gait per-
formance at a young age (Clayton, 1989a; Grant, 1989).                                                      0.30                                     4
   The inherent patterns of the angle–angle diagrams that are recog-
                                                                                                                                                        3 3 4 4
nized at foal age (Back et al., 1994a) might be related to the future                                       0.28                                  44 444 44
                                                                                                                                                                                     315
       14       Performance in equestrian sports
       Table 14.3  Recorded and predicted temporal kinematics of the forelimb and the hind limb of a group of horses trotting on a treadmill at
       foal and adult age
       Hind limb
       Stance            34.3           32.1–36.5      0.63†                  42.3      39.7–44.9   0.92†          38.1       35.8–40.4   0.98†          40.5*
       duration (%)
       Stance              0.21         0.20–0.22      0.65†                   0.26     0.25–0.27   0.61†            0.23     0.22–0.25   0.66†           0.27*
       duration (s)
       Swing               0.41         0.38–0.44      0.77†                   0.50     0.46–0.54   0.68†            0.45     0.42–0.49   0.73†           0.40
       duration (s)
       Stride              0.62         0.59–0.65      0.86†                   0.76     0.72–0.80   0.71†            0.68     0.65–0.72   0.80†           0.67*
       duration (s)
      movement. The basic patterns of limb coordination are governed                            Effect of training
      by central pattern generators in the spinal cord that regulate flexion
      and extension of the joints, which are the basis for stride rate and                      Prediction of good gait at a young age seems to be possible, but
      inter-limb coordination patterns that give rise to the recognizable                       the question remains as to whether good gait also results in
      gaits. Individual horses vary slightly in the synchronization of their                    good performance when the horse is being ridden. Swedish
      limb movements, which can have a marked effect on the esthetics                           researchers found that, during ridden exercise, good movers had
      and energetics of sporting performance.                                                   a longer stride duration compared to poor movers (Holmström
         When a new motor skill is learned, the initial attempts are                            et al., 1994b). Furthermore, they calculated that the subjective eval-
      clumsy and inefficient. After a period of practice, efficiency in per-                    uation of conformation and locomotion accounted for 43% of the
      forming motor tasks improves. In human athletes, muscular activa-                         variation of their gaits under saddle (Holmström & Philipsson,
      tion patterns are modified by practice; champion athletes have a                          1993).
      specific temporal and sequential pattern of muscle activation in                             Training is defined as a program of exercise to improve the horse’s
      the execution of their specific skill (Normand et  al., 1982). Sus-                       physical performance in a particular task (Blood & Studdert, 1990).
      tained practice establishes an advanced level of muscular control                         Most of the literature on training involves the effect on physiologi-
      and economy of effort. Codification that develops as a result of                          cal parameters and on blood chemistry. This section mainly focuses
      practice is attributed to reorganization of the motor program                             on the influence of training on kinematics of riding horses. Clayton
      required to execute the specific task within the central nervous                          (1993) found differences in stride variables of the extended canter
      system. These modifications are manifest as inhibition of unde-                           under a rider between horses trained for dressage and horses trained
      sired cocontractions in the antagonistic muscles, contributing to                         for racing. These included longer stance durations and longer over-
      lower overall tension and greater economy of effort. This is an                           laps between stance phases of different limbs in the dressage horses.
      important training consideration, especially in high-intensity                            The level of training of a dressage horse affects the ability to make
      sports, such as polo, cutting and eventing, that combine the need                         a transition directly between walk and trot (Argue & Clayton,
      for speed and endurance with highly coordinated technical skills.                         1993a) and between halt and trot (Tans et al., 2009), but not
      For more information, the reader is referred to the chapters on                           between trot and canter (Argue & Clayton, 1993b). Horses compet-
      initiation and coordination of gait.                                                      ing at a higher level performed transitions between walk and trot
316
                                                                                                                                                     Sport horses
Table 14.4 Recorded and predicted kinematics of the forelimb of a group of horses trotting on a treadmill at foal and adult age
 Scapula (degrees)
 Range of max rotation                                  15.5                       13.8–17.2                     17.8*                 0.47†
 Elbow (degrees)
 At IGC                                                 53.6                       50.1–57.1                     50.1*                 0.12
 Max extension relative to IGC                         −25.7                      −28.7–22.7                    −25.6                  0.36
 Max flexion relative to IGC                            30.9                       26.6–35.2                     34.6*                 0.48†
 Range of movement                                      56.6                       52.1–61.1                     60.2*                 0.44†
 Carpus (degrees)
 At IGC                                                   4.4                       1.8–7.0                       6.0                  0.03
 Max extension relative to IGC                          −7.6                       −9.9–5.3                      −9.0                  0.36
 Max flexion relative to IGC                            70.0                       64.9–75.1                     81.9*                 0.42†
 Range of movement                                      77.5                       73.2–81.8                     90.8*                 0.47†
 Fetlock (degrees)
 At IGC                                                −15.3                      −18.4–12.2                    −16.8                  0.01
 Max extension relative to IGC                         −36.9                      −40.4–33.4                    −39.1*                 0.37
 Max flexion relative to IGC                            42.2                       37.8–46.6                     41.5                  0.47†
 Range of movement                                      79.1                       73.6–84.6                     80.6                  0.36
more ‘cleanly’, that is with fewer support sequences that were not                        duration increased after 1 year of training. Similarly, in Andalusian
part of the normal pattern for either gait.                                               horses, 10 months of training resulted in an increase in swing dura-
   Many Warmblood registries have a stallion performance test as                          tion and a decrease in hind stance percentage (Cano et al., 2000).
part of the process for determines which stallions are accepted for                       Corley and Goodship (1994) also reported a decrease in stance
breeding. In Dutch Warmbloods a training period of 70 days has                            duration in cantering Thoroughbreds trained on a treadmill, as
been shown to correlate well with the future performance (Huiz-                           did Drevemo et al. (1987) in four young Standardbreds that
inga, 1991). Back et al. (1995a) compared the effects of a 70-day                         were trained over a 3-year period. Training changes the relation
training period with turn out on pasture by evaluating the temporal,                      ship between stance and swing durations (Cano et al., 2000) and
angular and segmental kinematics of the fore and hind limbs.                              between stride duration and stride frequency (Muñoz et al., 1997),
In the hind limbs of the trained horses, the same stride duration                         but the definition and effects of ‘training’ may differ between
was achieved with a significantly shorter stance duration after the                       studies.
70-day period, illustrating the development of ‘impulsion’ through                           In trained horses the load seems to shift from the forelimbs
improvement of muscular strength (Fig. 14.9). Horses pastured for                         towards the hind limbs, in which maximal fetlock extension
70 days also decreased their stance percentage, but this was associ-                      increases, and the horse is said to ‘carry itself ’ (Crossley, 1993). Back
ated with increases in both swing and stride duration (Back et al.,                       et al. (1995a) hypothesized that increased impulsion in trained
1995a).                                                                                   horses might be visible as increased extension of the tarsal and hind
   Schwarz (1971) analyzed some temporal kinematic variables                              fetlock joints, in contrast to the increased extension of the carpal
of Hannoverian stallions walking and trotting overground and                              and fore fetlock joints seen in pastured horses. Interestingly, young
found that swing duration expressed as a percentage of total stride                       Standardbreds that were trained for 5 months showed both
                                                                                                                                                                       317
       14       Performance in equestrian sports
Table 14.5 Recorded and predicted kinematics of the hind limb of a group of horses trotting on a treadmill at foal and adult age
       Pelvis (degrees)
       Range of max rotation                                    7.6                       5.9–9.3                      9.1*               0.77†
       Hip (degrees)
       At IGC                                                 91.7                       87.5–95.9                   88.4*                0.07
       Max extension relative to IGC                         −20.9                      −23.4–18.4                  −20.6                 0.70†
       Max flexion relative to IGC                              2.0                       0.9–3.1                      2.7*               0.55†
       Range of movement                                      22.9                       20.9–24.9                   23.3                 0.59†
       Stifle (degrees)
       At IGC                                                 15.9                       11.7–20.1                   12.0*                0.08
       Max extension relative to IGC                          −0.8                       −1.6–0.0                    −1.0                 0.19
       Max flexion relative to IGC                            48.4                       43.8–53.0                   46.3*                0.48†
       Range of movement                                      49.2                       44.4–54.0                   47.3*                0.55†
       Tarsus (degrees)
       At IGC                                                 21.4                       18.0–24.8                   16.1*                0.42†
       Stance flexion relative to IGC                           9.6                       6.8–12.4                   10.6*                0.52†
       Max extension relative to IGC                          −6.1                       −8.2–4.0                    −5.8                 0.17
       Max flexion relative to IGC                            47.3                       42.3–52.3                   49.7*                0.65†
       Range of movement                                      53.4                       48.3–58.5                   55.4*                0.70†
       Fetlock
       At IGC                                                 −8.8                      −12.9–4.7                   −13.5*                0.27
       Max extension relative to IGC                         −37.8                      −42.0–33.6                  −39.5*                0.53†
       Max flexion relative to IGC                            44.8                       38.9–50.7                   45.5*                0.61†
       Range of movement                                      82.6                       75.6–89.6                   85.0                 0.56†
      phenomena: increased carpal and fetlock extension in the forelimb                         similar to those of pastured horses (Table 14.6) (Back et al., 1995a).
      and increased tarsal and fetlock extension in the hind limbs (Weeren                      Overall, horses kept at pasture show increases in swing and stride
      et al., 1993).                                                                            durations, they have a larger range of protraction and retraction and
         At the beginning of a horse’s career under saddle the movement                         increases in maximal carpal and fetlock extension of the forelimb.
      often appears to become ‘shorter in front.’ For example, Andalusian                       They appear to be more on the forehand with a more relaxed type
      horses had a shortened stride length after 10 months in training                          of movement.
      (Cano et al., 2000). After a further period of training, young horses                       A more prolonged period of dressage training teaches horses
      find their balance, and are able to carry a rider ‘on the bit.’ These                     to move with greater collection and self-carriage. The hind limbs
      changes are accompanied by re-establishment of movement of the                            provide more of the forward propulsive force as self-carriage devel-
      proximal limb segments, which is reflected by gradual increases in                        ops. At the same time, the forelimbs show a reduced propulsive
      cranio-caudal movement of the distal segments of the forelimb                             force and develop an increased braking force to control balance and
318
                                                                                                                                                                        Sport horses
Fig 14.9  ‘Ravel’ ridden by Steffen Peters moves with impulsion and shows a large amount of forelimb retraction and hind limb protraction.
Courtesy of Jacob Melissen, The Netherlands.
  Table 14.6  Maximal cranial and caudal movement in centimeters of the forelimb segments relative to the proximal scapula before and
  after 70 days in training or 70 days at pasture
  Humerus
  Proximal                                         11.4                        12.3*                     11.1                         12.2*
  Distal                                           22.7                        23.6*                     22.4                         24.0*
  Radius
  Proximal                                         27.9                        29.2*                     27.2                         29.1*
                                                                                                                                                            †
  Distal                                           62.1                        62.4                      61.2                         62.7*
  Metacarpus
                                                                                                                                                            † #
  Proximal                                         75.6                        75.1                      74.3                         76.3*                  ()
                                                                                                                                                            † #
  Distal                                           93.9                        92.9                      92.2                         93.9*                  ()
  Hoof
                                                                                                                                                            † #
  Coronet                                        112.2                       111.2                      110.3                        112.6*                  ()
                                                                                                                                                            † #
  Heel                                           113.5                       112.7                       11.3                        114.2*                  ()
                                                                                                                                                            † #
  Toe                                            116.2                       115.8                      113.9                        116.5*                  ()
  *Indicates that the values before and after 70 days are significantly different (p < 0.05) within the training or pasture groups (Student’s t-test).
  †
      Indicates that the changes in the values over the period of 70 days are significantly different (p < 0.05) between the training and pasture groups (ANOVA).
  #
   Indicates the changes in the values over the period of 70 days are also significantly different between the training and pasture groups after a Bonferroni post-hoc test
  (p ≤ 0.05).
  There was a statistically significant interaction between ‘time’ (before/after) and ‘group’ (training/pasture), and between ‘segment’ (marker no. 1–10), ‘time’ and ‘group’ (p < 0.05;
  ANOVA).
  Data from Back et al. (1995a).
                                                                                                                                                                                           319
       14        Performance in equestrian sports
       Table 14.7  Time relative to initial ground contact (t = 0) of the maximal protraction of the different segments of the hind limb before and
       after 70 days in training or 70 days at pasture. Time is expressed as a percentage of total stride duration
       Tibia
       Proximal                                        −2.4                        −3.8*                      −3.0                        −3.5
       Distal                                          −1.4                        −2.4*                      −1.6                        −1.8                     †
       Metatarsus
       Proximal                                        −1.6                        −2.5*                      −1.7                        −1.9                     †
       Hoof
       Coronet                                         −2.0                        −2.7*                      −1.8                        −1.9
       Heel                                            −1.9                        −2.6*                      −1.8                        −1.8
       Toe                                             −1.8                        −2.5*                      −1.7                        −1.8
       *Indicates that the values before and after 70 days are significantly different (p < 0.05) within the training or pasture groups (Student’s t-test).
       †
        Indicates that the changes in the values over the period of 70 days are significantly different (p < 0.05) between the training and pasture groups (ANOVA).
       There was a statistically significant interaction between ‘time’ (before/after) and ‘group’ (training/pasture), and between ‘segment’ (marker no. 1–10), ‘time’ and ‘group’ (p < 0.05;
       ANOVA).
       Data from Back et al. (1995d).
      prevent the horse from falling onto the forehand as a result of the
                                                                                                        Table 14.8  Response to the 70 days in training or 70 days at
      increased hind limb propulsion. Consequently, the trained horse
                                                                                                        pasture assessed according to the change in maximal fetlock
      does not roll over the forelimbs; instead the forehand is vaulted
                                                                                                        extension of the forelimb and the hind limb
      upwards over the forelimb strut. ‘Engagement of the hind quarters’,
      which is one of the primary goals of training the young sport horse
      (Crossley, 1993), might be visible as an earlier maximal protraction                                                                           Forelimb
      of the hind limb with respect to the retracting ipsilateral forelimb
                                                                                                                             Training (n = 12)                      Pasture (n = 12)
      as a consequence of the ability to generate the impulse needed from
      the hind limbs during a shorter stance time (Fig. 14.9; Table 14.7).                                               Decrease            Increase         Decrease            Increase
      At the same time, increased fetlock extension illustrates more weight
      carrying by the hind limbs (Back et al., 1995a) (Table 14.8). After                               Hind limb
      an initial 10 months of dressage training Andalusian horses had                                   Decrease         3                   2                1                   6
      more flexion of the hip and stifle joints at the beginning of stance
      and at the beginning of swing, which may indicate the development                                 Increase         5                   2                2                   3
      of engagement (Cano et al., 2000).
                                                                                                        Total            8                   4                3                   9†
320
                                                                                                                                                      Dressage
                                                                          Force (N)
             4000                                                                     4000
             3000                                                                     3000
             2000                                                                     2000
             1000                                                                     1000
                0                                                                         0
                    0   20     40          60        80        100                            0     20       40           60       80        100
                                    Stance (%)                                                                    Stance (%)
                                                                          Force (N)
                                                                                         0
             –500                                                                                   20        40          60        80       100
                                                                                       -200
            –1000                                                                      -400
                                                                                       -600
            –1500
                                                                                       -800
            –2000                                                                     -1000
                                                                                                                   Stance (%)
Fig 14.10  Vertical (above) and longitudinal (below) ground reaction forces (GRFs) of the hind limbs (left) and the forelimbs (right) for horses trotting at the
same speed in hand (blue line) and with a rider (red line).
coordination) are determinants of competitive success. Since dres-                       cycle of hind limb movement is well forward under the horse’s
sage competitions are judged subjectively, the esthetic quality of the                   body, and the vertebral column is rounded while the forehand is
gaits and the expressiveness of the movements are important factors                      relatively elevated. Horses that are able to carry themselves in this
in determining competition scores. Estimated heritabilities for dres-                    manner are said to move in self-carriage. As the horse becomes more
sage in the Dutch Warmblood breed were 0.17 ± 0.05 and genetic                           collected, the range of pendular motion of the hind limb is reduced
correlations between conformation and performance were low to                            (Holmström & Drevemo, 1997).
moderate (Koenen et al., 1995). The length of the neck, length and
position of the shoulders, shape and length of the croup and mus-
cularity of the haunches had a significant moderate genetic correla-                     Rider effects
tion with dressage performance. Due to the low genetic correlations
with performance traits, it was concluded that indirect selection for                    The dressage rider strives follow the movements of the horse har-
performance based on conformation is of limited value. In Swedish                        moniously during all the gaits. This is a learned skill that improves
Warmbloods, similar heritabilities for gait traits were found (range                     with practice. For example, novice riders stabilize their position by
0.09–0.27) and, when combined with estimated heritabilities for                          gripping with the adductor muscles but these muscles become more
competitive dressage performance, they were interpreted as being                         relaxed as coordination between rectus abdominis and erector spinae
useful for early genetic evaluation and selection of both mares and                      muscles improves (Terada, 2000). Horses ridden by professional
stallions for sport performance traits (Wallin et al., 2003). Compari-                   riders perform more harmoniously and with a more consistent
son of gait variables of walk and trot with skeletal conformation                        motion pattern than horses ridden by recreational riders (Peham
measurements in 142 3-year-old horses of three breeds (German,                           et al., 2003). Experienced riders maintain an almost vertical trunk
French and Spanish saddle horses) were interpreted as indicating                         position in sitting trot (Schils et al., 1993) and are able to maintain
that the gaits of the German horses were more adapted for dressage                       dynamic equilibrium by anticipating the translational movements
competition, whereas purebred Spanish horses could be considered                         of the horse, leaning forward slightly by about 5° in late stance in
as a reference for collected gaits as used in academic dressage                          preparation for the push-off into the suspension, then leaning back-
(Barrey et al., 2003).                                                                   ward by about 5° in preparation for the deceleration of impact
   The qualities of rhythm and relaxation are important at all levels                    (Terada et al., 2006). Movements of the rider’s shoulder and elbow
of dressage training and as the horse progresses to the more                             joints are synchronized with these forward-backward trunk oscilla-
advanced levels, the amount of collection and self carriage must                         tions, which allow the rider’s hand to maintain a consistent posi-
be developed to a higher degree. Collection describes a manner of                        tion relative to the bit (Terada et al., 2006). The upper and middle
moving in which the strides become shorter and more elevated, the                        trapezius and middle deltoid muscles are active in early stance to
                                                                                                                                                                   321
       14          Performance in equestrian sports
       Regular                                                                       Table 14.9  Mean values for stride kinematics for the collected,
       rhythm:          RH          RF              LH             LF          RH
                                                                                     medium and extended walks in dressage horses
      stabilize the rider’s neck and shoulder through the impact phase
      (Terada et al., 2004). At the same time, biceps brachii stabilizes the
      elbow and prevents the forearm descending under the effect of                 These values are similar to the speed of 1.82 m/s achieved with a
      gravity, while the carpal flexors and extensors stabilize the wrist.          stride length of 1.93 m and a stride duration of 1.06 s reported by
         It is not only the effect of the horse on the rider that must be           Clayton (1995) in horses of slightly lower caliber. On average,
      taken into consideration; the position and movements of the rider             bipedal contact accounted for 61% of stride duration and tripedal
      have a dynamic effect on the horse’s ground reaction forces (Clayton          contact for 39% of stride duration in the Olympic competitors
      et al., 1999). For example, in the sitting trot the rider’s descent           (Deuel & Park, 1990).
      during the stance phase increases the vertical ground reaction force             Stride length in the walk can be considered as the sum of the
      on the horse’s forelimbs.                                                     lateral distance (distance between the hind hoof and the next place-
                                                                                    ment of the ipsilateral fore hoof) plus the tracking distance (dis-
      The gaits                                                                     tance between the fore hoof and the next placement of the ipsilateral
                                                                                    hind hoof). Changes in stride length at the walk are almost entirely
      The gaits performed in competition are the walk, trot, canter, rein           due to adjustments in tracking distance (Table 14.9). Lengthening
      back, passage and piaffe. The walk, trot and canter each have several         of the stride is accompanied by a wider arc of limb rotation during
      variations that differ in speed of progression. From slowest to fastest       the stance phase. The angle between the metapodial bone and the
      these are the collected, working, medium and extended gaits. Horses           ground is more acute at ground contact and more obtuse at lift-off
      are supposed to maintain the same stride frequency (tempo) during             in the extended walk than in the collected walk, without any change
      the transitions between these gait types. In other words, they should         in the carpal or tarsal angle at impact or at lift-off (Clayton, 1995).
      change stride length independently of stride frequency.                          Although dressage horses are required to maintain a regular, four-
                                                                                    beat rhythm in the walk, only a minority of horses achieve this
                                                                                    (Clayton, 1995). When the rhythm becomes irregular, the horses
      The walk                                                                      show either lateral couplets (lateral or pacing rhythm), in which
      The walk is a four-beat gait with a lateral footfall sequence in which        there is a shorter time between the lateral footfalls, or they show
      contact of a hind limb is followed by contact of the lateral forelimb:        diagonal couplets (diagonal rhythm), in which there is a shorter
      RH, RF, LH, LF. The footfalls should be evenly spaced in time, giving         time between the diagonal footfalls (Fig. 14.11). Clayton (1995)
      a regular, four-beat rhythm. The limb support sequences alternate             found that a majority of national level dressage horses showed
      between bipedal and tripedal supports (Fig. 14.11). The bipedal               lateral couplets, with the same footfall pattern being present in all
      supports always consist of a forelimb and a hind limb, which may              types of walk. The average step durations measured for dressage
      be a diagonal or a lateral pair. The tripedal supports may be two             finalists competing in the Seoul Olympics indicate that they moved
      hind limbs and one forelimb or two forelimbs and one hind limb.               with diagonal couplets (Deuel & Park, 1990).
         The Fédération Equestre Internationale (FEI) recognizes four                  In an investigation of the desirable characteristics of the walk,
      types of walk: collected, medium, extended and free. (There is no             Biau and Barrey (2004) attached an accelerometer beneath the
      working walk.) The free walk, in which the horse is allowed freedom           sternum of young horses (4–6 years old) and experienced horses
      to stretch the neck, is only performed in lower levels of competition.        (7–13 years old). Comparison between the accelerometric data and
      The speed, tempo and stride length of the collected, medium and               the scores awarded by dressage judges showed that the horses were
      extended walks measured in a group of national level FEI horses are           rewarded for having a slow, regular and symmetrical pattern of
      compared in Table 14.9 (Clayton, 1995). Speed of the medium and               movement with a large amount of dorsoventral displacement.
      extended walks was significantly faster than that of the collected               In highly trained dressage horses, both the collected and extended
      walk. Compared with the collected walk, stride length was 23%                 walk strides have a longer stance duration in the hind limbs than
      longer and stride frequency was 8% longer in the extended walk,               in the forelimbs (Clayton, 1995; Hodson et al., 1999). This may be
      which agrees with Dušek et al. (1970) who found that increases in             related to the requirement that highly trained horses move in self-
      speed at all gaits up to a moderate gallop were caused mainly by              carriage, which implies lightness of the forehand and a greater
      increasing stride length. However, dressage horses did not fulfill the        reliance on the hind limbs for propulsion.
      FEI requirement that the same stride frequency be maintained at all              In Andalusian horses, medium to high heritabilities were found
      types of walk.                                                                for many kinematic parameters of the walk, including stride length
         For dressage horses competing in the Seoul Olympics, the mean              and duration, maximal height of the hind hoof, range of forelimb
      speed of the extended walk was 1.88 m/s, the stride length was                protraction–retraction, hind limb stance duration, and fore and
      1.95 m and the stride duration was 1.03 s (Deuel & Park, 1990).               hind limb swing durations (Molina et al., 2008).
322
                                                                                                                                                 Dressage
Half pirouette at the walk                                                         frequency is significantly slower in collected than extended trot
                                                                                   (Clayton, 1994a), which does not meet the requirements to main-
The half pirouette in collected walk is a half circle in which the                 tain a constant stride frequency. Deuel and Park (1990) have shown
forehand moves around the hindquarters. The inside hind limb acts                  a positive relationship between speed and stride length and a nega-
as a pivot point for the movement, but it continues to step in the                 tive relationship between speed and stride duration in a group of
rhythm of the walk strides. In a study at the Atlanta Olympics                     top-level competitors. Interestingly, dressage horses that qualified
(Hodson et al., 1999) the majority (8/11) of the horses completed                  for the individual medal finals in the Seoul Olympics tended to
the half pirouette at walk in three strides; the remaining horses used             have faster speeds, longer stride lengths and higher stride frequen-
four strides. This is consistent with the FEI rules, which stipulate               cies in the extended trot than horses that failed to qualify (Deuel &
three to four strides in a half pirouette. None of the horses main-                Park, 1990).
tained a regular four-beat rhythm in the walk pirouette. Instead, the                 Stride length at the trot depends on the diagonal distance (dis-
footfall of the inside hind limb occurred relatively early in the                  tance between the diagonal pair of limbs during their stance phase)
stride. Consequently, the time between footfalls of the outside fore               and the tracking distance (distance between the fore hoof and the
and inside hind hooves was short, while the time between footfalls                 next contact of the ipsilateral hind hoof). Diagonal distance shows
of the inside hind and inside fore hooves was long (Fig. 14.11). This              a non-significant increase of 4.0–5.0 cm between working and
indicates that, to compensate for the lack of forward movement, the                medium trot, which is probably a consequence of the lengthening
horses become more reliant on the inside hind limb to maintain                     of the horse’s frame. However, most of the lengthening of the stride
their balance.                                                                     is a result of greater over-tracking (46 cm increase from collected to
                                                                                   extended trot), which represents the distance covered during the
                                                                                   suspension (Clayton, 1994a). The best way to increase over-tracking
The trot                                                                           and, therefore, stride length is to prolong the suspension by
The trot is a two-beat gait in which the diagonal pairs of limbs move              pushing-off with a higher vertical velocity. Suspension in the
more or less synchronously, and the footfalls of the diagonal limb                 medium and extended trots is twice as long as that of the collected
pairs are evenly spaced in time. The diagonal support phases are                   and working trots (Clayton, 1994a).
usually separated by periods of suspension, except in a very slow                     In the highest scoring dressage horses in the Seoul Olympics
(jog) trot. Therefore, each stride has two diagonal support phases                 the speed of the extended trot was strongly influenced by stride
and two suspensions. In young horses, an accelerometric study                      length but not closely related to stride duration (Deuel & Park,
showed that judges awarded higher marks to horses showing a slow                   1990). This indicates greater reliance on changes in stride length
trot with a large amount of dorsoventral displacement of the trunk                 rather than stride frequency in elite dressage horses. The speed of
(Biau & Barrey, 2004).                                                             the extended trot (4.93 m/s) in the national level competitors
   Slow motion analysis has shown a slight dissociation between                    studied by Clayton (1994a) is similar to the speed recorded in
ground contact and lift-off of the diagonal fore and hind limbs.                   Olympic competitors (4.98 m/s) by Deuel and Park (1990).
The interval between the fore and hind contacts is known as diago-                 However the Olympic competitors achieved this speed using a
nal dissociation. The value is positive if the hind limb contacts                  longer stride length (3.79 m versus 3.55 m) and a longer stride
the ground before the forelimb, zero if the diagonal pair contact the              duration (0.763 s versus 0.722 s). Therefore, horses of a slightly
ground simultaneously, and negative if the hind limb contacts                      lower caliber achieve the speed required in the extended trot using
the ground after the forelimb. Positive diagonal dissociation at                   shorter, faster strides.
contact (Fig. 14.9) is considered a desirable characteristic that is                  The stance durations of the forelimbs and hind limbs do not
indicative of good balance (Holmström et al., 1995). It occurs in                  differ from each other in any type of trot (Clayton, 1994a), but both
horses that travel with an elevated forehand, which is a character-                the fore and hind stance durations are significantly shorter in
istic of collection. However, a negative diagonal dissociation does                extended trot than in collected trot. The angles of the cannon
not preclude a horse from being successful in dressage. In the Seoul               segment to the horizontal are significantly more acute at hoof
Olympics, 15% of the extended trot strides that were analyzed had                  contact and more obtuse at lift-off in the extended trot than in the
a negative diagonal dissociation at contact (Deuel & Park, 1990).                  collected trot (Clayton, 1994a). The hind cannon consistently has
   Four types of trot are performed in competition: collected,                     a more acute angle to the ground on its plantar side than the fore
working, medium and extended. Table 14.10 shows that speed and                     cannon throughout the stance phase. The difference ranges from
stride length differ significantly between each type of trot, and stride           about 10° at hoof contact to 20° at lift-off.
Table 14.10 Mean values for stride kinematics of the collected, working, medium and extended trots in FEI level dressage horses
                                                                                                                                                            323
       14         Performance in equestrian sports
                                                                                 The piaffe
                                                                                 Piaffe (or piaffer) is a highly collected, cadenced, elevated diagonal
                                                                                 movement giving the impression of remaining in place. The horse’s
                                                                                 back is supple and elastic. The hindquarters are lowered; the
                                                                                 haunches with active hocks are well engaged, giving great freedom,
                                                                                 lightness and mobility to the shoulders and forehand. Each diago-
      Fig 14.12  ‘Salinero’ ridden by Anky van Grunsven performing passage and   nal pair of legs is raised and returned to the ground alternately, with
      showing elevation of the hooves in midswing.                               spring and an even cadence (Anon, 2009). As in passage, the limbs
      Courtesy of Jacob Melissen, The Netherlands.                               pause momentarily at their position of maximal elevation.
                                                                                    Stride duration is longer in piaffe than in collected trot but is
                                                                                 similar in piaffe and passage (Clayton, 1997a; Holmström et al.,
      The passage                                                                1995). The rules require piaffe to be performed in place in the
      According the FEI Rules for Dressage, passage is a measured, very          Grand Prix test, whereas in the Intermediate II test the horse is
      collected, elevated and cadenced trot. It is characterized by a pro-       allowed to move forward with a stride length of 20 cm (Table
      nounced engagement of the hindquarters, a more accentuated                 14.11), which is in accordance with the amount of forward progres-
      flexion of the knees and hocks, and the graceful elasticity of the         sion recorded during Olympic competition (Argue, 1994). Since
      movement (Anon, 2009). The limbs pause momentarily at their                piaffe has little, if any, forward momentum, horses maintain their
      position of maximal elevation (Fig. 14.12), when the toe of the            balance by increasing the stance durations and overlaps between
      raised forefoot should be level with the middle of the cannon bone         limbs. Piaffe has longer fore, hind and diagonal stance durations
      of the other supporting forelimb. The toe of the raised hind foot          than passage or trot and these are associated with longer overlaps
      should be slightly above the fetlock joint of the other supporting         between limbs (Clayton, 1997a). There is always at least one hoof
      hind limb (Anon, 2009). None of the horses competing in the                in contact with the ground, so piaffe has no suspension phase
      individual medal finals at the Barcelona Olympics achieved                 (Holmström et al., 1995; Clayton, 1997a). Therefore, piaffe is a
      the required elevation in the forelimbs in passage (Argue, 1994).          stepping gait, rather than a leaping gait, with a gradual transfer of
      The diagonal limb pairs move more or less in synchrony in passage          body weight from one diagonal to the other. The amount of overlap
      but with a pronounced positive diagonal dissociation (Clayton,             between successive diagonal stance phases is, however, shorter in
      1997a; Holmström et al., 1995; Weishaupt et al., 2009), which is           the better-quality piaffe (Clayton, 1997a).
      longer in the more successful competitors (Clayton, 1997a).                   Each horse performs the piaffe with its own, highly individual-
         Stride length and speed are significantly reduced from collected        ized coordination pattern and, although the mean value of the
      trot to passage and from passage to piaffe (Table 14.11). Passage          diagonal dissociation at contact for piaffe in a group of horses was
      and piaffe have the same stride frequency, which is significantly          negative (Argue, 1994; Holmström et al., 1995), the best competi-
      slower than that of collected trot (Clayton, 1997a).                       tive horses had a positive diagonal dissociation (Clayton, 1997a).
         Kinematic analysis indicated that the stifle and tarsal joints were     Piaffe is a highly collected gait and the collection is associated with
      more flexed at ground contact and the tarsus was also more flexed          more pelvic tilting throughout the stride cycle, greater stifle and
      in midstance in passage compared with collected trot (Holmström            tarsal flexion at the start of stance and greater tarsal flexion at mid-
      et al., 1995). For horses moving on a treadmill, there was more            stance compared with passage and collected trot. Horses do not,
      lumbosacral flexion throughout the stride in passage than in col-          however, step further underneath themselves in piaffe than in
      lected trot (Weishaupt et al., 2009).                                      passage or collected trot (Holmström et al., 1995).
         The ground reaction forces in passage resemble those of the col-           A unique feature of piaffe is the GRF profiles (Clayton, unpub-
      lected trot in horses moving overground (Clayton, unpublished).            lished data). The vertical GRF has a smaller amplitude than passage
      The forelimbs have a higher peak vertical force than the hind limbs.       or collected trot and the trace has a flattened profile during the long
324
                                                                                                                                                                                          Dressage
Force (N)
                                                                                                                                          Force (N)
            3000                                                                    3000                                                               3000
            2000                                                                    2000                                                               2000
            1000                                                                    1000                                                               1000
               0                                                                       0                                                                   0
                    0   20        40     60          80           100                       0   20         40     60        80     100                         0   20   40     60         80     100
                                  Stance (%)                                                               Stance (%)                                                   Stance (%)
Force (N)
                                                                                                                                          Force (N)
             –200                                                                    –200                                                              –200
             –400                                                                    –400                                                              –400
             –600                                                                    –600                                                              –600
             –800                                                                    –800                                                              –800
            –1000                                                                   –1000                                                             –1000
                    0   20        40     60          80           100                       0   20         40     60        80     100                         0   20   40     60         80     100
                                  Stance (%)                                                               Stance (%)                                                   Stance (%)
Fig 14.13  Vertical (above) and longitudinal (below) ground reaction forces for collected trot (left), passage (center) and piaffe (right) for the forelimbs (blue
line) and hind limbs (red line).
Table 14.12 Stride kinematics of the collected, working, medium and extended canters in FEI level dressage horses
stance phase (Fig. 14.13). The longitudinal force is almost entirely                                             to stay airborne longer and to cover a greater distance during the
propulsive in the forelimbs and almost entirely braking in the hind                                              suspension.
limbs (Fig. 14.13), which is the opposite of passage and collected                                                  For horses competing in the individual medal final at the Seoul
trot.                                                                                                            Olympic Games, the speed of the extended canter (7.03 m/s) was
                                                                                                                 considerably faster than that recorded in slightly lower-caliber
                                                                                                                 national level competitors (5.97 m/s). The difference was primarily
The canter                                                                                                       a result of a longer stride length (4.15 m versus 3.47 m), which was
The canter is the only asymmetrical gait of dressage horses. It has a                                            combined with a slightly slower stride frequency (101 strides/min
transverse sequence of limb placements, so the leading fore and                                                  in the national level horses versus 105 strides/min in the Olympic
hind limbs are on the same side of the body. Four types of canter                                                competitors). Higher overall competition scores have been recorded
are performed in dressage competitions: collected, working medium,                                               for horses with faster speeds and longer stride lengths in the
and extended, which have significantly different speeds (Clayton,                                                extended canter. No upper limit was detected for optimal stride
1994b). The stride frequency is the same for the different types of                                              length (Deuel & Park, 1990). Higher scoring horses also showed
canter, so changes in speed are accomplished by alterations in stride                                            shorter periods of ground contact of the limbs, while increasing
length (Table 14.12). Stride length increases as a result of a small                                             both the duration and distance covered during the suspension.
increase in the distance between the two hind limbs, a small increase                                               The rhythm of the stride differs between the collected and
in the distance between the two forelimbs, and a large increase in                                               extended canters (Clayton, 1994b). In collected canter, the three
the distance covered during the suspension. The ability to generate                                              footfalls are separated by relatively long intervals but the suspension
a high vertical velocity at the start of the suspension allows the horse                                         is relatively short. In extended canter the three footfalls are further
                                                                                                                                                                                                       325
            14                  Performance in equestrian sports
                     1.5
                                                                                          Suspension               −0.53               −0.47                    −0.33
                                                                                          LdF–TrH (m)
                     1.0
                                                                                          Stride frequency         97                  99                       97
                     0.5                                                                  (strides/min)
      Force (N/kg)
                     0.0                                                                  LdF, leading forelimb; LdH, leading hind limb; TrF, trailing forelimb; TrH, trailing
                                       20          40         60              80   100    hind limb.
                     -0.5                                                                 Data from Deuel and Park (1990).
                     -1.0
                     -1.5
                                                                                         characteristics of the canter strides during the two tempi (alternate
                     -2.0
                                                                                         stride) and one tempi (every stride) lead changes are shown in Table
                                                  Time (% stance)
                                                                                         14.13 (Deuel & Park, 1990). During the lead changes, all four limbs
      Fig 14.14  Vertical (above) and longitudinal (below) ground reaction forces        have long stance durations and short swing durations, and there is
      of the four limbs in the canter.                                                   a diagonal dissociation with contact of the leading hind hoof pre-
                                                                                         ceding that of the trailing fore hoof by 14.0–24.0 ms.
                                                                                            In the two tempi changes (Deuel & Park, 1990), the stride imme-
                                                                                         diately preceding the change (pre-change stride) has a slower speed,
      apart spatially but are more closely grouped temporally and the                    shorter stride length and higher stride frequency than the stride
      suspension is longer. The diagonal limb pair (leading hind and                     following the change (post-change stride). The shorter stride length
      trailing fore) do not always make contact with the ground synchro-                 of the pre-change stride is a result of taking a shorter step between
      nously, though the dissociation is very small and usually only                     the two forelimbs and covering less distance during the suspension
      detectable with the aid of slow motion analysis. In the extended                   (Table 14.13). In pre-change strides ground contact of the trailing
      canter either the fore or hind limb may contact the ground earlier                 forelimb precedes that of the leading hind limb, whereas in the
      (Deuel & Park, 1990; Clayton, 1994b).                                              post-change strides the sequence is reversed.
         The ground reaction forces at the canter (Merkens et al., 1993)                    In the one tempi lead changes, the strides share characteristics of
      show marked differences between the trailing and leading limbs                     both the pre- and post-change strides in the two tempi changes
      (Fig. 14.14). In collected canter the peak vertical ground reaction                (Table 14.13). The support sequence varies between horses, reflect-
      force is smallest in the trailing hind limb (approximately equal to                ing individual differences in technique, but the diagonal dissocia-
      body weight) and largest in the trailing forelimb (1.5 times body                  tion almost always involves placing the leading hind limb before
      weight). The peak vertical force in the leading hind and leading                   the trailing forelimb. There is a pronounced reliance on overlap
      forelimbs was approximately 1.2 times body weight. With regard to                  between the two hind limbs in the early part of the stride, which is
      the longitudinal ground reaction force, the trailing hind limb is                  similar to the post-change stride for the two tempi changes. Later
      primarily propulsive; it acts to change the direction of movement                  in the stride there is a reliance on forelimb overlap. Higher competi-
      of the center of mass from forward and downward to forward and                     tion scores are associated with a longer time in hind limb support
      horizontal. The leading hind limb and trailing forelimb (diagonal                  and a shorter time in forelimb support (Deuel & Park, 1990).
      pair) are principally responsible for supporting the body weight and
      supplying forward propulsion, with the trailing forelimb having
      a particularly large propulsive component. The leading forelimb                    The canter pirouette
      raises the center of mass as the horse moves into the suspension by                In the canter pirouette, horses are supposed to maintain the tempo
      exerting large vertical and braking forces.                                        and rhythm of the collected canter strides. However, a study of
                                                                                         horses competing in the individual medal finals at the Barcelona
                                                                                         Olympics showed that neither the tempo nor the rhythm of the
      Lead changes at the canter                                                         collected canter strides was maintained in the canter pirouette. The
      When a dressage horse performs a flying lead change, the leading                   tempo was significantly slower in the pirouette strides (68 strides/
      hind limb and leading forelimb change during the suspension                        min) than in the collected canter strides (95 strides/min). The
      phase. In high-level competitions, lead changes are performed                      footfalls of the diagonal limb pair were dissociated in the
      in series at intervals of four, three, two or one strides. The                     pirouette strides, giving a distinct four-beat rhythm, in contrast
326
                                                                                                                                              Jumping
                                                                                                                                                            327
       14        Performance in equestrian sports
      Terminology                                                                                        1989). Fewer knock-downs occurred when there was a larger dis-
                                                                                                         tance between the trailing forelimb in approach stride 1 and the
      Terminology for the strides during the approach to and departure                                   base of the fence (Deuel & Park, 1991).
      from a fence for horses jumping at a canter has been described                                        The timing and coordination of the limb movements during the
      (Clayton, 1989a). The stride in which the jump occurs is the jump                                  approach, jump stride, and departure are shown in Table 14.14.
      stride; its components are the lift-off, jump suspension and landing.                              Approach stride 2 and the strides that precede it are fairly typical
      The lift-off comprises the stance phases of the two hind limbs                                     canter strides performed with an elevated head and neck position.
      immediately preceding the jump. The jump suspension is the air-                                    The ability to maintain a high stride frequency during the approach
      borne phase starting when the last hind limb leaves the ground at                                  strides is a characteristic of good jumpers (Barrey & Galloux, 1997).
      lift-off and ending at ground contact of the trailing forelimb during                                 Approach stride 1 is a short, quick stride; both the stride length
      landing. The landing comprises the stance phases of the two fore-                                  and stride duration are significantly shorter than in approach stride
      limbs after the jump suspension. The strides preceding the jump                                    2. This stride has a distinctly four-beat rhythm with the leading hind
      stride are the approach strides and those following the jump stride                                limb contacting the ground before the trailing forelimb. The neck
      are the departure strides. Both the approach and departure strides                                 is stretched forward and downward in preparation for lift-off. This
      are numbered from the jump outwards (Fig. 14.16).                                                  action is similar to the ‘gather’ shown by human jumpers during
                                                                                                         the transition between the approach and lift-off. The objective of
                                                                                                         the gather is to lower the CM prior to the lift-off foot contacting the
      Jumping mechanics                                                                                  ground. This minimizes the need to overcome a downward move-
                                                                                                         ment of the CM before driving the body into the air. It has even
      The approach and lift-off                                                                          been suggested that the amount of lowering during the gather bears
      The path of the horse’s CM and the angular momentum of its body                                    a direct relationship to the height jumped. The leading hind limb
      during the jump suspension are determined during the lift-off. After                               has a very short stance duration in approach stride 1 and the horse’s
      the jump suspension begins, these properties cannot be changed                                     body does not roll forward over this limb as in a normal stride.
      until the horse makes contact with another object or with the                                      The forelimbs are stretched forward at ground contact and, conse-
      ground. Therefore, the approach and lift-off are extremely impor-                                  quently, have a relatively small angle between the palmar aspect
      tant in determining the outcome of the jump.                                                       of the metacarpus and the ground (Clayton & Barlow, 1991). The
         The positions of the limb placements on the lift-off side do not                                forelimbs initiate the upward movement of the forehand, convert-
      differ between a vertical fence and an oxer, or between fences of                                  ing forward movement into vertical movement. This involves reduc-
      different heights in the range of 1.10–1.40 m. One study showed                                    ing the horizontal speed, elevating the forehand and rotating the
      that, in 92 of 96 trials, the limb placed closest to the fence on the                              trunk segment into an appropriate position for lift-off. Because the
      lift-off side was the leading forelimb in approach stride 1. In the                                forehand is already starting to move upwards, the leading forelimb
      remaining four trials, all of which were over fences, the limb placed                              is pulled off the ground relatively early, when it is more or less in
      closest to the fence was the leading hind limb (Clayton & Barlow,                                  a vertical position.
       Approach stride 2               Approach stride 1                     Take–off            Jump suspension         Landing           Departure stride 1
                                                                                                   Jump stride
      Fig 14.16  Terminology for the strides preceding and following the jump.
Table 14.14 Stride characteristics of horses jumping a vertical fence 1.55 m high
       LdF, leading forelimb; LdH, leading hind limb; TrF, trailing forelimb; TrH, trailing hind limb.
       Data from Clayton and Barlow (1991).
328
                                                                                                                                                       Jumping
   When a horse jumps a fence that is less than 1 m high, it requires              the hind limbs and land on the forelimbs. Both hind limbs have
little, if any, elevation of the CM to clear the fence and, conse-                 relatively long stance durations, which allows the generation of
quently, the forces required to jump a small fence are not much                    large impulses. The two hind limbs show almost identical ground
greater than those in a canter stride. For example, in jumping a fence             reaction force profiles. The vertical force rises to a plateau, with a
0.8 m high, the combined vertical impulses of the fore and hind                    peak amplitude around 130% body weight for a horse jumping
limbs increase by only about 8% on the lift-off side and 3% on the                 a vertical fence 1.3 m high. The longitudinal forces are predomi-
landing side. For fences higher than about 1.0 m, the need to elevate              nantly propulsive (Fig. 14.17) (Schamhardt et al., 1993).
the CM increases progressively with the height of the fence, with a                   Studies using an accelerometer attached to the thorax beneath the
consequent increase in the vertical forces at lift-off and landing. A              sternum have shown that the action of the hind limbs produces a
considerable increase in vertical forces has been recorded when the                lower acceleration peak on the trunk segment than the push-off by
height of the fence was raised from 1.3 to 1.5 m (Fig. 14.17)                      the forelimbs (Fig. 14.18). However, the inclination of the trunk
(Schamhardt et al., 1993), and a vertical force of 3.85 times body                 axis during the hind limb push-off reduces the amplitude registered
weight has been measured in a horse jumping a vertical fence                       by the direction-sensitive accelerometer, so the acceleration due to
1.53 m high (Preuschoft, 1989). Both forelimbs exert a large                       the hind limb action may be underestimated. The hind limb accel-
braking impulse that decelerates the forward movement. The trail-                  eration peak at lift-off is significantly greater for fences with width
ing forelimb provides a little propulsion in the terminal part of its              (oxer, 1.48 g; water jump, 1.74 g) than for those with height only
stance phase, but the leading forelimb provides only a braking force               (vertical, 1.27 g) (Barrey & Galloux, 1997). This is because the flight
as a result of the early cessation of its stance phase (Schamhardt                 path must be higher and longer when jumping a wider obstacle.
et al., 1993). The braking action of the forelimbs causes a reduction                 For elite show jumping horses jumping a vertical fence 1.50 m
in horizontal velocity (Clayton & Barlow, 1991) and an upward                      high during an international competition (Bogert et al., 1994), a
acceleration of the trunk segment (Barrey & Galloux, 1997). After                  similar movement pattern was observed in all horses during lift-off.
the forelimbs leave the ground, the head and neck are raised, which                The duration of the lift-off phase averaged 221 ms. At the start of
helps to establish an advantageous position for optimal power                      lift-off the trunk was rotating backwards with an angular velocity of
production during the push-off by the hind limbs.                                  150°/s. The direction of rotation changed almost linearly to 50°/s
   A short suspension intervenes between approach stride 1 and the                 forward rotation at the start of the jump suspension. During this
jump stride. The jump stride is distinguished from the preceding                   time the horizontal velocity initially decreased from 4.5 m/s at the
and following strides by the inclusion of the jump suspension,                     start of lift-off to 3.6 m/s, then increased to 6.5 m/s at lift-off. The
which results in significant increases in stride length and stride                 vertical velocity, which was zero at the start of lift-off, reached a
duration. At lift-off the hind limbs often contact the ground syn-                 negative value of 1.0 m/s before increasing to 4.0 m/s at lift-off. The
chronously and at almost equal distances from the fence. Their                     initial downward movement of the trunk was a result of the total
functions are to provide upward and forward propulsion, and to                     vertical GRF being less than body weight. The neck rotated down-
reverse the direction of rotation of the trunk segment. Forward rota-              ward relative to the trunk throughout lift-off with an almost con-
tion of the trunk is necessary for the horse to leave the ground from              stant angular velocity.
0 0 0 0
               20                      20                                20                                 20
Force (N/kg)
                0                       0                                  0                                 0
                     0       100            0                   100            0                   100            0                  100
                                                                 Time (% stance)
Fig 14.17  Longitudinal (above) and vertical (below) ground reaction forces during the approach and lift-off for a horse jumping a vertical fence 1.1 m high.
The traces from left to right represent the trailing forelimb in approach stride 1, the leading forelimb in approach stride 1, the trailing hind limb at lift-off
and the leading hind limb at lift-off. Stance durations of the limbs are: trailing forelimb, 0.20 s; leading forelimb 0.18 s; trailing hind limb, 0.21 s; leading
hind limb, 0.22 s).
                                                                                                                                                                    329
                      14                   Performance in equestrian sports
                                      4
                                                   Stride frequency and FFT                       Acceleration
                                                   module of the approach strides                 peaks
                                      3
                                                                                                                                                            Landing
                                                                                                                   Forelimbs
                                      2
      Dorsoventral acceleration (g)
                                                                                                                                Hindlimbs
                                      1
-1
-2
                                                                                                                                                  Landing
                                                                                                                                Take off
                                                                                                        Stride-2
Stride-1
                                                                                                                                           Jump
                                                                                      Durations
                                      -3
                                                                                    Time (s)
        Fig 14.18  Dorsoventral accelerometer recording of the approach, lift-off, jump suspension, landing and departure. FFT, Fast Fourier transformation.
        Reprinted from Barrey & Galloux (1997) © EVJ Ltd.
           The hip joint extended during the first 152 ms at lift-off, then                    jumper over a fence 1.3 m high. It might be expected from these
        maintained the same angle until leaving the ground. The stifle and                     results that horses with poor technique would show earlier signs
        hock joints initially flexed then extended with the transition from                    of wear and tear injuries than horses with good technique. Poor
        flexion to extension occurring earlier in the hock than the stifle.                    jumpers, even when they clear a fence, tend to have a higher ratio
        The fetlock showed two phases of extension with a relatively con-                      between the acceleration provided during lift-off by the forelimbs
        stant angle in the period between. Maximal fetlock extension                           and the hind limbs. In other words, they increase the braking action
        occurred late in the stance phase after which there was rapid                          of the forelimbs in approach stride 1 to compensate for a weak
        flexion. The total power production by the hind limbs was esti-                        acceleration impulse of the hind limbs at lift-off (Barrey & Galloux,
        mated to be 13 000 J in this study, which represents an average                        1997).
        power production of 59 000 W (or about 100 W/kg) during the
        lift-off phase. These findings indicate that most of the energy
        required to clear the fence is provided by the hind limbs during                       The jump suspension
        lift-off (Bogert et al., 1994). Power production, however, appears                     The jump stride has a much longer stride length than the approach
        to be very dependent on the height of the fence and the speed with                     or departure strides due to the distance covered during the jump
        which it is approached. In the study by Bogert et al. (1994), fence                    suspension. In one study the total distance jumped from lift-off to
        height was 1.50 m. Dutto et al. (2004) studied horses jumping a                        landing did not differ between a vertical fence and an oxer, but
        much lower fence (0.63 m) which they approached at trot not                            increased significantly with fence height (Clayton & Barlow, 1989).
        canter; these authors calculated a power output during hind limb                       In a different study, the jump distance was longer over an oxer than
        push of only 30 W/kg. When studying horses jumping a 1.15 m                            a vertical fence, with the increase being approximately equal to the
        obstacle, Bobbert and Santamaría (2005) found a value of 75 W/                         spread of the oxer (Deuel & Park, 1991).
        kg. In the latter study the authors also investigated the contribu-                       After lift-off, the motions of the body and limb segments are
        tion of the forelimbs. They calculated that during forelimb push-                      coordinated so that the angular velocity of the trunk remains almost
        off total energy first decreased by 3.2 J/kg and then increased again                  constant throughout the jump suspension. All the segments act
        by 4.2 J/ kg. Energy stored in the elastic structures of the limb was                  synergistically with the approximate contributions of the different
        calculated to be only 0.4 J/kg in the trailing forelimb and 0.23 J/kg                  segments to the angular momentum being 50% from the trunk,
        in the leading forelimb. From this observation it was concluded                        25% from the hind limbs, 2% from the head–neck and 5% from
        that the forelimbs are not merely used as passive springs, but a                       the forelimbs (Galloux & Barrey, 1997). The presence of the rider
        considerable amount of energy is first dissipated and then regener-                    has virtually no effect on rotation of the horse’s body.
        ated by muscular power.                                                                   As the horse passes over the top of the fence, the forelimbs gener-
           Each horse has its own individual jumping technique that is                         ally have less clearance than the hind limbs, and clearance by all
        repeatable from jump to jump and produces a characteristic accel-                      limbs decreases with fence height (Jelen, 1976). Furthermore, a
        eration profile (Barrey & Galloux, 1997). Over a small fence, 0.8 m                    good horse paired with a good rider shows a smaller discrepancy
        high, horses with good technique that folded their lower limbs                         between the height of the fence and the height of the limbs; in other
        during the jump suspension, and had vertical and longitudinal                          words horses show less tendency to over-jump with a good rider.
        force profiles that were similar in shape and magnitude to those of                    Most jumping errors are a result of inappropriate aids from the rider
        a canter stride. However, a horse with poor jumping technique                          (Lauk et al., 1991). A study of trunk accelerations showed that 87%
        registered considerably higher forces both at lift-off and landing                     of jumping faults could be blamed on a forelimb error (Barrey &
        (Schamhardt et al. 1993). The forces used by a poor jumper over a                      Galloux, 1997). More faults occur at vertical fences than at oxers or
        fence 0.8 m high were similar in magnitude to those used by a good                     water jumps.
330
                                                                                                                                                         Jumping
                                                                                    sides. The high peak vertical forces at landing in the trailing fore-
The landing and departure                                                           limb also translate to higher peak flexor joint moments and hence
During landing, the two forelimbs are separated by only a short                     higher loading of the flexor tendons than in the leading forelimb
distance. The metacarpal segment of the trailing forelimb (the first                (Meershoek et al., 2001a). In a study using an inverse dynamics
limb to land) is almost vertical when the hoof makes ground                         approach Meershoek et al. (2001b) analyzed horses jumping fences
contact while the leading forelimb contacts the ground with a more                  of 0.8 , 1.0 m and 1.2 m and calculated peak forces in the suspen-
acute angulation (Clayton & Barlow, 1991). The trailing hind limb                   sory ligament, the deep digital flexor tendon and its check ligament,
is usually placed between the previous placements of the two fore-                  and the superficial digital flexure tendon, which reached maximum
limbs, and this characteristic is associated with fewer jumping pen-                values of 15 500 kN, 13 900 kN and 11 700 kN, respectively. When
alties (Deuel & Park, 1991). The leading hind limb is placed further                comparing the recorded values to the maximal load at rupture of
away from the fence than the forelimbs.                                             these structures, it became clear that the superficial digital flexor
   The placements of the leading forelimb and the leading hind                      tendon is loaded dangerously close to its limit during show jumping,
limb on the landing side are closer to the last element of an oxer                  possibly explaining the high incidence of lesions in this structure
than a vertical at all fence heights, and there is a trend toward                   in jumping horses.
landing further from the vertical than the oxer for the other limbs.                   The forelimbs absorb the initial force of landing and this is
The limb displacements from the fence on the landing side increase                  reflected in the high peak amplitudes of the vertical forces, espe-
with fence height but this effect becomes less apparent in the later                cially the trailing forelimb in which a vertical force peak of twice
strides as the horse moves away from the fence (Clayton & Barlow,                   body weight has been recorded in a horse jumping a vertical fence
1991). Therefore, the fewer the strides between fences in a combina-                1.3  m high (Schamhardt et  al., 1993). This limb makes ground
tion, the more important it is to take into account the height and                  contact with an almost vertical orientation, which is not conducive
type of the in-going fence in determining the appropriate distance                  to generating a braking force. Therefore, the longitudinal force of
between fences.                                                                     the trailing forelimb at landing is entirely propulsive, whereas the
   During landing the trailing forelimb has a very short stance dura-               leading forelimb exerts predominantly a braking force with a
tion as the horse rapidly rolls forward onto the leading forelimb                   smaller propulsive component in its terminal part (Merkens et  al.,
(Clayton & Barlow, 1991; Deuel & Park, 1991). Horses that have a                    1991; Schamhardt et  al., 1993). The actions of the trunk, hind
longer time interval between contact of the two forelimbs are less                  limbs and head and neck segments play a large role in reversing
likely to knock the fence down (Deuel & Park, 1991).                                the direction of rotation of the horse’s trunk which is necessary
   The trailing forelimb has the highest peak vertical forces both at               to allow the hind limbs to contact the ground underneath the
lift-off and at landing (Fig. 14.19) (Schamhardt et al., 1993), which               body mass.
may explain the fact that some horses have a preferred lead for lift-                  In departure stride 1 the horse regains its balance and the hind
off and landing and habitually switch to this lead one or two strides               limbs re-establish forward movement by generating large propulsive
before the jump. These horses probably have either a subclinical                    longitudinal forces and impulses, especially in the trailing hind
lameness or a marked strength asymmetry between the left and right                  limb (Schamhardt et al., 1993). This stride has a four-beat rhythm
0 0 0 0
               20                      20                                 20                                  20
Force (N/kg)
                0                       0                                   0                                  0
                     0        100            0                   100            0                    100           0                    100
                                                                 Time (% stance)
Fig 14.19  Longitudinal (above) and vertical (below) ground reaction forces during the landing and departure for a horse jumping a vertical fence 1.3 m
high. The traces from left to right represent the trailing forelimb at landing, the leading forelimb at landing, the trailing hind limb in departure stride 1 and
the leading hind limb in departure stride 1. Stance durations of the limbs are: trailing forelimb, 0.19 s; leading forelimb, 0.21 s; trailing hind limb, 0.17 s;
leading hind limb, 0.22 s.
                                                                                                                                                                    331
       14      Performance in equestrian sports
      with the leading hind limb contacting the ground in advance of the       correlates to good jumping performance. The latter feature has the
      trailing forelimb. The stride length is relatively short (Clayton &      strongest correlation to overall gait quality of all conformational
      Barlow, 1991), and the distance between the two hind limb place-         variables (Holmström & Philipsson, 1993). Show jumpers have
      ments is particularly variable. Sometimes they are placed almost         shorter backs than dressage horses, possibly related to the supple-
      equidistant from the fence, other times they are widely separated.       ness required in the dressage horse (Johnston et al., 2004).
      Fewer knock-downs were recorded when the trailing hind limb                 Kinematics can, to a certain extent, be seen as a dynamic measure
      landed closer to the fence (Deuel & Park, 1991). A study of a two-       of conformation. In a study relating back kinematics to jumping
      stride double in which the two fences were separated by a distance       performance using a relatively simple 4-marker set-up. Cassiat et al.
      of 10.96 m (Hole et al., 2002). The two intermediate strides had         (2004) found significant differences in kinematic patterns between
      similar velocities, but the second intermediate stride had signifi-      good and poor jumpers when jumping a 1.0 m fence, from which
      cantly shorter stride length and stride duration. The stride lengths     they concluded that criteria based on back kinematics might be
      of the two intermediate strides showed low inter-horse variability,      developed that could help in selecting talented show jumpers.
      but the step lengths were much more variable indicating that dif-
      ferent horses achieved similar stride lengths using different combi-
      nations of step lengths. Compared with published descriptions of         The effect of early training on jumping ability
      horses jumping a single fence of similar size, the first intermediate    and the predictability of jumping performance
      stride resembled the first departure stride and the second intermedi-
      ate stride resembled the final approach stride.                          Unlike racehorses, peak performance in show jumpers and dressage
                                                                               horses is achieved at a later age (approximately 10–16 years). There-
                                                                               fore, the time lapse between birth and the final evaluation of the
      Water jump technique                                                     athletic capacity of the animal is very long and requires a substan
      A study performed during the Barcelona Olympics identified the           tial investment of time and money before it is known whether
      factors that influence success in clearing a water jump. The vertical    any financial return can be expected. As a consequence the inter-
      velocity and the angle of projection at lift-off were significantly      generational interval is very long and genetic progress through
      greater, and the horizontal distance between the leading hind limb       selective breeding is slow. In a long-term study, Santamaría and
      and the CM at lift-off was significantly shorter, in horses that were    co-workers investigated two possible ways in which show jumpers
      successful in clearing the width of the water jump compared with         might be raised more cost-effectively. Their first research question
      those that failed to clear the entire width (Clayton et al., 1995,       was whether good predictors for future jumping ability could pos-
      1996; Colborne et al., 1995). The horizontal velocity at lift-off did    sibly be found through the analysis of jumping technique at foal
      not influence success, nor did the height of the CM at the start and     age (Santamaría et al., 2005). This would make earlier selection
      end of the jump suspension. It was concluded that, to be a success-      possible. An indication that jumping capacity might be more innate
      ful water jumper, a horse must generate a large vertical velocity        than acquired through specific training came from the work of
      during lift-off. Vertical velocity at the start of the jump suspension   Fabiani (1973), who reported that jumping ability showed little
      is highly correlated with trunk angle at lift-off and horizontal dis-    change after 6 months of jump training. The second question was
      tance between the leading hind hoof and the horse’s CM at both           whether jumping performance could be improved by starting train-
      the start and end of lift-off (Colborne et al., 1995).                   ing much earlier than the usual age of 3 years (Santamaría et al.,
                                                                               2006). This was based on the empirical observation that many elite
                                                                               human athletes start their careers as children, which suggests a
      Puissance jumping technique                                              lasting effect of such early athletic activity.
                                                                                  To answer these questions a cohort of 40 Warmblood foals
      When jumping very high fences body position at lift-off is particu-      was selected after weaning at age 6 months and divided into two
      larly important. In a study of horses during a puissance competition     groups. One group was raised traditionally (free paddock exercise
      that started at a height of 1.80 m and ended in the last round at        or group housing in open front stalls, depending on the season)
      2.27 m, success was significantly positively correlated with the fol-    until they were broken at age 3; the other group was subjected to a
      lowing variables at lift-off: vertical velocity of CM, height of CM,     specific jumping training program twice weekly combined with a
      distance of CM from the fence; and was significantly negatively          more general exercise regimen to ensure a sufficient level of physical
      correlated with the distance of the leading hind limb to the CM          fitness from 6 months to 3 years of age. At that age all animals were
      (Powers, 2005).                                                          joined in a single group to be broken and to receive a common
                                                                               exercise program to prepare for work under saddle. After a rest
      Conformation of jumping horses                                           period of 6 months, 30 of the now 4-year-olds were trained in a
                                                                               single group as show jumpers for an entire year. This group of 30
      The conformational trait that has been linked most consistently to       horses consisted of 15 animals from each training group; the five
      successful jumping performance is height at the withers (Fabiani,        worst animals from each exercise group had been culled because of
      1973; Langlois et al., 1978), which is more important in this            economical constraints.
      equestrian discipline than in dressage. The shoulder is preferably          Kinematic examinations were performed while free jumping at
      sloping and the fore pastern has been shown to be significantly          ages 6 months, 4 years and 5 years and also at 5 years with a rider.
      larger in elite jumping (and dressage) horses compared to other          The outcome parameter for jumping performance was a puissance
      riding horses (Holmström et al., 1990). Also, elite show jumpers         competition held at the end of the experiment during which horses
      have larger tarsal angles than other horses (Holmström et al.,           had to jump fences up to 1.50 m, whereas in the preceding year
      1990). The ratio between the chest girth and wither height tends to      they had been trained using obstacles with a maximum height of
      be relatively low in good show jumpers, as does the ratio between        1.20 m. During the puissance competition performance was char-
      cannon circumference and wither height (Fabiani, 1973). A long           acterized as good (faultless), moderate (able to finish the contest
      neck is thought to be an advantage for jumping horses, possibly          but with faults and/or refusals), or bad (unable to finish the
      because this feature makes it easier for the horse to maintain           competition).
      balance over the fence (Holmström, 2001). When the horse is                 Jumping technique was quite consistent from foal to adult horse
      viewed from behind, width through the hips and shoulders is desir-       (Santamaría et al., 2002, 2004). When the kinematic variables that
      able (Langlois et al., 1978). The length of the pelvis has a positive    were consistent over time were related to the outcome of the
      correlation with jumping ability and a forward sloping femur also        puissance competition as the main parameter for performance, it
332
                                                                                                                                                Eventing
appeared that elbow flexion, retraction angle of the hind limbs and               would-be breeding stock at ages of 3 or 4 years (Santamaría et al.,
inclination of the trunk with respect to the horizontal were among                2006). It should be emphasized that the lack of effect of specific
the variables that were related to performance at 5 years of age and              training for jumping does not take away the well-documented benefi-
could already be identified in the 6-month-old foals (Bobbert et al.,             cial effect of early exercise on the general development of the equine
2005; Santamaría et al., 2002, 2004). It was concluded, therefore,                musculoskeletal system (Weeren et al., 2000; Weeren, 2007).
that it is indeed possible to use some of the characteristics of the
jumping technique exhibited by foals when they are free jumping
as predictors for future athletic performance. However, it should be              The effect of a rider
stressed that many other factors influence eventual success of a                  In a kinematic study of the effect of a rider on jumping technique,
show jumper beyond jumping technique alone. The kinematic char-                   Powers and Harrison (2002) compared the same group of horses
acteristics that were identified are therefore probably of more help              jumping a 1.0 m obstacle freely or with a rider. The rider signifi-
in developing an effective culling strategy than in picking out a                 cantly influenced the following variables: vertical velocity at lift-off,
future top show jumper.                                                           height of the CM at lift-off, distance of the CM to the fence at lift-
   Early training resulted in a less variable and clearly more efficient          off, maximal height of CM during the suspension phase, position
jumping technique in the 4-year-olds (Fig. 14.20) (Santamaría et al.,             of the CM when passing over the fence, and height of the CM at
2004, 2005). However, when reassessing the effects after a year of                landing. They concluded that the effect of the rider on the horse
common and similar training, no significant difference could be                   was more due to behavioral influences than to the inertial effect of
detected anymore between the two former training groups. Also,                    the mass of the rider.
there was no relation of early training with performance, as measured
by the outcome of the puissance competition. Therefore, specific
training for jumping at foal age, at least when carried out according             Eventing
to the relatively mild protocol as used in this study, has no measur-
able long-term effect. It was noted, however, that there was a tempo-             The sport of eventing was originally devised as a test of athleticism
rary effect of early training on naïve horses that made them jump                 for cavalry horses, and the name ‘the military’ is still retained in
more efficiently and thus seemingly better than untrained horses.                 some languages. Event horses perform three tests: dressage, speed
Early jump training might therefore bias selection events of stud-                and endurance, and show jumping. Since dressage and show
books, many of which nowadays include free jumping sessions for                   jumping are covered elsewhere in this chapter, this section will
                                                                                  focus on studies that are specific to the sport of eventing, especially
       Trained horses                        Untrained horses                     those describing performance in the speed and endurance phases.
                                                                                     The multi-faceted nature of the sport dictates that event horses
                                                                                  must be versatile athletes. They should show relaxation and supple-
                                                                                  ness in the dressage phase; speed, strength, stamina and athleticism
                                                                                  in the endurance phase; and suppleness and coordination in the
                                                                                  show jumping phase. A long and energetically efficient galloping
                                                                                  stride is an important quality in a potential eventer. More data are
                                                                                  needed describing the techniques used to jump different types of
                                                                                  cross-country fences.
                                                                                  Dressage performance
                                                                                  In a study at the Barcelona Olympics, performance in the dressage
                                                                                  phase was correlated with finishing place. Stride length and speed
                        Forelimbs clearing fence                                  in the extended canter were positively related to points awarded by
                                                                                  the judges for the canter. Horses that failed to complete the entire
                                                                                  3-day event had longer stride lengths and faster speeds in the
                                                                                  extended canter during the dressage phase than horses that finished
                                                                                  the competition (Deuel, 1995). The author suggested that charac-
                                                                                  teristics of the extended canter that are highly rewarded by the
                                                                                  judges have little relation to subsequent galloping and jumping
                                                                                  performance, and qualities favored by dressage judges may even
                                                                                  predict failure to finish the event.
                                                                                                                                                              333
       14      Performance in equestrian sports
      average distance jumped was 5.2 m. The distances of the limbs from
                                                                                  Table 14.15  Temporal and linear kinematic variables for horses
      the base of the fence on the lift-off side were: trailing forelimb
                                                                                  jumping a table fence with a 61-kg rider (rider weight) and with a
      2.6 m, leading forelimb 2.1 m, trailing hind limb 2.0 m and leading
                                                                                  61-kg rider plus an 18-kg weighted saddle pad (added weight)
      hind limb 2.0 m. Unlike show jumpers, in which the trailing hind
      limb distance from the fence was between those of the two fore-
      limbs at lift-off, during steeplechasing both hind limbs were placed                                                    Rider weight           Added weight
      closer to the fence than the leading forelimb. The forelimb stance
                                                                                  Stance duration, TrF at                         0.18                  0.18
      durations were approximately 0.13 s, whereas the hind limbs had
                                                                                  landing (s)
      longer stance durations of around 0.17 s. In a regression analysis
      the only temporal variable that was a significant predictor of the          Stance duration, LdF at                         0.21                  0.21
      distance jumped was the overlap between the forelimb stance                 landing (s)
      phases. The longer the forelimbs overlapped, the shorter the hori-
      zontal distance jumped. For the linear variables, the distance of the       Stance duration, TrH in stride                  0.19*                 0.20*
      trailing forelimb from the base of the fence was positively related         D1 (s)
      to the distance jumped. When this limb was further from the jump,           Stance duration, LdH in stride                  0.21*                 0.22*
      the horse used a flatter trajectory, which carried it farther across the    D1 (s)
      fence.
                                                                                  Distance TrF to fence at                    173.5                  159.3
                                                                                  landing (cm)
      Effect of added weight on jumping                                           Distance LdF to fence at                    240.4*                 222.7*
      performance                                                                 landing (cm)
      In the past the competition rules stipulated that event horses had          Maximum carpal angle, TrF at                191.0                  190.0
      to carry a minimum weight of 75 kg (rider and tack), which repre-           landing (degrees)
      sented anything from 10 to 17% of body weight depending on the
      weight of the horse. It was suggested that this imposed an unsafe           Maximum fetlock angle, TrF at               252.9                  251.9
      burden on small horses. A study was performed (Clayton, 1997b)              landing (degrees)
      to compare the landing kinematics of small (maximum height                  Maximum carpal angle, LdF at                190.7*                 193.4*
      164 cm) event horses when carrying a 61 kg rider versus carrying            landing (degrees)
      the same rider plus an 18 kg weighted saddle pad. The test fence
      was a table fence with a sloping face that measured 1.1 m high,             Maximum fetlock angle, LdF at               247.4*                 250.7*
      1.9 m wide at the base and 1.3 m wide at the top. The results (Table        landing (degrees)
      14.15) showed that with the extra weight the leading forelimb
      landed closer to the fence, which confirmed the riders’ subjective          *Values that differ significantly (p < 0.05).
      impression that the horses were ‘cutting down’ during the landing.          D1, first departure stride; LdF, leading forelimb; LdH, leading hind limb; TrF, trailing
      This was probably a result of failing to generate sufficient impulse        forelimb; TrH, trailing hind limb.
      during the lift-off to compensate for the extra weight.                     Data from Clayton (1997b).
         During landing both the fetlock and carpal joints of the leading
      forelimb were significantly more extended with the extra weight as
      a direct result of the greater force at landing. Since strain of the       Cutting demonstrates the need for maneuverability during rapid
      suspensory ligament and the superficial digital flexor tendon increase     acceleration, deceleration and turning. Many sports call for a com-
      with extension of the fetlock, the extra weight may have put the           bination of stability and maneuverability.
      horses at greater risk of suspensory desmitis or superficial digital
      flexor tendonitis. Stance durations of both hind limbs increased in
      departure stride 1, which may have been indicative of the use of           Reaction time
      these limbs to restore the horse’s balance by elevating the forehand,      Reaction time is defined as the time that elapses between an external
      which was burdened by the extra weight. As a result of these findings      stimulus and the initial response to that stimulus. It is extremely
      the minimum weight rule for event horses was abolished.                    important in sports that require fast movements and quick reflexes,
                                                                                 such as cutting, in which there is an offensive–defensive component
      Western sports                                                             and in which the horse must perceive a visual stimulus and respond
                                                                                 appropriately within a short space of time.
                                                                                    Reaction time in response to an external stimulus is determined by
      Western sports are traditionally associated with skills required of        the sum of the pre-motor time and the motor time. Pre-motor time
      horses and riders in ranching, and are based on breeds such as the         is dependent on the speed of processing in the central nervous system
      Quarter Horse or Australian Stock Horse. The sports usually require        and speed of conduction along the nerve to the motor end plate.
      a short period of intense exercise, and may require speed and accel-       Motor time reflects the speed of muscle contraction, which is depen-
      eration, strength, stability, or explosive power.                          dent on muscle fiber type. The reaction times of human athletes are
                                                                                 substantially faster than those of non-athletes (Kroll & Clarkson,
                                                                                 1977). Because nerve conduction velocities do not appear to differ
      Stability and maneuverability                                              between individuals (Bodine-Rees & Bone, 1976), it has been sug-
      The qualities of stability and maneuverability are required to differ-     gested that the faster reaction time of athletes may be attributed to
      ent degrees in different sports. Stability is enhanced by lowering the     the superior functioning of the central nervous system. Furthermore,
      COM and positioning it centrally within the base of support.               the total reaction time is significantly correlated with pre-motor time
      Maneuverability, on the other hand, is enhanced when the center            but not with motor time (Viitsalo & Komi, 1981). In equine athletes,
      of mass is high and lies close to the perimeter of the base of support,    Clayton (1989b) found that the reaction time of cutting horses in
      so that it is easily displaced outside the base of support. An example     response to a visual stimulus ranged from 110 to 370 ms, and that
      of a sport based on stability is roping, in which the horse must           horses with shorter reaction times had higher competition earnings
      remain balanced while resisting the forces applied by a roped calf.        than those that were less successful in competition.
334
                                                                                                                                          Western sports
Western pleasure gaits                                                         Cutting is a high-intensity activity in which the horse must have
                                                                            quick reaction times and the ability to turn and accelerate in either
Stock types breeds, such as the American Quarter Horse and the              direction in response to the unpredictable movements of the calf.
American Paint Horse, comprise the majority of horses in North              Some horses are naturally more talented than others, and ‘cow
America. One of the popular competitions for these horses is                sense’ is a highly prized trait. Genetic evaluation of over 3000 horses
western pleasure classes, in which the horses are required to walk,         competing at the World Championship Futurities over a 9-year
jog and lope in both directions of the arena. The jog is a type of          period yielded a heritability estimate of cutting ability of 19 ± 5%
trot defined as a two-beat diagonal gait that is smooth and ground-         (Ellersieck et al., 1985).
covering. The lope is a type of canter defined as a three-beat gait            The tactics used to keep the calf separate from the herd are similar
performed with rhythm, forward motion and ease.                             to defensive play that blocks the progress of the offensive player in
   Analysis of the temporal gait kinematics of the jog and lope             sports such as American football. A study was performed to deter-
indicated that both gaits were actually performed as four-beat step-        mine factors that differed between horses with different levels
ping gaits with a lateral sequence of footfalls (Nicodemus & Clayton,       of ability (Clayton, 1989b). A group of cutting horses that were
2001). Thus, both gaits had the same footfall sequence as the walk.         of similar ages, training histories and competitive opportunities,
Furthermore, the lope was performed without suspension and the              were divided into two groups according to their competitive win-
limb support sequence included a period of quadrupedal support.             nings. The five horses in the ‘average’ group had won less than
In 2003, the executive committee of the American Quarter Horse              $35 000. The seven horses in the ‘elite’ group had won more
Association made changes to the rules with the intention of encour-         than $35 000. The horses worked a mechanical flag rather than a
aging more forward-moving gaits. However, subsequent kinematic              live steer, which allowed the use of a standard test to ensure that all
analysis (Nicodemus & Booker, 2007) performed during a national             horses performed a similar series of turns and runs in each direc-
caliber show indicated that the speed of the jog was 1.13 ± 0.14 m/s        tion. The mechanical flag is a piece of heavy cloth measuring about
and the speed of the lope was 1.77 ± 0.13 m/s, both of which are            30 cm2. All the horses had worked with the mechanical flag regu-
slower than the typical speed for the walk to trot transition. It is not    larly and frequently during their careers.
surprising that both gaits were again performed with a four-beat               Horses in the two groups differed significantly in several ways
rhythm and lateral sequence of limb placements, as in the walk              (Table 14.17). Elite horses had faster reaction times than average
(Table 14.16).                                                              horses, which allowed them to respond more quickly when the flag
   In the jog, the rhythm showed diagonal couplets and stance dura-         began moving and to stop sooner after the flag stopped moving.
tions were around 68% of stride duration for the forelimbs and              The faster reaction times of the elite horses may have some value
60% of stride duration for the hind limbs. During each half of the          as a predictor of performance. As a result of their faster reaction
stride, the limb support sequences, starting at contact of a hind limb      times the elite horses were significantly closer to the flag throughout
were as follows: quadrupedal (8.5%); tripedal with two hind limbs           the run and were less likely to overrun the flag when it stopped
(2%); bipedal diagonal (30%); and tripedal with two forelimbs               moving than the average horses. Other features of the performance
(9.5%).                                                                     were that elite horses leaned their shoulders in the direction of the
   In the lope, the footfalls occurred as diagonal couplets and the         turn before pushing off against the ground, which is a more effective
typical footfall sequence was: trailing hind; trailing fore; leading        method of turning. The average horses were more likely to move
hind; leading fore. There was no period of suspension. The limb             their hooves sideways as the first indication of turning, rather than
support phases, starting with contact of the trailing hind limb were        leaning into the turn and pushing sideways. The elite horses also
as follows: bipedal diagonal (leading front, trailing hind); unipedal       tended to turn using fewer strides than the average horses though
trailing hind; bipeal lateral (trailing hind and trailing fore); tripedal   this difference did not reach statistical significance.
(trailing hind, trailing fore, leading fore); bipedal diagonal; tripedal       In summary, cutting is a high-intensity sport that requires great
(leading hind, trailing fore, leading fore); bipedal lateral (leading       agility and an inherent ‘cow sense’. Successful cutting horses have
hind, leading fore); and unipedal leading fore. Thus, the limb              quick reaction times and an economical turning technique that
support sequence is very different from that of a canter.                   allows them to follow the calf closely at all times.
Cutting
Cutting horses perform almost independently of the rider; during             Table 14.17  Comparison of elite and average cutting horses
the judging points are lost if the rider cues the horse. The objective       working a mechanical flag
is to sort one calf from a herd and then to prevent it returning to
the other calves. The sport evolved from the practical aspects of                                                       Elite horses   Average horses
ranch work, with the first competition taking place around the turn
of the century. Since then, there has been increasing interest in            Reaction time after flag starts            200 ± 66*      282 ± 74*
cutting as a sport and it is currently one of the most rapidly growing       moving (ms)
equestrian sports. In competition the horse is judged for 2.5 min
                                                                             Time to stop after flag stops              386 ± 108*     492 ± 94*
during which it usually cuts two or three calves.
                                                                             moving (ms)
 Table 14.16  Speed and stride duration jog and lope of the                  Distance from flag at start of              52 ± 23*       81 ± 32*
 western pleasure horse                                                      run (cm)
                                                                             Maximal distance from flag                 148 ± 28*      221 ± 23*
                                     Jog                    Lope             during run (cm)
 Speed (m/s)                         1.13 ± 0.14            1.77 ± 0.13      Distance from flag at end of                55 ± 26*       78 ± 32*
                                                                             run (cm)
 Stride length (m)                   1.09 ± 0.07            1.27 ± 0.04
                                                                             *Values that differ significantly (p < 0.05).
 Stride duration (s)                 0.92 ± 0.03            0.72 ± 0.04
                                                                             Values are mean ± SD.
 Data from Nicodemus and Clayton (2001).                                     Data from Clayton (1989b).
                                                                                                                                                           335
       14      Performance in equestrian sports
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      Knopfhart, A., 1966. Het rijpaard: beoordeling           equine locomotion. Vet. Comp. Orthop.              Peham, C., Licka, T. Kapaun M., Scheidl, M.,
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338
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340
                                                                                                                    C H A P T ER          15 
                                               Horse–rider interaction
                                               Agneta Egenvall, Anna Byström, Michael Weishaupt, Lars Roepstorff
                                                                                                                                                       341
       15         Horse–rider interaction
      Fig 15.1  Graph showing total force during a typical trial for mounting from the ground. Still photographs and the corresponding maps of pressure
      distribution under the saddle are shown for the points marked 1–5 on the graph. This sequence shows the most common pattern with a single force peak as
      the right leg swings upwards. In the pressure maps, the cranial part of the mat is up and the left side is to the left.
      Reprinted from Geutjens, C.A., Clayton, H.M., Kaiser, L.J., 2008. Forces and pressures beneath the saddle during mounting from the ground and from a raised mounting platform. The Veterinary
      Journal 175 (3), 332–337, with permission from Elsevier.
      highly standardized conditions were necessary to obtain useful and                               is not possible, it is recommended to use a mounting block and
      valid results and that further technical development is necessary.                               mount alternately from the left and right sides.
      Better results, relative to agreement between different measurement
      conditions basically measuring the same things, was found in
      another study using a different type of saddle mat (de Cocq et al.,
                                                                                                       The effect of the saddle on motion of the back
      2009a). Different rider positions were evaluated and the mat regis-                              With the use of pressure sensitive saddle mats, the influence of the
      tered increased force beneath the saddle in the direction towards                                saddle on the horse’s back can be studied while moving at different
      which the rider was leaning (de Cocq et al., 2009a). Therefore, the                              gaits. However, there is only a weak association between the saddle
      mat could discriminate between rider positions and asymmetrical                                  pressures acting on the back in a standing horse and those exerted
      weighting of the saddle.                                                                         during movement (Jeffcott et al., 1999). Total saddle force curves
         A study of forces on the horse’s back during mounting showed that                             show a characteristic, gait dependent pattern (Pullin, 1996; Jeffcott
      the highest forces coincided with the rider’s free leg swinging up and                           et al., 1999; Fruehwirth et al., 2004; von Peinen et al., 2009).
      over the horse’s back. When the rider mounted from the conventional                                 Fruehwirth et al. (2004) registered force data from quarters of the
      (left) side forces were highest on the right side of the horse’s back                            saddle mat in horses ridden at walk, trot and right lead canter (12
      adjacent to the withers. High forces were also found lower on the left                           horses and 12 riders) and found that force patterns were reproduc-
      shoulder. Heavier riders yielded higher forces (Geutjens et al., 2008).                          ible from stride to stride in each gait and force magnitude increased
      The use of a mounting block produced a smoother force application                                with speed.
      and lower peak force (Fig. 15.1). In light of these findings it is recom-                           On the contrary, de Cocq et al. (2004) evaluated nine Dutch
      mended that, if possible, the rider should mount without using the                               Warmbloods walking, trotting and cantering on a treadmill in an
      stirrup to avoid the asymmetrical loading of the horse’s back. If this                           unloaded condition, wearing a surcingle, a saddle or a saddle plus
342
                                                                                                                                      Bits and reins
75 kg weight. The most marked changes occurred with the addition                Von Peinen et al. (2010) demonstrated that the mean and
of extra weight; the horse’s back moved through the same range of            maximal saddle pressure in walk, trot and canter were larger in
motion but with more extension and less flexion. Fewer changes               23 horses with clinical evidence of ill-fitting saddles compared to
were seen when comparing an unweighted saddle with the unsad-                16 control horses. Pressure was measured at the areas of dry spots
dled situation. Forelimb retraction increased in walk and trot when          (dry non-sweating areas that sustained local ischemia due to high
the horse had a weighted saddle compared with a saddle, a surcingle          saddle pressure) or acute soreness in the withers area in the horses
or unloaded. Increases in both forelimb retraction and hind limb             with the problems and compared to the same areas in the control
protraction are mechanisms that counteract back-extension, so the            horses. The results indicated that mean pressure was more repeat-
increase in forelimb retraction is likely to counteract over-extension       able than maximal pressure and was, therefore, a more reliable
of the back (Jeffcott, 1979).                                                variable for assessing saddle fit. Similar to the decubitus ulcer
                                                                             probem in people, critical values could be established for different
Saddle types                                                                 levels of saddle sores in the withers area. Such critical values would
                                                                             help fitting saddles in the future.
Early studies using a pressure mat evaluated various saddles quali-             In her pioneering work Harman (1994) looked at saddle fit of
tatively (Harman, 1994). Werner et al. (2002) studied two types of           equine patients and evaluated the effects of 14 different pads on one
dressage saddles in 25 horses ridden by the same rider in various            rider–horse combination, concluding that many pads make the pres-
gaits. They found differences between saddles and horses and                 sure distribution worse compared to using a simple cotton pad.
smaller differences with gait. It was suggested that mean pressure           Pullin et al. (1996) evaluated two saddles, two horses and 14 pad-
>15 kPa and maximal pressure >35 kPa at sitting trot correlated              liner combinations. Both static and dynamic measurements and
with back pain. Further, patient horses (n = 25) with various degrees        results were evaluated qualitatively. Repeatable differences were seen
of and reasons for back pain were evaluated with an interval of at           between the tested pads leading the authors to recommend that
least 12 weeks, during which time saddlery problems were corrected           dynamic evaluations were more useful, and that static scans without
based on saddle mat data (Mönkemöller, 2005). Qualitatively,                 riders should not be used for optimal saddle pad evaluation.
improvement was judged to be significant based on distribution                  A study of how the fit of a saddle with a tree that was too wide
and magnitude of pressure.                                                   was affected by using a pad made of gel, leather, foam or reindeer
   In a study comparing an English saddle with a side saddle, horses         fur was undertaken in one rider who rode 18 horses in trot and
(n = 13) without clinical signs of back-pain were evaluated at walk,         walk. All pad-saddle combinations were compared to the saddle
trot and canter using a saddle mat and kinematic measurements of             without pad. In many pad-saddle-horse combinations, maximal
back movement both in front of the withers and behind the saddle             overall force increased when using a pad and the pressure differ-
(4th lumbar vertebra, L4). The results showed asymmetrical loading           ences between adjacent areas of the saddle often did not decrease.
under the side saddle with the center of pressure located to the right       The potential benefits of using a pad need careful consideration in
of midline and slightly more caudally than the center of pressure            horses with back problems (Kotschwar et al., 2010a,b).
under the English saddle in all gaits. The sidesaddle also influenced
back movement. The authors suggested that the two saddle types               Panels and girths
could be used to change the load distribution on the back of horses
with potential back pain and as a training variation (Winkelmayr             De Cocq et al. (2006) documented that the force beneath the rear
et al., 2006).                                                               part of the panels could be measured more reliably than the force
   In racehorses (n = 8), no difference was found between saddles            beneath the more forward part of the panels because of the inclina-
with a normal tree, a flexible tree or treeless relative to the stipulated   tion of the horse’s back. The sensors measure force applied perpen-
critical pressure on the lower thoracic back at canter and gallop            dicular to their surface but shear forces give cross-talk to the
(Latif et al., 2010), which was the main concern. However, loading           measurements, i.e. the forces will not be correctly measured. This
and peak pressures were relatively high at the withers during canter-        means that a larger part of the force is captured in areas of the back
ing and galloping but shifted toward the mid and rear regions while          that have a more horizontal inclination. As a consequence of the
trotting. The authors concluded that the type of tree had no influ-          shape of the back on either side of the withers, forces are likely to
ence on the pressure profile at the rear of the saddle and that the          be underestimated by a larger amount in this area.
high peak pressures at the rear of the saddle in trot with all saddles          Another study examined saddle pressure patterns during riding
may limit back motion. The pressure distribution in trot and gallop          in trot and canter, comparing traditional and v-system girth strap
was mainly due to jockey position. The high pressure under the rear          placement, and wool and synthetic foam panel flocking material
of the treeless saddle, as well as the saddle with the flexible tree, was    (six horses, three riders) (Byström et al., 2010a). Controlling for
directly beneath the rider. With respect to the treed saddle, it was         speed, stride maximum pressures below the hind part of the saddle
due to an improperly-fitting tree or cushioning.                             increased by 7–12% and the area below the saddle with a stride
                                                                             mean pressure >11 kPa increased by 114 cm2 at trot and 127 cm2 at
                                                                             canter with foam-filled panels compared with wool-stuffed panels.
Saddle fit and saddle pads                                                   With the v-system girthing the area with pressure >11 kPa increased
The kinematics of horses (n = 21) ridden by one rider on a treadmill         by 53 cm2 and 38 cm2. It was concluded that both flocking material
at trot with either a well-fitting or ill-fitting saddle (Peham et al.,      and girthing are relevant considerations in saddle fitting. In this
2004), were documented using three saddles, and two kinematic                study, wool performed better than foam as panel flocking material
markers (L4 and right fore hoof). Variability of the motion cycles           and traditional placement of the girth was better or at least as good
was calculated as well as the derivates (velocities and accelerations)       compared to the v-system.
in the x, y, and z directions. With a rider the variability of velocity
and acceleration in the forward direction and acceleration in the
transverse direction decreased with a well-fitting saddle compared           Bits and reins
to an ill-fitting saddle. Meschan (2007) tested differently fitting
saddles with a pressure mat and concluded that the load under
poorly fitting saddles is distributed over a smaller area than under
                                                                             Bits
properly fitting saddles, leading to potentially harmful pressure            Clayton and Lee (1984) described the use of a fluoroscopic technique
peaks. Typical pressure profiles for saddles with correct, wide and          to evaluate bit position, the interactions of the bit with the intra-oral
narrow trees were shown.                                                     tissues and the effects of rein tension on bit position. This technique
                                                                                                                                                         343
       15         Horse–rider interaction
      Fig 15.2  Lateral radiographic views of bit positions without rein tension
      (left panel) and with 25 ± 5 N bilateral rein tension (right). Bits represented
      from top to bottom are jointed snaffle, KK Ultra, Boucher, Myler low port
      comfort snaffle, Myler ported barrel, Myler correctional-ported barrel.
      Reprinted from Manfredi, J., Clayton, H.M., Rosenstein, D., 2005b. Radiographic study of bit
      position within the horse’s oral cavity. Equine Comp. Exerc. Physiol. 2, 195–201, with
      permission from Cambridge University Press.
344
                                                                                                                                                               Bits and reins
                                                                                                    (Biau et al., 2002). The reins were: ‘rubber bands’ going from the
                                                                                                    lowest point of the girth to the bit; a ‘Chambon’ going from lowest
                                                                                                    point of the girth through a pulley at the poll area to the bit; and
                                                                                                    ‘back lifts’ that were attached to the sides of the girth by a double
                                                                                                    mechanism, and to the poll. Rubber bands increased propulsion (i.e.
                                                                                                    the mean acceleration vector used for propulsive work) of the fore-
                                                                                                    limbs at trot. Back lifts increased forelimb propulsion and dorsoven-
                                                                                                    tral activity at walk and trot (i.e. the FFT-integrated power spectrum
                                                                                                    signal of the dorsoventral acceleration signal). Chambons increased
                                                                                                    hind limb propulsion and forelimb propulsion and hind limb dor-
                                                                                                    soventral activity at trot. The authors’ interpretation was that a
                                                                                                    Chambon was likely the most effective if the aim was to increase hind
                                                                                                    limb activity in a long and low position.
                                                                                                       Draw reins used alone or in combination with normal reins were
 A                                                                                                  compared to normal reins only in horses ridden at trot on sand-
                                                                                                    covered asphalt over a forceplate (Roepstorff et al., 2002). The body
                                                                                                    weight was shifted caudally only when draw reins were used with
                                                                                                    normal reins (Byström et al., 2006). Kinematic analysis of the head
                                                                                                    angle, measured on the front of the nose relative to the horizontal
                                                                                                    plane (angles >90° equals nose in front of vertical), was different
                                                                                                    in all situations. With draw reins alone it was ~97°, combining draw
                                                                                                    reins with normal reins it was ~109°, while with normal reins it
                                                                                                    was ~116°. With draw reins forelimb retraction was increased at
                                                                                                    hoof lift. The hip joint extended more quickly and the hock joint
                                                                                                    flexed more with both reins compared to normal reins only. The
                                                                                                    pelvis was more horizontally inclined when draw reins were com-
                                                                                                    bined with a normal rein in comparison with draw reins alone, but
                                                                                                    the hip joint angular pattern was not significantly different between
 B
                                                                                                    these conditions. It was concluded that the riders were, to a certain
                                                                                                    extent, able to shift weight towards the hind quarters with the com-
                                                                                                    bination of reins. An important finding, though, was that when
                                                                                                    using the draw rein alone to simulate an overuse of the draw rein,
                                                                                                    the horse’s weight shifted to the fore quarters. So, when used incor-
                                                                                                    rectly draw reins had the opposite effect from that which is intended
                                                                                                    and the caution to use draw reins with the utmost care (Podhajsky,
                                                                                                    1965) seems to be scientifically validated.
 C                                                                                                  Rein tension
                                                                                                    From a technical point of view it is quite simple to measure rein forces
Fig 15.3  The three studied reins. (A) Rubber bands, (B) chambons and (C)                           acting between the hand of the rider and the bit. However, it is impor-
back lift.                                                                                          tant to use appropriate force transducers for dynamic measurements;
Reprinted from Biau, S., Couve, O., Lemaire, S., Barrey, E., 2002. The effect of reins on kinetic
                                                                                                    transducers based on a spring will not provide accurate force data and
variables of locomotion. Equine Vet. J. 34 (Suppl. ), 359–362, with permission from the Equine
                                                                                                    will underestimate forces when used in a dynamic system. Interpreta-
Veterinary Journal.
                                                                                                    tion of the data can also be problematical due to the inherent vari-
                                                                                                    ability associated with a pattern of spikes that are characteristic of each
                                                                                                    gait (Clayton et al., 2005). The mean tension ignores this inherent
Reins                                                                                               variability. A more detailed and informative approach measures the
Auxiliary reins, defined as reins other than simple inelastic reins                                 forces as minima, maxima and means with standard deviations. The
passing directly from the rider’s hand to the bit, differ widely in their                           force distribution can be mapped over time and compared between
popularity among riders. Many see them as coercive, because they                                    left and right reins. However, the force cannot be partitioned between
most often force the horse’s head in a downward direction, with some                                horse and rider using this method. Some studies have presented forces
types being perceived as having a more severe effect. Other trainers                                in weight units (see below), but for the sake of comparison we have
use them for a short time as temporary aids to provide better long-                                 here assumed that 1 kg (weight) equals 9.8 N (force).
term control of the horse’s head and neck position (see more on this                                   In pioneering work, it is stated that unexpectedly large rein forces
under collection below). For example, with draw reins the rider can                                 were found, 5–75 N, up to maximal 150 N, on each rein. Most
pull the horse’s head downwards and backwards to its anatomical                                     riders, using double bridles, used forces of around 5 N at halt
limit, whereas upwards movements are restricted by a running mar-                                   increasing to 20 N at canter (Preuschoft et al., 1995). In further
tingale in which the reins slide freely through loose rings that are                                work, different types of riders were compared (Preuschoft et al.,
held in place by a neck strap attached to the girth. The rings control                              1999). Very low rein tensions were found for western riders, for
the line of action of rein tension and prevent the head of the horse                                riders riding only on the curb and at a few dressage stables where
coming above the base of the skull. A few auxiliary reins have been                                 forces registered below or just above 20 N, when performing
compared (Biau et al., 2002) or evaluated (Roepstorff et al., 2002;                                 demanding exercises. In other dressage stables, mean forces ranged
Byström et al., 2006; Heleski et al., 2009) but more information is                                 from 59 to 147 N, without any difference between single and
needed to provide a comprehensive picture. In a study of eight saddle                               double bridles. Peak force during regular work was below 49 N in
horses, normal reins were compared with three types of auxiliary                                    driving horses, 98–176 N during dressage training rising to 245 N
reins (Fig. 15.3), using accelerometers attached at the sternum and                                 when slowing down from canter. In trotters moving at high speed,
sacrum as the horses walked and trotted unridden in a horse walker                                  forces up to 392 N were found (Preuschoft et al., 1999).
                                                                                                                                                                                  345
       15      Horse–rider interaction
         Cartier d’Yves and Ödberg (2005) studied right rein tension during                         1000
      a dressage test performed by three riders and 30 horses, including                                                                                              Left
      riding school horses, leisure horse and professional competition                                                                                                Right
                                                                                                     800
                                                                                 No. measurements
      horses. Mean rein tension was approximately 13 N in riding school
      horses and 9.8 N in leisure horses, with intermediate values in the                            600
      professional competition horses. Mean rein tension values were not
      statistically different between groups. Additionally, judge’s or rider’s                       400
      subjective evaluation of lightness did not correlate with actual mea-
      surements of mean rein tension. Clayton et al. (2003) also report that                         200
      the rider’s perceptions of rein tension differed from the registered
      forces in one horse. In further work by the same author, one experi-                            0
      enced rider rode one horse, chosen because it was known to lean
0–4
5–8
16
20
24
28
32
                                                                                                                                                                        33–
                                                                                                                       9–1
      against the bit. Although the rider perceived a constant rein tension,
13–
17–
21–
25–
                                                                                                                                                              29–
      in walk there were regularly occurring spikes with a frequency of 108                                                           Tension (kp)
      per min, in trot 168 spikes per min and in canter 90 spikes per min
      (Clayton et al., 2005). The maximum values of the rein tension              Fig 15.4  Distribution of number of left and right rein force recordings (y)
      ranged from 4 to 43 N at walk, 19 to 51 N at trot and 21 to 104 N at        by amount of tension (x) in one horse and rider in sitting trot on a treadmill
      canter. In this rider, synchronized video analysis showed that peak         during a period of 15 s with a sampling frequency of 140 Hz.
      rein tension occurred during diagonal stance in both trot and canter,       From Roepstorff (unpublished).
      which coincided with downward motion of the horse’s head.
         Rein tension and the steadiness of the hand were evaluated in            horse in walk, trot and canter. There were differences between the
      four horses and nine novice riders (Heleski et al., 2009). Three            sides for the two horses. For example, there was more slackening of
      experimental conditions were studied: running martingales that              the reins of the horse’s non-preferred side and taken together the
      stabilized the angle of the rein to the horses mouth during riding,         left rein, especially in the left-lateralized horse, had generally higher
      elastic rein inserts that yielded if tension exceeded 20 N, which           rein tension. The authors speculated that right-lateralized riders
      happened very rarely in this study (in 0.6% of the spikes evaluated),       might benefit from riding right-lateralized horses because this
      and controls without either rein aid. Conflict behaviours of the            seemed to enhance symmetry in the riding.
      horse, evaluated using an ethogram, did not differ between experi-             Warren-Smith et al. (2007) studied one professional, one interme-
      mental conditions. Mean rein tension was highest for the condition          diate and one novice rider on 22 horses performing a simple dres-
      with running martingales (4.1 N with a martingale versus 3.5 N for          sage test under saddle and the same horses being long-reined by a
      both rein inserts and controls). The authors suggested that carefully       professional handler. Mean rein tension during riding was 7.4 N and
      fitted running martingales may be advantageous for novice riders            during long-reining 10.7 N. Rein tension was highest when halting
      on the basis that the head position of the horse was less often             and higher when turning compared to riding on straight lines. When
      judged as unacceptably high. It is suggested by many riders and             horses were ridden, tension in the left rein when turning left was
      veterinarians that a somewhat lower head position actually spares           higher than the tensions in either rein when turning right, which
      the locomotor health of the horse.                                          could be interpreted as evidence of motor laterality in the rider or
         The rein tension of three horses, ridden by their own expert rider       the horse. The novice rider used more tension for turning. Tension
      on a treadmill, was studied at walk, trot and passage (Roepstorff,          did not differ between bridles and halters. Tensions were higher in
      unpublished). In the vertical head-neck position, data from both            ex-racehorses compared to other horses.
      reins averaged over four trials, showed that the three horses had              In an effort to separate the effects of horse and rider on rein
      different mean low and high values of 11 N and 16 N, 1.5 N and              tension, Clayton et al. (2011) studied the tension in side reins made
      3.5 N, and 2.7 N and 4.8 N. Mean rein tension increased with                of three materials with different amounts of elasticity and adjusted
      increasing collection (as determined by the head and neck posi-             to three lengths. The materials were inelastic, stiff elastic and, com-
      tion). This is contrary to most riding texts and to the concept that        pliant elastic. The rein lengths were neutral (equal to the length of
      rein contact should be able to be dropped in collection (descente           the horse’s neck when standing in a relaxed position), long (10 cm
      de main) with the horse remaining in the collected movement/                longer than neutral) and short (10 cm shorter than neutral). Horses
      position when rein contact is released (Decarpentry, 1949). In walk,        (n = 8) trotted in hand at consistent speed in a straight line wearing
      trot and passage the mean rein tension was higher in eight of nine          a bit and bridle with the three types of side reins being evaluated
      comparisons when the head and neck were in the vertical (competi-           in random order. Strain gauge transducers (240 Hz) measured rein
      tion) position compared with positions slightly behind the vertical,        tension dynamically and the authors reported minimal, maximal
      with a low neck or with a neck elevated and the bridge of the nose          and mean rein tension, rate of loading and impulse. Rein tension
      in front of the vertical. On the contrary, all three horses had a much      oscillated in a regular pattern with a peak during each diagonal
      lower mean rein tension when walking with the neck low and                  stance phase. Within each rein type minimal, maximal and mean
      forward compared with the competition position. The maximal                 tension were higher with shorter reins. At neutral or short lengths,
      peaks in walk were found at contralateral hind limb stance and in           minimal tension increased and maximal tension decreased with a
      trot there was one peak in each rein at stance, which agrees with           more elastic rein. Short, inelastic reins had the highest maximal
      the results found by Clayton et al. (2003, 2011).                           tension and highest rate of loading. Since the tension variables
         In walk and sitting trot, rein tension was generally lower in one        responded differently to rein elasticity at different lengths, it was
      of the reins in two of three horse–rider combinations. A typical            recommended that studies of rein tension should report a set of
      example from the vertical head–neck position in one of the horses           variables representing different aspects of rein tension.
      is shown (Fig. 15.4), where the right rein more often has lower                In conclusion, some studies only measured tension when horses
      tension, while the opposite pattern is seen for the two next bars.          were moving straight, others have looked at rein tension during
      This is further evidence of motor laterality, but the data cannot           dressage tests and correlated rein tension to various activities or to
      detect whether it comes from the horse, the rider or both. In rising        different head and neck positions. Only a few studies have correlated
      trot the tendency was that the tensions in both reins were higher           rein tension to the footfall sequence. It is likely that the situations
      for the diagonal on which the rider was sitting, compared to the            measured so far are relatively standardized experimental situations
      diagonal on which the rider rose.                                           and, in real life, much higher forces will be applied in emergency
         Kuhnke et al. (2010) studied 11 right-lateralized (right-handed)         situations or by novice riders. Since some studies presented their
      riders that rode one left-lateralized horse and one right-lateralized       results as mean tension there is a need for more information about
346
                                                                                                                                                                                         Basic rider movements
the tension patterns, minimal and maximal tensions, the evenness                                                 with diagonal hoof placement in which each diagonal stance
of the contact and the rein forces applied during half halts, halts and                                          encompasses a braking phase when the horse’s limbs are com-
jumping. It will also be necessary to study horse and rider laterality                                           pressed and a propulsive phase when the horse’s limbs extend
with respect to rein forces. If the rider/trainer could better analyze                                           (Farley et al., 1993). The horse keeps its back rigid through strong
the distribution of forces on the horse’s mouth, this may lead to a                                              muscle activity to resist wasteful lateral and rotational movements
more efficient and humane riding technique. One of the challenges                                                induced by the diagonal stance (Robert et al., 1998; Faber et al.,
facing researchers is to distinguish between correctly trained sport                                             2001). Accordingly it can be expected that the movement pattern of
horses that accept the bridle with a light soft contact and horses that                                          the rider will be dominated by the effects of and reactions to the
achieve a light contact by dropping the bit and working in a pseudo-                                             alternating impacts and push-offs. Even in high-level dressage riders
collected frame (with the nose behind the vertical, flexion not at the                                           riding at collected trot, i.e. rather slowly (~3 m/s), the rider’s move-
poll but further down the spine, see also further down on collection)                                            ments can largely be explained from the vertical and horizontal
(German National Equestrian Federation, p 143).                                                                  decelerations and acceleration of the horse’s trunk that take place
                                                                                                                 during each diagonal stance (Byström et al., 2009).
Angle (º)
                 0                                                              0                                                                 0
                                                                                                                                                 -20
                 -5                                                             -5
                                                                                                                                                 -40
                -10                                                            -10                                                               -60
Position (mm)
                 0                                                              0                                                                 0
                -20                                                            -20                                                               -20
                -40                                                            -40                                                               -40
                -60                                                            -60                                                               -60
                                                                                                                                                                                                                 347
       15        Horse–rider interaction
         Shortly after first contact the rider’s trunk (hip to shoulder) is tilted             of maximal propulsive ground reaction force (Merkens et al., 1993),
      maximally backwards as a consequence of both forward motion of                           the rider’s seat also starts to move forwards in relation to the horse.
      the rider’s hip and a backward motion of the rider’s shoulders, which                    As the rider is pushed out of the saddle the rider’s trunk tilts for-
      was interpreted as a feed forward mechanism by which experienced                         wards due to a combination of relative forwards movement of the
      riders anticipate and compensate for the longitudinal deceleration of                    shoulders and backwards movement of the hips (Terada et al.,
      the horse (Terada et al., 2006). As the rider’s seat moves forward in                    2006). At this time the rider’s pelvis rotates posteriorly and the
      relation to the horse, the rider’s neck and feet move backwards. At the                  rider’s back and neck straighten. The rider’s legs extend and the feet
      same time the rider’s pelvis is maximally posteriorly rotated (around                    move medially and backwards in relation to the hips. These move-
      the transverse axis), the rider’s back and neck are stretched in exten-                  ments then continue into the following suspension phase.
      sion and the rider’s legs are also maximally extended (Fig. 15.6).
         From 5% stance onwards both vertical and braking ground reac-                         The seat at rising trot
      tion forces increase rapidly in unridden horses (Barr et al., 1995)
      and the forwards movement of the horse’s center of mass is rapidly                       Rising trot is a rather recently invented technique that makes trotting
      decelerated (Buchner et al., 2000). At the same time the distance                        more comfortable for the rider and reduces peak forces on the
      between rider and horse decreases causing the rider’s seat to be                         horse’s back (de Cocq et al., 2010). Using this technique, the rider
      pressed against the saddle. Following this the pressure of the saddle                    alternately sits on one diagonal pair of limbs and rises on the other.
      against the back of the horse also increases rapidly (Fig. 15.7). The
      impact forces are now transmitted from the horse to the rider and                                          2.5
      this has a clear effect on the rider’s movements. The rider’s pelvis
      starts to rotate anteriorly, the rider’s back extends (hollows) and the
      rider’s neck flexes. The rider’s trunk assumes a vertical position                                          2
      (Terada et al., 2006) and the rider’s neck moves forwards in relation
                                                                                              Normalized force
      to the horse. The rider’s leg joints flex, the heels are lowered and
                                                                                                                 1.5
      the feet move laterally and forwards in relation to the rider’s hips.
      As the rider sinks deeper into the saddle the forward movement of
      the rider’s seat eventually ceases at about 16% of the stride after                                         1
      diagonal contact. The rider’s seat then starts to move backwards in
      relation of the horse as midstance is approached.
         At midstance both horse and rider reach maximal downwards                                               0.5
      displacement, the rider sits deepest into the saddle (Byström et al.,
      2009) (Fig. 15.8) and the pressure of the saddle against the back of
      the horse is maximal.                                                                                       0
         During the propulsive phase, the upwards–forwards directed                                                    0             50                               100
      push-off by the horse is transmitted to the rider’s seat through the                                                         % stride
      saddle. The rider’s seat starts to move out of the saddle as soon as                     Fig 15.7  The saddle force normalized to rider weight (N/kg) at trot with
      the horse’s trunk starts to move upwards (Fig. 15.5) and the pressure                    stance bars in seven horses ridden in sitting trot on a treadmill (Byström
      of the saddle against the back of the horse then starts to decrease                      unpublished). Solid line is mean, dashed lines indicate one standard
      (Fig. 15.7). A little later, at 36% of the stride following ground                       deviation. The lower bars show the stance of the left fore, right fore, left
      contact of the diagonal and coinciding approximately with the time                       hind and right hind (top to bottom).
      Fig 15.6  Rider in sitting trot landing on the right diagonal                            Fig 15.8  Rider in sitting trot at midstance on the left diagonal at midstance.
      Photograph courtesy of the Equine Biomechanics Research Team from the Universities of    Courtesy of the Equine Biomechanics Research Team from the Universities of Uppsala,
      Uppsala, Utrecht and Zürich.                                                             Utrecht and Zürich.
348
                                                                                                                                                                               Basic rider movements
The full stride sequence for rider movements during rising trot has                                      treadmill (Byström et al., 2010b) unless a different reference is given.
not yet been documented. A preliminary kinematic study of five                                           As in the trot, it is paramount to know the characteristics of the gait
riders performing rising trot on one horse showed that at first contact                                  in order to understand rider movement. The walk is a symmetrical
of the sitting diagonal the rider’s trunk and thigh were more vertical                                   gait without a suspension phase. The horse alternates between
while the shank was angled more backwards compared with the                                              tripedal and bipedal support, with the limbs functioning as rigid
equivalent time on the rising diagonal when the trunk leaned more                                        struts to raise the withers or croup from first contact to midstance.
forward and the thigh was also more angled forward while the shank                                       This is in contrast to trot, where both withers and croup move
was closer to the vertical (Lovett et al., 2005). These findings suggest                                 downwards during the first half of stance and then upwards in the
that the rider first leans the trunk forward by flexing the hip joints                                   following propulsion and suspension phase. As the forelimbs of the
and simultaneously moves the feet more forward relative to the hip                                       walking horse move approximately 25% of the stride out of phase
before rising with a forward–upward movement of the seat through                                         in relation to the hind limbs, the withers are raised when the croup
extension of the hip joints such that both trunk and thigh position                                      is lowered and vice versa. All together this causes the vertical dis-
approach the vertical. This interpretation must be, however, consid-                                     placement of the saddle area of the horse’s back at walk to be about
ered preliminary and perhaps incomplete as it is based on measure-                                       half that of the trot (Matsuura et al., 2003) while rotation of the
ments at diagonal first contacts. It is also possible that there are                                     horse’s trunk around the transverse axis (pitch) is almost doubled
relatively large variations in rider technique in rising trot.                                           (Table 15.1) (Byström et al., 2010b). The amplitudes of lateral and
   Saddle pressure measurements of one high-level dressage rider                                         longitudinal excursions of the horse’s body center of mass, which
riding at sitting and at rising trot on several different horses showed                                  are necessary for the horse to maintain its balance during the alter-
a tendency towards smaller longitudinal excursion of the center of                                       nating tripedal and bipedal support phases, are approximately equal
pressure during rising trot compared to sitting trot (Peham et al.,                                      to the vertical excursion at walk (Buchner et al., 2000). Such dis-
2009). This means that the rider maintains a more constant position                                      placement can be accomplished through lateral bending and axial
relative to the horse even though the longitudinal displacement of                                       rotation of the back and the axial rotation range of motion is almost
the rider’s body is larger at rising trot compared to sitting trot (Mat-                                 doubled during walk compared to trot (Faber et al., 2000; Faber
suura et al., 2005). A preliminary study of 30 riders with a strain                                      et al., 2001). Therefore, extra-sagittal movements constitute a pro-
gauge between the stirrup and the stirrup leather concluded that the                                     portionally larger part of the assembled motion pattern of the walk
force was higher at rising than sitting trot (van Beek et al., 2008).                                    compared to trot, and it is to be expected that the rider’s movement
   One study examined saddle and leg forces using three saddle mat                                       pattern will be equally more complex. To gain full understanding
systems between the saddle and the horse in 11 horse–rider combi-                                        of the horse–rider interaction at walk, the rotations of the rider’s
nations of high but not international level, moving in straight                                          body segments around the vertical and longitudinal axes must also
line, shoulder-in (when the horse is bent away from the line of                                          be considered. However, focusing on sagittal plane movements is a
travel) and in travers (when the horse is bent towards the line                                          good place to start describing the rider’s movements.
of travel) (de Cocq et al., 2010b). Mean total saddle force was sig-
nificantly lower when riding straight ahead (671 N) than when
riding shoulder-in (707 N) or travers (726 N). Mean inside saddle                                        Rider movements in the sagittal plane at walk
force was significantly higher when riding travers (468 N) than
                                                                                                         At walk both the range of vertical displacement of the rider’s body
when riding straight on (425 N) or shoulder-in (413 N). Maximum
                                                                                                         (Matsuura et al., 2003) and the rider’s seat in relation to the front
outside leg force was significantly higher when riding travers
                                                                                                         part of the saddle are smaller than at trot (Table 15.1). Further, the
(47.2 N) than when riding straight (31.6 N) or shoulder-in
                                                                                                         rider’s seat moves upwards in relation to the front part of the saddle
(34.2 N). This information enhances the understanding of contem-
                                                                                                         while moving downwards in relation to L3 of the horse and vice
porary rider movement but should be complemented with data on
                                                                                                         versa (Fig. 15.9). This indicates that the vertical displacement of the
more riders and various dressage riding styles.
                                                                                                         rider’s seat at walk results mainly from the croup being lowered and
                                                                                                         raised in relation to the withers rather than true vertical displace-
Walk                                                                                                     ment of the rider in relation to horse and saddle. The fact that the
The description is based on kinematic measurements of seven high-                                        rider shows a decreased range of motion for pelvic pitch, back
level dressage riders riding at collected walk on a force-measuring                                      flexion–extension and all head–neck rotations at walk compared
                                                                                                                          Distance (mm)
Angle (º)
0 0 0
-2 -10 -10
                                                                       -20                                                                -20
            -4
                                                                       -30                                                                -30
            -6
                 0             50                100                         0                50                    100                         0                50                    100
                             % stride                                                       % stride                                                           % stride
Fig 15.9  Left to right: The horse’s trunk pitch angle, the vertical distance between the rider’s seat and the horse’s third lumbar vertebra (L3) and the vertical
distance from the rider’s seat to the front of the saddle in seven horses ridden in walk on a treadmill. Solid line is mean, dashed lines indicate one standard
deviation. Zero value on the y axis represents mean value for the stride with each horse/rider combination curve being adjusted so individual means are
zero. The lower bars show the stance of the left fore, right fore, left hind and right hind (top to bottom).
Data from Byström (unpublished).
                                                                                                                                                                                                       349
       15          Horse–rider interaction
       Table 15.1  Stride range of motion in degrees or mm for variables measured in high-level dressage horses and riders (n = 7) during
       collected walk and trot on a treadmill#. Pitch is rotation around a transverse axis, roll is rotation around a longitudinal axis and yaw is
       rotation around a vertical axis.
      with trot (Table 15.1) may reflect the absence of impact effects on
      the rider at walk. This is supported by the fact that the range of
                                                                                                      Lateral and rotational rider movements at walk
      motion for vertical displacement of the rider’s body is only about                              For the rider’s body movements at walk the lateral amplitude is
      1 cm at walk (Matsuura et al., 2003) and the amplitude of the                                   approximately equal to the longitudinal amplitude and signifi-
      rider’s body movements is significantly lower in the vertical than in                           cantly greater than the vertical amplitude (Matsuura et al., 2005).
      the lateral and longitudinal directions, which is contrary to the                               Consequently, the extra-sagittal movements constitute a significant
      findings at trot (Matsuura et al., 2005). Riders are therefore more                             part of the assembled motion pattern of the walk, both for the
      likely to be adjusting their movements at walk to the alternating                               horse and the rider and these have to be taken into account to
      difference in height between the horse’s croup and withers rather                               form a comprehensive picture. This is clearly reflected in the
      than to vertical and horizontal deceleration and acceleration of the                            saddle pressure pattern of walk (Fig. 15.13) and the fact that the
      horse’s trunk as in trot (Byström et al., 2009).                                                vertical movements of the horse and rider were insufficient to
         To appreciate the rider’s positional adjustments at walk, we note                            explain the various force peaks observed (von Peinen et al., 2009).
      that from the tripedal support of one forelimb and both hind limbs                              To explain this pattern the rotation of the rider’s pelvis around the
      to the tripedal support of both forelimbs and one hind limb, i.e.                               longitudinal axis (roll rotation) as well as the lateral bending and
      from forelimb midstance to hind limb midstance, the horse’s croup                               axial rotation of the horse’s back must be considered in addition
      is raised while the withers are lowered in relation to the croup (Fig.                          to sagittal plane movements. Rotations of the rider’s pelvis around
      15.9). When the horse’s trunk starts to rotate cranially this transmits                         the vertical axis (yaw rotation) generally follow the movements of
      a forward push to the rider’s seat from behind that causes the seat                             the saddle and seem to have little influence on the saddle pressure
      to slide forward (Byström et al., 2010b). To maintain balance the                               pattern.
      rider’s pelvis rotates posteriorly (around the transverse axis), the                               The motion pattern has been described in high-level dressage
      neck moves backwards relative to the horse and the feet are retracted                           riders riding at collected walk on a treadmill (von Peinen et al.,
      through extension of the leg joints, particularly the hip joints (Fig.                          2009; Byström et al., 2010b). During the tripedal dual hind limb
      15.10). These movements are reversed after hind limb midstance                                  support phase, the horse’s croup is rapidly lowered and, at the same
      when the croup descends relative to the withers.                                                time, the horse’s back is bent laterally towards the left hind limb
350
                                                                                                                                                                                                  Basic rider movements
                                 Pitch angle rider's pelvis                                          Flexion–extension rider's back                                  Flexion–extension rider's hip joint
                 5                                                                                                                                          10
                                                                                          4
                                                                                                                                                             5
                 0                                                                        2
  Angle (º)
Angle (º)
                                                                                                                                                Angle (º)
                                                                                          0                                                                  0
                 -5                                                                       -2                                                                -5
                                                                                          -4
                -10                                                                                                                                     -10
                                                                                          -6
                      0                      50                   100                          0                    50                    100                    0                  50                     100
                                           % stride                                                               % stride                                                        % stride
                20                                                                        0
Distance (mm)
Distance (mm)
-20 -20
                -40
                                                                                         -40
                -60
                      0                      50                   100                          0                    50                    100
                                           % stride                                                               % stride
Fig 15.10  Top row, left to right: Rider pelvic pitch, flexion–extension of the rider’s back and flexion/extension of the rider’s hip joints in seven horses ridden
in walk on a treadmill. Bottom row, left to right: longitudinal distances from the rider’s neck and from the rider’s seat to the horse’s third lumbar vertebra (L3)
in seven horses ridden in walk on a treadmill. Solid line is mean, dashed lines indicate one standard deviation. Zero value on the y axis represents mean value
for the stride with each horse/rider combination curve being adjusted so individual means are zero. For the rider’s pelvis, positive pitch represents anterior
movement of the upper part of the pelvis relative to the lower part. For the rider’s back, flexion is cranial pitch of the upper body relative to the pelvis, i.e.
flexion of the lumbar spine. The lower bars show the stance of the left fore, right fore, left hind and right hind (top to bottom).
Data from Byström (unpublished).
                                    FGFL              FGHL
                                    FGFR              FGHR
GRF (%hnwt)
                 60
                 30
                  0
                120                                                P3
                                      P1
                              M1                       P2
                110
FS (%nwt)
                                                M2           M3
                100
90
                             0             14         27          41    50         63                        77          92     100
                                                                    % stride duration
Fig 15.11  Mean stride normalized ground reaction forces of the four limb (FGFL, left forelimb; FGFR, right forelimb; FGHL, left hind limb; FGHR, right hind
limb) (top) and total saddle force (bottom) of seven horses at walk. Ground reactions forces of individual limbs (FG limb) are expressed as percentage of the
total weight of horse and rider (% hrwt). Total saddle force (FS) is expressed as percentage of the rider’s weight (% rwt). The thick line is mean value and thin
lines indicate one standard deviation. The local extremes (minima M1 to M3, maxima P1 to P3) are indicated.
Reprinted from Peinen, K., von, Wiestner, T., Bogisch, S., Roepstorff, L., van Weeren, P.R., Weishaupt, M.A., 2009. Relationship between the forces acting on the horse’s back and the movements
of rider and horse while walking on a treadmill. Equine Vet. J. 41, 285–291, with permission from the Equine Veterinary Journal.
such that the back is convex to the right, and rotated around the                                                             movements causes a marked reduction in pressure under both the
longitudinal axis such that the left tuber coxae is higher than                                                               left and right front thirds of the saddle while pressure increases
the right. Simultaneously the rider’s seat moves rapidly backwards                                                            mainly on the left side under the rear part of the saddle (Fig. 15.13)
in relation to the horse and the rider’s left hip is being lowered in                                                         (von Peinen et al., 2009).
relation to the right hip, i.e. the rider’s pelvis undergoes roll rotation                                                       When the right hind limb starts to break-over and the croup rises
to the left (Fig. 15.12). This combination of horse and rider                                                                 relative to the withers, the pressure under the rear left third of the
                                                                                                                                                                                                                          351
             15                 Horse–rider interaction
                                                                               Angle (º)
                       0
                       -2                                                                  -5
                       -4
                                                                                       -10
                       -6
                            0                 50                    100                         0              50                   100
                                            % stride                                                         % stride
                       0                                                                   2
                                                                               Angle (º)   0
                      -20                                                                  -2
                                                                                           -4
                      -40
                                                                                           -6
                            0                 50                    100                         0              50                   100
                                            % stride                                                         % stride
      Fig 15.12  Rider kinematics in seven horses ridden at walk on a treadmill. Top row, left to right: rider’s pelvic roll angle (positive is rotation to the right when
      viewed from behind) and rider’s pelvic yaw angle (positive yaw is rotation to the right when viewed from below) during the walk. Bottom row, left to right:
      longitudinal distance from the rider’s seat to the horse’s third lumbar vertebra (L3) and pitch angle of the horse’s trunk (positive pitch is lowering of the
      withers relative to the croup). Solid line is mean, dashed lines indicate one standard deviation. The lower bars show the stance of the left fore, right fore, left
      hind and right hind (top to bottom).
      Data from Byström (unpublished).
                       10                                                                                               10
      %rwt
                                                                                                      FSL                                                                           FSR
                        0                                                                                                0
-10 -10
                       10                                                                                               10
                        5                                                                                                5
      %rwt
                                                                                                      FSLf                                                                          FSRf
                        0                                                                                                0
                       -5                                                                                                -5
                       10                                                                                               10
                        5                                                                                                5
      %rwt
                                                                                                      FSLc                                                                          FSRc
                        0                                                                                                0
                       -5                                                                                                -5
                       10                                                                                               10
                        5                                                                                                5
      %rwt
                                                                                                      FSLh                                                                          FSRh
                        0                                                                                                0
                       -5                                                                                                -5
                                0    14     27       41 50     83         77               92 100                               0         14   27   41 50     83      77   92 100
                                                       % stride                                                                                       % stride
      Fig 15.13  Mean (thick line) ± SD (dashed lines) for relative changes of stride standardized saddle forces of the left (FSL, left panel) and right (FSR, right panel)
      mat half and partial forces of six sectors (n = 7 horses). Each half of the mat was divided into a front (f), central (c) and hind (h) sector; partial forces are
      labeled accordingly. Forces are presented as deviation from the stride mean value of the respective sector. Bold curve sections mark significant deviations
      from the stride mean (p < 0.05). For scaling of the abscissa see Fig. 15.11. Solid line is mean, dashed lines indicate one standard deviation.
      Reprinted from Peinen, K., von, Wiestner, T., Bogisch, S., Roepstorff, L., van Weeren, P.R., Weishaupt, M.A., 2009. Relationship between the forces acting on the horse’s back and the movements
      of rider and horse while walking on a treadmill. Equine Vet. J. 41, 285–291, with permission from the Equine Veterinary Journal.
352
                                                                                                                                           Rider skill
saddle increases even further (Fig. 15.12). This induces not only             Rider skill
forwards movement of the rider’s seat but also roll rotation of the
rider’s pelvis to the right.
   During the following diagonal (right front, left hind) support             General
phase the rider’s seat moves rapidly forwards in relation to the
                                                                              The following section presents the results of studies that evaluate
horse. At the same time the horse’s dorsal back muscles contract
                                                                              the effect of rider skill level with most of the results being derived
strongly on the left side in the cranial saddle area during retraction
                                                                              from traditional riders. A large kinematic overground study by
of the right forelimb (studied without rider) (Licka et al., 2009).
                                                                              Schils et al. (1993) included 63 riders divided into three groups of
This coincides with a marked increase in pressure under the left
                                                                              beginner, intermediate and advanced based on video evaluation of
front third of the saddle while the rider’s pelvis continues to roll to
                                                                              their skill level by judges. Midstance and midswing rider angles were
the right.
                                                                              determined. Other studies have strived to evaluate rider skill (Lovett
   After the transition from bipedal to tripedal support at ground
                                                                              et al., 2005) and some of these results will be presented in the fol-
contact of the left forelimb the dorsal back muscles in the left
                                                                              lowing paragraphs. Speed and temporal characteristics of the horse
cranial saddle area start to relax (Licka et al., 2009) and the forwards
                                                                              as well as riding style and the rider’s degree of control of the
rotation of the horse’s trunk slows as the left hind limb approaches
                                                                              horse’s movements are likely to be important factors affecting
midstance. Following this the pressure distribution between the
                                                                              the rider’s movement pattern. The influence of these factors on the
front thirds of the saddle starts to even out as the pressure increases
                                                                              rider’s movements has however not been evaluated.
under the right front third (Fig. 15.13). Just after this, roll rotation
of the rider’s pelvis to the right also ceases (Fig. 15.12).
   When the left hind limb has passed its midstance position the
horse’s back becomes progressively more axially rotated to the left
                                                                              Trot
(lower on the left side) and bent to the right (convex to the left).          The rider needs to have excellent postural control through well-
This decreases the support under the left rear third of the saddle,           timed muscle activity to constantly maintain the same posture in
which is reflected in the very low pressure measured under this part          every trotting stride. A study using surface EMG measurements in
of the saddle at the end of tripedal support (right front, left hind,         experienced riders showed that the upper part of m. trapezius has
left front) and during the following (left hind, left front) bipedal          strong and distinct activity during the first half of stance to stabilize
ipsilateral support phase (Fig. 15.13). Decreased support of the left         the rider’s head and neck and that m. rectus abdominis is active
rear third of the saddle, perhaps combined with the slight increase           during the middle and later parts of the stance phase (Terada et al.,
in pressure under the right front third of the saddle following lift-off      2004) to maintain pressurization of the abdomen and stabilize the
of the right forelimb, explains why the rider’s pelvis starts to roll to      trunk. The sequence and timing of activation of the other abdomi-
the left at lift-off of the right forelimb. Most riders also retract their    nal muscles of the rider have not been evaluated but are likely to
left hip in relation to the right hip (left yaw rotation), this being the     be equally, if not more important, than the action of rectus abdomi-
only period in the stride (approximately forelimb lift-off to ground          nis, which is more easily accessible to surface EMG. Postural control
contact of the next hind limb) when yaw rotation of the rider’s pelvis        is clearly something the rider must learn through training.
does not follow yaw rotation of the saddle. However, at the same                 Comparing riders of different skill levels, three studies found that
time the horse’s dorsal back muscles in the middle saddle area con-           the cranio-caudal movements of the rider’s head or shoulders were
tract strongly on the left side as the left hind limb is retracted (Licka     more regular between strides in advanced compared to less experi-
et al., 2009). It is therefore not surprising that left roll and yaw rota-    enced riders (Terada, 2000; Peham et al., 2001; Lagarde et al.,
tion of the rider’s pelvis are followed by an increase in pressure under      2005). More efficient postural control in more skilled riders allowed
the left central third of the saddle, peaking at ground contact of the        them to maintain their shoulders closer to the vertical at diagonal
right hind limb. Following this peak, roll rotation of the rider’s pelvis     midstance whereas the novice riders tilted more forwards (Schils
is abruptly redirected to a right yaw rotation as the rider’s pelvis starts   et al., 1993). Comparisons of EMG recordings of two important
to follow the saddle again and right roll rotation continues during           postural muscles, m. erector spinae and m. rectus abdominis, and the
the early part of the right hind limb stance.                                 great adductor of the thigh, m. adductor magnus, also confirm differ-
                                                                              ences in activity pattern between advanced and novice riders
                                                                              (Terada, 2000). Advanced riders had forceful contractions in both
Canter                                                                        m. erector spinae and m. rectus abdominis while m. adductor magnus
The canter shows mixed gait mechanics where the trailing hind and             was largely inactive. Novice riders, however, had proportionally
leading forelimbs function essentially as rigid struts while the diag-        more forceful contractions of m. rectus abdominis compared to m.
onal stance of the leading hind and trailing fore is best likened to          erector spinae and m. adductor magnus was markedly more active
a bounce. The trunk of the horse rotates quite extensively around             compared to the advanced riders (Terada, 2000). Unbalanced activ-
its transverse axis and the back, particularly the lumbosacral joint,         ity between abdominal and epaxial muscles could reflect a less
has the largest range of motion in flexion–extension of all gaits. The        efficient postural control in novice riders and relatively greater activ-
rolling motion pattern of the canter is sometimes perceived by the            ity of the abdominal muscles could contribute to a more protracted
rider as being easier to sit than the trot. This perception is supported      (rounded) shoulder position. Increased activity of the thigh adduc-
by the fact that measurements of the accelerations of the rider’s             tors is likely an attempt to compensate for the unstable upper body
helmet showed no differences between advanced and novice level                position (Terada, 2000). Although the movements of the horse
riders at canter, which is in contrast to the differences found at walk       seem to dictate the basic pattern of the rider’s movements, postural
and sitting trot (Terada, 2000).                                              control is clearly influenced by the rider’s active responses to the
   The full stride sequence for rider movements during canter                 movements of the horse and these responses vary with skill level.
has not yet been documented. However, a preliminary study com-                   A different study (Pantall et al., 2009) used surface EMG to evalu-
pared rider position at first contact of the trailing hind limb, the          ate activation of m. iliocostalis lumborum and m. rectus abdominis in
diagonal limb pair and the leading forelimb. It showed that                   rising trot. All riders showed coactivation of the right and left
the rider’s trunk was tilted forwards during trailing hind limb               muscles. In the novice riders m. rectus abdominis and m. iliocostalis
stance then rotated back towards the vertical during leading fore-            lumborum were coactivated whereas in experienced riders there was
limb stance and suspension (Lovett et al., 2005). These trunk                 a phase shift between them. M. rectus abdominis behaved as an
movements of the rider to follow the rotation of the horse’s trunk            agonist in the experienced rider, contracting as the rider made
at canter.                                                                    contact with the saddle on the sitting diagonal.
                                                                                                                                                          353
          15                Horse–rider interaction
         The rising trot is often perceived by the novice rider as being less                                 moved the neck caudally in relation to the horse when the horse’s
      tiring than sitting trot (German National Equestrian Federation,                                        croup was raised, but the relative contribution of the pelvis and
      2002, p. 50). As in sitting trot the skill level of the rider seems to                                  upper body to these movements varied between the riders (Byström
      have a significant influence on the rider’s movements. Advanced                                         et al., 2010b). One rider compensated by flexion–extension of the
      riders have their shoulders further backwards relative to their hips                                    lumbar back while keeping the neck more stationary, while others
      at diagonal midstance both at the sitting and rising phases and they                                    tended to use their entire upper body to balance the movements of
      also extend their hip joints more when rising (Schils et al., 1993).                                    the horse (Fig. 15.14). Skill level dependency of upper body move-
                                                                                                              ments at walk is supported by the finding that advanced riders had
                                                                                                              a more regular pattern in their vertical head movements whereas
                                                                                                              novice riders had greater between-stride variability (Terada, 2000).
      Walk                                                                                                    This was associated with proportionally more concentric activity of
      At walk there is more variation, compared to the trot, in the upper                                     the postural muscles m. erector spinae and m. rectus abdominis in the
      body movements between individual riders both regarding extent                                          advanced riders while the novices showed a more static activity
      and regularity and likely also timing in relation to the horse. It is                                   pattern (Terada, 2000). More skilled riders may exert a more active
      suggested that variation is caused by the individual style of the rider                                 postural control leading to a more regular movement pattern and
      and/or skill level. In a group of high-level dressage riders all riders                                 smaller phase shift in relation to the horse.
                                      Horse 1                                                       Horse 2
                                                             Pitch angle rider's pelvis
                  10                                                         10
                   5                                                          5
      Angle (º)
0 0
-5 -5
                  -10                                                       -10
                        0                50                     100               0                   50                  100
                                       % stride                                                     % stride
                                                         Flexion–extension rider's back
                  10                                                         10
                   5                                                          5
      Angle (º)
0 0
                   -5
                                                                             -5
                        0                50                     100               0                   50                  100
                                       % stride                                                     % stride
20 20
                   0                                                          0
      Angle (º)
-20 -20
-40 -40
                        0                  50                   100               0                  50                   100
                                     Distance (mm)                                             Distance (mm)
      Fig 15.14  Rider’s upper body kinematics in two horses (Horse 1, left panel, Horse 2, right panel) ridden at walk on a treadmill. Data are for one stride starting
      at left hind contact. Top row, pitch angle of the rider’s pelvis, middle row, flexion/extension of the rider’s back; bottom row, longitudinal distance from the
      rider’s neck to the horse’s third lumbar vertebra (L3). Zero represents mean value for the stride. Solid line is mean, dashed lines indicate one standard
      deviation. The lower bars show the stance of the left fore, right fore, left hind and right hind (top to bottom).
      From Byström, unpublished.
354
                                                                                                                                          Rider skill
   The rider’s stability can be assessed by tracking movements of the       indicating that the rider has a significant influence on the horse–
center of pressure (COP) using a pressure mat beneath the saddle.           rider system.
Able-bodied riders have been shown to have smaller amplitudes of               Peham et al. (2001) compared a professional with a recreational
COP motion in both the anteroposterior and mediolateral direc-              rider riding 20 horses at sitting trot over a sand arena with high-
tions compared with riders with cerebral palsy. COP velocity in the         speed cameras recording marker positions. Angular velocities and
mediolateral direction was also significantly smaller in able-bodied        accelerations were derived, and resulting vectors in the phase space
riders (Clayton et al., 2010). Although this study was directed             were computed. The professional horse–rider system had the most
toward the value of COP measurements for monitoring progress in             consistent motion pattern and higher dressage scores (evaluated
a therapeutic riding program, the technique may also be useful for          during the experiment), compared to the recreational horse–rider
assessing stability of riders in general.                                   system. Using the same material, motion asymmetries of the head
   Rider skill level also seems to influence the rider’s leg movements      and sacrum were compared using markers tracked at 120 Hz (Licka
at walk. At forelimb midstance (i.e. approximately at hind limb             et al., 2004). The lameness of the unridden horse (assessed visually
contact) advanced riders show less hip flexion but similar shoulder         using a dichotomous scale) was not reproduced under either rider.
position compared to novices (Schils et al., 1993). This could be           For the dressage rider there was a significant increase in hind-limb
due to a phase-shift between riders at different skill levels or it could   asymmetry, compared to the unridden situation. Using partly the
reflect the fact that advanced riders are more exact and efficient in       same trials (n = 14 horses), Schöllhorn et al. (2006) used artificial
their movements. Compared to novice riders, advanced riders have            neural networks to analyze kinematic parameters over time. The
greater concentric activity in m. adductor magnus at walk (Terada,          professional rider was able to control 13 of the 14 horses with
2000), which could indicate a more active control of leg movements          respect to the head, while the recreational rider controlled only
as well as upper body movements. However, walking speed was not             three horses. On the contrary, hind fetlock and hock movements
presented in these studies (Schils et al., 1993; Terada, 2000) and it       were not influenced much by the riders, but were more affected by
is possible that differences in the horse’s stride length and/or stride     the inherent motion pattern of the horse.
frequency between rider skill levels contributed to the observed               Terada (2000) studied two experienced and two novice riders
differences in rider movement patterns.                                     riding two horses over an 80-m sand arena in the three gaits, with
                                                                            instructions to use as few aids as possible. A camera recorded the
The hand                                                                    stride durations, the riders’ head movements were monitored with
                                                                            an accelerometer, and activity in three of the riders’ muscles were
The equestrian literature often states that the hand should be inde-        recorded electromyographically. Differences were found in the walk
pendent from the seat, meaning that the movements of the hand               and trot, where it was concluded that novice riders had more dif-
should follow the movements of the horse’s head and mouth,                  ficulty in stabilizing the body. At sitting trot, novice riders used their
rather than the movements of the rider’s torso. Accordingly, well-          m. adductor magnus muscle to maintain their posture because of lack
timed flexion–extension movements of the rider’s shoulder and               of coordination between the m. rectus abdominis and m. erector spinae
elbow joints are necessary to compensate for movements of the               (Terada, 2000; Terada et al., 2004).
rider’s upper body in relation to the horse. High-level dressage               In earlier work, Schamhardt et al. (1991) studied walk and rising
riders indeed do perform such movements (Terada et al., 2006;               trot using ground reaction force analysis (x, y and z) in 13 Dutch
Byström et al., 2009) and EMG measurements in experienced riders            Warmbloods comparing one experienced rider, one novice rider
indicate that these movements are actively induced by the rider             and an equal amount of dead weight (two sandbags). They con-
(Fig. 15.15).                                                               cluded that, compared with sandbags, the riders managed to shift
   During trotting, in the first half of stance the rider’s neck moves      part of the weight towards the hind limbs. However skill of rider
forwards in relation to the horse, the rider’s trunk (hip to shoulder)      did not, in general, influence the patterns of the ground reaction
tilts forwards and the distance from the rider’s shoulders to the bit       forces. It should be cautioned that velocity was not standardized in
in the horse’s mouth decreases. Simultaneously the rider’s shoulder         that study. Another study in which horses moved at the same trot-
and elbow joints flex while the m. biceps brachii and m. deltoideus         ting speed with and without a rider confirmed that there was a
muscles are active and m. flexor carpi radialis is also active to flex or   reduction in mass normalized peak vertical force with an experi-
stabilize the wrist. During the second half of stance the rider’s neck      enced rider (Clayton et al., 1999).
moves backwards in relation to the horse, the rider’s trunk tilts              Kinematics of 20 horses were evaluated using high-speed video
backwards and the distance from the rider’s shoulders to the bit            to compare three conditions: unridden at trot, ridden at sitting trot
increases. At the same time the rider’s shoulder and elbow joints           by a professional rider and ridden at sitting trot by a recreational
extend and m. triceps brachii becomes active while the activity of the      rider (Kapaun et al., 1998). Significant differences between the
flexor muscles ceases. These compensatory movements stabilize the           unridden situation and the professional rider were found for impul-
riders’ hands at a more constant position in relation to the horse’s        sion, pelvic inclination, fore and hind limb vertical movement, and
moving head (Terada et al., 2006) (Fig. 15.16). Vertical displace-          fore and hind stance durations. After speed-normalization, only the
ment of the rider’s wrist was significantly smaller than that of the        difference in vertical movement of the fore and hind limbs remained
rider’s hips and shoulders and the distance from the rider’s wrist to       significant. Comparison between the professional and recreational
the bit varied significantly less than the distance from the rider’s hip    rider showed differences in speed, stride length, head angle, hind
to the bit (Terada et al., 2006). A preliminary study comparing one         limb protraction, pelvic inclination, fore and hind limb vertical
novice and one expert rider also found that the expert rider had a          movement, and fore stance duration. After speed-normalization
significantly lower phase shift between the vertical movements of           only impulsion remained significantly different.
the head and shoulder and the wrist and elbow (Lagarde et al.,                 With regard to jumping kinematics, 50 Hz video recordings of 10
2005), further supporting the idea that these arm movements are             horses jumping a 1.05-m fence with an experienced and a novice
under the rider’s active control and are learned through training,          rider revealed no significant differences in velocity or stride length
rather than induced by the movements of the horse.                          during the approach, take-off or landing (Powers & Harrison,
                                                                            2002). It was concluded that horses jumped in the same way,
Horse movement in relation to rider skill                                   regardless of what the riders were doing. However, the authors
                                                                            cautioned that the similar results could have arisen because the
Compared with an average rider, an expert rider’s movements are             horses were riding school horses and not competition horses, the
more consistent and less phase-shifted in relation to the horse’s           fence was not very high, the weight of the riders differed between
movements (Terada, 2000; Peham et al., 2001; Lagarde et al., 2005)          12 and 15% of the horse’s weight, the novice rider was possibly too
                                                                                                                                                         355
        15          Horse–rider interaction
rly ht1
ds 1
                 sta 1
               rly 1
            La ght2
rly ht2
ds 2
                 sta 2
                         e2
ht1
rly ht1
ds 1
                                                                                                     sta 1
                                                                                                   rly 1
                                                                                                La ght2
rly ht2
ds 2
                                                                                                     sta 2
                                                                                                             e2
           Mi nce
                         e
           Ea nce
Mi nce
Mi nce
                                                                                                             e
                                                                                               Ea ce
Mi nce
                                                                                                             e
          La anc
La anc
nc
La anc
La anc
                                                                                                          nc
                    flig
Ea flig
Ea flig
flig
Ea flig
                                                                                              Ea flig
                                                                                                          n
                    fli
                                                                                                        fli
                 sta
sta
sta
                                                                                                     sta
                  t
                                                                                                      t
        r ly
te
te
r ly
te
                                                                                                    te
             te
te
te
                                                                                                 te
               La
                                                                                                  La
      Ea
Ea
      Fig 15.15  Muscular activity for 12 muscles of six subjects over 10 phases of the stride. Each datum point represents mean activity during a phase of the
      stride expressed as a percentage of maximal activity for that muscle. Dashed lines indicate one standard deviation. Vertical dotted lines separate the four
      consecutive phases of flight 1, stance 1, flight 2 and stance 2.
      Reprinted from Terada, K., Mullineaux, D.R., Lanovaz, J., Kato, K., Clayton, H.M., 2004. Electromyographic analysis of the rider’s muscles at trot. Equine Comp. Exerc. Physiol. 1, 193–198, with
      permission of Cambridge University Press.
      experienced and the riders may not be representative of experienced                                  for turning and the authors concluded that experienced riders can
      and novice riders in general.                                                                        use finer aids.
         Warren-Smith et al. (2007) studied rein tension in one profes-                                       Most studies that have compared experienced and novice riders
      sional, one intermediate and one novice rider on 22 horses per-                                      relative to the motion of the horse have used only a few riders. The
      forming a simple dressage test. The novice rider used more tension                                   experienced riders often have a long riding experience and have
356
                                                                                                                                                     Riding methodology
                      Bit to wrist      Bit to hip                                                 extension in both fore and hind limbs increases with a rider (Sloet
                      Bit to shoulder                                                              van Oldruitenborgh-Oosterbaan et al., 1995). Furthermore, the
                40                                                                                 horse’s head is carried in a higher position with a rider, so the neck
                                                                                                   is also more extended (Sloet van Oldruitenborgh-Oosterbaan et al.,
                                                                                                   1996).
                20
Distance (mm)
                -10
                                                                                                   Rider weight
                                        Time (% stride)                                            Peham and Schobesberger (2004) performed a biomechanical sim-
                                                                                                   ulation using a combination of electromyographical data from m.
Fig 15.16  Mean values of linear angular variables in six experienced riders                       longissimus dorsi, saddle mat data and kinematic data from two back
during half a stride at trot. Distances are measured from the bit to the riders’                   markers of 15 horses ridden overground in trot with their customary
wrist, shoulder and hip (top panel) and angulations of the riders’ elbow                           riders and saddles. They concluded that the forces were higher when
joint, shoulder joint, trunk to vertical (tilting the upper body back is positive)                 the back was stiffer, compared to the simple rider weight. It is of
and forearm to vertical (moving the elbow forward relative to the shoulder                         course natural that heavier riders in general yield higher forces and
is positive) (bottom). Ground contact time of the right forelimb is indicated                      pressures (Geutjens et al., 2008). The effects of rider weight should
by the vertical line at 11% stride. The data have been normalized so the                           be studied in the dynamic situation to gain a better understanding
mean value during the entire trial is represented as zero for each variable.
                                                                                                   of what constitutes unacceptably high pressures from heavyweight
Reprinted from Terada, K., Clayton, H.M., Kato, K., 2006. Stabilization of wrist position during
                                                                                                   riders.
horseback riding at trot. Equine Comp. Exerc. Physiol. 3, 179–184, with permission from
Cambridge University Press.
                                                                                                   Riding methodology
competed up to high levels, while the novice riders have less riding                               Numerous texts on riding and equestrianism have been written
experience. However, the experience and ability of the novice riders                               during the past 500 years but the terminology is often poorly and
likely varies between studies. A general conclusion is that profes-                                inconsistently defined from both a scientific and practical perspec-
sional riders are more stable than novice riders.                                                  tive and terms are sometimes circularly referenced (Roepstorff,
                                                                                                   unpublished). Even though riding will always have an artistic
                                                                                                   element, especially in dressage, there are also parts of the perfor-
The influence of the rider’s weight                                                                mance that should be quantifiable. Measurements of equestrian
                                                                                                   technique require definitions that relate equestrian terminology
Learning how to ride involves developing the ability to follow the                                 with measured biomechanical variables.
movements of the horse and to influence the horse’s movements.                                        The training scale, as described in the Official Instruction Handbook
Since the rider’s weight has a marked influence on the horse’s move-                               of the German National Equestrian Federation (German National
ments, the effects of the rider’s weight will be discussed first.                                  Equestrian Federation, 2002) consists of a series of steps, which are
                                                                                                   translated as rhythm, suppleness/relaxation, contact, impulsion,
                                                                                                   straightness and collection. These terms will be used as a basis for
Load carrying at walk                                                                              discussion of biomechanical research.
When the horse carries a rider, the vertical and longitudinal ground
reaction force peaks and impulses increase and the peaks occur                                     Rhythm
significantly later during stance in the forelimb (Schamhardt et al.,
1991). In the hind limb all force peaks increase except peak braking                               Rhythm, the first requirement in the training scale, is described
force.                                                                                             biomechanically by temporal variables. The stride rate is the number
   Stride duration is not influenced by the presence of a rider at                                 of strides per stride interval, also denoted beat, which should not
trot, but relative stance duration tends to increase in both fore                                  be confused with rhythm. The rhythm of the footfalls within each
and hind limbs (Schamhardt et al., 1991). Fetlock joint maximal                                    stride is described by the time intervals between first-contacts of the
                                                                                                                                                                              357
       15      Horse–rider interaction
      individual limbs, such as time of advanced placements and step                  In a later study, reflective markers were placed bilaterally on the
      durations. The same rhythm should be maintained through the                  facial crests and the lateral aspects of C1 and C3 in six horses, to
      variations in gait types (collected, working, medium, extended,              calculate the head and neck angles (Zsoldos et al., 2010a). Activity
      free).                                                                       of m. splenius was measured with surface EMG. In trot, functional
         The rhythm of the different gaits is described in Chapter 14. The         stabilization against flexion of the head and neck was found with
      walk should have a regular four-beat rhythm. More irregularities             maximal activity of this muscle at the beginning of the forelimb
      were found in the medium and the extended walk, compared to the              stance phases. Unilateral activity of m. splenius to stabilize against
      collected walk (Clayton, 1995), which is in accordance with general          lateral movement was not found.
      dressage rider perceptions. At trot the regular, two-beat rhythm                Surface EMG activities of the m. rectus abdominis and the external
      was maintained from collected through working, medium and                    abdominal oblique muscles and kinematics of the hooves, withers
      extended trot though stride duration was significantly shorter in            and sacrum were measured at walk and trot in six horses (Zsoldos
      the extended trot compared with collected trot (Clayton, 1994b).             et al., 2010b). EMG values (minimum, maximum and mean) were
      In canter stride duration did not differ significantly between col-          significantly higher at trot than at walk in all horses for the external
      lected, working, medium and extended canters but the timing                  abdominal oblique muscle and in five out of six horses for m. rectus
      between footfalls changed such that in extended canter the three             abdominis. The activities of both muscles differed between left
      beats were more closely associated while the time elapsing between           and right sides for all horses in walk and for four out of six horses
      contact of the leading forelimb and the next contact of the trailing         at trot. The ratio of muscle coactivation between the external
      hind limb increased (Clayton, 1994a).                                        abdominal oblique muscles and m. rectus abdominis, which was
         Elite dressage horses show more irregularities in walk pirouette          interpreted as providing trunk stability, was lower at walk than trot.
      strides than in canter pirouette strides (Burns & Clayton, 1997;             The external abdominal oblique muscles were more clearly acti-
      Hodson et al., 1999). Another aspect of rhythm is that the expert            vated in an alternating left and right sequence while m. rectus abdom-
      rider’s movements have been found to be more consistent and less             inis was activated more simultaneously on the left and right sides.
      phase-shifted in relation to the horse compared to novice riders             In both walk and trot, the activity of m. rectus abdominis is out of
      (Terada, 2000; Peham et al., 2001; Lagarde et al., 2005). These find-        phase with that of m. longissimus dorsi (Licka et al., 2004; Licka et al.,
      ings may explain the greater smoothness in the horse’s gaits when            2009).
      ridden by expert riders, often in a more collected form.                        Using surface electrodes the quotient of the mean of the maximal
                                                                                   and minimal surface EMG activity of m. longissimus dorsi in unrid-
      Suppleness/relaxation                                                        den horses (n = 15) at walk was judged to be higher at the twelfth
                                                                                   thoracic vertebra (T12) than at the sixteenth thoracic vertebra (T16)
      Suppleness and relaxation are prerequisites for all further training         or the third lumbar vertebra (L3) (Licka et al., 2009), with some
      and, along with rhythm, are an essential aim of the preliminary              tension being maintained at the minima. Activity was maximal
      training phase. The horse should be free from physical and mental            during the ipsilateral hind limb support; this occurred at the begin-
      tension with ‘a rhythmically swinging back’ (German National                 ning of the support phase for L3, followed by T12 and then T16. At
      Equestrian Federation, 2002). Even if the rhythm is maintained, the          these instances low activity was found in the contralateral muscle.
      movement cannot be considered correct unless the muscles are free            The authors’ interpretation was that the large activity at T12 com-
      from unnecessary tension.                                                    pared to T16 and L3 suggested that m. longissimus dorsi is mainly
         Suppleness is difficult to measure objectively with biomechanical         responsible for stabilising the back during locomotion, which
      methods. An approach might be to use electromyography (EMG)                  agrees with other authors (Robert et al., 2001; Robert et al., 2002;
      in relation to kinetic and/or kinematic studies. Biologically, muscles       Groesel et al., 2010). In another study it was shown that the func-
      must generate tension to support the body and to produce locomo-             tion of m. longissimus dorsi may vary at different spinal levels; uni-
      tion. In addition, a certain amount of contraction of antagonistic           lateral activity predominates in the more cranial segments at the
      muscles is needed to stabilize the joints. Thus, it is difficult to evalu-   level of the fourteenth thoracic vertebra (T14) during walking,
      ate EMG results in relation to ‘necessary’ and ‘unnecessary’ muscular        which was interpreted as indicating that the muscle developed
      activity, because there are no common and widely accepted defini-            lateral bending moments, whereas there were more cocontractions
      tions of which muscles should be active at specific periods of the           in the caudal segments (Wakeling et al., 2007).
      stride cycle in different gaits.                                                During lateral bending, EMG activity in m. longissimus dorsi at
         Robert et al. (1998) have published several EMG studies of                T12, T16 and L3 was present only on the concave side of the back.
      horses. Three horses were ridden in walk, trot and canter and activ-         When the back position of standing horses was manually induced
      ity of the m. longissimus dorsi was recorded in relation to the stage        to extend or bend laterally, EMG amplitudes in m. longissimus dorsi
      of the stride cycle determined by accelerometers. The longissimus            were highest at T16. During extension there was a temporal correla-
      dorsi muscle showed two bursts of activity during each stride at walk        tion at the three locations, but less so during lateral bending (Peham
      and trot but only one burst during each stride at canter. Muscles on         et al., 2001; Wakeling et al., 2007).
      the right and left sides acted simultaneously. There was considerable
      variation with speed and between-horse variation was also substan-
      tial (Robert et al., 1998). In the unridden horse, activity of the
                                                                                   Contact
      longissimus dorsi muscle increased both with speed and uphill slope          Contact is defined as a soft, steady, connection between the hand
      when trotting on a treadmill (n = 4). At faster speed, muscle activity       of the rider and the mouth of the horse. The horse should go
      began and ended earlier in the stride cycle, while the opposite was          forward rhythmically according to the driving aids of the rider and
      seen with increasing slope (Robert et al., 2001).                            seek a contact with the hand of the rider, thus going into the contact
         In a study of a larger number of muscles, the basic pattern of            (German National Equestrian Federation, 2002).
      trunk muscle activation at trot showed two bursts of EMG activity               There are no studies directly aiming at defining or validating what
      per stride. Activity of m. splenius started just before contact of each      contact is. It has been documented that in some rider–horse com-
      forelimb and ended in the middle of the corresponding stance                 binations the contact varies between the left and right sides with
      phase. M. longissimus dorsi contracted bilaterally before each hind          one hand consistently having a larger proportion of low contacts
      limb lifted off. M. rectus abdominis was consistently active as each         (Roepstorff, unpublished).
      hind foot contacted the ground (Robert et al., 2002). Similar to                Studies of rein tension have shown that the rhythmic head and
      previous results, increasing speed yielded earlier EMG activity and          neck movements of the horse produce a pattern of regular spikes in
      increasing treadmill slope postponed it.                                     rein tension when the horses are ridden by experienced riders
358
                                                                                                                             Riding methodology
(Clayton et al., 2005) or when side reins are used (Clayton et al.,         with riding the horse in a vertical head and neck position (HNP2
2011) but not when ridden by novice riders (Heleski et al., 2009).          see definition in Fig. 15.19) there was an increase in asymmetry in
It has been interpreted that the baseline tension comes from the            a number of kinematic parameters, such as the lumbar spine and
rider or side rein and the spikes are from the head motion of the           sacral angle (Rhodin et al., 2009). The roll rotation of the rider’s
horse. A prerequisite to establishing a correct contact is that the rider   upper body was markedly asymmetrical between diagonals for
can stabilize the hand position thus encouraging the horse to seek          some rider–horse combinations, which is likely to be an indication
a contact through controlled relaxation of the cervical musculature.        of rider-laterality (Byström et al., 2009). A study of 17 dressage
Within this baseline contact, inertially driven movements of the            riders with varying levels of experience showed that all had a shorter
head and neck result in the rein tension spikes (Clayton,                   right limb, moved their left shoulders more than the right, and that
unpublished).                                                               they were differently asymmetric between right and left canter with
                                                                            the most inharmonious pattern in the right canter (Symes & Ellis,
                                                                            2009).
Impulsion
The horse is considered to have impulsion, when the energy created          Asymmetry in rising trot
by the hind limbs is transmitted into the gait and into every aspect
of the forward movement (German National Equestrian Federation,             At rising trot the load on the horse’s back is lower on the rising
2002). This is another area that has not been specifically addressed        diagonal than on the sitting diagonal and, furthermore, both of
with biomechanical methodology. Accelerometers have been used               these loads are lower than when the rider sits the trot (de Cocq
to study forward motion of the body parts in relation to fore and           et al., 2010a). The same effect is seen in the ground reaction forces
hind quarter impulsion during the use of different types of auxiliary       (Schamhardt et al., 1991). Parameters for rising trot, mainly vertical
reins (Biau et al., 2002) (see previous section).                           peak force and impulse, were higher for the diagonal on which the
                                                                            riders were sitting. Similarly for riders performing rising trot on a
                                                                            treadmill force loading was generally increased in the limbs of the
Straightness                                                                sitting diagonal (Roepstorff et al., 2009). The following asymme-
                                                                            tries were found: the lumbar spine was lower between midstances
A horse is considered straight when the hind quarters follow the            of the sitting and rising stance phases; pelvic roll was limited
same track as the forehand and the longitudinal axis of the body is         and heights of the tubera coxarum were lower on the sitting side
aligned with the straight or curved track that the horse moves along.       (Fig. 15.17); maximal hind limb protraction was decreased and
The weight should be evenly distributed between the left and right          forelimb retraction was increased; and T6 height decreased. The
sides of the body (German National Equestrian Federation, 2002).            conclusion was that the rising and sitting motion of the rider
However, every horse and rider can be assumed to be born with               induced an uneven biphasic load that affected the horse’s back,
some kind of sidedness. Sidedness has been studied quite exten-             pelvis and limb kinematics and the vertical ground reaction force.
sively in humans but to a much lesser extent in horses. The interest-       It should be noted that phase-shifting in the rising trot differed
ing question is how to straighten the horse and correct asymmetrical        between the left and right diagonals, which provides further evi-
locomotor patterns associated with sidedness. A further important           dence that inherent or rider-induced asymmetry was present in
consideration is that asymmetry in the movement pattern is the              these top-level dressage horses.
basic concept of the lameness work up. From the diagnostic point               Both genetic and environmental factors have been implicated
of view there is a gray area between normal physiological responses         in equine inter-stride asymmetry (motor laterality, sidedness)
(e.g. sidedness inherent in the horse or induced by the rider’s sided-      (Murphy & Arkins, 2008). There are likely two aspects of laterality,
ness), and asymmetry in response to painful processes (lameness).           one defined by ethologists (Murphy & Arkins, 2008) and another,
Asymmetry directly related to rider influence has been reported in          possibly a different phenomenon, studied by biomechanists. From
several papers and has been elucidated in the section on rider skills.      the rider’s perspective, the biomechanical asymmetry is commonly
   Alignment of the forehand with the hind quarters has not been            described as the neck muscles being more contracted on the ‘stiff’
scientifically addressed. A number of kinematic studies have                side, compared to the other ‘hollow’ side. The ‘hollow’ side has
reported on different aspects of asymmetry. In the following we             the haunches positioned ipsilaterally relative to the forehand
discuss the most relevant from a horse–rider interaction perspective.       (German National Equestrian Federation, 2002). Any intra-stride
Studies targeting lameness are addressed in Chapter 9.                      asymmetry might encompass motor laterality and/or training-
                                                                            induced asymmetry.
                                                                               In a study of seven horses, all were asymmetric to the same side
Asymmetry basics                                                            (Roepstorff et al., 2009). Regardless of whether the riders were
In trot ridden overground, Clayton determined that three of six             rising on the left or right diagonal, the left fore/right hind diagonal
highly trained dressage horses in collected, working, medium and            was relatively more loaded than the opposite diagonal. The more
extended trot were asymmetrical (Clayton, 1994). This included a            loaded left fore and right hind limbs were likely placed further
longer suspension phase (on the right one horse), longer diagonal           under the horse. The forward placement of the right hind limb
distance (on the right one horse), and longer diagonal advanced             might indicate unloading of the left hind limb (German National
completion times (right and left, one horse each). The fact that riders     Equestrian Federation, 2002). This is generally accepted as the horse
often perceive one side as easier for a canter transition, or that most     being stiff to the left, which is perceived as the more common side
horses have a preferred canter lead when unridden (unpublished              (German National Equestrian Federation, 2002).
observations) points to the presence of asymmetries between the two            In conclusion, straightness and related expected symmetry in
leads at canter, though the effect of the rider on this has not yet         locomotion and force patterns are extremely important to study
been evaluated. In a study of the kinematics of high level dressage         further and in more depth. This is definitely an important key to
horses and expert riders on a treadmill, some movements of the              successful performance and in keeping the horse sound. However,
riders and saddles were more asymmetric than expected. The study            these two concepts are also heavily interrelated by the fact that it is
design could not distinguish between asymmetries caused by lateral-         hard to compete or perform with an unsound horse. In mounted
ity of the horse or rider (Byström et al., 2009).                           studies it is important to realize and take into account the fact that
   The asymmetry during riding with various head and neck posi-             the rider’s asymmetry affects the laterality of the horse.
tions (see below) was larger when the rider tried to affect the horse          It may be asked whether there is correlation between forces
more. For example, when trotting on a loose rein was compared               exerted on horseback and kinematic evaluation of rising trot
                                                                                                                                                      359
                 15                    Horse–rider interaction
                                                          Left tuber coxae                               rising diagonal. Another study with 12 horses ridden overground
                                                                                                         by one intermediate rider found an increased range of flexion–
                                                                                                         extension in the back in rising trot compared to sitting trot
                             80
                                                                                                         (de Cocq et al., 2009). Taken together, there does not seem to be a
                             60                                                                          correlation between increased range of forces and increased range
                                                                                                         of motion in back flexion–extension. Whether it is good for the
                             40                                                                          horse to have an increased range of motion of the back remains
      Relative height (mm)
20 to be seen.
                              0
                                                                                                         Collection
                             -20
                             -40                                                                         General
                             -60                                                                         The aim of all gymnastic training is to create a horse that is athletic
                                                                                                         and ready and willing to perform. For the horse to meet these cri-
                             -80                                                                         teria, its weight, plus that of its rider, must be distributed as evenly
                                                                                                         as possible over all four limbs. This means reducing the weight on
                                   0     10    20   30    40     50     60    70   80   90      100
                                                                                                         the forelimbs (which naturally carry more of the load than the hind
                                                               % stride
                                                                                                         limbs), and increasing the weight on the hind limbs, which were
                                                                                                         originally intended mainly for creating the forward movement.
                                                                                                         Equestrian texts indicate that in collection the hind limbs (the hock
                                                          Right tuber coxae
                                                                                                         and stifle joints) flex more, stepping further underneath the horse
                                                                                                         in the direction of the center of gravity, thereby taking a greater
                             60                                                                          share of the load. This in turn lightens the forehand, allowing the
                                                                                                         forelimbs to move more freely. The horse looks more ‘uphill’. The
                             40                                                                          strides become shorter, but without losing the energy or activity.
                                                                                                         The impulsion is maintained in full at the trot and canter, and as a
                             20
                                                                                                         result the strides become more expressive and ‘stately’ (German
      Relative height (mm)
360
                                                                                                                                                             Collection
                                                                                                  •	 HNP3: Neck raised, poll high and bridge of the nose slightly
                                                                                                     behind the vertical (behind).
                                                                                                  •	 HNP4: Neck lowered and flexed, bridge of the nose
                                                                                                     considerably behind the vertical (low: to imitate Rollkür,
                                                                                                     neck low).
                                                                                                  •	 HNP5: Neck extremely elevated and bridge of the nose
                                                                                                     considerably in front of the vertical (above; absolute
                                                                                                     elevation).
                                                                                                  •	 HNP6: Neck and head extended forward and downward (low
                                                                                                     and open; ridden, only performed at walk, not shown in
                   HNP1                                             HNP2                             Fig. 15.19).
                                                                                                  Walk
                                                                                                  Kinetic evaluation in the different HNPs at walk showed that, in
                                                                                                  general, being ‘above’ the bit or ‘behind’ the vertical differed from
                                                                                                  the vertical position in the same direction, while having the neck
                                                                                                  ‘free’ or ‘low and open’ differed in the opposite direction (Weishaupt
                                                                                                  et al., 2006) (Table 15.2).
                                                                                                     Comparing the ‘competition’ HNP with the other HNPs several
                                                                                                  kinematic parameters were found to be different. The sixth thoracic
                   HNP3                                             HNP4                          vertebra (T6) height was affected during three-limb support by one
                                                                                                  forelimb and two hind limbs, except for in the low and open HNP
                                                                                                  when it was increased throughout the stride. In the free and above
                                                                                                  positions there was a tendency for L5 to be higher during three-limb
                                                                                                  support by one forelimb and two hind limbs. In the behind and
                                                                                                  low and open HNPs the height of L5 increased during the second
                                                                                                  half of hind limb stance. The lumbar back angle (the ‘small’ angle
                                                                                                  between a horizontal plane and a line through L5 to L3) increased
                                                                                                  in the ‘behind’, ‘neck low’ and ‘above’ positions and decreased in
                                                                                                  the free position with the peak value coinciding with three-limb
                                                                                                  support with one hind and two forelimbs.
                                                                                                     In the free and above positions, pelvis pitch increased (tilted
                    HNP5                                           HNP6                           forward in the free position) and decreased (tilted backward in the
                                                                                                  above position) respectively, from forelimb three-limb support to
Fig 15.18  The head and neck positions used in the Zurich study. See text                         hind limb three-limb support. In the behind position a decrease in
for description of positions.                                                                     pelvic pitch was found throughout the stride and in the low and
Reprinted from Rhodin, M. et al., 2009. The effect of different head and neck positions on the    open pelvic position pitch decreased at three-limb support with one
caudal back and hindlimb kinematics in the elite dressage horse at trot. Equine Vet. J. 41 (3),   forelimb.
274–279, with permission from the Equine Veterinary Journal.                                         In the free and above HNPs the femur angle was increased in the
                                                                                                  later part of stance in the free position and decreased in early swing
                                                                                                  in the above position, relative to the competition HNP. In the
Head and neck positions                                                                           ‘behind’ HNP it was smaller at the end of stance.
                                                                                                     In the free position the stifle joint was more flexed during the
In 2005 an experiment was conducted with seven advanced-level
                                                                                                  later part of stance. In the behind position the stifle was more flexed
horses ridden by their own riders on a treadmill (Gomez Alvarez
                                                                                                  during diagonal stance and following three-limb support with two
et al., 2006; Weishaupt et al., 2006; Rhodin, 2008; Rhodin et al.,
                                                                                                  hind limbs. With a low neck it was more flexed during midswing.
2009). Vertical ground reaction forces were measured by the instru-
                                                                                                  In the above position the stifle joint was more flexed during diago-
mented treadmill and kinematic analysis was performed with a
                                                                                                  nal support, less flexed during ipsilateral support and more flexed
high-speed video system tracking 80 markers distributed over ana-
                                                                                                  during the first half of swing, indicating a greater ROM (Rhodin,
tomical landmarks on the horse, rider and saddle. Forces between
                                                                                                  2008). Figure 15.19 compares the hind limb position for the ‘com-
the saddle and the horse’s back were measured with a pressure sensi-
                                                                                                  petition’ position to the free and above positions. Generally, ROM
tive saddle mat and, in three horses, rein forces were measured.
                                                                                                  increased in the low positions implying that these are good for
   The horses were ridden at walk and trot with six different HNPs
                                                                                                  gymnastic effects on the horse, i.e. increasing suppleness.
(Fig. 15.18). A correct HNP was assumed to be one result, or a
prerequisite of, collection. The vertical ‘competition’ HNP was used
for comparison and therefore a series of recordings at a range of                                 Trot
speeds were made in this position to enable speed-matched com-
                                                                                                  The horses shifted weight to the forequarters in the low position and
parisons with the other positions. All of these trials were also per-
                                                                                                  a number of kinetic parameters were affected in the ‘above’ position
formed without the rider achieving the head neck positions with
                                                                                                  (Table 15.3) (Weishaupt et al., 2006). Kinematically, in the ‘free’
different kinds of auxiliary reins. Finally also passage trials were
                                                                                                  position sacral flexion (pelvic pitch) decreased during suspension
performed. All in all approximately 240 trials were recorded during
                                                                                                  and early stance and in the ‘above’ position the sacrum was signifi-
a 2-week period:
                                                                                                  cantly more angled during breakover and suspension (Table 15.4).
•	   HNP1: Free or natural; voluntarily acquired position,                                        In the free position the femur angle was larger during breakover and
     unrestrained with loose reins (free).                                                        early swing whereas in the above position it was smaller in early and
•	   HNP2: Neck raised, poll high and bridge of the nose slightly                                 late swing. In the free position the stifle flexed more slowly in early
     in front of the vertical; reference position (competition, the                               swing and in the above position the stifle showed increased flexion
     Ramener).                                                                                    during stance and the first two-thirds of swing (Rhodin et al., 2009).
                                                                                                                                                                            361
       15         Horse–rider interaction
        Table 15.2  The directions of the statistically significant differences found for kinetic parameters comparing the competition position to
        various head and neck positions in ridden walk. One arrow, percentage changes <5%; two arrows, percentage changes >5%
        Adapted and reprinted from Weishaupt, M.A., Wiestner, T., von Peinen, K., et al., 2006. Effect of head and neck position on vertical ground reaction forces and interlimb
        coordination in the dressage horse ridden at walk and trot on a treadmill. Equine Vet. J. 36 (Suppl.), 387–392, with permission from the Equine Veterinary Journal.
1400 1400
1200 1200
           1000                                                                      1000
      mm
mm
800 800
600 600
400 400
            200                                                                         200
                      -1000 -800         -600     -400     -200       0                       -800      -600     -400 -200            0       200
                                          mm                                                                         mm
      Fig 15.19  Stick figures illustrating the hind limb position during walking at first contact, midstance and toe-off for HNP2 (competition position) (blue line),
      HNP1 (free position) (red line on left) and HNP5 (above position) (red line on right). Markers from proximal to distal; greater trochanter of the hip joint, stifle
      joint, hock joint, fetlock joint and hind hoof.
      Reprinted from Rhodin, M., 2008. A biomechanical analysis of relationship between the head and neck position, vertebral column and limbs in the horse at walk and trot. Dissertation,
      Uppsala., with kind permission of Marie Rhodin.
         Data from the same horses were studied without a rider in walk                                  In this study the highest neck position had the largest weight
      and trot to study back kinematics that are impossible to interpret                               shift to the hind quarters (Weishaupt et  al., 2006). This might be
      fully with a rider. The comparison base was the free HNP. In the                                 interpreted as collection (being one definition of collection).
      ‘competition’, behind and above HNPs, the back was more extended                                 However, the front limb locomotor pattern changed with stance
      in the anterior thoracic region and the ROM in flexion–extension                                 being shortened to such an extent that, even though weight was
      was reduced in the lumbar region (Gomez Alvarez et al., 2006). For                               shifted to the hind quarters, the maximal peak force in the fore-
      the low neck HNP the pattern was opposite. In the above HNP the                                  limb was increased. The forelimb stride simply became very
      intravertebral pattern symmetry was negatively affected and hind                                 short and sharp, which is not desired from an equestrian
      limb protraction was reduced.                                                                    perspective.
362
                                                                                                                                                                          Collection
 Table 15.3  The directions of the statistically significant differences found for kinetic parameters comparing the competition position to
 various head and neck positions in ridden trot as well as passage (using the competition position). One arrow, percentage changes <5%;
 two arrows, percentage changes >5%
   The collected body orientation achieved in this way at the                                 considered more demanding. Classically, it is said that the horse
passage redistributed the diagonal vertical impulse to the hindquar-                          must not drop the bit and work behind the vertical. Approximating
ters. The shift amounted to approximately 3-fold of that which was                            the behind position to such a state, rather few changes were found
observed in the same horses trotting in an extremely high elevated                            compared to the competition position and only in walk. Interest-
head-neck position (Weishaupt et al., 2006). However, because of                              ingly taking the head ‘back (behind)’ or ‘down’ (rollkur) had almost
the longer absolute stance durations, the higher limb impulses at                             the same main effects, i.e. the measurements of back height
the passage did not result in higher peak forces, in either the fore- or                      increased and pelvic pitch and yaw decreased. The above the bit
hind limbs. In this respect the passage seems to be less of a strain                          position had the largest effects on the horses and from the perspec-
for the distal limbs compared to horses moving with the head-neck                             tive of collection, the horse actually shifted the vertical stride
in a high elevated position in which, despite the redistribution of                           impulse to the hind quarters in both walk and trot. However, force
the vertical impulse to the rear, peak vertical forces were increased                         peaks increased in the forelimbs in walk and in both fore and hind
in the forelimbs due to shortened stance durations (Weishaupt                                 limbs in trot. Such force peaks may be detrimental to, for example,
et al., 2006).                                                                                riding school horses, which often trot with their heads in a high
   This observation leads us to the conclusion that correct collection                        position. In walk, the total forces are lower than at trot and likely
of the horse’s movement is characterized by relative elevation in                             to be less harmful. Rather few riders voluntarily strive for ‘above’
the forehand matched to the degree of ‘Hankenbeugung’ which                                   HNP, with the exception of piaffe, where pictures of old masters are
includes increased flexion at the lumbosacral junction and of the                             often shown with the nose in front of the vertical (Karl, 2008). A
proximal limb joints (hip, stifle, hock) during weight-bearing.                               few elite horses took part in the highly controlled treadmill experi-
Whereas an absolute elevation of the head and neck with the back                              ment and whether the results can be generalized extensively to more
held in extension (Rhodin et al., 2009) and with shortened over-                              horses of various levels ridden overground remains to be studied.
track distance and consequently insufficient engagement of the                                   In another study of seven horses lunged in various HNPs it was
hind legs forward under the body (Waldern et al., 2009; Weishaupt                             found that the below position (in this text translated to rollkur) had
et al., 2006) results in an overload situation with increased peak                            the highest rise in serum lactate dehydrogenase and most increases
vertical forces (Weishaupt et al., 2006).                                                     in variables measuring neuromuscular functionality, which was
   In conclusion, as anticipated by riders the HNPs were shown to                             measured by single muscle fibre potentials and motor unit action
have effects on the horses. Among dressage riders one of these posi-                          potentials (Wijnberg et al., 2010). Artificial positions in general
tions, the competition position, could be considered as an ideal,                             affected neuromuscular functionality more than the free position.
i.e. as a way to collection. However, most riders consciously vary                            Further, the interaction between the rider and the horse when
the neck and head positions and thereby increase the range of                                 placing the head of the horse needs elucidation also from the per-
motion of several body parts, to exert a gymnastic effect on the                              spective of how much self-carriage the horse is in (whether leaning
horse, for example during warm-up, compared to the work                                       on the reins) to non-biomechanical aspects, including horse
                                                                                                                                                                                       363
       15          Horse–rider interaction
       Table 15.4  The directions of the statistically significant differences found for kinematic parameters comparing the competition position to
       various head and neck positions in ridden trot as well as passage (with the competition position)
      behavior (in which studies have been done), human perception and                              when trotting unridden on a treadmill, hind limb protraction was
      horse longevity.                                                                              reduced in the above HNP (Gomez Alvarez et al., 2006).
364
                                                                                                                                          Collection
                                                                         Force
   At walk and trot, the metacarpus and metatarsus had a more verti-
cal orientation both at contact and at lift-off in the more collected            0.4
gaits. In other words, the limb rotated through a smaller angle
during stance with less forward progression of the body mass in the
                                                                                 0.2
more collected gaits. However, metacarpal/metatarsal angulations
were generally more acute in the hind limbs than the forelimbs as
a consequence of conformational differences (Clayton, 1994b,                     0.0
1995). In walk when comparing the competition HNP to the free                          -0.6   -0.4   -0.2     0.0       0.2       0.4       0.6
HNP, pelvic pitch decreased in the competition HNP, the height of                                            Time
L5 during three-limb support with two hind limbs increased, the
                                                                         Fig 15.20  A schematic drawing of vertical ground reaction force over time,
lumbar back angle increased, T6 height during three-limb support
                                                                         with the half-sine shape that is observed in running gaits. The highest point
with two forelimbs decreased, and the femoral angle in late stance
                                                                         is the peak force and the area under the curve is the impulse. Note that the
and early swing decreased (Rhodin, 2008). The stifle joint was less      three traces have equal impulses, but peak vertical forces are inversely
flexed during late stance. When trotting on a treadmill sacral flexion   related to the stance durations according to Fpeak ~ 1/D if the shape of the
(pelvic pitch) was increased in the competition HNP compared             force curve remains similar.
with the free HNP (Rhodin et al., 2009).
   Piaffe has more pelvic inclination during the entire stride cycle
compared to collected trot and passage (Holmström et al., 1995).         Commonly the total impulse of the fore/hind limbs is determined,
Furthermore, the stifle and hock joints were more flexed at the start    which can be done with a force-measuring horseshoe, force plate
of stance and the hock joint was also more flexed in midstance in        or an instrumented treadmill. However, it is important to distin-
passage and piaffe compared to collected trot (Holmström et al.,         guish between impulse (total weight bearing of one limb during
1995). When comparing the passage with the collected trot, the           one stance phase) and peak force (Fig. 15.20).
horses moved at a slower forward velocity (−43.2%) and with a
lower stride frequency (cadence; −23.6%), with a more elevated
HNP and an overall pronounced upwards excursion of the trunk             Absolute versus relative weight
during the suspension phase. The strides were more elevated result-      The weight distribution of an unridden horse trotting freely over-
ing from reduced limb pro- and retraction and increased limb             ground is 55/45% on the fore/hind limbs for (Schamhardt et al.,
flexion at the carpus, stifle and tarsus during the swing phase.         1991), 56/44% (Weishaupt et al., 2004), and 58/42–44% (Waldern
However, the prolonged suspension duration could not be con-             et al., 2009) when trotting on a treadmill, and 59/41% at walk on
firmed. Also Clayton (1997) observed a gradual shortening of the         a treadmill (Waldern et al., 2009). The presence of a rider sitting
airborne phase from collected trot to passage.                           passively, leads to a quotient of 52/48%.
   The greater reliance for hind limb support, indicating a higher          From the free HNP to the HNPs in which most riders need to use
degree of self-carriage and balance, was reflected in prolonged          their reins, in walk there is a small increase in weight bearing of the
stance duration and positive diagonal dissociation. Similar changes      hind quarters that is statistically significant for the ‘above’ HNP
were described by Clayton (1994, 1997) and Holmström et al.              (vertical impulse of the forelimbs decreased by 1.6% in walk and
(1995) for the over-ground situation in which the passage stride         1.8% in trot). However, this position was judged to be uncomfort-
duration and fore- and hind limb stance duration increased while         able for the horse (Weishaupt et al., 2006). In the high HNPs,
speed and stride length were reduced.                                    2.5–3% less vertical impulse was carried by the forehand compared
   It seems difficult to prove biomechanically that lowering of the      with the free HNP (Weishaupt et al., 2006). In passage the vertical
hind quarters is a consistent finding in collection. One likely expla-   impulse carried by the forehand was decreased by 4.8% compared
nation is that the human eye confuses movement during the swing          to collected trot (Weishaupt et al., 2009).
phase with temporal characteristics of limb placement.                      Weishaupt et al. (2006) confirmed that, indeed, relative shifts
                                                                         of the center of mass can be induced by altering the HNP of the
                                                                         horse. The HNPs with the neck stretched out (HNP1 and HNP6)
Diagonal dissociation                                                    shifted the weight towards the forelimbs; more restrained HNPs and
In speed-matched trots on a treadmill, significant decreases in diag-    especially the elevated neck position (HNP5) shifted the weight
onal dissociation relative to stride duration were found in the com-     towards the hind quarters in both gaits. However, compared to the
petition HNP compared to the free HNP (Weishaupt et al., 2006),          reference position HNP2, the changes were surprisingly small; the
and the mean value was negative, meaning that the fore hooves            cranio-caudal load distribution varied only between +0.7% and
made contact before the diagonal hind hooves. Diagonal dissocia-         −1.0% at walk and +0.5% and −1.0% at the trot
tion was further significantly longer on the treadmill (Weishaupt           A further essential finding was to quantitatively demonstrate that
et al., 2009) in passage compared to collected trot. In this study       a load shift towards certain limbs would not necessarily increase
speed-matching was not done.                                             the peak forces in those limbs and vice versa. In the free HNP and
                                                                         the low and open HNP peak vertical forces (Fzpeak) in the forelimbs
                                                                         decreased although the center of mass was shifted towards the
Relative weight bearing                                                  forehand. In a single peak, sinusoidal curve such as the vertical
                                                                         ground reaction force curve of the trot, maximal values can be
Increased weight bearing by the hind quarters is another common          reduced by distributing the impulse (area under the curve) over a
term used to describe collection. Although it is easy to define, it is   longer stance duration, which was the case for the free HNP and
not so easy to measure comprehensively in the practical situation.       the low and open HNP. The opposite was observed in the above
                                                                                                                                                         365
       15      Horse–rider interaction
      HNP where the shift of load from the forehand to the hind quarters            association with collection, i.e. the impulse may be shifted to earlier
      was not associated with a reduction of Fzpeak in the forelimbs. On            within the stride.
      the contrary, because of the pronounced vertical stride pattern of               Trainers use terms such as ‘letting the aids through’ and ‘working
      the forelimbs coupled with unproportionally short stance dura-                through the back’ that are related to the feeling of the horse being
      tions, Fzpeak actually increased compared to the speed-matched refer-         ‘between the aids’ when the rider perceives that it is possible to do
      ence. In movement patterns that have a short stance duration,                 whatever he or she wishes without any resistance from the horse.
      higher peak forces are to be expected!                                        Most riders with a certain amount of experience can identify a
         Conflicting results between different studies may have arisen              specific feeling when the horse and rider seem to become one unit,
      because the changes being measured are so small or they may be                and the feeling is that every aid is accepted with ease by the horse.
      confounded by the use of a treadmill. Changes in timing of the                It is likely that this is related to timing between fore- and hind-
      force applications by the fore and hind limbs may also be important           quarter locomotion and temporal coordination of back muscle
      in achieving collection. As an example the vertical force in the hind         activity (Robert et al., 1998; Licka et al., 2009). However, this field
      limb might increase faster during the first part of stance in                 is yet to be explored.
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      Preuschoft, H., Witte, H., Recknagel, S., Bar,          C.N., 1993. Kinematic analysis of the           Weishaupt, M.A., Byström, A., von Peinen, K.,
         H., Lesch, C., Wuthrich, M., 1999. Effect on         equestrian – walk, posting trot and sitting        Wiestner, T., Meyer, H., Waldern, N., et al.,
         horses of commonly used bridles. Deut.               trot. Hum. Mov. Sci. 12, 693–712.                  2009. Kinetics and kinematics of the
         Tierarzt. Wochenschr. 106, 169–175.               Schöllhorn, W.I., Peham, C., Licka, T., Scheidl,      passage. Equine Vet. J. 41, 263–267.
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368
                                                                                                                C H A P T ER         16 
                                                                                                                                                  369
       16                     Ethology and welfare aspects
0.01 mya
                                                                                                                                                      Sindohipparion
                                                             Hippidion group       Equus
                           1.05 mya
       PLIOCENE
                                                                                               Nannippus
                                                                                                            Neohipparion          Hipparion
                                                                               Pilohippus
                                                                                            Calippus                                                  Sinohippus
                                                                                                             Hipparion            Megahippus
                           3.3 mya
                            Pilohippus                                                                           Archaeohippus
                                                                                                                                                      Anchtherium
       MIOCENE
Hypohippus
Merychippus
                                                Merychippus
                                                                                                                 Parahippus       Anchitherlines
                           23.7 mya
                                                                                                                           Miohippus
       OLIGOCENE
Miohippus Mesohippus
Hypracotherium
                                                                                              Hypracotherium
      Fig 16.1  Evolutionary tree of the horse. Note the transition from browsing forest dweller to hypsodontic grass eating Steppe roamer in the Miocene, as well
      as the extinction in the America’s in the last ice age.
      intensive housing of foals at this early stage may hamper the devel-                             is an instinctive tendency in a foal, refined through learning during
      opment of many behaviors, including locomotion.                                                  the first week of life. Over time, the mare and foal will spend more
        One of the primary activities foals engage in is stretching, which                             time apart, until by the age of 1 year the youngster may be grazing
      seems to be of greatest importance during the first few weeks after                              for approximately 44 min/h alongside the rest of the herd. Grazing
      birth. Foals have been observed to perform this activity 40–60 times                             involves moving whilst foraging, an activity that horses in their
      each day (more than sucking) (Fraser, 1992). It is suggested that                                natural state will perform for around 16 h each day depending on
      both recumbent and upright stretching are important for athletic                                 their physiological and reproductive state, the time of year, available
      development, growth and joint formation. Especially in the first 10                              forage and weather conditions. Thus horses have evolved to spend
      days of their life, foals are engaged in many short bouts of solitary                            much of their time moving slowly with their head and necks
      locomotory play around their dams, allowing their muscles to                                     lowered, whilst selecting suitable forage. In the natural environ-
      develop.                                                                                         ment, horses may travel up to 80 km during grazing and for water,
                                                                                                       and even when kept on restricted pastures, horses are estimated to
                                                                                                       move around 20 km each day (McGreevy, 2004). Increased locomo-
      Grazing                                                                                          tory activity has been found in horses kept socially isolated from
      During the first week of life the mare and foal spend approximately                              others in which case they will walk and trot three times more fre-
      90% of their time within 5 m of each other (Waring, 2003). During                                quently than horses kept in groups or in visual contact with another
      these early weeks, the mare repeatedly leaves the foal and moves a                               horse (Houpt & Houpt, 1989), apparently to try to get into more
      short distance away, and the foal follows. This following behavior                               close contact with conspecifics.
370
                                                                                                                           Development of locomotion
Fig 16.2  A foal just after birth quickly learns to balance and to move       Fig 16.4  Fifty percent of foals develop a side preference while equally
around so it can follow its dam, even in canter. However, complex behaviors   distributed left and right.
like lying down take much longer to learn.                                    © Arnd Bronkhorst/www.arnd.nl.
© Arnd Bronkhorst/www.arnd.nl.
                                                                                                                                                         371
                16                    Ethology and welfare aspects
372
                                                                                      Effect of management regimes on locomotion and welfare
suggests that at least during a stressful time such as occurs at          is not necessary, and they do not require as careful monitoring of
weaning, high-energy diets appear to be associated with increased         exercise and feeding as competition horses do. This system works
locomotion. However, inappropriate or over-feeding high-energy            best where group composition can be kept stable, and where there
foods to horses is also known to be associated with unwanted              is space available for horses to escape any unwanted attention from
locomotory responses, such as explosive reactions to signals (aids),      others in the group. Its advantages are that horses can interact freely,
and this is particularly the case for horses housed in stables (Riveria   move fairly freely and live a more natural life. Group sizes vary from
et al., 2002). Hyperactivity responses, including shying, pulling,        two or three to 60 or more and space allowances of the same dimen-
bolting, and rushing could all be considered to be the result of a        sions as a loose-box per individual are recommended.
restricted environment, lack of exercise and too much sugar/starch           Relatively recently technology borrowed from the automatic
in the diet. It is likely that the behavioral problems often experi-      milking systems for dairy cows has been adapted and used in group
enced by horse owners and that lead to poor owner–horse relation-         housing for horses. Unpublished studies by one of the authors
ships, and thus lower equine welfare, could be prevented through          (MvD) have shown that despite these systems needing more techni-
improved understanding of the effect of food and feeding on horse         cal (software) development, the horses housed in this way more
behavior and by providing the horse with a more natural time-             closely resemble the natural (semi-feral) feeding, locomotion and
budget including access to an area to enable it to perform a normal       resting time budgets than stabled/stalled horses. Moreover, in these
locomotion pattern.                                                       systems the animals can perform biologically essential behavior
                                                                          when they want to: so they can be social, move freely and perform
Impact of housing/restricted grazing                                      locomotory behaviors more similar to those seen in horses in
                                                                          paddocks/at grass. This ability to perform more natural responses
on locomotion                                                             including locomotion is considered to lead to a reduction in stress
                                                                          (Weiss, 1971) and therefore enhanced welfare as compared with
As far as locomotion behavior under more natural conditions is            other intensive housing systems.
concerned, horses have been shown to travel distances of up to
65–80 km/day. Where horses are managed at pasture, grazing is the         Effect of management regimes on locomotion
main initiator of locomotion and the distance they cover is there-
fore usually much less. There are a number of different methods for
                                                                          and welfare
managing sports horses, however the demands of competition and
training are often associated with controlled exercise, restricted        The method of management obviously impacts greatly on horse
feeding regimes and restricted housing for at least part of the day.      locomotion time and type. The confined conditions in which most
There are three basic types of housing for intensively managed            performance and recreation horses are kept at least for part of a
horses, which include the stall, the stable or loose box and group        24-h period, clearly restricts normal behavior. The stable appears to
or loose housing.                                                         conflict with many of the horse’s survival instincts, and the associ-
   The stall (known as the straight stall in the USA), in which the       ated effects of restricted feeding and exercise are thought to lead to
horse is tethered in a space usually not much greater than the width      a number of problems for the horse (VanDierendonck & Goodwin,
and length of the animal is therefore the most restrictive for the        2005). Changes in kinetic behavior associated with housing are
horse. Generally there is very limited access to other horses, and no     quite extreme – horses in stables will stand for up to 40% of their
space to turn or move around voluntarily. The horse is limited to         daily time budget, and move infrequently, whereas horses free-
some forward and backward movement, and lying down on its                 ranging in Camargue district of France will only stand for 20% of
brisket and sometimes its side if the tether allows. Although stalls      the day, and will spend 60% grazing and 10% in other activities
are less popular now than during the era of the working draught           including social grooming, rolling and play (Kiley-Worthington,
horse, they are still used where space is limited or where traditional    1987). These figures are confirmed in studies of feral horses in other
methods of housing are valued. In some countries (e.g. Germany            area’s around the world such as New Zealand, USA, Iceland and
‘Bundesländer’, Sweden and Denmark) they are forbidden by law.            Mongolia (Linklater et al., 2000; VanDierendonck et al., 1996; Cran
The most common type of housing in Europe is the stable or loose-         et al., 1997; Sigurjónsdóttir et al., 2003).
box (also called the box stall in the USA), where the horse has              However there is a question regarding whether exercise is actually
limited freedom of movement, some external stimulation, and dif-          important to the horse. That is, although there are undoubted dif-
fering degrees of access to conspecifics depending on the internal        ferences in the amount of time, the type and the space available for
partitions. Most Western European countries have a recommended            movement in the different housing systems, is this really a problem
minimal stable size for adult horses and ponies (e.g. 2 × height-at-      for a horse? This issue has recently arisen due to public concern
the-withers). This allows a pony/horse to perform its normal              about the welfare of horses used in the Pregnant Mare Urine (PMU)
feeding, resting and maintenance behaviors without space limita-          industry in the USA, and in particular the fact that mares are con-
tions. Despite this minimum requirement, in many countries (e.g.          fined for long periods in straight stalls in which they can not turn
UK, The Netherlands, Belgium, Germany and Spain) most stables             around and do not have the chance to move or exercise. To answer
are standardized at 3 × 3 m or less and therefore often very restric-     this, Houpt et al. (2000) developed a device based on the phenom-
tive for the most common breeds. In the UK 4 × 4 m is recom-              enon of operant conditioning. In their study, horses had to learn to
mended for horses ‘kept inside for long periods’, while the European      press a panel a number of times in succession (the switch) in order
Union law uses 5 × 4 m for research horses.                               to release themselves from the stall. Houpt and co-workers mea-
   Horses in the restricted stalls perform no ‘normal’ locomotion,        sured the strength of a horse’s motivation for each of three com-
possibly stepping back and forward being the only movement being          modities: food, exercise (release into a paddock for 3 min) or
possible, apart from the hour or so during which they may be exer-        companionship (access to another mare for 3 min). They found
cised. Horses in stables or loose-boxes can move, but can only do         that the chance to leave the stall (i.e. to experience free movement)
so within the confines of the enclosure and generally are restricted      was less important than leaving to access food and the opportunity
to only walking, although some horses manage to perform other             to exercise and have access to another mare was equally chosen. In
forms of locomotion such as bucking and rearing.                          a further trial the authors looked at the preference of the horse for
   The third type of housing used for the performance horses is           engaging in exercise on a treadmill or alternatively, returning to the
group or loose-housing in barns or yards. Group housing is mainly         home stall. Interestingly most horses chose their home stall and
used for keeping breeding mares or young stock together, since            actively avoided the treadmill, suggesting that exercise per se, may
these are rarely handled, and so access to each individual every day      not be as important to the horse as often considered. However when
                                                                                                                                                     373
       16      Ethology and welfare aspects
374
                                                                                                                                      Overtraining
                                                                                                                                                       375
       16        Ethology and welfare aspects
                                                                                  (McGreevy & McLean, 2007). All these effects could possibly have
                                                                                  psychological and welfare implications.
376
                                                                                                                                          References
                                                                                 Several welfare issues have been the subject of the previous para-
                                                                                 graphs, challenging scientists to find acceptable solutions to train-
                                                                                 ing and management issues. As van Weeren (2008) points out, the
                                                                                 equestrian industry is a conservative one slow to adopt the available
                                                                                 technological and scientific advances to help progress training
                                                                                 and better safeguard equine welfare. This has been recognized
                                                                                 as an emerging area combining many fields of equine research
                                                                                 called equitation science (McGreevy, 2007; Goodwin et al., 2008;
                                                                                 McGreevy & McLean, 2007).
                                                                                    Ever since horses were domesticated people have managed their
                                                                                 behavior in a restrictive manner. This has had and still has serious
                                                                                 consequences for the horse. As discussed, research has shown that
                                                                                 foals post partum need enough ‘Steppe like’ space and social stimu-
                                                                                 lation to exercise and develop sufficiently (Kurvers et al., 2006;
                                                                                 Brama et al., 2001, 2009) (see Chapter 13) and it is clear that
                                                                                 modern demands on the horse differ greatly from the requirements
                                                                                 of horses in previous times (see Chapter 1).
                                                                                    Technologies which can be attached to the horse during training
                                                                                 and use telemetry to transfer data regarding the horse and the
                                                                                 horse–rider interaction (e.g. tension meters in the reins, and pres-
                                                                                 sure sensors in the stirrups (Warren-Smith et al., 2006), pressure
                                                                                 meters in saddle pads (de Cocq et al., 2004; Geutjes et al., 2008),
                                                                                 on the limbs or head (Warren-Smith, pers. comm.) and heart (Von
                                                                                 Borell et al., 2007) all have the potential to provide us with more
                                                                                 objective empirical information to aid with training and manage-
                                                                                 ment. In addition detailed experiments using force places, kine-
Fig 16.9  The use of so called ‘shoes’ in training Hackneys in which the         matic analyses with motion cameras (see Chapter 2) (van Weeren,
strap between the two front legs is too short, forcing the horse to lift its     2002) and other such advances will lead toward better ergonomics
opposite leg earlier and higher than natural, as well as that the horse cannot   (van Weeren, 2005), prevent overtraining (de Graaf-Roelfsema,
stand on both feet at the same time.                                             2007) and stimulate better skeletal development in the horse
© Arnd Bronkhorst/www.arnd.nl.                                                   (Rogers et al., 2008a,b). Add to this advanced practice involved in
                                                                                 the application of ethologically sound training practices using
                                                                                 knowledge of learning processes and the horse’s natural behavioral
(rapping) as a horse jumps an obstacle, and other such painful                   responses (McGreevy & McLean, 2007), we will develop a greater
stimuli to cause the horse to avoid touching the jumping poles.                  understanding of what is acceptable from the horse’s point of view.
Given that this is a welfare issue and banned by the professional                   There are many and varied demands made upon the horse by
body, the extent to which this occurs and the effect on the (short               humans. All forms of performance and recreational use of the horse
and long term) welfare of the horse is largely unknown. A recent                 relate to its locomotory behavior – and in all cases humans have
issue concerns the use of different performance enhancing boots on               modified the horse’s normal behavior to accommodate our needs.
distal limbs in jumping horses. A study by Murphy (2008) revealed                The breeding, management and training of horses to enable humans
that weight and extra pressure does indeed alter the flexion of the              to enjoy interacting with the horse often compromise the horse’s
hind legs above the jump and according to Murphy: ‘In the absence                welfare. Recognition of this fact, and questioning the way in which
of scientific appraisal, it is unclear if such boots are acceptable and          we apply such pressure on horses is an important step forward in
innovative training aids within equitation’.                                     improving our relationship with them.
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         (2), 403–411.                                       Weeren, P.R., Back, W., 2006.                    Rivera, E., Benjimen, S., Nielsen, B., 2002.
      Feist, J.D., McCullough, D.R., 1976. Behavior          Developmental aspects of distal limb                Behavioral and physiological responses of
         patterns and communication in feral                 conformation in the horse: the potential            horses to initial training: comparison
         horses. Zeitschrift fur Tierpsychologie 41,         consequences of uneven feet in foals.               between pastured versus stalled horses.
         337–371.                                            Equine Vet. J. 38, 652–656.                         Appl. Anim. Behav. Sci. 78, 235–252.
      Fraser, A.F., 1992. The behavior of the horse.      Kurvers, C.M.H., van Weeren, P.R., Rogers,          Rogers, C.W., Firth, E.C., McIlwraith, C.W.,
         CAB International, Oxon, UK.                        C.W., VanDierendonck, M.C., 2006.                   Barneveld, A., Goodship, A.E., Kawcak,
      Geutjes, C.A., Clayton, H.M., Kaiser, L.J., 2008.      Quantification of spontaneous locomotion            C.E., et al., 2008a. Evaluation of a
         Forces and pressures beneath the saddle             activity in foals kept in pastures under            new strategy to modulate skeletal
         during mounting from the ground and                 various management conditions. Am. J. Vet.          development in Thoroughbred
         from a raised mounting platform. Vet. J. 3,         Res. 67, 1212–1217.                                 performance horses by imposing track-
         137–140.                                         Lausanne, 2006. The use of over bending                based exercise during growth. Equine
      Gibbs, P.G., Cohen, N.D., 2001. Early                  (“Rollkur”) in: FEI Competition Report of           Vet. J. 40 (2), 111–118.
         management of race-bred weanlings and               the FEI Veterinary and Dressage                  Rogers, C.W., Firth, E.C., McIlwraith, C.W.,
         yearlings on farms. J. Equine Vet. Sci. 21          Committees’ Workshop. 31 January 2006               Barneveld, A., Goodship, A.E., Kawcak,
         (6), 279–283.                                       during the FEI Veterinary Committee                 C.E., et al., 2008b. Evaluation of a new
      Gomez-Alvarez, C.B., Rhodin, M., Bobber,               meeting at the Olympic Museum,                      strategy to modulate skeletal development
         M.F., Meyer, H., Weishaupt, M.A., Johnston,         Lausanne.                                           in racehorses by imposing track-based
         C., et al., 2006. The effect of head and neck    Linklater, W.L., Cameron, E.Z., Stafford, K.J.,        exercise during growth: the effects on
         position on the thoracolumbar kinematics            Veltman, C.J., 2000. Social and spatial             2- and 3-year-old racing careers. Equine
         in the unridden horse. Equine Vet. J. Suppl.        structure and range use by Kaimanawa wild           Vet. J. 40 (2), 119–127.
         36, 445–451.                                        horses (Equus Caballus: Equidae). N. Z. J.       Rushen, J., Lawrence, A., Terlouw, E.M.C.,
      Goodwin, D., 1999. The importance of                   Ecol. 24 (2), 139–152.                              1993. The motivational basis of
         ethology in understanding the behavior of        McBride, S., Long, L., 2001. Management of             stereotypes. In: Lawrence, A. B., Rushen, J.
         the horse. WALTHAM Symposium. Equine                horses showing stereotypic behavior: owner          (Eds.), Stereotypic anmial behavior. CAB
         Vet. J. Suppl. 28, 15–19.                           perception and implications for welfare.            International, Wallingford, UK, pp. 41–64.
      Goodwin, D., 2002. Horse behavior:                     Vet. Rec. 148 (26), 799–802.                     Sigurjónsdóttir, H., Van Dierendonck, M.C.,
         evolution, domestication and feralisation.       McGreevy, P., 2004. Equine behavior, a guide           Snorrason, S., Thorhallsdottir, A.G., 2003.
         In: Waran, N. (Ed.), Welfare of horses.             for veterinarians and equine scientists.            Social relationships in a group of horses
         Kluwer Academic Publishers, pp. 1–18.               Saunders, Edinburgh, UK.                            without a mature stallion. Behav. 140 (6),
      Goodwin, D., Hughes, C.F., 2005. Equine Play        McGreevy, P.D., 2007. The advent of                    783–804.
         Behavior. In: Mills, D., McDonnell, S.M.            equitation science. Vet. J. 174, 492–500.        Sloet van Oldruitenborgh-Oosterbaan, M.M.,
         (Eds.), In the domestic horse: the origins,      McGreevy, P.D., McLean, A.N., 2007. The                Blok, M.B., Begeman, L., Kamphuis,
         development and management of its                   roles of learning theory and ethology in            M.C.D., Lameris, M.C., Spierenburg, A.J., et
         behavior. Cambridge University Press, pp.           equitation. J. Vet. Behav. Clin. Appl. Res.         al., 2006. Workload and stress in horses:
         150–160.                                            2, 108–118.                                         comparison in horses ridden deep and
      Goodwin, D., McGreevy, P., Heleski, C.,             McGreevy, P.D., Thomson, P.C., 2006.                   round (‘rollkur’) with a draw rein and
         Randle, H., Waran, N., 2008. Equitation             Differences in motor laterality between             horses ridden in a natural frame with only
         science: the application of science in              breeds of performance horse. Appl. Anim.            light rein contact. Tijschrift Voor
         equitation. J. Appl. Anim. Welfare Sci. 11          Behav. Sci. 99 (1-2), 183–190.                      Diergeneeskunde 131 (5), 152–157.
         (3), 185–191.                                    McGreevy, P.D., Rogers, L.J., 2005. Motor           Spinka, M., Newberry, R.C., Bekoff, M., 2001.
      Houpt, K.A., Houpt, T.R., 1989. Social and             and sensory laterality in thoroughbred              Mammalian play: training for the
         Illumination preference of mares. J. Anim.          horses. Appl. Anim. Behav. Sci. 92 (4),             unexpected. Quart. Rev. Biol. 76 (2),
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       17      Rehabilitation of the locomotor apparatus
      rehabilitation and, more recently, performance enhancement and            pain and dysfunction techniques (Simons et al., 1999), electro-
      sports medicine. Physiotherapy has been defined as ‘A holistic            therapy (Watson, 2008) and integrative therapeutic approaches
      approach to the prevention, diagnosis and therapeutic management          relating to mechanical passive constraints of locomotion and neu-
      of pain, disorders of movement or optimization of function to             romotor control including facilitation and strengthening techniques
      enhance the health and welfare of the community from an indi-             (McGill, 2007; Mooney, 2007; Lee & Vleeming, 2007).
      vidual or population perspective’. McGowan et al. (2007c) empha-
      sized that one of the fundamental differences between PT and the
      medical or veterinary profession is that physiotherapists are trained
      to focus on the assessment and management of a patient’s function,
                                                                                Longevity and musculoskeletal disorders
      rather than focusing purely on the specific patho-anatomical diag-        The clinical need for rehabilitation interventions and justification
      nosis. The aim of PT and rehabilitation is to restore function and        for research into this field are verified by the amount of wastage in
      promote tissue healing by assisting normal physiological processes        equine sports due to musculoskeletal injuries (Peloso et al., 1994;
      through the application of manual therapy techniques, electromo-          Valentine, 2008; Barr et al., 2009; Ely et al., 2009). Statistics related
      dalities and exercise-based regimens. Buchner and Schildboeck             to longevity and life spans are often collated according to insurance
      (2006) and McGowan et al. (2007c) recognized these specific areas:        company records. These indicate that diseases of the musculoskel-
      manual/manipulative therapies (PT, massage, chiropractic, osteopa-        etal system are the predominant cause of death in sport horses
      thy) and complementary alternative medicine (CAM) also known              (Clausen et al., 1990; AGRIA, 1995 cited in Wallin et al., 2000;
      as physical or technical/modality based therapies (physiotechnical        Heisele, 1995), whereas diseases of the digestive system are the most
      therapies): acupuncture, electrotherapy, exercise, hydrotherapy, laser    frequently reported cause of death in companion horses (Baker &
      therapy, magnetic field therapy, thermotherapy and therapeutic            Ellis, 1981). In a follow-up 5-year survival study of 2495 horses with
      ultrasound.                                                               at least one costly veterinary-care event and 15 576 horses with no
         Rehabilitation in veterinary medicine involves the veterinarian        costly veterinary care event evaluated for 1 year, the risk of death
      as primary patho-anatomical diagnostician, a thorough objective           increased linearly with age and with increasing life-insurance value
      functional assessment of the patient and consultation with other          (Egenvall et al., 2006). Horses with previous lameness had the
      health professionals (McGowan et al., 2007a). Using knowledge             lowest survival. Horses with previous locomotor problems contin-
      and skills unique to these professions the patient’s movement             ued to have considerably more veterinary-care events and higher
      potential is assessed, with all information and confounding factors       costs for locomotor problems during the follow-up period (Egen-
      being incorporated to establish an accurate functional diagnosis,         vall et al., 2008), highlighting the potential need for further and
      problem list, management plan and goals. Clinically, and particu-         improved rehabilitation strategies. The most common disease in
      larly in relation to research, it is imperative that during the reha-     107 310 horses of varying age, gender, breed and use requiring vet-
      bilitation process valid and reliable objective measurements are          erinary care covered by complete insurance in Sweden from 1997
      taken to determine accurate outcome measures. The integration of          to 2000 was arthritis, which most frequently affected the fetlock
      research into evidence-based practice continues to be a challenge in      (28%) or multiple joints (16%) (Penell et al., 2005).
      veterinary medicine and rehabilitation is no exception. Currently            In a 5-year study of 5140 horses from 136 riding schools the
      there is limited research in equine locomotion in relation to reha-       overall yearly incidence rate was 1584 events of veterinary care per
      bilitation, though many animal models have been used for human            10 000 horse-years at risk (Egenvall et al., 2009). The total and
      rehabilitation research with the findings being integrated into           diagnostic mortalities were 790 and 763 deaths per 10 000 horse-
      current concepts of equine rehabilitation.                                years at risk. Rates varied substantially among riding schools. For
         Textbooks and review articles in the area of veterinary PT and         locomotor problems the rates were 1116 events of veterinary care
      rehabilitation include Animal physiotherapy: assessment, treatment and    and 524 deaths per 10 000 horse-years at risk. For the outcome
      rehabilitation of animals (McGowan et al., 2007a). This is an evidence-   veterinary care for locomotor problems, the hazard ratio (HR)
      based textbook that reviews the literature in relation to animal PT       increased with increasing life-insurance value, was higher in horses
      and is a useful reference with respect to outlining the foundations       than ponies, and was higher in Warmbloods than other horses. The
      of rehabilitation and equine locomotion. A recent review Equine           HR increased by 33% for each year of age at entry. Age at entry
      Physiotherapy: the science behind the profession (McGowan et al.,         ≥8 years was associated with decreased HR due to locomotor
      2007c) also highlights the potential input of PT in equine rehabili-      problems.
      tation. Another useful text is Physical Therapy and Massage for the          Wallin et al. (2000) investigated the longevity, causes of death
      Horse which complements both evidence based and clinical practice         and culling of Swedish Warmblooded and Coldblooded horses via
      (Denoix & Pailloux, 2005). In addition there are clinical and evi-        a retrospective owner questionnaire. Data were retrieved from
      dence based articles, chapters and textbooks (Porter, 2005; Bromi-        horses born 1968–1986 participating in Riding Horse Quality Tests
      ley, 2007; Henson et al., 2009; Pusey et al., 2010). The profile of       as 4-year-olds, with information about the horses available until
      rehabilitation and performance enhancement has also been height-          1990. Of the 1847 Warmbloods, 503 were dead, 85% had com-
      ened in recent years by the official use of physiotherapists during       peted in different sporting disciplines and many were used as
      international equestrian competitions. In this context, equestrian        leisure horses after retirement from competition. Data also included
      sports are rapidly catching up to other international competitive         horses of the Swedish Cavalry Horse Foundation born between
      sports, such as football and athletics, in which individuals and          1970 and 1975 with information available until 1989: 208/344
      teams utilize the professional service of physiotherapists not only       Warmbloods and 97/204 Coldbloods were dead. The most
      in treatment of injuries, but also in maintenance and enhancement         common causes of death were musculoskeletal diseases (56–57%),
      of performance.                                                           respiratory diseases (8–9%), diseases of the digestive system (5–
         In addition, there is a growing body of literature describing          6%), accidents (3–9%), and causes unknown in 13.0% of Warm-
      research studies in equine rehabilitation (e.g. Wakeling et al., 2006;    blooded horses. In the Coldblooded horses death was attributable
      Haussler et al., 2007, 2010; Ramon et al., 2004; Wennerstrand et al.,     to temperamental disorders (23%), diseases of the musculoskeletal
      2006; Xie, 2005; Clayton et al., 2008, 2010a,b, 2011a,b; De Heus          system (14%) and hoof diseases (8%). A written questionnaire
      et al., 2010; Stubbs et al., 2010, 2011). Many forms of PT, manual        among (Swiss) horse owners (n = 2912 horses and ponies) indi-
      therapies and alternative medicine can play a role in the horse’s         cated that a veterinarian examined 718 horses (24.7% of the sample
      return to optimal performance. Human therapeutic texts should be          population) within the 12 months prior to the survey (Knubben et
      consulted to further the reader’s understanding of manual therapies,      al., 2008). Orthopedic and traumatic disorders (41.5%) had the
      soft tissue mobilization/massage (Boyling et al., 2004), myofascial       largest proportion, followed by gastrointestinal (27.1%) and
382
                                                                                                                               General introduction
respiratory (14.0%) diseases. Half of the lameness cases occurred             Gibson et al. (2002) reported the frequency of soft tissue injury
as a direct consequence of an injury. In 25.6% of all cases diag-          in 70 elite sport horses competing at the 2000 Sydney Olympics in
nosed by a veterinarian, alternative therapeutic methods were used         dressage (8), show jumping (15), and eventing (47). As reported
either in addition to traditional medicine or exclusively (Knubben         previously (Reef, 1998), suspensory desmitis (n = 4) was most
et al., 2008).                                                             common in dressage horses affecting both fore and hind limbs.
   A UK study surveyed owners of registered dressage horses (n =           Some were able to compete despite having suspensory desmitis,
2554) reporting that 33% of horses had been lame at some time              others had to withdraw. The most common lesion in show jumpers
during their career, with 24% of these within the previous 2 years         (n = 10) was suspensory desmitis including desmitis of the extensor
(Murray et al., 2010). A number of factors were associated with the        branches, with four medalists amongst this group. The authors
occurrence of lameness in the last 2 years, with increased risk for        suggest that show jumpers can continue to compete successfully
older and bigger horses; use of arenas that were indoors, not pri-         with good management despite chronic low-grade injury. Tendon
vately owned, and that became deeper in wet conditions or were             and ligament injuries occurred more frequently in eventers due to
sand-based; use of and longer time spent in horse-walkers (cause           the requirement for speed and jumping. Soft tissue lesions were
or effect); not lunging; shorter turnout time; and back pain.              present in 45/47 horses that were presented to the veterinary clinic,
   It is well established in the literature that flexor tendon and sus-    10 horses had multiple affected sites, most commonly superficial
pensory ligament injuries are the most frequently reported injuries        digital flexor tendonitis and/or suspensory desmitis (proximal or
in sports requiring the horse to perform at high speed and over            branches), tenosynovitis, desmitis, core lesions and diffuse loss of
jumps (Rooney & Genovese, 1981; Jeffcott et al., 1982; Rossdale            echogenicity. Many did not complete due to retiring on course (n
et al., 1985; Mohammed et al., 1991; Marr et al., 1993; Colbourn           = 10), elimination on course (n = 3) or withdrawal before the third
& Yovich, 1994; Reef, 1998). In the Thoroughbred (TB) racing               inspection (n = 6). However, 20 horses passed the veterinary inspec-
industry musculoskeletal injuries account for three times more             tions and completed the event, whilst adhering to the veterinary
wastage than all other medical problems (Rossdale et al., 1985;            rules of the Fédération Equestre Internationale (FEI) (2011) with
Robinson & Gordon, 1988). More than half of the 2–4-year-old               respect to non-pharmaceutical treatments (www.fei.org). Fourteen
racehorses become lame and 20% of all racehorses eventually suffer         horses were presented for veterinary evaluation before the start of
a career ending musculoskeletal injury or disease (Bourke, 1995).          the competition, only one of these completed all three phases
Ely et al. (2009) found that fractures, tendon and suspensory liga-        (proximal suspensory desmitis), five did not complete because of
ment injuries were important causes of morbidity and mortality in          the existing injury at the time of arrival in Sydney or during training
1223 National Hunt racehorses in training in the UK. Ramzan and            leading up to the Games. The remaining eight horses fell or were
Palmer (2010) recently investigated musculoskeletal injuries in            eliminated during competition for reasons other than a lesion.
three training yards (616 horses) in Newmarket (UK) finding a total           A study in event horses training to compete in Concours Com-
of 248 injuries that occurred in 217 horses with fractures of the tibia    plète Internationale (CCI) showed that 21% did not start due to
(20.7%) and proximal phalanx (14.5%) being the most common.                injury: 43% had soft tissue injuries, 33.3% involving the superficial
A post mortem study of the third metacarpal and metatarsal bones           digital flexor tendon and 30.6% involving the suspensory ligament
of 64 TB racehorses reported a 67% prevalence of palmar/plantar            (Singer et al., 2008). Of those competing in the CCI, the most
osteochondral disease (Barr et al., 2009), which is considered to be       common injuries included lacerations and abrasions to the carpus
a consequence of repetitive cyclical high intensive overload result-       and stifle, superficial digital flexor tendonitis and exertional rhab-
ing in arthrosis (Pool, 1996). This painful condition is recognized        domyolysis. These injuries were significantly higher in CCI competi-
in most racing breeds including TB (Arthur et al., 2003; Pilsworth,        tions than at one-day events, most likely due to the increase in
2003), Standardbreds (Mitchell et al., 2003; Torre, 2003), Quarter         demands of athletic performance.
Horses (Lewis, 2003) and Scandinavian Coldblooded trotters                    Scott (2008) performed an extensive literature review summariz-
(Ertola & Houttue, 2003). Overall, the incidence of catastrophic           ing the musculoskeletal injuries in non-racing Quarter Horses
musculoskeletal injury of Thoroughbreds in the USA has been                which included palmar foot pain, osteoarthritis of the proximal
reported as 1.2/1000 race starts (Hernandez et al., 2001). Incidence       interphalangeal joints, pastern fractures, suspensory ligament des-
of injury was significantly higher for turf races (2.3/1000 starts) than   mitis, osteoarthritis of the distal tarsal joints, stifle injuries and back
for dirt races (0.9/1000 starts). The number of days since the last        pain. The review presents the current literature on the diagnosis,
race (≥33 days) was associated with a higher risk of injury.               treatment and rehabilitation strategies including concepts of injury
   A study of 265 Danish Standardbreds evaluated over a 5-month            predisposition and prevention. A retrospective study by Dabareiner
period showed that a change of trainer affected the risk of lameness       et al. (2005a) identified types of musculoskeletal problems associ-
(Vigre et al., 2002). Compared to the period in which horses had           ated with lameness or poor performance in 118 horses used for
been with the same trainer for >3 months, horses that entered a            barrel racing. The forelimbs were more frequently affected than the
different training regime within the past 1.5–2.5 months had a             hind limbs, with forelimb foot pain and osteoarthritis of the distal
higher risk of lameness. Participation in races increased the risk of      tarsal joints being the most common abnormalities. Reasons for
lameness significantly in the 5 days following a race.                     presentation were lameness (61%) or poor performance (39%). The
   In a (USA) study of 357 lameness cases, 78.6% were reported to          most common performance change (41%) was refusal or failure to
have recovered after a median duration of 18 days (Ross et al.,            turn properly around the first barrel. Dabareiner et al. (2005b) also
1999). Some type of treatment was administered in 82.9% of lame-           reported on 118 team roping horses presenting with lameness or
ness incidents. Of 619 total treatments used, 53.2% were adminis-          poor performance. A significantly greater proportion (74/118) of
tered or applied by a veterinarian. Horses experiencing hoof               horses used for ‘heading’ (roping the steer around the horns) pre-
lameness were more likely to recover than those with other types           sented for examination compared to (44/118) horses used for
of lameness. Horses that had participated in exercise-related activi-      ‘heeling’ (roping around the hind limbs of the steer). Most horses
ties during the study period and prior to the development of lame-         examined for poor performance were lame, however, the biome-
ness were more likely to recover. Treatment of the lameness was            chanical loading patterns influenced the type of lameness: ‘headers’
associated with an increased likelihood of recovery. Cases with a          had more right forelimb lameness (35%) compared with ‘heelers’
veterinarian involved in the diagnosis were associated with a              (16%); ‘headers’ had a significantly greater proportion of bilateral
decreased likelihood of recovery and a longer duration of lameness,        forelimb lameness (24%) compared with ‘heelers’ (9%), but
which might indicate that these cases were more complex or severe.         ‘heelers’ had more bilateral hind limb lameness (7%) compared to
Although cases treated for lameness were more likely to recover,           ‘headers’ (0%). The most common musculoskeletal problems for
treatment did not affect lameness duration (Ross et al., 1999).            ‘headers’ were pain limited to the distal sesamoid (navicular) area,
                                                                                                                                                         383
       17      Rehabilitation of the locomotor apparatus
      with or without osteoarthritis of the distal tarsal joints and soft      These percentages were significantly higher than those recorded in
      tissue injury in the forelimb proximal phalangeal (pastern) region.      the same study for a control population of 399 horses, in which
      The most common signs of pain in ‘heelers’ were in the navicular         20% were lame and 12% had back problems. Therefore there is a
      area, osteoarthritis of the metatarsophalangeal joints and osteoar-      strong association between lameness and back problems. Even
      thritis of the distal tarsal joints.                                     subtle hind limb lameness can cause changes in spinal kinematics
         Veterinarians are more often consulted for the more complex           at trot involving increased range of motion and hyperextension in
      lameness cases, with 25% of the cases diagnosed by a veterinarian        the TL spine and reduced range of motion in the lumbosacral region
      being reported to receive alternative therapeutic methods (Knubben       (Gomez Alvarez et al., 2007a).
      et al., 2008). Physiotherapists who work in racehorse training yards        It is widely reported that the TL spine is predisposed to damage
      routinely treat horses’ backs and hindquarters. It has been reported     and/or pain (Wennerstrand et al., 2004). A retrospective study by
      that racehorses presented for PT showing pelvic bony asymmetry,          Jeffcott (1980) reviewed 443 cases of equine back pain. The primary
      muscle atrophy of the hindquarters and/or spasm or tenderness on         pathological lesions associated with TL pain were vertebral lesions
      palpation of the gluteal muscles should alert the physiotherapist to     (38.6%), soft tissue injuries (25%), sacroiliac strain (13%) and
      the possibility of impending pelvic or hind limb fracture (Hesse &       non-TL lesions (13%). Vertebral lesions were predominantly crowd-
      Verheyen, 2010).                                                         ing and over-riding dorsal spinous processes (DSP), which were
                                                                               most common beneath the saddle from T12–T17 and were most
                                                                               prevalent in young adult to middle aged horses used for jumping
      Prevalence of neck and back pain                                         or dressage and in Thoroughbreds (TB) with short backs. Soft tissue
                                                                               lesions were predominantly in the longissimus dorsi muscles and
      Equine back pain is a condition where PT and rehabilitation strate-      supraspinous ligament in the caudal withers and cranial lumbar
      gies are clinically useful and is an area of expanding research inter-   regions. Specific causes of back pain that have now been identified
      est. As discussed in Chapter 10, back problems are associated with       include muscle strain (Jeffcott & Dalin, 1980; Piercy & Weller,
      alterations of gait and performance (cause and/or effect). Improved      2009); ligamentous lesions (Jeffcott, 1980; Henson et al., 2007;
      diagnostic capabilities combined with increased clinical and             Tomlinson et al., 2003); fractures of the TL and/or lumbo-pelvic
      research interest has raised awareness of the importance of equine       complex (Sumner, 1948; Mason, 1971: Jeffcott & Whitwell 1976;
      back pain. Historically, Jeffcott (1980) reported the prevalence of      Vaughan & Mason 1976; Haussler & Stover, 1998; Driver & Pils-
      equine back pain to be 0.9% in general veterinary practice, 2% in        worth, 2009); vertebral body osteophytes and spondylosis (Geres,
      TB racehorse practice, 5% in a veterinary school referral practice,      1978; Jeffcott, 1980; Haussler et al., 1999b; Meehan et al., 2009);
      13% in a mixed equine practice (dressage, show jumpers, eventing),       osteoarthritis and ankylosis of the inter-transverse and or lateral
      and 47% in a spinal research clinic. These figures can be compared       inter-transverse joints (Mitchell, 1933; Stecher & Goss, 1961;
      with a reported rate of 94% at an equine chiropractic clinic             Smythe, 1962; Haussler et al., 1999b); impingement of the DSPs
      (Haussler, 1999a, 2000). Racehorse trainers in Sydney, Australia         (Roberts, 1968; Jeffcott & Hickman, 1975; von Salis & Huskamp,
      reported back problems to be in the top quartile ranked conditions       1978; Walmsley et al., 2002; Cousty et al., 2010); sacroiliac disease
      (Bailey et al., 1997), and one of the most common injuries prevent-      (Rooney, 1977; Jeffcott, 1980; Jeffcott et al., 1985; Haussler et al.,
      ing training and racing. In a survey of registered dressage horse        1999b; Goff et al., 2008); degenerative intervertebral disc disease
      owners in the UK, 25% (644/2554) of the respondents indicated            (Hansen, 1959; Rooney, 1970; Taylor et al., 1977; Townsend et al.,
      that their horse had a ‘back problem’ (Murray et al., 2010), though      1986; Denoix, 2007); and osteoarthritis of the synovial interverte-
      the majority (80%) had not been diagnosed by a veterinary surgeon.       bral articulations (facet joints) (Jeffcott, 1980; Haussler et al.,
      Of those that sought treatment (447/644) complementary therapy           1999b; Girodroux et al., 2009; Cousty et al., 2010; Stubbs et al.,
      was the most common (63%) followed by saddle fit (24%); veteri-          2010). Historically, the most widely documented osseous lesion is
      nary involvement (20%); rest (20%); a change in training (13%);          impingement or over-riding of the DSPs (Jeffcott, 1980; Walmsley
      and other (6%) (Murray et al., 2010). From the 25% of horses             et al., 2002; Erichsen et al., 2004; Cousty et al., 2010). More recently,
      thought to have back pain, 2.5% received veterinary care alone and       osteoarthritis of the facet joints has been identified as a source of
      3% received a combination of veterinary care and complimentary           pain and dysfunction (Denoix & Dyson, 2003; Girodroux et al.,
      therapy, highlighting the need for a team approach to treatment and      2009; Stubbs et al., 2010). Nuclear scintigraphy showed moderate
      owner education. Interestingly horses reported to have a ‘previous       to intense increased radiopharmaceutical uptake in the facet joints
      back problem’ that was resolved by complimentary therapy or rest         of horses with pain in the region from T13–L1 compared with clini-
      were more likely to have been lame in the last year. Historically        cally normal horses (Gillen et al., 2009). However, only 61.5% of
      Jeffcott (1979) reported that in 190 horses treated for chronic back     67 horses with back pain associated with radiographic evidence of
      problems 57% recovered completely, 17% showed no improvement             osteoarthritis had increased radiopharmaceutical uptake in one or
      and 38% had a recurrence or continuation of signs of low-grade           more facet joints, highlighting the inherent difficulties, even with
      back pain. This highlights the need for research into rehabilitation     advanced technology, in localizing the cause of back pain and loss
      strategies and long-term management of chronic and recurrent back        of function.
      pain in horses.                                                             Haussler et al. (1999b) highlighted the potential under-diagnosis
         Equine back pain often presents with more than one lesion or          of TL vertebral or pelvic lesions in a post mortem study of 36 TB
      problem area including limb lameness. Osseous lesions of the tho-        racehorses that were euthanized for reasons unrelated to back pain.
      racolumbar (TL) spine and the lumbopelvic complex are widely             An alarming rate of osseous lesions was reported in the caudal
      recognized as significant causes of equine back pain, poor perfor-       thoracic and lumbar regions. Degenerative changes were observed
      mance, loss of performance, and altered back and limb kinematics         at lumbar intertransverse joints and sacroiliac articulations in all
      (Jeffcott, 1975, 1980; Townsend et al., 1986; Denoix, 2005, 2007;        specimens, with variable degrees of degenerative changes of the TL
      Wennerstrand et al., 2004; Cousty et al., 2010; van Weeren et al.,       articular processes in 97% of specimens. Impingement of the DSPs
      2010). Such lesions may arise as primary injuries to the vertebral       (92%) and transverse processes (97%) was very prevalent, with
      column and related structures, or secondary to other musculoskel-        many specimens having widespread and severe osseous changes
      etal injuries (Landman et al., 2004; Meehan et al., 2009; Girodroux      including stress fractures of the facet joints. The relationship
      et al., 2009). In a population of 805 horses (70% dressage, 20%          between the changes observed at necropsy examination and the
      show jumpers, 10% trotters) with orthopedic problems, 74% that           presence of pain or loss of function could not be established. Stubbs
      were presented with a back problem were lame and 32% of those            et al. (2010) reported osseous pathologies in a group of 22 TB
      presented for lameness had a back problem (Landman et al., 2004).        racehorses euthanized at the Hong Kong Jockey Club for reasons
384
                                                                                                                                           General introduction
unrelated to back pain. Osseous lesions were graded as mild, mod-                   ligament injuries, muscle pain, wither injuries, polysaccharide
erate or severe at vertebral levels from T9–Ca1 in a non-cumulative                 storage myopathy (PSSM) and saddle fit problems. Sixteen horses
fashion. All horses exhibited lesions of moderate severity and 77%                  also had limb lameness. The treatment protocol included adminis-
had evidence of severe (grade 3) osseous pathology at various sites                 tration of systemic anti-inflammatories and/or a local anti-
in the TL spine and pelvis (Fig. 17.1).                                             inflammatory injection and a variable combination of acupuncture,
   Turner (2003) evaluated 5352 medical records from 1997 to 2002                   chiropractic techniques, massage therapy, electro-stimulation, mag-
at a veterinary teaching hospital and found the occurrence of true                  netic therapy, therapeutic ultrasound, extracorporeal shockwave
back problems to be 2.2% in the lameness caseload of mixed breeds                   and training (exercise) management. Follow-up information was
and sporting disciplines. One hundred and twenty-four horses pre-                   available on 112 horses with 90% returning to work; however, 15
sented with the complaint of back pain with the diagnosis con-                      of those horses did not return to their previous level and were
firmed in 102 (82%) cases. An additional 16 horses that were                        retired or used for other activities. Of the 86 horses that returned
presented for other problems were diagnosed with back problems.                     to their previous level of work, 60% did not need further therapy
The most prevalent lesions involved the sacroiliac area (66). Other                 but the remaining 40% continued to receive some form of therapy.
problems included kissing spinous processes, dorsal spinous                         The need for therapy was based on the owner’s and trainer’s
A B
Fig 17.1  Severe osseous lesions and asymmetry in the lumbosacral/pelvic region in a Thoroughbred racehorse. (A) Sacral transitional that is ankylosed to
the pelvis on the right side of the specimen (left side of photo). The biomechanical effects of unilateral ankylosis on the lumbosacral and sacroiliac
biomechanics likely contributed to (B) a fracture with some displacement on the opposing sacral facet, lamina and articular pillar. (C) Severe sacroiliac
degenerative joint disease, including marked new bone formation on the ventral ilial surface and bilateral fracture lines, and (D) an intra-articular facet joint
fracture.
                                                                                                                                                                    385
       17      Rehabilitation of the locomotor apparatus
      impression of the horse’s behavior. The rate of successful return to       pathology in horses with back pain but may also be due to pathol-
      previous level of work is much higher than reported by Jeffcott            ogy of the muscles themselves or to a generalized muscular disorder
      (1979), which may reflect advancements in veterinary diagnostics,          (Valberg, 1999; Quiroz-Rothe et al., 2002). It is suggested that this
      medical management and the implementation of complementary                 is due to altered motor control as a result of the underlying lesion
      therapies as part of the rehabilitation strategy.                          in the spine and/or due to peripheral joint disease with pain and
         There is a smaller body of literature describing the equine cervical    inflammation which causes reflex inhibition of motor neurons
      spine, neck pain and pathology. Studies of cervical osseous patholo-       resulting in weakness and atrophy of associated muscles (Young,
      gies have focused mainly on cervical vertebral compressive myelop-         1993). Local muscle damage attributed to a poorly fitting saddle,
      athy (van Biervliet et al., 2006; Levine et al., 2007). Arthropathy of     for example, can also cause atrophy of the epaxial muscles (Gellman,
      the cervical facet joints has been cited in the aetiology of reduced       1998; Harman, 1999). Figure 17.2 visually shows three examples
      performance in the horse and has been reported to cause forelimb           of asymmetrical hindquarter muscle development, or relative. The
      lameness (Ricardi & Dyson, 1993), stiffness in movement, neck              authors suggest objectively measuring muscle size using ultrasonog-
      muscle atrophy, and neck pain (Beck et al., 2002; Dyson, 2003). A          raphy, which may be a reliable tool for comparative measures across
      recent examination of six cadaveric necks by Claridge et al. (2010)        time and during the rehabilitation process. Research is currently
      developed a three-dimensional model of the cervical facet joints           underway using this modality in the horse. Jeffcott (1980) surveyed
      based on radiographs and computed tomography (CT) images and               443 cases referred with TL disorders finding that 23.37% had evi-
      used the model to determine that effusion within the articular facet       dence of epaxial muscle pain. Stubbs et al. (2010) reported that
      joints of the cervical spine is unlikely to cause compression of the       there was a relationship between muscle function and pathology
      spinal cord, which is known to be associated with neurological             via ultrasonographic and necropsy analysis where significant
      manifestations (Ricardi & Dyson, 1993).                                    atrophy of the multifidus muscles was evident at the level and site/
         In vitro kinematic studies of the cervical spine have demonstrated      side of TL lesions in 22 racehorses.
      that dorsoventral flexion and extension, axial rotation and lateral           Valentine (2008) investigated the pathological findings in equine
      bending take place at each of the intervertebral joints with the           muscle (excluding PSSM) in 229 equids (217 horses and eight
      largest ranges of motion in the upper (occiput to C2) and lower            ponies of multiple breeds, three donkeys and one mule) over a 2.5-
      (C5–T1) joints (Clayton & Townsend, 1989a). There is a general             year period through necropsy and histopathology. Muscle lesions
      reduction in overall cervical spinal mobility from foal to adulthood       were present in 65% with the most common findings being chronic
      (Clayton & Townsend, 1989b). In vivo kinematics of the cervical            myopathic changes (15%), generalized muscle atrophy (13%),
      spine have confirmed that most of the flexion–extension occurs at          denervation atrophy (6%), and other lesions and pathologies that
      the poll and the base of the neck when the horse voluntarily per-          occurred less frequently (<5%) including myonecrosis, bone frac-
      forms dynamic mobilization exercises to end range of motion in             tures, bacterial infections, muscle rupture, selenium deficiency, exer-
      cervical flexion (Clayton et al., 2010a) or in cervical lateral bending    tional rhabdomyolysis, intramuscular protozoa, neoplasia, injection
      (Clayton, et al., 2012).                                                   site reactions, lymphocytic infiltrates, ring fibers, fiber splitting, and
         There have been few published anatomical descriptions of the            fat infiltrations. The aetiology was undetermined in 4% of cases.
      facet joints in the equine cervical spine, particularly with reference     Hunt et al. (2008) performed an epidemiological study of myopa-
      to the prevalence, clinical signs and pathological features of degen-      thies in Warmblood horses in which the most common was PSSM
      erative changes. Ultrasonographic imaging of the equine cervical           (72/132 horses), followed by RER (7/132), neurogenic or myogenic
      region provided a reference for normal appearance of cervical ver-         atrophy (7/132) and non-specific myopathic changes (14/132).
      tebrae, facet joints, and paravertebral structures in eight horses of      Thirty-two biopsies were normal. Recently there have been signifi-
      unspecified breed, between the ages of 2 and 14 years (Berg et al.,        cant advances in understanding the etiopathogenesis underlying
      2003). A retrospective study of radiographic images of 122 horses          these disorders including recognizing the similarities between
      concluded that the size of the caudal cervical facet joint at the level    human and equine muscle diseases (Piercy & Rivero, 2004). Myopa-
      of C5–C6 increases with age but it is not known whether there is           thies often present as gait abnormalities or overt RER, with slow
      an association between such changes and clinical symptoms or               improvements in clinical signs through dietary management and a
      performance (Down & Henson, 2009). Claridge et al. (2010)                  regulated exercise routine as part of their rehabilitation (Hunt et al.,
      described normal anatomical shape, spatial orientation and joint           2008).
      volume for the cervical facet joints in six subjects.
         Little is known about cervical intervertebral disc disease in horses.
      The only study of the gross anatomy of the discs (Bullwein &
      Hannichen, 1989) involved evaluations of midline sections the
                                                                                 Patho-anatomical diagnosis
      cervical vertebrae without preparing histological sections. The
      authors saw no evidence of an annulus fibrosus or a nucleus pulpo-         Accurate patho-anatomical diagnosis of back pain is clinically chal-
      sus and some discs showed disintegration of the tissue fibers.             lenging. It requires a lengthy clinical examination and multiple
      Cervical disc disease has been reported in horses, but is likely under-    diagnostic procedures including radiography, ultrasonography,
      reported since it poses a diagnostic challenge that may be solved by       scintigraphy, local analgesia, kinematics and EMG imaging in
      modern imaging equipment. Information on disc structure and                the attempt to reach a diagnosis and increase the knowledge about
      common pathological changes will facilitate the interpretation of          the possible causes (Jeffcott, 1980; Steckel, 1992; Weaver et al.,
      images of the discs. The joints in the mid neck (C3–C4, C4–C5 and          1999; Denoix & Dyson, 2003; Peham et al., 2001; Peham &
      C5–C6) undergo considerably less motion in vivo even when the              Schobesberger, 2006; Roethlisberger Holm et al., 2006; Gillen
      neck is fully flexed or extended (Clayton et al., 2010a). It seems         et al., 2009; Girodroux et al., 2009; Meehan et al., 2009; Fuglbjerg
      likely, therefore, that the equine cervical intervertebral discs will      et al., 2010). Further, as previously stated, many horses have multiple
      vary in thickness. Future CT imaging studies may provide informa-          osseous lesions that can be detected along the length of the verte-
      tion about the size and structure of the discs that cannot be obtained     bral column (Meehan et al., 2009; Girodroux et al., 2009; Gillen
      from standard radiographic or ultrasonographic imaging.                    et al., 2009; Cousty et al., 2010; Stubbs et al., 2010). Post mortem
         As discussed in Chapter 13, disorders and lesions affecting skel-       studies have confirmed the presence of multiple types of osseous
      etal muscle and peripheral nerves are common in horses and                 lesions at multiple sites; unfortunately these horses were unable to
      adversely affect athletic ability (Cardinet & Holliday, 1979; Free-        be examined ante-mortem to determine the relationship between
      stone & Carlson, 1991; Martin et al., 2000; Gregory, 2004). Fre-           the grades of lesions and pain and function (Townsend et al., 1986;
      quently, muscular dysfunctions are secondary to underlying bone            Haussler & Stover, 1998; Haussler et al., 1999b). Thus it is
386
                                                                                                                                 Patho-anatomical diagnosis
A B C
Fig 17.2  Three horses with asymmetrical hindquarter muscle development or relative atrophy on one side. (A) Right hemipelvis has markedly reduced
muscle mass compared with the left, particularly biceps femoris and gluteus medius, secondary to degenerative joint disease of the right tarsus. (B) Right
hemipelvis muscle mass moderately reduced compared to left in a successful international eventer with a history of limb lesions and degenerative
pathology. (C) Gross generalized disuse and secondary muscle atrophy affecting primarily the left hind limb following luxation of the superficial digital flexor
tendon off the calcaneus. The lines on the photographs facilitate a more objective assessment of asymmetry.
still difficult to determine the relationship between clinical signs,             summary, the clinical signs often are unclear, so it is important to
diagnostic findings (the grade/severity of the lesions) and level of              exclude other problems in order to arrive at a diagnosis of back
pain, as this is very variable between individual performances and                pain. Microtrauma from chronic overuse because of poor saddle
horses (Haussler et al., 1999b; Meehan et al., 2009). The clinical                and tack fit (Harman, 1999), sub-optimal riding technique or an
signs associated with a variety of osseous lesions of the vertebral               inappropriate training schedule can all predispose horses to back
column and pelvis are poorly described, often non-specific and                    pain (Haussler, 2000).
difficult to validate objectively, with a decrease in performance                    Objective assessment of musculoskeletal pain in horses is chal-
being the main complaint of the rider/owner. Clinical diagnosis is                lenging (Casey, 2002). Local tenderness is the major manifestation
further complicated by the fact that horses vary in their response to             of most, if not all, musculoskeletal pain (Vanderweeën et al., 1996).
pain and it is believed that temperament also plays a role (Jeffcott,             Tenderness in the axial skeleton has traditionally been assessed by
1999).                                                                            manual palpation, although the interpretation of its outcome is
                                                                                  highly subjective (Haussler et al., 2007). Nonetheless, palpation
                                                                                  plays an important role in the clinical examination of cases with
                                                                                  suspected neck and back muscle sensitivity. Therefore, both equine
Functional assessment                                                             veterinarians and physiotherapists have included palpation in their
Clinical signs of back pain in horses include both behavioral and                 physical examination protocol (Ranner et al., 2002; Denoix & Pail-
physical signs including altered sensitivity to palpation, which may              loux, 2005; Cauvin, 1997). This is obviously particularly important
be described as decreased mechanical nociceptive threshold (MNT);                 for clinical decision-making and evaluation of therapeutic interven-
sinking when placing the saddle on the horse, when securing the                   tion (Ashley et al., 2005). Pathological findings of the vertebral
girth (‘girthiness’) or when the rider mounts (‘cold back’); resistance           column identified on radiographs often do not correlate with the
in work, for example, not wanting to trot, canter or rein back, refus-            clinical findings (Gundel et al., 1997; Ranner et al., 2002). Thus,
ing to jump or tail swishing; and/or lameness of one or more limbs                Ranner et al. (2002) concluded that palpation remains one of the
without a cause or possible diagnosis (Martin & Klide, 1997;                      most important clinical examination methods to determine whether
Haussler et al., 2006; Mills et al., 2007). Horses may express pain               or not a horse is suffering from neck and back muscle sensitivity or
by fleeing or evasion; adopting an abnormal stance, gait or speed;                pain. Pain in the TL region of a horse is very complex as it can
vocalizing or showing signs of aggression during movement or                      originate from various pain receptor structures. Afferent nerve
manipulation; restlessness; swishing the tail; and muscle tension                 endings are found in various types of connective tissue including
and tremors (Gregory, 2004; Mills et al., 2007). When back pain                   fascia around muscle bundles, muscle spindles, joint capsules,
becomes chronic, muscular atrophy of the back can become visible                  tendons and ligaments, blood vessel walls and bone. Some of these
(Fig. 17.2). Chronic pain, unlike acute pain, can be present without              receptors are nociceptors (pain receptors) and respond to noxious
inflammation or noticeable tissue damage. Horses with chronic                     stimuli, including mechanical, thermal or chemical stimulation.
pain can be aggressive or evasive when they cannot react in their                 Muscle pain may range from very intense sharp localized pain in
natural way by fleeing. This is why owners and/or riders sometimes                the acute setting (for example, a muscle tear), to chronic muscle
believe their horse has a behavioral problem, as they are not able                pain, which may be dull and diffuse. Referred pain from abdominal
to identify the underlying painful process (Ridgway et al., 2005). In             or thoracic organs can project onto different parts of the body
                                                                                                                                                                   387
       17      Rehabilitation of the locomotor apparatus
      including the back (Gregory, 2004). Although very difficult to quan-      to assess tissue irritability, gross and intersegmental movement
      tify in the horse neurogenic and or referred pain may also be present     evaluation, and specific provocation tests of the vertebral column,
      which is well documented in the human literature. Macgregor and           osseous structures and pelvic soft tissue. Additional techniques
      von Schweinitz (2006) identified equine myofascial trigger points         include radiography, ultrasonography, CT, magnetic resonance
      with similar objective signs and electrophysiological properties to       imaging (MRI), EMG, scintigraphy and kinematic analysis.
      those documented in human and rabbit skeletal muscle tissue.
      Unfortunately, referred pain patterns and reproduction of the pain
      profile cannot be determined in animals. Comparative pain charac-         Kinematics
      teristics between muscular and ligamentous saline injections have
                                                                                Kinematic measurements describe stride and step timing, stride and
      been investigated, as these methods are commonly used to induce
                                                                                step lengths, and intervertebral joint motion and the symmetry in
      human and animal back pain (Tsao et al., 2010). Interspinous liga-
                                                                                different gaits. It is a useful tool in evaluating the effectiveness of
      ment injections produced pain of greater intensity and duration
                                                                                therapeutic interventions like chiropractic manipulation (Faber
      compared to injecting the paraspinal muscles in the normal human
                                                                                et al., 2003, Gomez Alvarez et al., 2008; Haussler et al., 2010).
      lumbar spine. Interestingly muscle pain was reduced with contract-
                                                                                Johnston et al. (2004) performed a kinematic evaluation of the
      ing and stretching the injected muscle, but this did not affect the
                                                                                back in horses without a history of back problems in order to
      pain produced from the ligament injection. The authors were also
                                                                                develop a database on kinematics. Older horses were shown to have
      surprised that many of the subjects (n = 10) pointed to a region of
                                                                                decreased flexion and extension of the TL junction in trot. Kine-
      pain 1–2 segments away from the injection site (Tsao et al., 2010).
                                                                                matic analysis can be a useful tool to identify horses with back pain
         Pain works as a protective mechanism to prevent further tissue
                                                                                because the movement pattern of the back changes so that dorso-
      damage and to allow healing of wounds and damaged tissue. Pain
                                                                                ventral flexion and extension at T13 and T17 at walk and at T17
      cannot be objectively measured, because it has no units. Changes
                                                                                and L1 at trot are significantly reduced compared to horses without
      in heart rate, blood pressure, plasma cortisol and behavior can be
                                                                                back pain but there is no difference in lateral bending between
      helpful to identify and study pain (Ashley et al., 2005; Robertson,
                                                                                horses with and without back pain. During walk, horses with back
      2006). Examples of ways to subdivide pain are acute versus chronic,
                                                                                pain have a decreased axial rotation of the pelvis. Decreased
      somatic versus visceral and physiological versus pathological, which
                                                                                back motion can also be present due to pathological conditions
      occurs when the tissue is damaged and responds with inflammation
                                                                                (Wennerstrand et al., 2004; Gomez Alvarez et al., 2007a, b), with
      (Robertson, 2002). In mammals, inflammation is the greatest
                                                                                the most significant differences being visible in walk rather than
      source of pain (Gregory, 2004). During inflammation, the nerve
                                                                                trot. This is likely due to the fact that the trot inherently has less
      endings that respond to noxious stimuli such as heat, pressure and
                                                                                intervertebral motion than the walk. However, these studies were
      chemical stimuli become sensitized. When normal, non-painful
                                                                                performed only on a treadmill and further investigation is war-
      stimuli are applied to sensitized tissue, the patient experiences a
                                                                                ranted on a circle, on varying gradients and under saddle in a larger
      painful sensation. In the human this is commonly referred to as
                                                                                number of subjects with different types of back pain/pathology.
      ‘allodynia’ (Woolf & Mannion, 1999). Bussières et al. (2008) estab-
      lished the value of behavioral and physiological criteria by develop-
      ing and validating a composite multifactorial pain scale (CPS) in         EMG
      an experimental equine model of acute orthopedic pain. Eighteen
      horses were allocated to control and experimental groups that             The ‘normal’ movement of the horse’s back has been investigated
      received Amphotericin-B injection to induce pain in the tarsocrural       via EMG in conjunction with comparisons of locomotor kinematics
      joint and various forms of analgesia. Inter- and intra-observer repro-    and kinetics. Many factors contribute to locomotion including the
      ducibility was good (0.8 < K < 1), with the key specific and sensitive    muscular system (longissimus dorsi, iliocostalis, semitendinosus, biceps
      behavioral indices being palpation of the painful area and the            femoris, and gluteus medius), acceleration from the hind legs, gravity
      horse’s posture. Other less valuable signs were pawing the floor,         and the influence of the rider (Licka et al., 2004, 2009; Peham &
      kicking the abdomen and head movement. There was a statistical            Schobesberger 2006; Wakeling et al., 2007; Zaneb et al., 2009).
      correlation between the CPS and both non-invasive blood pressure          Gluteus medius is considered an epaxial muscle as it covers the
      (p < 0.0001) and blood cortisol (p < 0.002). Van Loon et al. (2010)       majority of the dorsal lumbar spine, with attachments onto the
      recently investigated the reliability and clinical applicability of       thoracolumbar fascia and iliocostalis ventrally. The anatomical
      applying a CPS to objectively monitor somatic and visceral pain           epaxial musculature of the lumbar spine is displayed in Figure 17.3.
      under hospital conditions in 94 horses (control, acute and chronic           EMG is becoming a widely accepted tool for the examination of
      surgical and non-surgical groups). CPS showed low baseline values         muscle function in horses (Robert et al., 2000; Wakeling et al.,
      in healthy animals with non-painful conditions and these were not         2007; Zsoldos et al., 2010; Groesel et al., 2010). The longissimus dorsi
      affected when general anesthesia was the only intervention. Inter-        is medially located directly overlying multifidus (Stubbs et al., 2006).
      observer reliability was very high (n = 23 horses; weighted kappa         It runs from the transverse processes of the thoracic and lumbar
      correlation coefficient, κ = 0.81). Horses with painful conditions        vertebrae and the dorsal extremity of the ribs to the tuber sacralae
      responding well to analgesic treatment could be discriminated from        and the ventro-medial aspect of the iliac crest (Haussler, 1999a;
      horses that had to be euthanized on humane grounds because of             Stubbs et al., 2006). The longissimus dorsi muscle contributes to sup-
      painful non-responsive conditions. It was concluded that the CPS          porting the weight of the rider and saddle against dynamic forces
      is a promising tool to potentially provide a basis for direct day-to-     (Licka et al., 2004). Bilateral contraction of the epaxial muscles
      day assessment of pain status in equine patients with various             produces extension of the spine and unilateral contraction produces
      painful conditions in the future. The CPS may be a useful subjective      lateral flexion and rotation (Haussler, 1999a; Denoix & Pailloux,
      tool as an adjunct to other subjective/objective measurements             2005; Peham et al., 2001). At the walk, the back moves passively
      during the rehabilitation process.                                        but at the trot, the back muscles are active to control back move-
                                                                                ments (Robert et al., 2001). Walk and trot are symmetrical gaits, and
                                                                                the movement of the back in these gaits is highly symmetrical (Jef-
                                                                                fcott, 1979). Wakeling et al. (2007) found segmental variation in
      Objective measurements                                                    the activity and function of longissimus during walk and trot. Zaneb
      For evaluation of back function there are various diagnostic possi-       et al. (2009) investigated the quantitative differences of back
      bilities. Firstly, a thorough clinical evaluation is important, includ-   and pelvic muscles during walk and trot between chronically lame
      ing a complete lameness examination, general and specific palpation       and non-lame horses using surface EMG (SEMG). For each muscle
388
                                                                                                                                   Patho-anatomical diagnosis
B C
Fig 17.3  Lateral view of the dorsal thoracolumbar spine and pelvis. (A) Dissection of the caudal thoracic, lumbar and sacral outline of the middle gluteal
muscle, which has been removed. Note that this muscle covers a large area of the lumbar region and attaches cranially at the level of the last rib which can
be seen ventrally. Underneath the middle gluteal lies the thoracolumbar fascia (TLF), longissimus dorsi, and the more lateral iliocostalis. The dorsal and lateral
parts of the dorsal sacroiliac ligament (DSIL) are labeled. Underneath the lateral DSIL are sacrocaudalis dorsalis medialis and lateralis, the latter having
attachments to the caudal lumbar dorsal spinous processes. (B) Part of longissimus dorsi and iliocostalis have been removed to reveal the underlying
multifidus, which has multiple fascicles originating from each spinous process that run caudally spanning 1–5 more caudal vertebrae. (C) Cross-sectional
image at the level of the 13th thoracic vertebra showing the structure and location of multifidus (M) and longissimus dorsi (L) muscles. Note the fibrous
content of multifidus.
(longissimus dorsi, semitendinosus, biceps femoris, gluteus medius, exten-          trotting on a treadmill is at T12 (Peham et al., 2001; Licka et al.,
sor digitorum longus) kinematics and SEMG data were recorded syn-                   2004).
chronously at walk and trot on a treadmill; mean, maximum, and                         It is only through needle/fine wire EMG that the electrical activity
minimum muscle activities and maximum-to-mean and minimum-                          of the motor unit can be evaluated. In this way a possible pathologi-
to-mean activity ratios were calculated. For each horse (lame or                    cal process can be detected and the difference between neurogenic
non-lame) pelvic limb data were averaged; in lame horses, data were                 and myogenic disorders can be made (Wijnberg et al., 2002). The
also examined separately (NL–L and L–L values, respectively). Com-                  advantages of SEMG compared to needle EMG are that it is less
parisons were made between gaits. At walk the NL–L maximum-to-                      invasive and that measurements during movement are possible
mean ratios for biceps femoris and gluteus medius muscles were                      (Franssen, 1995). However, the clinical relevance of SEMG is still
significantly greater, and in lame horses, L–L and NL–L minimum-                    limited because of the great variation in measurement outcomes
to-mean ratios for semitendinosus, biceps femoris, gluteus medius, and              (Licka et al., 2004). In pathological conditions, muscle tension
longissimus dorsi muscles were significantly less in NL horses. At trot             changes the relation of the minimal and maximal EMG activity
minimum-to-mean ratios for semitendinosus, gluteus medius and lon-                  independent of muscle mass, the conduction of the skin, the exact
gissimus dorsi muscles in lame horses were significantly lower than                 location of the electrodes, the EMG measuring device or its configu-
those for NL horses. Activity of extensor digitorum longus muscle was               ration (Licka et al., 2004), as well as the presence of the cutaneous
not affected by lameness. In chronically lame horses, back and                      trunci muscle directly attaching to the skin in the shoulder and tho-
pelvic limb muscle activities were affected differently during walking              racolumbar and abdominal regions. In people, back pain can be
and trotting. SEMG has confirmed that motor control is altered in                   induced, by injecting hypertonic saline into the back muscles with
the lame horse, whereby the compensation strategy is an increase                    recordings showing an increase in mean EMG signal compared to a
in muscle activity in the NL limb which may have major implica-                     control group. However there was no correlation between degree of
tions in the assessment and treatment of horses, especially those                   pain and changes in the EMG signal (Arendt-Nielsen et al., 1995).
with chronic lameness and adaptive motor control patterns and/or                       In the horse manual therapy has been proven to significantly
secondary muscle atrophy.                                                           alter/decrease muscle tone and total muscle activity measured by
   By combining kinematics and EMG, the relationship between the                    EMG (Wakeling et al., 2006), though the direct mechanism has yet
muscle activity and back movement can be determined (Peham &                        to be established. In contrast, EMG measurements following acu-
Schobesberger, 2006). The maximal EMG activity of the back pre-                     puncture in healthy humans, showed no difference in muscle activ-
cedes the maximal vertical movement. It is theorized that at the end                ity (Tough et al., 2006), although whether motor control may be
of stance and during the suspension phases of every stride cycle, the               altered by therapeutic intervention is debatable. A decrease in left-
longissimus dorsi muscle provides lumbosacral extension and pro-                    right asymmetry of the EMG signal was found after applying acu-
vides the propulsion force for the hind leg (Denoix & Pailloux,                     puncture to the paraspinal muscles in the human back (Tanaka
2005). The highest muscle activity of longissimus dorsi both during                 et al., 1998). Further research, particularly using fine wire EMG with
passive flexion and extension of the back in stance and during                      respect to rehabilitation techniques is definitely warranted.
                                                                                                                                                                     389
       17      Rehabilitation of the locomotor apparatus
      Pressure algometry                                                        There is still much debate amongst human and equine researchers
                                                                                with respect to whether this technique requires further validation
      Pressure algometry (PA) is a subjective and potentially objective         utilizing other objective measures such as EMG. The human litera-
      diagnostic tool used in both human and equine research to assist          ture still classes PA as a subjective tool that should be combined
      in quantifying musculoskeletal pain relative to the tissues response      with other pain scale measurements, such as the visual analogue
      (irritability) to mechanical pressure, whereby the mechanical noci-       scale, for clinical and experimental purposes (Ylinen, 2007; Ylinen
      ceptive threshold is determined (MNT). It is used in research and         et al., 2007).
      clinical practice to evaluate treatment results in humans and horses         Pressure algometry is a relatively new tool in equine medicine.
      (Fischer, 1998; Pöntinen, 1998; Haussler & Erb, 2003). Pressure is        Benefits include the non-invasive character of the method and the
      applied via the algometer probe with the investigator subjectively        ease of use in horses (Haussler & Erb, 2003). Regional median MNT
      noting the tissue response (e.g. muscle fasciculation or spasms and/      values were 9 kg/cm2 in the cervical area, 12 kg/cm2 in the thoracic
      or behavioral avoidance reactions). The MNT is expressed in kg/cm2        area, 13 kg/cm2 in the lumbar area and 16 kg/cm2 in the pelvic area
      (Fig. 17.4). Pressure algometry has proved to be repeatable in            (Haussler & Erb, 2006a). MNT values were higher in non-TB horses,
      humans and horses (Pöntinen, 1998; Ylinen 2007; Ohrbach & Gale,           thus emphasizing the need to collect MNT values for horses of dif-
      1989a; Fischer, 1987; Varcoe-Cocks et al., 2006; Love et al., 2011),      ferent breeds and performance levels.
      but its reliability depends on the device itself as well as the experi-      When using PA, the pressure should be increased gradually at a
      ence and technique of the examiner (Pöntinen, 1998; Nussbaum &            constant rate and should stop when the horse shows a behavioral
      Downes, 1998; Ohrbach & Gale, 1989a; Antonaci et al., 1998).              and/or tissue reaction that may reflect pain (Varcoe-Cocks et al.,
                                                                                Fig 17.4  Two types of pressure algometers used in research. (A) FPK 60
                                                                                pressure algometer. Note the position of the device in the hand of the
                                                                                operator and the rubber tip. The dial indicates pressure applied to the skin
                                                                                in kg/cm2. (B) COMMANDER™ algometer. Pressure applied to the tip of the
                                                                                algometer is registered digitally on the unit worn on the operator’s arm.
                                                                                With this unit, the digital readings can be stored and downloaded without
                                                                                revealing the values to the examiner.
                                                                                (A) Reprinted from De Heus, P., Van Oossanen, G., Machteld, C. et al., 2010, A pressure
                                                                                algometer is a useful tool to objectively monitor the effect of diagnostic palpation by a
                                                                                physiotherapist in warmblood horses, Journal of Equine Veterinary Science 30 (6), 310–321,
                                                                                with permission from Elsevier (B) Courtesy of JTECH Medical, Salt Lake City, Utah, USA.
390
                                                                                                                      Patho-anatomical diagnosis
2006; De Heus et al., 2010; Love et al., 2011). This can be a twitching     physiotherapists. This study tested inter-examiner repeatability of
of the skin, ear movement, sinking, stepping aside, kicking or biting.      animal physiotherapists and tried to correlate subjective clinical
The maximal applied pressure until a pain reaction occurs is                scores of neck and back function in horses. Owners frequently
recorded as the MNT for that site. When performed by an experi-             believe that their horse has improved after the physiotherapist made
enced investigator, PA may be a reliable and repeatable tool that           a diagnosis, even though the actual treatment had not yet started.
correlates significantly with palpation score in horses. It may con-        Therefore, it was hypothesized that PT diagnostic intervention in
tribute to a clinical examination of the back and may be a useful           itself could have a therapeutic, objectively measurable effect that
adjunct subjective tool for evaluation of the effectiveness of thera-       would increase the MNT of horses evaluated physiotherapeutically
peutic or analgesic interventions (Varcoe-Cocks et al., 2006;               compared to the control group. Therapeutic effects were especially
Haussler, 2006; Sullivan et al., 2008; De Heus et al., 2010). However,      expected from stiffness testing, since this is also a spinal manipula-
horses have been shown to develop a learned response in which               tive technique used as therapy by physiotherapists and there is some
they respond to a stimulus in anticipation of it becoming aversive.         evidence that manipulative therapy is effective in horses (Haussler
Regular sham testing may avoid this problem (Kamerling et al.,              et al., 2007; Haussler et al., 2010). The effects of three consecutive
1985).                                                                      diagnostic palpation examinations within 1 day on MNTs were
   In humans, bruising was observed in some subjects after a 3-day          measured, with three physiotherapists examining and grading the
PA study with a total of 18 measurements on one location (3 days,           same horses, which made it possible to evaluate agreement between
three trials/day by two examiners) (Nussbaum & Downes, 1998).               physiotherapists.
In horses, bruising after repeated measurements has not yet been               De Heus et al. (2010) studied six clinically sound Dutch Warm-
reported (Haussler & Erb, 2006a), but local bruising can be difficult       bloods. Since they were riding school horses, they were expected to
to differentiate since dark skin coloration masks the presence of a         have some neck or back pain that could lower the MNT and alter
hematoma. Different pain scales are commonly used in humans                 other palpation criteria, even though they did not have a current
including visual analog scales to assess pain intensity, which can          history of lameness or therapy. Horses were randomly assigned to
also be transferred to horses: the numeric rating scale (NRS) and           an experimental (n = 3) or control (n = 3) group. The experimental
the simple descriptive scale (SDS) (Holton et al., 1998; Williamson         group received diagnostic PT intervention between morning and
& Hoggart, 2005). For the NRS, the patient picks the number that            evening PA measurements, the control group received only the two
best represents his or her pain. The SDS is usually a four-point scale      PA measurement sessions.
with numbers attached to descriptive terms, such as 0 (no pain) to             A non-electrical PA (FPK 60 Wagner Instruments Inc., Post Office
3 (severe pain) (Holton et al., 1998; Williamson & Hoggart, 2005).          Box 12.17, Greenwich, Connecticut, USA) was used (Fig. 17.4A),
The pain intensity scales were developed for self-reporting of pain         which has a force gauge with a 1 cm2 rubber tip and a maximal
in humans, something that is obviously impossible in veterinary             reading of 30 kg. According to the certificate of calibration it has an
medicine, thus an observer has to score the pain on behalf of the           accuracy of ± 2 graduations below 2.5 kg and an accuracy of ± 1
animal, relying on behavioral observations and sometimes physi-             graduation above 2.5 kg. Since there is a learning curve associated
ological variables (i.e. heart rate, respiratory rate). The physiological   with the use of a PA (Nussbaum & Downes, 1998; Ohrbach & Gale,
variables are, however, not exclusively influenced by pain and are          1989a,b; Antonaci et al., 1998), operators learned to increase pres-
more useful in combination with behavioral responses (Pritchett             sure at a constant rate (force/time) and to recognize pain behavioral
et al., 2003). The pain behavior construct proposes that pain affects       reactions of horses in response to the pressure algometer. The
behavior in ways that are accessible to observers and that the mag-         authors suggested practicing exerting a constant force over time
nitude of change correlates with the severity of the pain (Hansen           using a pressure mat (RsScan Flexible Solutions System, RSscan
2003). As previously stated, scoring systems used in equine research        INTERNATIONAL, Lammerdries 27 B-2250 Olen, Belgium), which
to assess pain severity were designed to evaluate the effectiveness of      is designed for measurement of intra-articular pressure in the
an epidural block or to quantify postoperative pain in orthopedic           equine fetlock joint. Secondly, the operators practiced PA on horses
surgery or colic (Pritchett et al., 2003). Ashley et al. (2005) con-        under the supervision of an equine behaviorist. MNT measurements
cluded in a review that there is strong evidence that aggressive            should be made in a quiet room, with both the room and the
behavior emerges from pain.                                                 technique being familiar to the horses to avoid a conditioned fear
   Dyson and Murray (2003) reported clear behavioral responses to           response that could interfere with the reaction to a painful stimulus
palpatory actions in horses with pain in the sacroiliac joint. Vertical     through opiate release (Fanselow et al., 1989).
forces or painful stimuli applied near the lumbosacral junction                Pressure algometer measurements were performed with the neck
often induced maximal extension at the lumbosacral joint (Haussler          straight holding the PA in one hand and stabilizing the neck on the
et al., 2001). Wennerstrand et al. (2004) used palpation as an inclu-       contralateral side with the other hand. The plunger tip of the PA
sion criterion for back pain in her research on back kinematics in          was held between thumb and forefinger (Fig. 17.4A), to avoid acci-
horses with back pain. She reported the following adverse reactions         dental shifting of the tip (Haussler & Erb, 2006a). Pressure was
to palpation commonly seen in horses with back pain: bolting or             applied perpendicular to the surface and increased at a constant
rearing, tail swishing, unruliness, rapid caudal movement of the            value of 10 kg/cm2, which was similar to that used by Haussler &
ears, or stiff, jerky movements. The palpation scoring system of            Erb, (2006a). The pressure stimulus was applied until a behavioral
Varcoe-Cocks’s et al. (2006) included many aspects of palpation             avoidance reaction was evoked (muscle fasciculations, cutaneous
(muscle tone, pain and stiffness) in a single scale. Wolf (2002)            trunci reflex, active vertebral movement or stepping away (Haussler
related muscle tone and pain through chronic irritation of muscles          & Erb, 2003)). The presence of the ‘pain face’, which is recognized
leading to permanent elevation in muscle tone, which continuously           as a fixed stare, with the eyes puckered slightly, the ears held back
feeds back to reinforce the condition. This is the mechanism by             slightly, and the nostrils dilated (Fraser, 1969), was observed and
which segmental dysfunction leads to muscle spasm. Wennerstrand             reported. When an avoidance reaction was observed, the pressure
et al. (2004) found that the clinical manifestation of back pain            was immediately stopped and the value recorded was considered to
resulted in diminished flexion–extension movement at or near the            be the MNT value. To increase reliability, measurements were
TL junction. These examples again indicate that musculoskeletal             repeated in three successive trials at one site (Nussbaum & Downes,
pain, increased muscle tone and stiffness often concur, and seem to         1998). Measurements were performed blinded: the PA was passed
be related.                                                                 to a third party to record the result.
   Research conducted by De Heus et al. (2010) is an example                   The 35 anatomical locations were adopted from Haussler & Erb
of subjective/objective evidence of the use of PA to evaluate the           (2006a) and Varcoe-Cocks et al. (2006) (Table 17.1). The anatomi-
use and possible effect of (diagnostic) palpation applied by                cal measurement sites were marked because identification of
                                                                                                                                                      391
       17       Rehabilitation of the locomotor apparatus
      anatomical landmarks is subject to wide variation (Weller et al.,               4, hypertonicity. Mobility was scored as: 0, hypermobility; 1, normal
      2006). Measurements started on the left of the withers moving                   mobility; 2, slight decrease in expected range of motion; 3, moder-
      caudally, then continued at the poll and neck. They were repeated               ate decrease in expected range of motion; 4, stiff and rigid, no range
      in the same order on the right side. All three physiotherapists/                of motion. For further description of the scoring system see De Heus
      examiners graded four elements of neck and back dysfunction                     et al. (2010). A mean physioscore was calculated from the scores of
      (‘temperature’, ‘pain’, ‘muscle tone’, and ‘mobility’) in the experi-           the three individual physiotherapists.
      mental group (n = 3) between the MNT measurements using a                          Local assessment of back or neck dysfunction at and adjacent to
      scoring system specifically developed for this study. The elements              the MNT measurement was recorded, since stiffness and increased
      were scored according to a grading system. Temperature was scored:              muscle tone can be manifestations of back pain and they are
      0, cold; 1, normal temperature; 2, mildly increased temperature; 3,             included in the scales modeled as an SDS (Holton et al., 1998;
      moderately increased temperature; 4, severely increased tempera-                Williamson & Hoggart, 2005).
      ture. Pain was scored as: 0, pain free; 1, mildly painful; 2, moder-               Both the MNT measurements and the physiotherapeutic diag
      ately painful; 3, moderately increased pain; 4, severely painful.               nostic intervention were well accepted by the horses. The three
      Muscle tone was scored as: 0, hypotonicity; 1, normal tone; 2,                  successive pressure algometer measurements did not differ signifi-
      mildly increased muscle tone; 3, moderately increased muscle tone;              cantly from each other, and there were no significant differences
392
                                                                                                                             Patho-anatomical diagnosis
between left and right sides, which were pooled for analysis, or at     algometry measurements. Sullivan et al. (2008) reported 20%
the same site over time. There were significant differences in MNT      sequential increase, 13% sequential decrease and 67% no change
values at different sites and between morning and evening values        or consistent pattern, similar to De Heus et al. (2010). Pain thresh-
at the same site (Tables 17.2 and 17.3). Median MNT values              old shows diurnal variation in humans (Göbel & Cordes, 1990;
increased from cranial to caudal in both the morning and the            Procacci, 1993) but different pathological conditions vary in the
evening (Tables 17.2 and 17.3). MNT values of muscle were signifi-      time of day when pain is more severe. Circadian rhythms of pain
cantly higher than those for the supraspinous ligament and bone.        could be related to the time-dependent variation in endogenous
There were significant differences (p < 0.05), in scores between the    opiod peptides, which are higher in the morning and lower in the
three physiotherapists for ‘temperature’, ‘muscle tone’ and ‘mobil-     evening in man (Labracque & Vanier, 2003). Hamra et al. (1993)
ity’ but not for ‘pain’.                                                found a strong positive correlation between the equine plasma
   This study showed that the palpation findings of individual phys-    immunoreactive β-endorphin and nocioceptive threshold, both
iotherapists were correlated with the objective MNT measurements        peaking in the morning at 09.00 hours and again less high at 15.00
Horses that received scores indicative of being more sensitive          hours, which corresponds with the significantly higher MNTs in the
(higher scores for pain, temperature, and muscle tone) had lower        morning measurements.
MNT values. On the contrary, there was a positive correlation             In humans as well as in horses the MNT between individuals
between the subjective ‘mobility’ score and the objective PA mea-       varied more than that within one individual (Haussler & Erb,
surements, illustrating that the more rigid vertebral columns will      2006a; Ylinen et al., 2007; Pöntinen, 1998; Vanderweeën et al.
show higher MNT values. Inter-horse differences in MNT reflected        (1996), which was confirmed in this study. Haussler and Erb
differences in individual sensitivity. The lower MNT values of horses   (2003), noticed that the individual MNT measurements varied
in the evening may have been due to sensitization of the measure-       greatly between horses, but were very consistent within horses.
ment location, a learning effect of the horses or a diurnal fluctua-
tion. Haussler & Erb, (2003) found that the majority of horses did
not demonstrate accommodation or sensitization to serial pressure         Table 17.3  MNT recorded in the evening (mean ± SD) from a
                                                                          group of riding school horses (Heus et al., 2010)
 Table 17.2  MNT recorded in the morning (mean ± SD) from a               Site            Left                 Middle               Right                Site
 group of riding school horses (Heus et al., 2010)
                                                                          Cervical
 Site         Left            Middle          Right           Site         1               4.5 ± 0.9                                 3.8 ± 1.2           19
 Cervical                                                                  2               5.1 ± 1.3                                 4.6 ± 0.5           20
  1            4.9 ± 1.6                       3.7 ± 1.7      19           3               4.5 ± 2.5                                 4.7 ± 1.7           21
  2            6.0 ± 2.6                       4.8 ± 1.9      20           4               4.7 ± 1.7                                 5.7 ± 1.4           22
  3            5.2 ± 1.9                       4.8 ± 1.9      21           5               7.7 ± 3.3                                 6.4 ± 0.8           23
  4            5.5 ± 1.6                       5.5 ± 0.9      22           6               4.5 ± 1.4                                 5.7 ± 1.3           24
  5            7.2 ± 1.2                       6.8 ± 1.2      23          Thoracic
  6            5.8 ± 2.6                       5.8 ± 1.8      24           7               6.3 ± 1.4                                 6.6 ± 0.9           25
 Thoracic                                                                  8               6.1 ± 1.6                                 6.7 ± 1.4           26
  7            7.3 ± 1.8                       6.6 ± 1.3      25           9               6.4 ± 0.8                                 6.5 ± 1.3           27
  8            6.7 ± 1.7                       7.5 ± 0.9      26          10                                   5.8 ± 1.7                                 10
  9            6.8 ± 1.2                       6.6 ± 1.1      27          28                                   5.9 ± 0.9                                 28
 10                           8.1 ± 2.4                       10          11                                   6.6 ± 1.6                                 11
 28                           7.3 ± 2.2                       28          12               7.7 ± 1.8                                 7.9 ± 1.5           30
 11                           6.7 ± 1.0                       11          13               7.4 ± 1.7                                 7.5 ± 0.9           29
 12            6.9 ± 1.7                       8.8 ± 1.5      30          Lumbar
 13            6.6 ± 2.1                       8.0 ± 1.7      29          31                                   6.7 ± 2.4                                 31
 Lumbar                                                                   14                                   7.4 ± 1.9                                 14
 31                           7.3 ± 1.4                       31          15               8.5 ± 2.5                                 8.8 ± 1.4           32
 14                           7.6 ± 1.6                       14          Pelvis
 15            8.2 ± 1.6                       9.3 ± 1.8      32          16               9.9 ± 2.5                                 9.7 ± 3.3           33
 Pelvis                                                                   17               8.9 ± 2.9                                 9.3 ± 1.5           34
 16            9.7 ± 2.5                      11.0 ± 2.4      33          18              11.7 ± 2.7                                11.4 ± 2.9           35
 17            9.7 ± 2.7                      10.2 ± 2.5      34        Reprinted from Clayton, H.M., Lavagnino, M., Kaiser, L.J. and Stubbs, N.C. (2011b) Hind
 18           13.3 ± 2.8                      12.7 ± 1.4      35        limb flexion response to different types of tactile devices, with permission from the
                                                                        American Journal of Veterinary Research, http://avmajournals.avma.org/loi/ajvr
                                                                                                                                                                  393
       17      Rehabilitation of the locomotor apparatus
      Pöntinen, (1998) argued therefore that it would be impossible to             Ultrasonography provides an immediate image of structures
      determine absolute reference values, since the variation between          beneath the probe enabling the practitioner to determine soft tissue
      individuals is too large. Therefore, relative values are considered to    sizes, particularly ligamentous and muscle CSA and linear measure-
      be more specific and more sensitive. Interpretation of the measure-       ments (Stokes & Young, 1986; Pickersgill et al., 2001). It also allows
      ments at the cervical points were disputable in the study of De Heus      real-time acquisition of muscle activity, whereby the practitioner
      et al. (2010) because some horses started head shaking before pres-       can visually observe and measure changes in muscle shape during
      sure was applied, possibly in anticipation of experiencing pressure       both concentric and eccentric volitional activation in comparison
      that they found aversive. Since right-left MNTs are not significantly     to the relaxed state (Kidd et al., 2002; Hodges et al., 2003b;
      different (Haussler & Erb, 2006a; De Heus et al., 2010), the contra-      McMeeken et al., 2004). In people, changes in muscle thickness as
      lateral side can be used to compare MNT values in case of unilateral      measured by ultrasound have been shown to be highly correlated
      pathology.                                                                to EMG activity of the lumbar multifidus in asymptomatic subjects
         In conclusion, a PA can be a useful tool to objectively monitor        (Kiesel et al., 2006). McMeeken et al. (2004) also found that
      the palpation of individual physiotherapists. It has proven difficult     changes in thickness of transversus abdominus are indicative of elec-
      to maintain a constant rate of pressure leading to repeatable results.    trical activity of the muscle. The use of US in this manner has been
      Introduction and implementation of a more detailed protocol               extensively described in the human literature, including reliability
      describing the procedure for diagnostic examination by palpation          and normative data, particularly with respect to back pain and
      of the neck and back area, describing for example hand movement           rehabilitation (Hides et al., 1998; 2001: 2008; Ferreira et al., 2004;
      and aimed-for hand pressure, could aid in achieving a more uniform        Hodges, 2005; Koppenhaver et al., 2009).
      scoring outcome. This is not standardized yet in physiotherapeutic           Despite US being an essential imaging modality in the assessment
      and veterinary diagnostic palpation protocols. The effects of phys-       and rehabilitation of the equine musculoskeletal system, data on
      iotherapeutic diagnostic palpation in relation to MNT must be             its accuracy and reproducibility in veterinary medicine are extremely
      taken into account when applying the PA to assess the effects of          limited. Research in equine biomechanics and PT interventions is
      physiotherapeutic intervention in rehabilitation programs. Pressure       using both functional objective measures including US and the
      algometry may be useful for quantifying clinical neck and back            human motor control model to investigate various equine prob-
      muscle sensitivity in horses possibly leading to dysfunction, as well     lems including TL-pelvic pain including sacroiliac joint biomechan-
      as for evaluating treatment outcomes. Repeated measurements on            ics (Degueurce et al., 2004, Goff et al. 2006) and equine back pain
      the same day and at the same location along the vertebral column          (Denoix, 1999, Stubbs et al., 2006; Stubbs et al., 2010a; 2011;
      may influence absolute MNT values. It is important that the opera-        Clayton et al., 2010). Data describing repeatability and validity of
      tor is trained in use of the PA.                                          US in the horse are limited to the tendon and epaxial musculature
                                                                                (Pickersgill et al., 2001; van Schie et al., 1999, 2000; McGowan
      Ultrasonography                                                           et al., 2007c; Stubbs et al., 2010). Pickersgill et al. (2001) performed
                                                                                a quantitative investigation of the reliability of US analysis of the
      In the field of human physiotherapeutic rehabilitation, ultrasonog-       morphometric properties of the equine SDF tendon. The effects of
      raphy (US) has emerged as an invaluable tool for objective func-          three variables on tendon CSA measurements were determined by
      tional assessment and management of neck, low back and pelvic             comparing two skilled operators acquiring US images and measur-
      girdle pain and dysfunction in relation to muscle function and            ing CSA values in 16 National Hunt TB racehorses. Variables ana-
      motor control (see section XVIII.3.2: Motor control) (Jull & Rich-        lyzed included inter-operator reliability during image acquisition
      ardson, 2000; Pietrek et al., 2000; Richardson et al., 2002; Whit-        and CSA measurement, and intra-operator reliability when using
      taker et al., 2007; Hodges & Cholewicki, 2007). Ultrasonographic          different analytical equipment from previously stored images. There
      measurement of multifidus CSA and function has proven to be a             was no statistically significant difference in the inter-operator image
      reliable, objective guide in the assessment, management and pre-          acquisition (p > 0.05) but inter-operator image analysis showed a
      vention of recurrence of back pain in man (Hides et al., 2008).           significant difference (p < 0.01) with one operator consistently
      Comparison of measurements of muscle size (cross sectional area,          returning larger measurements. The use of different equipment
      CSA) from the left and right sides at a given vertebral level provide     within one operator was not reliable in the distal metacarpal region.
      a method of direct assessment of muscle function by indicating            It was concluded that consistency of image acquisition across skilled
      whether the muscle is of normal size, atrophied, or hypertrophied.        ultrasonographers was good but the images should be evaluated by
      This is a functional assessment that can be used to monitor the           a single-skilled operator.
      effectiveness of treatment over time in rehabilitation (Rantanen             Van Schie et al. (1999) used first-order gray-level statistics of US
      et al., 1993; Stokes et al., 2005; Whittaker et al., 2007). Ultrasonog-   images in an in vitro study to quantify the effects of some instrumen-
      raphy is used extensively in equine veterinary practice and many          tal variables on the evaluation of equine SDF tendons to compare
      practitioners already have an ultrasound machine, thus the use of         normal tendon tissue, an acute lesion, or a chronic scar. Results
      ultrasound measurements has practical value in equine rehabilita-         showed considerable effects on the gray levels of the US image with
      tion (Stubbs et al., 2010).                                               slight variations in scanner settings and transducer handling. Tilting
         Historically in veterinary medicine, US has been widely used to        the transducer had substantial effects on mean gray levels, especially
      diagnose and monitor tendon and ligament lesions in the distal            in acute lesions (40%) and, to a lesser extent, in normal tendon
      limbs, with more recent clinical applications being recognized in         tissue (18%) and chronic scar tissue (12%). Displacement of the
      the vertebral column and pelvis (Tomlinson et al., 2001; 2003;            transducer causes relatively small changes in normal tendon tissue,
      Kersten & Edinger, 2004; Mattoon et al., 2004; Denoix & Dyson,            but changes the mean gray-level by 7% in chronic scar tissue and
      2003; McGowan et al., 2007c; Stubbs et al., 2010; 2011). In com-          20% in an acute lesion. The US image is also substantially influenced
      parison to other modern diagnostic and biomechanical technology,          by the total amplifier gain output: a low gain setting in an acute
      US is relatively inexpensive, non-invasive, easy to use, and allows       lesion results in an almost completely black image and, conversely,
      rapid analysis by an experienced practitioner. For clinical and           a marked ‘filling in’ effect on the lesion occurs with higher gain set-
      research purposes both objective and subjective scales of measure-        tings. Therefore, the value of exclusively using a quantitative evalu-
      ment are used (Reef et al., 1998; Genovese et al., 1997; Pickersgill      ation method on the first-order gray-level statistics may not
      et al., 2001). These involve comparison of contralateral tissues and      discriminate accurately enough to assess the integrity of tendon
      determination of echogenicity using gray-scale analysis and prede-        during rehabilitation. A further study that quantified the transverse
      termined ordinal scales (Martinoli et al., 1993; Gillis et al., 1993;     US image by use of first-order gray-level statistics concluded that
      Tsukiyama et al., 2005).                                                  the method was not sufficiently sensitive to accurately and
394
                                                                                                                                                     Patho-anatomical diagnosis
unequivocally determine the type of tendon tissue (van Schie et al.,                           1998a,1998b; Pressler et al., 2006; Wallwork et al., 2007; Lee et al.,
2000). Therefore, quantitative analysis should incorporate both                                2007; Delaney et al., 2010).
transverse and longitudinal information. These studies highlight the                              In the horse, McGowan et al. (2007c) determined the reliability
need for standardized techniques and instrumentation for image                                 of US measurements of CSA of multifidus mm, longissimus dorsi mm,
acquisitions over the period of rehabilitation.                                                and sacrocaudalis dorsalis mm complex. These studies determine
   In human medicine and rehabilitation, reliability data and clini-                           intra-operator reliability of repeated measurements of muscle CSA,
cal rehabilitative applications are more accessible, and US is widely                          using magnetic resonance imaging (MRI) as the gold standard for
used for functional muscle diagnosis, real time analysis during treat-                         comparison. MRI images were taken in 1 cm axial slices from T11
ment, and as an objective measure of motor control enabling the                                to the tail. Measurements of CSA were repeated three times using
practitioner to monitor rehabilitation and performance (Hides                                  the standard Bruker analysis package on each image of the multifidus
et al., 1992; 1994, 1995; Kidd et al., 2002; Hodges et al., 2003b;                             muscle at four vertebral regions (T13/14, T18/L1, L3/4, L5/6) and
McMeeken et al., 2004; Whittaker, 2007). The methodology and                                   the sacrocaudalis dorsalis muscle complex at the S3 (Figs 17.3 &
intra-operator reliability for the use of ultrasound imaging to                                17.5). Digital photography was used to record the CSA in the same
measure skeletal muscle has been described for the following                                   spinal segments that were cut in cross-section after freezing. Ana-
muscles: anterior tibial; quadriceps; transversus abdominis; multifidus;                       tomical dissection verified the anatomical relationship of multifidus,
rectus abdominis; internal and external obliques; erector spinae; splenius                     longissimus dorsi and sacrocaudalis dorsalis muscles and comparisons
capitis, semispinalis capitis; masseter; iliopsoas; muscles of the pelvic                      were made with MRI (Fig. 17.5). Median coefficient of variation
floor; and the diaphragm (Hides et al., 1992; Martinson & Stokes,                              (CV) for all individual MRI readings was 1.7%, showing good intra-
1991; Stokes & Young, 1986; Kelly & Stokes, 1993; Blaney et al.,                               operator reliability of measurement of multifidus CSA using MRI.
1999; Norasteh et al., 2007; Ferreira et al., 2004; Watanabe et al.,                           The pooled SD for all readings was calculated to be 0.22 cm2 with
2004; Raadsheer et al., 1994; Barker et al 2004; Rezasoltani et al.,                           95% confidence interval ± 0.43 cm.
Fig 17.5  Ultrasonographic images of multifidus (M), sacrocaudalis dorsalis medialis (SM) and sacrocaudalis dorsalis lateralis (SL) muscles at the levels of the
13th thoracic vertebra (T13) (top left), the 1st lumbar vertebra (L1) (top right), the 5th lumbar vertebra (L5) (bottom left), and the 3rd sacral vertebra (S3)
(bottom right). The vertebral spinous process (SP) forms the medial border of these muscles. Longissimus dorsi (L) lies on the lateral side in the
thoracolumbar region and biceps femoris (B) is on the lateral side at S3. The ventral border at T13 is the costovertebral joint (CVJ), at L5 is the transverse
process (TP) and at S3 is the lateral sacral crest (LS). The gluteus medius (MG) and iliocostalis (I) muscles are also shown.
Reprinted from Stubbs, N.C., Clayton H.M., Hodges P.W., Jeffcott, L.B. and McGowan C.M. (2010) Osseous spinal pathology and epaxial muscle ultrasonography in Thoroughbred racehorses.
Equine Vet. J. 42 (Suppl. 38), 654–661, with permission from the Equine Veterinary Journal.
                                                                                                                                                                                         395
       17        Rehabilitation of the locomotor apparatus
         McGowan et al. (2007c) further investigated the reliability of                              back pain, showed that 91% had asymmetrical development of
      measuring multifidus CSA using a 4–7 MHz curved linear probe at                                biceps femoris muscle and 82% had asymmetrical gluteal muscle
      a depth of 15 cm. Two skilled examiners independently collected                                mass (McGowan et al., 2007c). Ultrasonographic images were
      three images at each site. CSA measurements were analyzed blindly                              acquired on the left and right sides at 5 TL levels to measure CSA
      on three occasions by both examiners using Image J software. Data                              of multifidus or sacrocaudalis dorsalis. At necropsy, osseous pathologi-
      were analyzed for overall intra- and inter-operator reliability at each                        cal lesions of the TL spine and pelvis were recorded according
      level, and measurements of left and right sides in the same horse                              to spinal level and anatomical site, and graded (0–3) according to
      were compared. Images taken over the intervertebral space at all                               severity. The mean typical measurement error in estimating
      levels were most repeatable, with greater variability over the facet                           multifidus/sacrocaudalis dorsalis CSA was used to determine the sig-
      joints possibly due to differences in facet size and/or shape. Reli-                           nificance of left/right asymmetries. An association between multifi-
      ability for multifidus CSA was good: Interclass coefficient (ICC) was                          dus CSA asymmetry and asymmetrical grading of pathological
      0.83; standard error of the measurement (SEM) was 0.78 cm; and                                 lesions was sought using Pearson’s chi-squared analysis. All horses
      the smallest detectable difference was 1.5 cm across all levels. The                           had significant left/right asymmetry of multifidus CSA at >2 spinal
      relative variance components of measurement of CSA were 56%                                    levels, most commonly at L5 with a total of 74 sites affected in the
      inter-operator variance, 11% intra-operator variance and 33% image                             22 horses. Seventeen horses had severe (Grade 3) pathology and 16
      variance. Hence the variance was minimized by having just one                                  of these had ipsilateral atrophy of multifidus/sacrocaudalis dorsalis.
      operator and taking several images of each site. Comparing repeat-                             There was a significant association between pathological grade and
      ability of US measurement of CSA with the gold standard of MRI,                                degree of multifidus asymmetry. Severe osseous pathological changes
      the pooled SD was 0.4 cm2, almost double, but still within accept-                             were common in this population of TB racehorses and were associ-
      able limits. Longissimus dorsi CSA could be measured in the lumbo-                             ated with measurable left/right asymmetry in multifidus at or close
      sacral region (L5), just cranial to the tuber sacrale, where it narrows                        to the level of pathology (Fig. 17.6). Ultrasonography of multifidus
      down sufficiently to be entirely visible in the US image.                                      muscles is a useful and reliable clinical tool in the functional diag-
         In normal horses without back pain the epaxial muscles are sym-                             nosis and rehabilitation of back problems in horses, potentially
      metrical on the left and right sides. Ultrasonography of thoracolum-                           together with other US functional muscular measures (linear, and
      bar and sacral epaxial musculature revealed significant individuality                          contraction measurements).
      and regional variation in the shape and size of multifidus, which is                              B-mode ultrasonography, which has the ability to produce images
      largest in the lumbosacral region. From a functional biomechanical                             of moving objects almost instantaneously, has been used to measure
      perspective this would be expected since maximal dorsoventral                                  CSA of longissimus dorsi (D’Angelis et al., 2007). Images were
      flexion and extension occurs at the lumbosacral junction, and the                              acquired before, during and after a 90-day aerobic training program
      primary role of multifidus mm is stability and proprioception                                  on a treadmill. With the horse stationary, images were recorded at
      (Stubbs et al., 2006).                                                                         the level of the last rib with longissimus dorsi relaxed. CSA of longis-
         Ultrasonography is a repeatable and reliable tool for measuring                             simus dorsi increased significantly during the exercise period. Unfor-
      epaxial muscle size in clinical cases of equine back pathology                                 tunately, reliability data were not published for the US methodology
      (McGowan et al., 2007c). Stubbs et al. (2010) reported that in 22                              with respect to both image acquisition and calculation of CSA.
      TB racehorses there was a significant reduction in multifidus size                                In the human field advancements have also been made in the
      (CSA) at the level of significant injury or pathology seen on post                             measurement of muscle contraction over time using M-mode ultra-
      mortem examination. This is comparable with research in people                                 sonography. This technique is reliable within a single operator
      with back pain (Hides et al., 1994, 1996) in which US imaging has                              when the probe is fixed to the antero-lateral abdominal wall to
      shown a significant reduction in CSA of multifidus on the symptom-                             measure transversus abdominis in supine, standing and walking
      atic side of the spine, indicating a relationship between pain and                             human subjects with and without back pain (Bunce et al., 2002;
      muscle atrophy (Hides et al., 1994). Pre-clinical examination of 22                            Kidd et al., 2002). To date there are no reports in the literature using
      racehorses presented for euthanasia for primary reasons other than                             M-mode ultrasonographic muscle assessment in the horse.
      Fig 17.6  Left and right ultrasonographic images of multifidus (M) at the 5th lumbar vertebra. Osseous pathology on the right side (facet and neural arch
      fractures with incomplete vertebral body spondylosis) matches the reduction in multifidus CSA on the right. (Left mean CSA 15.07 cm2 (SD ± 0.21); right
      mean CSA 11.21 cm2 (SD ± 0.24); absolute difference: 3.86 cm2.)
      Reprinted from Stubbs, N.C., Clayton H.M., Hodges P.W., Jeffcott, L.B. and McGowan C.M. (2010) Osseous spinal pathology and epaxial muscle ultrasonography in Thoroughbred racehorses.
      Equine Vet. J. 42 (Suppl. 38), 654–661, with permission from the Equine Veterinary Journal.
396
                                                                                                          Rehabilitation techniques: manual therapy
                                                                                                                                                      397
       17       Rehabilitation of the locomotor apparatus
         Rose et al. (2009) studied the effects of two different 8-week                walking program along with other forms of therapy as soon as the
      stretching regimes on stride length and range of motion (ROM) in                 lesion is determined to be stabilized. It is the authors’ suggestion
      the equine trot. There was no significant effect on stride length but            to also include unmounted dynamic mobilization exercises to
      a number of significant differences between treatments were found                increase the dynamic ‘core’ muscle strength as described above
      in ROM of the shoulder, stifle and hock joints, which suggested                  (Stubbs & Clayton, 2008; Clayton et al., 2010a, 2012; Stubbs et al.,
      negative biomechanical effects of the stretching. However, the meth-             2011).
      odology was flawed and the results need further clarification; mul-
      tiple variables including individual horse variation may have played
      a role and the specific stretching techniques and forces applied need            Evaluation of information on manipulative/
      to be quantified in a larger number of subjects.                                 mobilization intervention
         An osteopathic technique that is reported in the clinical literature
      suggests that a form of gentle passive stretching (‘positional release’)         Specific techniques in PT, chiropracty and osteopathy are passive
      in the treatment of chronic myofascial restrictions can be performed             accessory and physiological joint mobilization and manipulation
      under sedation or anesthesia. Clinically this technique has been                 techniques that have been clinically reported to be successfully
      reported to have some success (Pusey et al., 2010). The technique                adapted to treat the horse (Goff, 2009; Haussler, 2009; Paulekas &
      is often utilized after all other avenues have been exhausted due to             Haussler, 2009), with some evidence indicating positive effects in
      the anesthetic risk. These techniques are performed rhythmically or              reducing muscle tone and increasing range of motion (Wakeling
      in a sustained manner dependent on the desired response and effect               et al., 2006; Gomez-Alvarez et al., 2008). These techniques encom-
      on the tissues. Therefore tissue and/or joint ‘mobilization with                 pass the application of very specific passive and/or active assisted
      movement’ exercises may be a more apt title for many forms of                    movements by the therapist to the horse, to manage and/or alter
      stretching techniques in the horse, an example being those exercises             pain and dysfunction of the articular, neural and muscular systems.
      described in Stubbs et al., (2011), which have been coined in the                Manual therapy techniques are based on a wide range of methods
      clinical and lay literature as ‘neck and back stretches’, which is               and theories related to the intervertebral and peripheral joint com-
      discussed later in this chapter.                                                 plexes, myofascia and the neuromuscular system.
         If there is a primary lesion of a soft-tissue structure such as                  Passive mobilizations and manipulations are applied at different
      muscle, ligament or tendon, it is the authors’ suggestion that these             amplitudes, velocities and directions determined by the assessment
      active mobilizations with movement exercises of the affected struc-              procedure and biomechanics of the joint complex (Goff & Stubbs,
      tures and/or the whole horse are appropriate, in conjunction with                2007). Figure 17.8 shows an active assisted direct modified ‘Mait-
      other therapies. The mobilizations may be appropriate to avoid                   land’ mobilization technique into end of range of motion (Mait-
      excessive scar formation and disorientation of the fiber alignment               land et al., 2000). In this technique, the therapist facilitates lateral
      in the subacute and chronic phases of healing, along with primary                bending and dorsoventral flexion to attain end range of motion of
      or secondary disuse atrophy. With respect to rehabilitation of distal            the thoracolumbar spine by applying pressure to one side of the
      tendon and ligament lesions, it has been widely reported in the                  hindquarters (pressure from the middle of the medial gluteal to the
      human literature that dynamic motor control-based exercises                      base of the sacrum). The position is maintained while applying a
      including eccentric loading exercises accelerate healing and tensile             lateral flexion and rotation oscillating mobilization to the lateral
      strength, especially in relation to Achilles tendon lesions (Kingma              dorsal spinous process at the desired amplitude and frequency. This
      et al., 2007). This type of rehabilitation strategy, sometimes referred          technique, if modified appropriately, can become what is termed in
      to as active rest, is being implemented in horses by commencing a                the human literature a ‘Mulligan mobilization-with-movement
      Fig 17.8  Visual demonstration of an active assisted direct modified ‘Maitland’ mobilization technique into end of range of motion (Maitland et al., 2000). The
      therapist facilitates lateral bending and dorsoventral flexion to attain end range of motion of the thoracolumbar spine by exerting pressure to one side of the
      hindquarter (pressure from the middle part of gluteus medius to the base of the sacrum). While maintaining this position, a lateral flexion and rotation
      oscillating mobilization technique with lateral flexion and rotation is applied laterally to the dorsal spinous process at the desired amplitude and frequency.
398
                                                                                                      Rehabilitation techniques: manual therapy
technique’. These techniques have been positively reviewed in the         (n = 12) and control (n = 12) groups. Outcomes were measured
scientific literature with regard to producing immediate and sub-         each week pre- and post-intervention and showed significantly
stantial pain reduction and improved function. Vicenzino et al.           higher amplitudes and applied forces post intervention in the treat-
(2007) reviewed the clinical efficacy, effects and putative mecha-        ment group compared to the controls, with a trend for increased
nisms of action of the approach, including the mechanisms and             passive spinal stiffness. Further studies with improved objective
action in both biomechanical and pain science paradigms. This             measures of musculoskeletal dysfunction are needed to assess the
technique (Fig. 17.8) requires the oscillatory mobilization and           effectiveness of manual therapies (Haussler, 2009).
response techniques to be applied simultaneously and repeated
during multiple oscillations, hence both active lateral bend and
dorsoventral flexion occur whilst the mobilization technique is           Evaluation of information on exercise and
applied. Manual passive assessment and treatment techniques
directed at a joint, soft tissue or neural structure are well tolerated   facilitation techniques
by the horse due to the rhythmical motion being applied at a com-         Exercise-based treatment techniques:
fortable speed as has been widely reported in people (Hurwitz et al.,
1996). This may include high-velocity, low-amplitude thrust               motor control
(HVLA) techniques. In the human literature it is hypothesized that        In the human rehabilitation literature much emphasis is placed on
the velocity may be more important than the amplitude, as dem-            functional assessment and objective measurements in relation to
onstrated and standardized by using a mechanical ‘activator’ to           neuromotor control. As described in Chapter 4, locomotion can be
perform the technique (Fuhr & Meke, 2005). Although the HVLA              viewed as an emerging pattern within a complex system initiated
involves high speed, horses also appear to tolerate these techniques      by spinal central pattern generators. Locomotion involves central
well, as they take place in a very short period of time, in conjunction   neural structures, peripheral organs and interactions with the envi-
with what is theorized as a rebound parasympathetic reaction and          ronment (Latash, 2008). In equestrian sports, the rider must be
thus relaxation (Haussler, 2000; Pickar, 2002; Triano, 2005; Haussler     included (Peham et al., 2004; Valentin et al., 2010). Dynamic
et al., 2010).                                                            control involves a spectrum of control strategies during locomotion,
   The effect of manual therapy in horses in relation to equine back      ranging from muscular co-contraction causing stiffening, to more
pain has been evaluated (Haussler et al., 1999a, 2007; Faber et al.,      dynamic control strategies that involve carefully timed muscle activ-
2003; Colborne et al., 2004; Wakeling et al., 2006; Gomez-Alvarez         ity and movement. Multiple factors influence selection of the
et al., 2008). These studies highlight the difficulties in conducting     appropriate dynamic control strategy: load, movement, predictabil-
manual therapy research, especially across time. There is certainly a     ity, proprioceptive function and error-tolerance or robustness
lack of randomized clinical trials. Methodological limitations are        (Hodges & Cholewicki, 2007). An essential element of motor
primarily due to limited subject numbers, variations within and           control is accurate internal and external receptor activity, especially
between horses and practitioners, and the difficulty in the differen-     regarding proprioceptive feedback on joint position during locomo-
tial diagnosis and monitoring of back pain. Even with modern              tion, which can be altered due to pathology. In the last two decades,
motion analysis systems there are inherent difficulties in measuring      much of the research in human PT and sports medicine in relation
intervertebral motion accurately and non-invasively (see Chapters         to musculoskeletal disorders has focused on the neurosciences
2 and 10), and in measuring pain objectively. In spite of these limi-     including neuromotor control and pain associated with musculo-
tations, joint mobilization and chiropractic manipulations have           skeletal conditions, as well as the inter-relationship between pain
been shown to affect the kinematics of the back. For example, kine-       and function. This complements work in biomechanics and kine-
matic measurements following treatment showed less extension in           matics. In this research, functional impairments and interventions
the thoracic region and a greater symmetry of pelvic motion (Gomez        have been studied via randomized clinical trials investigating and
Alvarez et al., 2008). Haussler, (2009) recently reviewed the scien-      comparing one or more approaches.
tific literature supporting manipulative therapy in the horse, where         One of the major and current areas of interest in human muscu-
the focus of chiropractic has been on the clinical effects. In a pilot    loskeletal PT is the field of neuromotor control and dynamic stabil-
study, Haussler et al. (1999a) showed that manipulative techniques        ity. Research in this area has allowed major advancements in the
produce substantial spinal motion. In one study manipulative              prevention and treatment of important problems in people includ-
therapy modulated MNT, and a clinical trial using PA indicated that       ing pelvic pain (Richardson et al., 2002) and low back pain (Hodges
manual and mechanical spinal manipulation increase MNTs (Sul-             et al., 2003a; Hodges, 2005), as well as prevention and treatment
livan et al., 2008; Haussler & Erb, 2003). Further preliminary studies    of peripheral joint injuries (Reimann & Lephart, 2002a, b) and
have investigated the effects of manipulative techniques on verte-        performance enhancement in athletes (Saunders et al., 2005).
bral mobility and muscle tone (Haussler et al., 2007; Wakeling            These are also key issues in equine performance and wastage (Jeff-
et al., 2006). Wakeling et al. (2006) investigated spinal (McTim-         cott et al., 1982; Stubbs et al., 2010) and research in these areas for
oney) manipulations (Colloca et al., 2009) and reflex inhibition          horses is clearly warranted and currently underway in a number of
therapy versus a control group in 26 randomly assigned horses.            research facilities around the world.
Compared with controls, both treatment groups had significantly              For example, research in human back pain, spinal stability and
less muscle tone as measured by EMG after treatment. Collectively,        control of movement is highly dependent on the contribution of the
these studies suggest that manipulative therapy elicits changes in TL     muscular system. In the past, attention focused on muscle strength
and pelvic kinematics, and muscle tone, which are likely to be            alone. However, it is now recognized that the central nervous sys-
beneficial (Faber et al., 2003; Gomez Alvarez et al., 2008). However,     tem’s control of the muscular system (when and how the muscles
further investigation is warranted to improve the objectivity of the      work) is probably of greater importance to the muscle system’s
methodology, decrease the number of variables, and increase               ability to satisfy the needs of spinal movement and stability. The
sample size.                                                              central nervous system must plan suitable strategies of muscle
   Recently Haussler et al. (2010) reported on the efficacy of dorso-     recruitment, co-ordination, and levels of activity to meet the
ventral spinal manipulation and mobilization on trunk flexibility         demands of internal and external forces and initiate appropriate
and stiffness in 24 actively ridden horses. Passive spinal mobility       responses to unexpected disturbances of movements and function.
was assessed once per week for 3 weeks by measuring peak vertical            Research has shown that the deep, local muscles of the TL region
displacement, loading and unloading velocities, applied force and         (for example, the transversus abdominis and the segmental lumbar
frequency of truncal oscillations induced during dorsoventral spinal      multifidi) play key roles in modulating the stiffness of the lumbar
mobilization at 5 TL sites. This was compared between treatment           spinal segments and pelvic joints during limb and lumbo-pelvic
                                                                                                                                                    399
       17      Rehabilitation of the locomotor apparatus
      movements (Indahl et al., 1997; Richardson et al., 2002; Hodges            trunk muscles are then re-educated to retrain painless and con-
      et al., 2006; Kalichman et al., 2009; Mok et al., 2011). It has also       trolled functional activities. Progressively the stability system is
      been shown that the central nervous system pre-programs activity           functionally challenged with load (static and dynamic exercises) as
      in certain trunk muscles in preparation for limb movement. For             control improves. Most importantly there is growing evidence that
      instance, the transversus abdominis and multifidi activate prior to limb   this exercise approach can reduce low back pain and possibly reduce
      movement, regardless of direction. This serves to increase segmental       its recurrence rate (O’Sullivan et al., 1997; Hides et al., 2006; Mac-
      stiffness for spinal segmental support prior to loading (Hodges &          Donald et al., 2006). Specific physiotherapeutic intervention in
      Richardson, 1997, 1999; Hodges et al., 2003b; Holm et al., 2002;           people with multifidus dysfunction following an episode of acute
      MacDonald et al., 2010). Back pain patients display delayed activa-        back pain reduced the rate of recurrence of injury to 30% in the PT
      tion of the transversus abdominis and multifidi, depriving the painful     intervention group compared with a recurrence rate of 84% in
      and injured spinal segments of timely support (MacDonald et al.,           controls (Hides et al., 2001).
      2009). Findings to date indicate that the horse follows the same               The human motor control model has been applied in investiga-
      sequence of events (Stubbs et al., 2010). Further research into the        tions of the equine multifidus muscle (Stubbs et al., 2006, 2011)
      activation patterns in normal horses and those with back pain is           revealing striking similarities in structure and function across
      necessary and currently underway.                                          species. The equine multifidus has similar morphological orienta-
         Until recently relatively little was known about other epaxial and      tion; therefore, its biomechanical activity is comparable to man,
      hypaxial muscles in normal horses or those with back pain. In the          with the primary function being to stabilize intervertebral motion.
      human literature there is a vast body of evidence (>80 peer reviewed       Sacrocaudalis dorsalis lateralis forms the caudal continuation of mul-
      research papers: Pubmed), with in vivo and in vitro observations of        tifidus in the equine sacro-caudal spine (Stubbs et al., 2006) (Figure
      the role of transversus abdominis and multifidus muscles in controling     17.5). Multifidus CSA is largest in the lumbosacral region, which is
      intervertebral motion. The multifidi provide intersegmental stabili-       the area with the greatest amount of motion (Townsend et al.,
      zation and stiffen the spine, contributing two-thirds of the total         1983; Stubbs et al., 2006).
      increase in spinal stiffness imparted by muscular action (Wilke                Anatomical variations in the equine lumbosacral region occur in
      et al., 1995). In vivo studies in pigs confirmed that the multifidi are    at least a third of horses (Haussler et al., 1999b). The predominant
      also a major stabilizer of lumbar intersegmental motion in quad-           variation is divergence between the dorsal spinous processes of L5
      rupeds (Kaigle, 1995). Morphological changes occur in the multifi-         and L6, with L6 being a transitional vertebra and functioning as
      dus muscle in association with low back pain. In both acute and            part of the lumbosacral joint (Stubbs et al., 2006). These variations
      chronic low back pain, reduced CSA of multifidus was observed              may affect range of motion and performance.
      within 24 h of injury at the same intervertebral level and on the              In people with back pain, the deep spinal stabilizer multifidus is
      same side as the spinal pathology (Hides et al., 1994, 1996; Hodges        inhibited ipsilaterally leading to muscle atrophy, asymmetry in CSA
      et al., 2006; 2009). In a recent study, a decrease in density of           and loss of its function leading to intervertebral instability. Specific
      multifidus/erector spinae was found in association with facet joint        physiotherapeutic exercises are required to reactivate multifidus. This
      osteoarthritis, spondylolisthesis and disc narrowing (Kalichman            information has influenced the management of back pain in humans
      et al., 2009). This also occurs within 3 days after a unilateral experi-   (MacDonald et al., 2006, 2009). In horses, Stubbs et al. (2011)
      mental lesion to an intervertebral disc in pigs (Hodges et al., 2006).     applied these physiotherapeutic and motor control principles to the
         Another interesting finding is that multifidus does not automati-       horse in a study that assessed the effects of dynamic mobilization
      cally resume its normal function following recovery from or resolu-        exercises on size and symmetry of multifidus in the equine caudal
      tion of an episode of acute back pain (Hides et al., 1996). Specific       thoracic and lumbar spine. Eight horses performed dynamic mobi-
      physiotherapeutic interventions (exercises) are required to restore        lization exercises (three cervical flexions, one cervical extension, and
      the size and function of multifidus after an episode of acute back         three lateral bending exercises to the left and right sides) with five
      pain in people and these interventions reduce the rate of recurrence       repetitions/exercise/day on 4–5 days/week for 3 months during
      of injury from 84% in untreated controls to 30% (Hides et al.,             which time they were not ridden (Fig. 17.9). These exercises are
      2001) in patients who received specific interventions. In horses,          widely used in clinical practice with the aim of increasing ‘core’
      generalized secondary atrophy of the epaxial muscles, especially           muscle activation (Stubbs & Clayton, 2008). Left and right multifidus
      longissimus dorsi and gluteus medius have been reported in horses          CSA was measured ultrasonographically at 6 levels from T10–L5 at
      with back pain (Jeffcott et al., 1982; Quiroz-Rothe et al., 2002).         the start (initial evaluation) and end (final evaluation) of the
      Changes in multifidus CSA associated with ipsilateral osseous              3-month study. Changes in CSA of the left and right multifidi and
      pathology in the horse has been reported (Stubbs et al., 2010).            symmetry of multifidus CSA on the right and left sides between the
      Furthermore, the muscles hypertrophy in response to regular per-           two evaluations were sought using analysis of variance (p < 0.05).
      formance of dynamic mobilization exercises (Stubbs et al., 2011).          Between the initial evaluation and final evaluations multifidus CSA
         Knowledge gained from ultrasonographic research in relation to          increased significantly at all six spinal levels on both right and left
      changes in neuromotor control associated with back pain has trans-         sides. Asymmetries in multifidus CSA between the right and left sides
      lated to the development of new rehabilitation strategies for the          decreased significantly between the initial and final evaluations at
      lumbo-pelvic muscles in human back pain patients. This is an               all six spinal levels indicating the dynamic mobilization exercises are
      example of anatomical and biomechanical research creating a                effective in activating the equine multifidus (Stubbs et al., 2011).
      framework for future neuromotor control research in the horse                  Clayton et al. (2010a, 2012) reported the intervertebral angula-
      along the same lines as the human research model. MacDonald and            tions in the end position of the dynamic mobilization exercises
      colleagues (2006) recently reviewed the evidence of these treatment        performed in flexion and lateral bending, respectively. Most of the
      strategies in clinical practice. Rehabilitation in this context using      movements occurred at the cranial and caudal cervical joints with
      ultrasonography-guided feedback places emphasis on motor                   less motion in the mid neck. The results were interpreted in the
      relearning to optimize motor control for spinal dynamic stability.         context that articulations at the cervicothoracic junction are primar-
      The rehabilitation first uses the end organs of the neuromotor             ily responsible for raising, lowering and turning the neck while the
      system, the muscles, with the aim that cognitive, repeated contrac-        cranial cervical joints position the head relative to the neck, which
      tions of the muscles and correct movement patterns will result in a        is important with regard to proprioceptive input.
      transition to automated use (i.e. skill training) (O’Sullivan et al.,          Regular performance of dynamic mobilization exercises may also
      1998). Initially, the deep muscles such as transversus abdominis and       have neuromuscular training effects as a consequence of the activa-
      lumbar multifidus are repeatedly activated in the relearning process       tion, recruitment, and strengthening of the deep dynamic segmental
      during rehabilitation. Movement patterns and strategies for all            stability muscles in the neck and back (longus colli, intertransversarii,
400
                                                                                                                                    Rehabilitation techniques: manual therapy
A B C D
E F G
Fig 17.9  Dynamic mobilization exercises (baited stretches) performed in flexion–extension (top row): (A) chin to chest, (B) chin between carpi, (C) chin
between fetlocks, and (D) cervical extension; and in lateral bending (bottom row): (E) chin to girth/ribcage, (F) chin towards stifle, and (G) chin towards hock.
Reprinted from Stubbs, N.C. and Clayton, H.M. (2008) Activate Your Horse’s Core: Unmounted Exercises for Dynamic Mobility, Strength, and Balance., with permission from Sport Horse
Publications.
multifidi); the thoracic sling (primarily serratus ventralis thoracis); the                     Jeffcott, 1986), which is conisitent with the finding that the direc-
hypaxial musculature (abdominals, iliopsoas complex); and the                                   tion of greatest movement is in the lateral and oblique planes (Goff
pelvic dynamic stabilizers (superficial and medial gluteals, tensor                             et al., 2006). In conclusion, research to date supports the use of
facia latae, biceps femoris). It is believed that the horse develops more                       manual provocation tests for SID in horses.
appropriate dynamic control strategies as a consequence of per-
forming these exercises. It is further suggested that, as the horse’s
dynamic stability and strength improve, the exercises should be
                                                                                                Facilitation-based exercise therapy
made more challenging, for example, by deliberately having the                                  In conjunction with direct manual therapy techniques, facilitation
horse stand in a slightly unbalanced position or by teaching                                    techniques may be utilized to cause the horse to move through a
the horse to perform the exercises with one leg raised off the ground.                          desired range of motion. These techniques and exercises encompass
It is important for the therapist to assess each horse’s compensation                           many forms of direct and indirect mobilizations with/through
strategies and to always encourage horses to use the appropriate                                movement techniques/exercises, which clinically have been seen to
dynamic control.                                                                                be very effective, especially in relation to functional motor control.
   Research into the biomechanics and neuromotor control of the                                 Altered motor control (neuromuscular function) may be a result of
human sacroiliac joint (SIJ) has also contributed to clinicians’                                an underlying lesion in the spine and/or peripheral joint disease
ability to diagnose sacroiliac disease (SID) in humans. It has been                             with pain and inflammation causing reflex inhibition of motor
shown that non-invasive, manual SIJ provocation tests are as predic-                            neurons, resulting in weakness and atrophy of associated muscles
tive for SIJ being the source of pain as diagnostic joint blocks (van                           (Young, 1993). Many of these mobilization techniques/exercises are
der Wurff et al., 2006). These pain provocation tests compress the                              reported to use neuromuscular reflexive responses along with mus-
SIJ articular surfaces and/or stress the extra-articular structures of                          cular facilitation and inhibition. In horses, these techniques are
the joint. Manual tests based on the examiner’s impression of the                               based on similar theoretical principles to those used in human
amount of motion (hypo/hypermobility) and quality of motion                                     manual therapy, including muscle energy techniques to gain motion
(the status of the neuromotor system) at the SIJ are also used clini-                           that is limited by restrictions of neuromuscular structures and
cally to assess the functional status of the SIJ. This includes assess-                         restore or normalize motor control. The human patient is asked to
ment of the amount of movement of the SIJ during application of                                 contract and relax specific muscles in a given range of motion and
manual force and, specifically, analysis of sacral movement relative                            often resistance is applied to the body part. In theory these tech-
to the pelvis in weight bearing through specific motion tests, such                             niques promote muscle relaxation by activating the Golgi tendon
as the one leg flexion test in standing or the ‘stork test’ (Gillet test)                       reflex (DiGiovanna et al., 2005) via the principles of reciprocal
(Lee, 2004). Diagnosis of equine sacroiliac disease using manual                                inhibition and post-isometric relaxation. Reciprocal inhibition uses
tests similar to those used in the human literature has been eluded                             the body’s antagonist–inhibition reflex to induce relaxation of a
to (Haussler, 1999b, 2003a, b; Varcoe-Cocks et al., 2006; Goff &                                muscle. Conversely, other techniques use the antagonist–inhibition
Crook, 2007). Motion between the sacrum and ilium (dorsal sac-                                  reflex to incrementally restore range of motion, whereby a muscle
roiliac ligament provocation test) during the application of manual                             is stretched immediately following an isometric contraction due to
force has been reported and the direction and amount of movement                                the neuromuscular apparatus becoming briefly refractory or unable
of the ilium relative to a fixed sacrum in response to manual pres-                             to respond to further excitation.
sure has been measured in an in vitro model (Goff et al., 2006). The                               Although these techniques have not yet been investigated scien-
sacroiliac joint lies at an angle of 30o to the horizontal (Dalin &                             tifically, it is the author’s opinion that many of these applied
                                                                                                                                                                                      401
       17       Rehabilitation of the locomotor apparatus
      techniques/exercises are very useful in the majority of rehabilitation           the chest or between carpi/fetlocks stimulate flexion, whereas move-
      cases to maintain and improve mobility, strength and dynamic                     ment of the chin toward the girth, flank or hock is achieved using
      stability, especially in regions where the affected joint complexes              coupled lateral bending and axial rotation. The aim of these exer-
      are inaccessible due to the horse’s morphology such as the horse’s               cises is not only to mobilize both the axial and appendicular skel-
      cervicothoracic region and back. The intention is not only to                    eton, but also to facilitate core muscle activity (thoracic sling,
      increase joint mobility but also to activate and strengthen muscles              hypaxial/epaxial and pelvic musculature), improve neuromuscular
      that move the horse’s body to the desired position, promote inter-               control and strengthen the active musculature, which is a key
      segmental joint stability, and restore functional locomotion and                 concept in rehabilitation and sports medicine.
      sport specific motion. Indirect mobilization techniques can be uti-                 The human scientific literature indicates that core stability exer-
      lized clinically to mobilize the cervicothoracic junction, whereby a             cises improve neuromotor control in back pain patients to aid
      muscle reflex/response occurs in response to applying constant                   recovery and prevent further reccurrence (Hides et al., 2001, 2006).
      pressure between the index finger and the thumb while they are                   It seems likely that core training exercises as described in horses by
      wrapped around the distal third of the brachiocephalicus muscle,                 Stubbs & Clayton (2008) will have similar therapeutic applications
      producing flexion in this region. The brachiocephalic response can               in horses that are rehabilitating from neck and back pain. Further-
      be coupled with ventral pressure to the sternum to mobilize the                  more, regular use of the exercises may help to prevent the occur-
      joint complexes by stimulating flexion in the cranial thoracic region.           rence or recurrence of equine neck and back pain. Further studies
      This may be combined with lifting of one forelimb to progress the                in equine neck and back pain patients are needed to test this
      technique (Fig. 17.10).                                                          hypothesis.
         Many combinations of mobilization, core strengthening and                        A vital aspect of musculoskeletal and neurological rehabilitation
      stability/balancing exercises have been described in the clinical lit-           and performance enhancement is related to motor control and
      erature (Stubbs & Clayton, 2008; Goff, 2009; Paulekas & Haussler,                motor-skill retraining, not only with respect to pain management
      2009; Stubbs et al., 2011). These often use food as an incentive or              but directly related to and mediated by proprioceptive and mecha-
      bait (such as a carrot) to encourage the horse to move into the                  noreceptive afferent feedback from joints, tendons, ligaments, fascia
      desired posture, with the end range of motion posture being main-                and skin, which modulate efferent neuromuscular control. As stated
      tained for a period of 3–10 s. The exercises that move the chin to               previously, the overall aim of rehabilitation is to restore the appro-
                                                                                       priate neuromuscular pathways, and strengthen the musculature to
                                                                                       allow the horse to return to perform to its athletic potential.
                                                                                          Sensory integration is a form of facilitation-based exercise therapy
                                                                                       that involves tactile stimulation during exercise. These techniques
                                                                                       have clinically (Goff & Stubbs, 2007; Stubbs & Clayton, 2008; Goff,
                                                                                       2009; Paulekas & Haussler, 2009) and scientifically (Ramon et al.,
                                                                                       2004; Clayton et al., 2008, 2010b, 2011a,b) been reported to be
                                                                                       useful tools in the treatment of the horse. The aim of these tech-
                                                                                       niques is to alter the horse’s kinesthesia (proprioception and joint
                                                                                       position sense), which ultimately influences static and dynamic
                                                                                       posture. Static and dynamic position senses are dependent on feed-
                                                                                       back from peripheral receptors that determine joint angulations in
                                                                                       all planes and their rate of change. Peripheral receptors include
                                                                                       cutaneous mechanoreceptors, nociceptors, Golgi tendon organs,
                                                                                       muscle spindles and capsular receptors, which relay information to
                                                                                       the central nervous system via type Ia and type II afferent fibers, to
                                                                                       modulate and coordinate locomotion (Loeb, 2005). Sensory inte-
                                                                                       gration is very effective because the horse has a heightened cutane-
                                                                                       ous mechanoreceptive system, in conjunction with the underlying
                                                                                       myofascial attachments of cutaneous trunci to the skin. Theoretically,
                                                                                       tactile stimulants including adhesive tape, exercise bands, loose-
                                                                                       fitting tactile limb bracelets (55 g), or tactile cues can be applied to
                                                                                       the skin over targeted regions including the limbs or specific
                                                                                       muscles, with the aim of altering mechanoreceptive and proprio-
                                                                                       ceptive feedback, which alters motor control. There is a vast body
                                                                                       of literature to support the application of these techniques in people
                                                                                       (Seki et al., 2003; Rose & Scott, 2003).
                                                                                          A series of studies has explored the effects of sensory integration
                                                                                       techniques in horses (Clayton et al., 2008, 2010b, 2011a,b). The first
                                                                                       study determined the short-term habituation to the effects of light-
                                                                                       weight (55 g) stimulators consisting of a strap with seven double
                                                                                       stranded oval brass links that were 7 cm in length. The straps were
                                                                                       loosely attached around the pastern. Trials were conducted under
                                                                                       three conditions: no stimulators, stimulators attached to the pas-
                                                                                       terns of both forelimbs and stimulators attached to the pasterns of
                                                                                       both hind limbs, with 10 consecutive trails collected for each condi-
      Fig 17.10  Combined facilitation technique used to assess and treat              tion (Clayton et al., 2008). Eight sound Arabians (450 ± 56.1 kg)
      dynamic stability in the cervicothoracic and thoracic sling regions. The first   were trained by an experienced handler to trot in a straight line
      step is to perform a ‘sternal lift’ or ‘rounding response’ by pressing upward    at a consistent velocity. Kinematic data were collected using an
      on the sternum. The horse responds to the noxious provocation by flexing         automated motion analysis system (eight cameras; data collection
      the cervicothoracic spine with the flexed position being maintained for          volume 5 × 3 × 2 m) with reflective markers attached to the head,
      3–5 s. A progression of the exercise is to lift one forelimb off the ground      trunk (T10 and L6), tuber spinae scapulae, tuber coxae, and each
      while performing the sternal lift.                                               hoof. Velocity did not vary significantly across all trials (± 0.4 m/s)
402
                                                                                                                     Rehabilitation techniques: manual therapy
and hoof height in the control condition did not differ significantly                                      Control   Lightweight chain    Leg weight +
across the 10 trials. As determined by the slope of the regression                                         Strap     Leg weight           lightweight chain
lines, the effect on peak hoof height was largest immediately after
                                                                                                 400
the application of the fore and hind stimulators and decreased over
time. Peak hoof height was significantly greater than the control                                350
across the first six trials for the forelimbs and for all 10 trials for the
hind limbs with extrapolation of the regression line estimating that                             300
hind hoof elevation would no longer be significant after the 14th
                                                                                                                                                                    403
       17        Rehabilitation of the locomotor apparatus
Table 17.4 Effects of four types of hind limb stimulators on swing phase kinematics at trot
       Type of stimulator             None                     Strap                 Tactile stimulator           Leg weight            Leg weight + tactile stimulator
       Peak hoof height (cm)              5.4 ± 1.4 a,b,c
                                                                   6.7 ± 2.2 d,e,f
                                                                                        14.1 ± 7.3 a,d,g
                                                                                                                    16.9 ± 15.9 b,e,h
                                                                                                                                          24.4 ± 13.1c,f,g,h
       Values in the same row with the same superscript are significantly different from each other (p < 0.05).
       Reprinted with permission from Clayton et al., 2011b.
      underlying neuromotor control problems in human patients with                                This type of taping is commonly used in human athletes and is
      back and knee pain, including abnormal knee joint position sense,                            known as kinesiology taping. In theory, the effects are achieved
      altered joint proprioception (Baker et al., 2002), altered electro-                          through tension that increases the kinesthetic awareness along the
      myographic (EMG) firing patterns of vastus medialis obliquus and                             fibers of a muscle or muscles when a facilitatory effect is desired.
      vastus lateralis that contribute to maltracking of the patella (Cowan                        The horse performs specific exercises with the tape attached, includ-
      et al., 2001; Owings et al., 2002), reduced knee flexion in early                            ing sport-specific activities under saddle, which leads to alteration
      stance due to the delay in onset of eccentric activity in vastus media-                      of neuromotor function over time. The author has used taping
      lis obliquus (Crossley et al., 2004) and significantly decreased                             techniques with clinical success to facilitate activity of the core
      strength in the more proximal musculature including hip external                             dynamic stability musculature, more specifically biceps femoris and
      rotators and abductors (Ireland et al., 2003) in patients with patel-                        the abdominal complex (Fig. 17.13). Further investigation into
      lofemoral pain syndrome. Similar neuromotor control problems                                 these sensory facilitation techniques is definitely warranted given
      may occur in the horse and confound many gait abnormalities and                              the clinical improvements observed.
      disease processes, as shown by subtle, and often related, changes in                            These sensory integration techniques may be combined with
      lameness patterns and back kinematics (Gomez-Alvarez et al.                                  many forms of in-hand and ridden exercises that have been
      2007a,b, 2008) due to altered neuromotor control. The use of                                 described in the clinical literature (Paulekas & Haussler, 2009;
      tactile stimulation as a form of sensory integration may be a valu-                          Steiner & Bryant, 2003; Tellington-Jones & Burns, 1988). The exer-
      able tool to facilitate restoration of normal locomotor function by                          cise protocol should be individually tailored and monitored by the
      activating and strengthening specific muscle groups, with a training                         therapist, as there are vast individual variations in responses from
      effect over time.                                                                            the horse to these therapeutic strategies. A skilled handler/trainer is
         Clinically it has been reported that other forms of sensory integra-                      required to perform the exercises on a daily basis. The exercise
      tion are useful during training but further investigation is needed                          protocol should follow the principles of conditioning (Clayton,
      to confirm their value. These include the use of different materials                         1991), with ongoing re-assessment of the horse’s motion to ensure
      such as bandages, such as Vetrap or ‘body wrap’, and exercise-bands                          that compensatory strategies are minimal and the desired effects are
      wrapped around the horse’s hindquarter, abdomen and/or chest                                 evident. Considerations should include exercise time, gaits, transi-
      (Goff & Stubbs, 2007). It is the authors’ opinion that exercise bands                        tions, direction, surfaces and gradients/slopes, with constant moni-
      are the most useful of these techniques in a clinical setting as they                        toring for signs of fatigue.
      appear to increase the horse’s body awareness (kinesthesia) and the
      ability to use the core muscles when exercised in hand, on the longe
      or under saddle (Fig. 17.12).                                                                Hydrotherapy
         Another effective technique for sensory stimulation in a clinical                         There is limited evidence in the literature regarding the musculo
      setting is the ‘functional proprioceptive taping technique’, which is                        skeletal benefits of equine hydrotherapy. Irwin & Howell (1980)
      widely used in human rehabilitation, sports medicine and athletic                            suggested several indications for and some observations of swim-
      performance. In the veterinary literature, Ramon et al. (2004)                               ming horses. Kato et al. (2003) determined the effects of immersion
      reported that ‘rigid mechanical athletic taping’ of the fetlock did not                      in warm spring-water (38–40°C) on autonomic nervous system
      alter the kinematics of the forelimb during stance, but did limit                            activity in horses. Variations in heart rate (HR) were evaluated from
      fetlock flexion in the swing phase. There was also a decrease in peak                        the power spectrum in terms of low-frequency (LF) and high-
      vertical ground reaction force, which may have been due to an                                frequency (HF) power as indices of autonomic nervous activity.
      increased proprioceptive effect. The authors concluded that reduced                          They found that an increase in HF power, indicative of parasympa-
      vertical force may be beneficial in preventing or reducing the risk                          thetic nervous activity, occurred during immersion in warm spring-
      of injury and might be useful for tendinous or ligamentous reha-                             water, which may thus provide a means of relaxation for horses.
      bilitation in equine patients.                                                               Kohn et al. (1999) proved that active cooling by washing with cold
         Different effects may be seen when using a functional, rather than                        (15.6 ± 0.6°C) water is a safe, effective means of facilitating heat
      mechanical, taping technique to facilitate increased muscle activity.                        dissipation of horses after exercise in a hot, humid environment.
404
                                                                                                          Rehabilitation techniques: manual therapy
                                                         Fig 17.12  Three applications of exercise bands to the horse. (A) Exercise band around the
                                                         hindquarters for exercise in hand or on the longe. (B) Exercise band around the hindquarters
                                                         for exercise under saddle. (C) Exercise band in the thoracic sling region attached ventrally to
  C                                                      the girth, held in place at the manubrium via a ring, and then attached to the front of the
                                                         saddle on each side.
                                                                                                                                                           405
       17       Rehabilitation of the locomotor apparatus
A B
      Fig 17.13  Examples of functional proprioceptive taping techniques using kinesiotape. (A) The abdominal complex is taped to facilitate activity of transversus
      abdominis, internal oblique and rectus abdominis. (B) Taping technique to facilitate activity of the pelvic stabilizer muscles including: biceps femoris, gluteus
      superficialis and medius, and tensor fascia latae.
      Fig 17.14  Event horse after returning to its stable following the cross-country phase at an international competition. The horse is standing in boots filled
      with a slush of ice and water and has a wet ice towel placed along its back.
      therapeutic threshold of 41°C in the metacarpal region. It is not                   Electrotherapy entails the introduction of electrical currents to the
      known whether other anatomical regions might be different.                        body to gain therapeutic effects. These modalities utilize various
         Therapeutic ultrasound is another modality commonly used in                    types and frequencies of current, dependent on the desired effect.
      people to heat tissue (3–5 cm depth) and increase fluid motion                    In the human, transcutaneous electrical nerve stimulation (TENS)
      around cell membranes, but evidence of a therapeutic effect is still              has been well documented to provide temporary pain relief by
      lacking (Paulekas & Haussler, 2009).                                              central release of endogenous endorphins and opioids, and/or by
406
                                                                                                          Rehabilitation techniques: manual therapy
stimulation of inhibitory inter-neurons at the spinal level (Watson,           body, but mostly they appear on stable, anatomically described
2008). Even though there is no evidence that TENS is effective in              points (Janssens, 1992). There is a correlation between the location
horses, it is the authors’ experience that it is a well-tolerated and clini-   of trigger points and the location of acupuncture points, which were
cally useful modality to complement other treatment strategies.                discovered independently in Eastern and Western medicine, respec-
   Neuromuscular electrical stimulation (NMES) is a useful electro-            tively. Pressure applied to a trigger point can produce pain in the
modality in cases of muscle atrophy due to disuse, immobility and/             trigger point itself, or referred pain in myofascial or visceral
or nerve damage in people. When a patient is unable to voluntarily             structures.
contract the muscle(s), NMES can be applied to generate 80–90%                    It is generally perceived that by applying pressure to a painful
of the maximal voluntary contraction to assist in maintaining neu-             point on the body, the pain decreases. Physical therapists use this
romuscular control and muscle development (Paulekas & Haussler,                information during therapy (Simons et al., 1999). Instead of apply-
2009). In denervated muscle the findings are inconsistent though               ing pressure, acupuncturists insert needles into these points
there is some evidence of a delay in denervation atrophy (Watson,              (Melzack et al., 1977). Acupoints are located at specific locations of
2008). To date there are no equine studies, but it is the authors’             the body where the skin has a localized decrease in electrical resis-
opinion that, if the horse will tolerate it, NMES is a useful adjunct          tance. Needle insertion influences the energy in the meridian and
to assess and treat horses with muscle dysfunction and/or atrophy.             in the corresponding organ. The theory of acupuncture therapy is
Cases in which NEMS may be useful include suprascapular and                    to restore the balance of energy (Qi) in the body (van der Molen,
radial nerve lesions.                                                          1999; Xie et al., 2005). Besides the specific acupoints described in
   Anecdotal reports suggest beneficial effects from a variety of treat-       manuals and atlases, every point on the body can be used as an
ment modalities (e.g. Bromiley, 1999; Porter, 2005). However,                  acupoint. Points that are painful on palpation, so called Ah Shi
objective evidence to support their use is not available. Extrapola-           points, can be stimulated by any form of acupuncture. Insertion of
tion from the human field is complicated by the fact that there are            an acupuncture needle causes micro trauma, which produces a local
differences in skin resistance, pigmentation, energy transmission              inflammatory reaction (Ridgway, 2005) and always has a degree of
and absorption between equine tissue and the tissues of people or              afferent sensory stimulation (Skarda et al., 2002). The use of a
research animals that the modalities have been tested on. Conse-               twitch in horses is based on the same principle as acupuncture;
quently, therapeutic regimes are recommended by the manufacturer               stimulation of the receptors in the skin of the nose produces anal-
rather than being based on scientific evidence.                                gesia (Lagerweij et al. 1984; Macgregor and von Schweinitz, 2006).
                                                                               The effect of the twitch and of acupuncture can be blocked by
                                                                               naloxon, a specific opioid antagonist (Xie et al., 2005), which indi-
Acupuncture                                                                    cates that opioids play a role in the pain transmission (Veeneklaas,
Acupuncture is a part of the traditional Chinese medicine (TCM)                1999; Han, 2004). A significant increase of β-endorphins in plasma
dating back to 1500 BC. In addition to acupuncture, TCM also uses              and cerebrospinal fluid has been found following acupuncture
herbal medicine, massage, breathing exercises and others. The word             treatment in horses (Xie et al., 2001). Electro-acupuncture produces
acupuncture is formed by the combination of the Latin words acus,              a greater β-endorphin release in the cerebrospinal fluid than
‘needle’, and pungere, ‘prick’. Typically, acupuncture involves insert-        needle acupuncture (Skarda et al., 2002). Besides the β-endorphin
ing needles at specific acupuncture points (acupoints), although the           release, acupuncture is also thought to act via the gate control
points may be stimulated by other methods including electro-                   theory in which pain in the central nervous system is inhibited by
acupuncture, laser acupuncture and acupressure (massaging of acu-              stimulation of sensory receptors (by needle insertion) in the same
puncture points). Since the formation of the International Veterinary          innervation area (Veeneklaas, 1999; Ammendolia et al., 2008).
Acupuncture Society (IVAS) in 1974, acupuncture has become more                   In human research there is a correlation between activation and
popular as a therapy in animals. There are some indications of a               deactivation of specific areas in the brain by stimulation of acu-
positive clinical effect (Xie et al., 2001; Martin & Klide, 1987), but         puncture points compared to stimulation of sham points (points
literature reviews indicate insufficient evidence to accept or reject          that are not described as being acupuncture points, but which are
the effectiveness of acupuncture for certain problems in both veteri-          located nearby the used acupuncture points and are innervated by
nary and human medicine (Cherkin et al., 2003; Habacher et al.,                the same spinal segment). Some brain areas are activated and deac-
2006; Johnston et al., 2008). Prospective, randomized, double                  tivated by both acupuncture points and sham points (Yan et al.,
blind, clinical trials are necessary to determine whether acupuncture          2005; Hsieh et al., 2001). Stimulation by acupuncture needles at
has more than a placebo effect (Sluijs, 2000). This section will               the vertebral level of the pathological process gives better analgesia
highlight objective evidence for the use of acupuncture in the treat-          in the short term than stimulation distal to the pathological process
ment of horses suffering from chronic back pain (Ridgway, 1999;                (Skarda et al., 2002). In research on the effect of acupuncture
Martin et al., 1987; Xie et al., 2005).                                        in people with back pain, a positive effect has been described.
   The philosophy is based on the Yin-Yang principle, which explains           The largest positive effect was found when acupuncture was com-
that everything in nature is constantly subject to change. Yin and             pared to a negative control group or when acupuncture was used as
Yang are each other’s opposites but on the other hand they comple-             a complementary therapy. There are conflicting results from studies
ment each other. Diseases can also be divided into Yin or Yang. Yin            that compare acupuncture with needling of sham points with
diseases are chronic conditions in which the pain decreases by                 insufficient evidence to prove that the effect of acupuncture is
applying warmth and movement. Yang diseases are inflammations,                 greater than the effect of needling sham points (Ammendolia
which usually show redness, swelling, heat and a sharp pain. Yang              et al., 2008).
pain decreases by applying rest and cold. Yin and Yang are parts of               Acupuncture points in horses originate from two sources. One
the life energy, called Qi or Chi, which is present everywhere, but            system used human acupuncture points and ‘translated’ them to the
researchers have not been able to quantify or measure Qi. Qi circu-            equine model, using corresponding anatomical landmarks. Western
lates through 12 channels, called meridians, each of which is con-             acupuncturists generally use the transpositional atlas in equine acu-
nected to a certain organ or organ system. Most of the acupuncture             puncture (Fleming, 2001). Two articles are found with relevant data
points are located on the meridians (Van der Molen, 1999).                     on the effect of acupuncture in horses with chronic back pain. Xie
   Trigger points are used in Western medicine for making a diag-              et al. (2005) used fifteen horses with TL pain that were randomly
nosis and for treatment of pathological pain (Simons et al., 1999).            assigned to one of the three treatment groups. The pain-relieving
They can be recognized as painful, hard nodular structures within              effect of acupuncture in horses with back pain was compared with
a muscle or fascia. Sometimes they can be localized subcutaneously             phenylbutazone treatment and with a control group in which the
or in the periosteum. Trigger points can occur anywhere on the                 horses received 0.9 % NaCl per os. Group 1 (four horses) received
                                                                                                                                                        407
       17      Rehabilitation of the locomotor apparatus
      electroacupuncture every 3 days for five treatments. Group 2 (seven       3) analysis of weight distribution using a force plate. Though the
      horses) received phenylbutazone 2.2 mg/kg, PO, q 12 h for five            majority of horses improved (60% with chronic laminitis, 70% with
      days. Group 3 (four horses) was the control group which received          navicular disease) there were no statistically significant differences
      0.9% NaCl 20 ml, PO, q 12h for 5 days. The horse owners and               between treatment and control groups. Skarda et al. (2002) found
      trainers were not informed as to what treatment their horse had           that electroacupuncture was more effective than acupuncture in
      received. TL pain score (TPS) was evaluated before, on days 1, 4, 7,      stimulating the spinal cord to release β-endorphins into the CSF of
      10 and 13 during treatment and on days 7 and 14 after the last            horses. Both methods provided cutaneous analgesia in horses, mea-
      electroacupuncture treatment. The mean score of 2 TPS investiga-          sured by use of skin twitch reflex latency without adverse cardiovas-
      tions was used because of the subjective nature of behavior with          cular and respiratory effects.
      one TPS score being evaluated from videotape of the examinations.            A considerable body of literature on acupuncture in human and
      After a washout period of 4 weeks, the measurements were repeated,        veterinary alternative medicine is available, but there is a lack of
      but for unexplained reasons group 3 (control) was not included            good-quality study designs. Patient groups are often relatively small,
      and horses in this group were reallocated to one of the other groups.     negative controls are not included, and blinding is difficult. Articles
      The results showed that after two treatments there was no significant     have described some of the effects of acupuncture, like endorphin
      difference in pain scores between the three groups. After treatment       release or improvement of performance. Controversial outcomes
      3 until 14 days after the final treatment, the group treated with         are given in articles comparing acupuncture with sham treatment.
      acupuncture had a significantly decreased pain score compared to          It is unclear if specific acupuncture points are of greater value
      the other groups. Between the NaCl and phenylbutazone group               than a specific needling of the painful area. Further studies with
      there was no significant difference. The article concluded that the       larger sample sizes and relevant control groups are necessary to
      decrease in TPS scores for the acupuncture group occurred after           obtain scientific evidence to accept or reject the effectiveness of
      three treatments and could last at least 14 days after the fifth treat-   acupuncture.
      ment. Deficiencies in the study include the lack of a negative control
      group during the second phase and the fact that treatment duration
      in the three groups was different. Phenylbutazone and NaCl were
      administered for 5 days, but acupuncture therapy was continued for        Conclusions
      15 days (once every 3 days for five treatments). Furthermore, it is
      not clear if the person investigating the TPS scores was blinded to       The use of rehabilitation strategies and PT in equine veterinary
      the given treatment.                                                      medicine is rapidly expanding; to date there is a relatively small
         Martin and Klide (1987) used 15 horses that were referred to a         body of scientific evidence of their applications and benefits.
      university clinic by other veterinarians. All horses showed signs of      However, the existing data are extremely promising, highlighting
      chronic back pain, which existed for 2–24 months and had not              the beneficial effects of complementary and alternative medicine,
      improved with previous therapies. Hind limb lameness, poor saddle         particularly from a manual therapy and motor control approach as
      fit and poor riding technique were ruled out as causes of the back        an adjunct to traditional medical management in the prevention,
      pain. All horses were treated by injecting 1 mL of saline at the same     treatment, and rehabilitation of sport horses. Equine researchers
      nine acupoints once a week for 7–12 weeks with an average of nine         should evaluate the human literature to develop research strategies,
      treatments. Signs of back pain (clinical signs, behavioral signs, per-    paying particular attention to therapeutic research that has used
      formance changes) were evaluated by the investigators, rider/trainer      quadrupeds as an animal model for human interventions. In clini-
      and referring veterinarian on three occasions: before, during and         cal practices that are widely used including acupuncture, electromo-
      after the treatment period. Response to treatment was classified          dalities and biophysical agents including therapeutic ultrasound,
      as alleviation of signs or no change. The horses were classified as       magnetic field therapy, laser therapy, hydrotherapy (swimming
      having their signs alleviated only if all three evaluators agreed that    pools, spas, underwater treadmills) and thermotherapy. These
      the horse’s performance was normal, there were not clinical signs         modalities are reported in the lay literature to have beneficial effects
      of back pain and the owner/rider thought the horse could perform          (Bromiley, 1999; Porter, 2005) but objective evidence and scientific
      normally. Signs were alleviated in 13/15 horses. Six to twelve            indications for their use are not yet clear in horses. Moreover, many
      months after the final treatment, 11/13 horses that returned to           of these treatment techniques are still the subject of scientific
      normal performance were still competing without signs of back             dispute in the human literature. TENS and NMES, although not
      pain and the other two were no longer competing for reasons unre-         proven effective in the horse, are supported by many studies in
      lated to back pain. The nomenclature of the acupoints used in this        relation to pain modulation and muscle tissue stimulation. Increas-
      study is different from the traditional and transpositional points,       ing evidence is appearing in the equine scientific literature to
      which are commonly used worldwide. No explanation is given on             support the implementation of manual therapy and exercise-based
      why different points were used. No control group was included in          therapies derived from scientific motor control principles. These
      the study, which makes it impossible to rule out a placebo effect.        include intervertebral joint mobilizations/manipulations, dynamic
      The exact moment of evaluation of back pain signs is not made             mobilization exercises and proprioceptive sensory integration
      clear in the report and the method of classification of the horses        techniques.
      is not described. Because the classification of the horses was not           Although research and documented clinical experiences are still
      performed objectively, the outcome has a high risk of being               necessary to complement the adaptation of scientific-based princi-
      subjective.                                                               ples presented in this chapter, it is the authors’ opinion and clinical
         Other studies have shown further systemic effects. Cheng et al.        experience that rehabilitation/PT strategies can be successfully
      (1980) found that electro-acupuncture elevated blood cortisol             incorporated in conjunction with traditional veterinary medicine.
      levels in naive horses whereas sham treatment did not. Bossut et al.      A team approach with the necessary clinical reasoning skills is vital
      (1984) noted production of cutaneous analgesia by electroacupunc-         to choose the appropriate rehabilitation strategy, PT technique and
      ture in horses, with variations in response due to sex of subject and     objective monitoring of the patient’s progress and protocol. Con-
      locus of stimulation. Steiss et al. (1989) used electroacupuncture to     stant reassessment and, where possible, the use of objective mea-
      treat lameness in horses and ponies with chronic laminitis (n = 10)       sures to validate the outcome of the interventions are indicated for
      or navicular disease (n = 10) and assessed the degree of lameness         successful treatment strategies involving PT and rehabilitative
      by: 1) a grading scheme, 2) measurement of stride lengths and             techniques.
408
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      Stubbs, N.C., Kaiser, L.J., Hauptman, J.,                  scale histogram analysis of tendon               Vanderweeën, L., Oostendorp, R.A.B., Vaes, P.,
          Clayton, H.M., 2011. Dynamic mobilization              ultrasonograms. Vet. Radiol. Ultrasound 37          Duquet, W., 1996. Pressure algometry in
          exercises increase cross sectional area of             (1), 46–50.                                         manual therapy. Man. Ther. 1, 258–265.
          multifidus. Equine Vet. J. doi:                    Turner, T.A., 2003. Back problems in Horses.         Vanderweeën, L., Oostendorp, R.A.B., Vaes, P.,
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      Sullivan, K.A., Hill, A.E., Haussler, K.K., 2008.          Practitioners, New Orleans, LA. USA, pp.            manual therapy. Man. Ther. 1 (5),
          The effects of chiropractic, massage and               21–25.                                              258–265.
          phenylbutazone on spinal nociceptive               Valberg, S., 1999. Spinal muscle pathology.          Varcoe-Cocks, K., Sagar, K.N., Jeffcott, L.B.,
          thresholds in horses without clinical signs.           Vet. Clin. N. Am.: Equine Pract. 15 (1),            McGowan, C.M., 2006. Pressure algometry
          Equine Vet. J. 40, 14–20.                              87–96.                                              to quantify muscle pain in racehorses with
      Sumner, H., 1948. Equine accidents in the              Valentin, S., Davis, R., Wilson, A., Pfau, T.,          suspected sacroiliac dysfunction. Equine
          field of sport. Vet. Rec. 60, 579–581.                 2010. The effect of loading on the equine           Vet. J. 38, 558–562.
      Tanaka, T.H., Leisman, G., Nishijo, K., 1998.              spine – a preliminary study. Vet. Med.           Vaughan, L.C., Mason, J.E., 1976. A clinic-
          Dynamic electromyographic response                     Austria 97, 74–80. doi: 10.4112–10–921.             pathological study of racing accidents in
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      Taylor, H.W., Vandevelde, M., Firth, E.C., 1977.           Invest. 20 (5), 572–579.                         Veeneklaas, R.J., 1999. Neurofysiologische
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                                                                                                                CHAPTER                18 
                                              Metabolic energetics
                                              Mathew P. Gerard, E. de Graaf-Roelfsema, David R. Hodgson, J.H. van der Kolk
Introduction                                                              critical as the flux of glucose from the circulation during exercise is
                                                                          limited and is likely to provide no more than ~10% of the energy
                                                                          used during intense exercise. Mitochondria produce the energy for
The horse is a superb athlete, the result of the evolutionary adapta-     muscle contraction. It is not surprising therefore that skeletal muscle
tions required to live as a species on open landscapes. These             of horses contains approximately twice the concentration of mito-
adaptations resulted in speed, to escape predators, and endurance,        chondria found in humans, sheep and cattle. These factors com-
necessary in the search for nutrition. Selective breeding by humans       bined with the profound cardiac output and oxygen carrying
has further modified these evolutionary traits.                           capacity of horses permits this species to have a higher whole
   Domesticated horses have been selected for certain characteristics     animal maximal aerobic capacity when compared to less athletic
depending on the intended use. Heavy breeds were selected for draft       domestic species (Hinchcliff et al., 2004).
or military work whereas lighter horses were chosen because of their         The circulation is responsible for transport of oxygen from the
speed and endurance. This has resulted in myriad breeds and capac-        lungs to exercising muscle and other tissues. Cardiac output and
ities of each. For example, Thoroughbreds can achieve speeds of           oxygen-carrying capacity of blood are key determinants in this
>65 km/h when racing over 800–7000 m, Standardbreds trot or               process. As stated earlier horses achieve rapid increases in the
pace at up to 55 km/h for up to 4000 m, Quarter Horses sprint over        oxygen-carrying capacity of blood via exercise-induced splenic
400 m (1/4 mile) at speeds approaching 90 km/h, yet endurance             contraction. This epinephrine-induced contraction (autoinfusion)
horses (of Arabian breed) can cover 160 km at average speeds of           results in substantive increases (~50%) in blood hemoglobin con-
~25 km/h. In contrast, a pair of draft horses pull a sled weighing        centrations without concomitant increases in plasma volume.
>2000 kg over specific distances from 3.7 to 8.5 m, whereas breeds           The limbs of horses are long and their associated muscles have
such as Warmbloods may participate in eventing, show jumping              relatively low power outputs when compared to smaller athletic
and dressage competitions.                                                species. However, despite this, horses have adapted such that their
   The athletic capacity of horses results from physiologic properties.   gait is energetically efficient. This results from the fact that up to
These may be innate and as such are not affected by training, for         50% of the muscular work occurring during galloping is stored as
example respiratory capacity. In contrast other variables do respond      elastic energy in muscle and tendon units. This mechanism is of
to training, including skeletal muscle respiratory capacity and blood     such magnitude that it has been estimated that in the forelimb of
volume. Overall, particularly when compared to humans, the note-          horses, energy storage and subsequent release means key muscles
worthy athletic ability of horses can be attributed to:                   of the forelimb are substantially smaller than if this process were
                                                                          not available (Hinchcliff et al., 2004).
•	 High maximal aerobic capacity.
                                                                             Vertebrate locomotion requires the controlled integration of
•	 Large intramuscular stores of energy, particularly glycogen.
                                                                          numerous physiological and metabolic pathways that have an
•	 High respiratory capacity of skeletal muscle.
                                                                          impact on the musculoskeletal system to provide the organism with
•	 Splenic contraction, which results in the oxygen-carrying
                                                                          mobility. Perhaps the most important pathways are those concerned
   capacity of blood increasing by up to 50% soon after the
   onset of exercise.                                                     with the production of energy, for without energy muscles cannot
                                                                          contract and mobility is not achieved. One of the major survival
•	 Highly efficient and adaptable gait(s).
                                                                          mechanisms for the wild equid is swift retreat from threatening
•	 Well-developed capacity for effective thermoregulation
                                                                          circumstances. Consequently, the horse has an efficient locomotor
   (Hinchcliff et al., 2004).
                                                                          system designed to move a relatively large mass with great speed
The maximal aerobic capacity of horses is over 2-fold greater             and endurance.
than that of similarly sized cattle. This is due to many of the adapta-      Muscular movement requires the transformation of chemical
tions outlined in the previous paragraph. Substrate is required           energy stored in metabolic fuels to the kinetic energy of muscular
to support these high metabolic rates during exercise. Substrate to       contraction. All pathways integral to energy supply are concerned
support exercise is generally either carbohydrate or fatty acids. In      with the ultimate production of adenosine triphosphate (ATP), the
most species oxidation of fatty acids, although highly efficient in       final carrier of energy ‘packages’ utilized by muscle for contraction.
terms of energy yield, is limited, and is likely to reach capacity when   Muscular contraction involves coupling of thin actin and thick
work rate requires ~50% of the maximal oxygen consumption.                myosin filaments to form cross-bridges and then these filaments
Above this exercise intensity substrate is provided by the oxidation      slide relative to each other by a change in orientation of the cross-
of carbohydrates, predominantly glycogen. Athletic species such as        bridges (Guyton, 1986). Energy is necessary for the change in ori-
horses and dogs have high intramuscular concentrations of glyco-          entation of the cross-bridges to occur. Cleavage of a high-energy
gen relative to humans. This locally available source of substrate is     phosphate bond from ATP results in adenosine diphosphate (ADP),
                                                                                                                                                    419
       18         Metabolic energetics
420
                                                                                                                                                               Production of energy
CARBOHYDRATES FATS
Glycolysis Triglycerides
                         Glucose                Glycogen
                 ATP
                             HK                                                           Glycerol                      Fatty acids (Cn)
                 ADP                         Glucose-1-P
                                                                                   ATP                NAD+            CoA                ATP
                                             Glucose-6-P                          ADP                 NADH                               AMP+2Pi
                                         ATP
                                                    PFK
                                         ADP
Anaerobic
                                                                                        TPI
                                            Fructose-1,6-BP
                Dihydroxyacetone-P                                  Glyceraldehyde-3-P
                                                  TPI
                                                                    ADP                NAD+                                                          Cytosol
                                                                     ATP               NADH
                                                                                                                                                   Mitochondria
                                                                    Phosphoenolpyruvate
                                                                                                                              Acyl CoA
                                                                    ADP                                                                   NAD+
                                                                                  PK                                                      FAD
                                                                     ATP
                                                                           Pyruvate                                     Beta oxidation
                                                                                                                     C(n-2)
                                                            NAD+      NADH
                                                                                                                                          NADH
                                             Lactate                                                    Acetyl CoA (C2)                   FADH2
               Cytosol                                              LDH                PDH
Mitochondria e-
                                                                            3NAD+                                                                     ATP
Aerobic
                                                                            FAD
                                                                                           3NADH                          2CO2
                                                                                           FADH2
                                                                            2e-              Electron
                                                              ATP
                                                                                         transport chain
                                                        ATP                 2H+
                                                  ATP
                                      H2O                                                     O2
Fig 18.2  Schematic representation of the principal components of glycolysis, fatty acid oxidation, the tricarboxcylic acid (TCA) cycle and the electron
transport chain (ETC) in a muscle cell. ATP, adenosine triphosphate; ADP, adenosine diphosphate; BP, bisphosphate; C, carbon; CS, citrate synthase; FAD,
FADH2, flavin adenine dinucleotide; HK, hexokinase; LDH, lactate dehydrogenase; NAD+, NADH, nicotinamide adenine dinucleotide; P, phosphate; PDH,
pyruvate dehydrogenase; PFK, phosphofructokinase; PK, pyruvate kinase; TPI, triose phosphate isomerase.
                                                                                                                                                                                      421
       18      Metabolic energetics
      Fatty acid utilization                                                   In the gluteus medius muscle of Standardbreds, the size of the CP
                                                                               pool is estimated to be 15–20 mmol/kg wet muscle (Lindholm &
      Following lipolysis, non-esterified fatty acids (NEFAs) are released     Piehl, 1974; Lindholm, 1979). This source of ATP replenishment
      into the circulation and are subsequently available as hydrogen          would support maximum intensity exercise for no more than a few
      donors for energy production in skeletal muscle. NEFAs likely            seconds (Åstrand & Rodahl, 1986; Clayton, 1991).
      diffuse into muscle cells down a concentration gradient (Hodgson,
      1985) as well as being actively transported across the cell mem-
      brane. The latter is facilitated by a membrane-associated protein        Myokinase reaction
      called membrane fatty acid translocase (FAT/CD36). This mem-
                                                                               The myokinase enzyme catalyzes the synthesis of ATP and adenosine
      brane fatty acid translocase resides in intracellular membrane frac-
                                                                               monophosphate (AMP) from two ADP molecules:
      tions and translocates to the plasma membrane of skeletal muscle
      cells also after insulin or contraction stimuli and is seen intracel-                           ADP + ADP → ATP + AMP
      lularly in equine muscle exclusively in type 1 fibers (van Dam,          At rest, this reaction proceeds at an approximately equal rate in both
      2004). At the cytoplasmic surface of the outer mitochondrial             directions with little net ATP being produced. In working muscle,
      membrane, the NEFAs are esterified (activated) enzymatically             AMP-deaminase reduces AMP concentration by converting it to
      forming long-chain acyl CoA molecules. The acyl CoA molecules            ionosine monophosphate (IMP) and ammonia. This provides the
      are then linked to carnitine and shuttled across to the matrix side      driving force for the myokinase reaction towards the production of
      of the inner mitochondrial membrane. In the mitochondria the             ATP (McMiken, 1983). Again this pathway only has the capabilities
      acyl CoA molecules undergo a series of four reactions known as           of providing small amounts of ATP.
      β-oxidation. With each cycle of β-oxidation two-carbon (C2) units
      are sequentially removed from the acyl CoA molecule and acetyl
      CoA, NADH and FADH2 are produced (Fig. 18.2). NADH and                   Anaerobic glycolysis
      FADH2 subsequently donate their electrons in the electron trans-         The anaerobic production of two molecules of pyruvate from one
      port chain generating ATP and being reoxidized to NAD+ and FAD           molecule of glucose or glycogen is identical to that described for
      in the process. Acetyl CoA is utilized in the TCA cycle as previously    aerobic glycolysis. In the absence of available O2, pyruvate accepts
      described. The splitting of C2 units from the parent acyl CoA mol-       hydrogen atoms from NADH and is converted to lactate, rather than
      ecule is repeated until the whole chain has been cleaved into the        being converted to acetyl CoA and entering the TCA cycle. The reac-
      acetyl CoA molecules. The number of carbon atoms in the parent           tion is catalyzed by lactate dehydrogenase and the regeneration of
      FA chain will determine the net energy yield from β-oxidation.           NAD+ during the reduction of pyruvate to lactate sustains glycolysis
      Complete oxidation of one palmitic acid molecule produces 129            under anaerobic conditions (Fig. 18.2). The net result of anaerobic
      molecules of ATP.                                                        glycolysis is the production of three molecules of ATP from one
                                                                               molecule of glycogen or two molecules of ATP from one molecule
                                                                               of glucose. This form of energy production is relatively rapid com-
      Anaerobic phosphorylation                                                pared to aerobic glycolysis but yields a significantly lower amount
      The pathways of anaerobic phosphorylation occur solely in the            of ATP and substrates are limited.
      muscle cell cytoplasm, with no reactions in the mitochondria as
      there are for aerobic phosphorylation. However, in general mito-
      chondria are no longer the once-thought uniform ATP-producing            Regulation of aerobic and anaerobic pathways
      organelles, identical in all organisms, but are rather diverse and
      adapted to distinct conditions. Next to the classical aerobic mito-      At all exercise levels both systems of energy supply are active;
      chondria, which contain a respiratory chain and use oxygen as a          however, one will predominate, depending in particular on the
      final electron acceptor, anaerobically functioning mitochondria          intensity and duration of the activity. A complex method of meta-
      were identified that also contain a respiratory chain and perform        bolic regulation controls the input of each pathway. Substrate and
      oxidative phosphorylation, but do not use oxygen as a terminal           enzyme availability, end product concentrations and various feed-
      electron acceptor. The energy metabolism in anaerobic mitochon-          back mechanisms contribute to pathway dynamics.
      dria differs from that in aerobic mitochondria, as no external final        Oxygen supply to muscle and the ratio of ATP:ADP are the most
      electron acceptors are used (Tielens & van Hellemond, 2007).             significant regulators of the energy producing pathways. When
         With the initiation of exercise there is a lag period before oxida-   adequate O2 is available aerobic phosphorylation persists, provid-
      tive energy production becomes an important source of ATP. During        ing a driving force for substrate to enter the TCA cycle and produce
      this time rapid supplies of ATP must still be available if muscular      high concentrations of citrate. Citrate retards the activity of PFK, the
      contraction is to continue. Stores of ATP in skeletal muscle are         enzyme responsible for the irreversible conversion of F-6-P to
      limited (4–6 mmol/kg wet muscle) and contribute little to the total      F-1,6-BP in the glycolytic pathway. This has the effect of inhibiting
      energy supply (Lindholm & Piehl, 1974; McMiken, 1983). Until             glucose and glycogen metabolism. Accumulation of glycolytic inter-
      aerobic phosphorylation makes a substantial contribution to energy       mediates before the PFK step, including G-6-P, inhibits the activities
      supply, rapid regeneration of ATP must occur in the absence of O2.       of HK and phosphorylase, thus also dampening the glycolytic
      The anaerobic phosphorylation of ADP is achieved by three path-          pathway. High cellular concentrations of ATP (i.e. a high ATP : ADP
      ways: the phosphocreatine reaction, the myokinase reaction and           ratio) also inhibits PFK activity. Pyruvate kinase, the third control
      anaerobic glycolysis. The former two pathways may be described           site in glycolysis, is inhibited by ATP and activated by F-1,6-BP.
      as anaerobic alactic reactions because no lactate is produced as it is   When the relatively slow production of energy by oxidative phos-
      in the latter process (Clayton, 1991).                                   phorylation is unable to meet the demands for ATP, the ATP : ADP
                                                                               ratio swings in favor of ADP and this in turn stimulates PFK and
                                                                               enhances glycolysis and the utilization of glucose and glycogen
      Phosphocreatine reaction                                                 stores. The pyruvate produced is metabolized to lactate and this
                                                                               allows the reoxidization of NADH to NAD+ for continued electron
      In this pathway the enzyme creatine kinase catalyzes a reversible        acceptance in the glycolytic pathway.
      reaction where creatine phosphate (CP or phosphocreatine) donates           Control of the TCA cycle starts with regulation of the irreversible
      its high-energy phosphate to ADP producing ATP:                          oxidative decarboxylation of pyruvate to acetyl CoA by pyruvate
                          CP + ADP → Creatine + ATP                            dehydrogenase (PDH). Acetyl CoA, NADH and ATP inhibit PDH
422
                                                                                                                                            Energy substrates
                                                                                                                                                                   423
       18       Metabolic energetics
                                                                                              equine muscle. The primary dietary sources of energy stores for the
       Table 18.2  Mean plasma non-esterified fatty acid (NEFA)
                                                                                              horse are soluble and fiber CHOs and fats. Protein is considered to
       concentration in horses performing various athletic activities
                                                                                              play a minor role as an energy source.
424
                                                                                                                                                                       Energy substrates
Fig 18.3  Effect of consumption of carbohydrate or fat immediately before or during exercise on energy metabolism.
Reprinted from Frape, D.L., (1988) Dietary requirements and athletic performanceof horses, Equine Vet J, 20 (3), 163–172, with permission from the Equine Veterinary Journal.
norepinephrine, glucagon and adrenocorticotrophic hormone and                                     and therefore earlier onset of fatigue. Free FA mobilization is also
inhibited by insulin via hormone sensitive lipase. Glycerol is con-                               inhibited by insulin. Frape (1988) summarized the effects of con-
verted in a number of steps to Gl-3-P, which is an intermediate in                                sumption of CHO or fat before or during exercise on metabolism,
both the glycolytic and gluconeogenic pathways. The FFAs undergo                                  as depicted in Figure 18.3.
β-oxidation and enter the TCA cycle as previously described. Oleic,                                  On the other hand, a lack of available CHO during submaximal
palmitic and linoleic acids (Robb et al., 1972; Westermann, 2008a)                                exercise can also limit performance and there is strong evidence
as well as 3-OH-butyric and 3-OH-iso-butyric acid (Westermann,                                    supporting the use of high CHO diets by humans for endurance
2008a) represent the major FAs in the equine species.                                             exercise (Lawrence, 1990). In humans, muscle glycogen loading was
   Fat has been shown to be the major energy substrate during low-                                achieved by performing intense exercise and then consuming a
intensity exercise. This is best evidenced by a decrease in the respira-                          CHO-rich diet (Lindholm, 1979). Current practice is to combine a
tory exchange ratio (R) (McMiken, 1983; Pagan et al., 1987; Rose                                  program of decreased activity with increased CHO consumption a
et al., 1991) and an increase in plasma NEFA concentrations (Lind-                                few days before competition to achieve a glycogen load. Glycogen
holm, 1979; Rose et al., 1980; Essén-Gustavsson et al., 1991) that                                loading in horses has been accomplished but no obvious improve-
occurs with prolonged submaximal exercise. R is calculated by divid-                              ment in work performance has been demonstrated (Topliff et al.,
ing the volume of carbon dioxide (CO2) expired by the volume of                                   1983, 1985; Frape, 1988; Lawrence, 1990; Snow, 1994). Intrave-
O2 consumed during exercise. R values around 0.7 indicate fat utili-                              nous, but not oral, glucose supplementation has increased glycogen
zation whereas for CHO utilization the value is 1.0. Values within                                repletion rates after exercise (Snow et al., 1987; Davie et al., 1994,
this range reflect various mixtures of FA and CHO metabolism.                                     1995; Snow, 1994). Although glycogen loading is not recom-
When anaerobic metabolism predominates R values will exceed 1.0                                   mended in the horse adequate CHO intake must still be ensured
because lactate production is high, thereby adding to the CO2 load                                (Hintz, 1994). A low CHO diet and regular exercise leads to glyco-
to be eliminated. In addition, in the equine species carnitine forms                              gen depletion and decreased performance in horses (Topliff et al.,
esters predominantly with short- and medium-chain fatty acids in                                  1983, 1985). In a study where fit Standardbreds were exercised
plasma. Submaximal exercise in Standardbreds mainly affected con-                                 strenuously for 3 consecutive days to achieve a 55% depletion of
centrations of short-chain acylcarnitines (Westermann, 2008a).                                    the muscle glycogen store, anaerobic, but not aerobic, capacity was
                                                                                                  impaired (Lacombe et al., 1999). However the association between
                                                                                                  glycogen depletion and impaired anaerobic metabolism is not con-
Protein                                                                                           clusive as confounding effects of other exercise-induced changes on
                                                                                                  performance could not be eliminated (Lacombe et al., 1999). When
Digested protein is absorbed from the small intestine as amino                                    muscle glycogen was depleted by 22% there was no significant effect
acids and small peptides. When amino acids are available in excess                                on performance of Thoroughbreds exercising at high intensities
of the animal’s requirements they may be broken down to provide                                   (Davie et al., 1996).
energy. Degradation by deamination or transamination reactions                                       A CHO supplement taken an hour or two before exercise does
occurs mostly in the liver, with the final product being acetyl CoA                               not seem to benefit endurance performance but intake of glucose
for utilization in the TCA cycle. Leucine, a branched-chain amino                                 during exercise may supplement waning plasma concentrations and
acid, may undergo oxidation directly in muscle (Lawrence, 1990).                                  delay onset of fatigue (Lawrence, 1990) (see Fig. 18.3).
The contribution of amino acids to energy production during exer-                                    The beneficial effects of feeding high-fat diets to horses remains
cise is minor compared to that of CHO and FA (Åstrand & Rodahl,                                   shrouded in controversy. Differences in the condition of the horses,
1986), perhaps in the range of 1–15% (Lawrence, 1990). High                                       type of exercise, the length of the adaptation period to the diets, the
protein diets (up to 16%) were once thought necessary to sustain                                  type of fat used as the supplement, and the level of fat supple-
the performance of mature equine athletes but now it is considered                                mented, particularly in relation to CHO, make comparing the
that approximately 10% protein in the diet is adequate (Snow,                                     published results difficult (Lawrence, 1990; Hintz, 1994). Many
1994). The main amino acids in equine plasma are serine, gluta-                                   variations in study designs influence results obtained. Feeding an
mine, proline, glycine, alanine, and valine. Training of Standard-                                increased level of fat is suggested to cause metabolic adaptations
breds reduced plasma concentrations of aspartic acid (Westermann,                                 like increase in equine heparin-released lipoprotein lipase activity
2010).                                                                                            (Geelen et al., 2001) that permits horses to preferentially utilize fat
                                                                                                  and spare glycogen during exercise but the evidence to support such
                                                                                                  a proposal is inconclusive (Lawrence, 1990; Hintz, 1994; Snow,
Effects of dietary alterations on energy                                                          1994; Geelen et al., 2000). Furthermore, it should be realized that
                                                                                                  dietary soyabean oil depresses the apparent digestibility of fiber
substrate utilization                                                                             when substituted for an iso-energetic amount of cornstarch or
Many published reports have described the effect that altering com-                               glucose (Jansen et al., 2002).
ponents of the normal diet has on substrate utilization and perfor-                                  It has been suggested that improvements in oxidative capacity can
mance in the horse. The consumption of large amounts of digestible                                be brought about by certain amino acid supplements (Lawrence,
CHO within a few hours of strenuous activity may depress the                                      1990; Hintz, 1994). Higher than necessary protein diets are often
performance of that exercise (Åstrand & Rodahl, 1986). This is                                    fed to performance horses but studies to indicate that this practice
possible because insulin-stimulated uptake of blood glucose results                               enhances exercise capabilities are lacking (Lawrence, 1990). On
in hypoglycemia and a greater dependence on muscle glycogen                                       CHO-rich and fat-rich diets, plasma concentrations of glucose,
                                                                                                                                                                                           425
       18      Metabolic energetics
      ammonia, lactate, alanine and the muscle concentrations of G-6-P                                      Atmospheric O2              Altitude
      and lactate were higher at the end of exercise compared to normal
      diets (Essén-Gustavsson et al., 1991). Higher pre-exercise muscle
      glycogen concentrations and FFA concentrations were present in the       Airway resistance
                                                                                                           O2 transport via
      horses fed a CHO-rich diet when compared to the fat-rich and              Ventilation rate
                                                                                                           airways to alveoli
      normal-diet fed periods. No significant difference in performance           Tidal volume
      during trotting at submaximal intensity on a horizontal treadmill
      was detected between the three diets (Essén-Gustavsson et al., 1991)                                                            P(A-a)O2 difference
      with the average time to fatigue being 51–56 min. Whether or not                                     O2 diffusion across
                                                                                                                                          Ventilation/
                                                                                                       alveolar/capillary interface
      the diets would alter performance in shorter or longer exercise                                                                   perfusion ratio
      periods remains unanswered. The effects on protein metabolism
      need to be further investigated as both the CHO-rich and the fat-
      rich diets were associated with significant increases in branched-          Hematocrit                 O2 binding to
      chain amino acids in the plasma during and at the end of exercise         Hb concentration             hemoglobin
      compared to the normal diet (Essén-Gustavsson et al., 1991). The
      resting plasma concentration of the branched-chain amino acids                                                                       Heart rate
      was increased 26% on the fat-rich diet but only 8% on the CHO-                                         O2 distribution
                                                                                                                                         Stroke volume
      rich diet.                                                                                           via the circulation
                                                                                                                                         Blood volume
         A 9% (control) or 18.5% (high) crude protein diet had no effect
      on hepatic or muscular glycogen utilization and did not affect
      exercise performance in Quarter Horses exercising at submaximal                                          O2 uptake
                                                                                  Capillarization
      intensities (Miller-Graber et al., 1991). Performance of Arabian                                         by muscle
      endurance horses was not augmented by excessive protein in
      their diet (Hintz, 1983). In contrast, Standardbreds fed a high-
                                                                                                                                       Oxidative enzymes
      protein diet (20%) or high-fat diet (15% soybean oil) showed                                           O2 utilization
                                                                                                                                         Mitochondrial
      greater muscle and liver glycogen utilization during prolonged exer-                                  by mitochondria
                                                                                                                                            density
      cise compared to when fed a control diet of 12% crude protein
      (Pagan et al., 1987). During higher-intensity, shorter-duration exer-
                                                                              Fig 18.4  The oxygen transport chain, indicating the steps in the transfer of
      cise, glycogen utilization was less when horses were fed the high-
                                                                              oxygen from the inspired air to the final utilization by the mitochondria.
      protein or high-fat diets. Of interest, there was no difference in
                                                                              Physiological variables that will influence the capacity of the oxygen
      concentrations of various plasma amino acids in overtrained Stan-       transport chain are listed beside each step they affect. Hb, hemoglobin;
      dardbreds and age-matched controls (Westermann, 2010).                  P(A–a)O2, alveolar – arterial oxygen pressure.
         The timing of feeding and what to feed before exercise has con-
      siderable influence on the metabolic and physiological responses
      to exercise (Lawrence et al., 1995; Harris & Graham-Thiers, 1999).
      In one study, it was concluded that feeding only hay shortly before
      exercise would not adversely affect performance but feeding grain
      would, and that therefore grain should be withheld (Pagan &             Oxygen uptake at rest and during submaximal exercise
      Harris, 1999).                                                          At rest, V.O2 is in the order of 3–5 mL/kg/min or 1.5–2.5 L/min for
         Of course, many other nutritional components not discussed in        a 500-kg horse (Thornton et al., 1983; Eaton, 1994). It can be dif-
      this chapter may play roles in equine performance (Marlin & Nan-        ficult to accurately obtain a basal V.O2 prior to exercise as often
      kervis, 2002; Hinchcliff et al., 2004). These include water, electro-   horses are excited in anticipation of impending activity. Therefore
      lytes, acid–base balance, minerals and vitamins.                        a resting V.O2 level of 2 mL/kg/min may be more realistic (Eaton,
                                                                              1994).
                                                                                 During submaximal exercise a number of factors will influence
      Energy expenditure                                                      the level of V.O2, including speed of exercise, load being carried,
                                                                              degree of incline on which exercise is being performed, duration of
                                                                              exercise, thermoregulation and track surface.
      Aerobic power                                                              There is a well-established linear relationship between V.O2 and
                                                                              the speed of exercise at submaximal intensities in horses (Hoyt &
      Oxygen uptake                                                           Taylor, 1981; Hörnicke et al., 1983; Evans & Rose, 1987, 1988a;
      The oxygen consumed by the body at a given time is a measure of         Rose et al., 1990a; Eaton, 1994) and humans (Åstrand & Rodahl,
      the body’s total aerobic metabolic rate and is termed the oxygen        1986). When speed increases such that V.O2max is approached, this
      uptake (V.O2). Units of measurement are usually milliliters of          linear relationship is lost as V.O2 plateaus and anaerobic sources of
      oxygen per kilogram of body weight per minute (mL/kg/min) or            energy production become significant. In addition, if horses exercise
      liters per minute (L/min), therefore representing a rate of consump-    at unnatural (extended or restricted) gaits the linear relationship
      tion and not a finite capacity. The maximum rate of oxygen uptake       will be lost due to a loss in economy of locomotion (Hoyt & Taylor,
      is called the V.O2max. Oxygen consumption by the body is princi-        1981; Eaton, 1994; Preedy & Colborne, 2001; Wickler et al., 2001;
      pally a function of the cardiorespiratory system to supply oxygen       Griffin et al., 2004).
      and the capacity of end organs to utilize oxygen. The sequence of          Few equine sports are performed without the horse carrying an
      events is described as the oxygen transport chain (Fig. 18.4). It is    extra load in the form of a rider or driver. Oxygen consumption (or
      influenced by the O2 concentration in the air, ventilation of the       energy expenditure) increases in proportion to the load carried
      lungs, diffusion of O2 through the alveolar wall, circulatory perfu-    (Taylor et al., 1980; Pagan & Hintz, 1986b; Thornton et al., 1987;
      sion of the lungs and affinity of hemoglobin (Hb) for O2, distribu-     Gottlieb-Vedi, et al., 1991).
      tion of O2 to the periphery by the circulation, extraction by the end      Taylor and colleagues (1980) reported that when a 10% load was
      organ (muscle) and, finally, O2 utilization by the mitochondria. A      added to the horse when trotting, V.O2 increased approximately
      large number of physiological variables contribute to the capacity      10% and this direct proportionality was consistent for loads between
      of the oxygen transport chain.                                          7% and 27% of the horse’s body mass. A direct proportionality
426
                                                                                                                          Energy expenditure
between load and V.O2 was also demonstrated for trotting rats, trot-     and electrolyte losses in the sweat, contributing to thermoregulatory
ting and galloping dogs and running humans (Taylor et al., 1980).        and circulatory problems, would be key factors in the horse’s ability
As a consequence, small animals use more oxygen and expend more          to perform endurance activity (Rose & Evans, 1986). Naturally, the
energy to carry each gram of a load a given distance than do large       intensity of exercise will be a determinant of the duration of any
animals, be it their own body mass or an additional load carried.        activity.
Pagan and Hintz (1986b) demonstrated that a 450-kg horse with a             The effect of temperature on V.O2 will be a consequence of any
50-kg rider would expend the same amount of energy as a 500-kg           impedance that altered thermoregulation may have on energy
horse. Thornton and colleagues (1987) found no significant differ-       demands. Redistribution of cardiac output to skin for heat dissipa-
ence in the oxygen cost per kilogram per meter traveled between          tion, fluid shifts and metabolic disturbances may all contribute to
loaded and unloaded horses. The increase in V.O2 due to load is          a less-efficient oxygen transport chain and therefore diminished
achieved largely by an increase in ventilation until maximum tidal       performance. The optimum temperature range for oxygen utiliza-
volume is approached (Thornton et al., 1987) and this is readily         tion has yet to be established.
explained by the close and linear relationship between V.O2                 Track surfaces may affect the economy of locomotion due to
and pulmonary ventilation (Hörnicke et al., 1983; Gottlieb-Vedi          altered stride patterns (change in frequency and length of stride) in
et al., 1991).                                                           slippery, uneven or ‘heavy’ conditions. Quantifying track effects
   The implications for racing performance should be considered.         on energy expenditure is difficult but Thoroughbreds and endur-
A horse of less mass will expend proportionally less total energy to     ance horses have longer race times in heavy conditions (Eaton,
move the same distance when compared to a heavier horse.                 1994). Different treadmills also influence the energetic cost of
   The degree of incline on which exercise is being performed has a      locomotion: it costs less energy for horses to walk, trot or canter
significant impact on V.O2. For Standardbreds, trotting on a 6.25%       on a stiffer treadmill than on a more compliant treadmill (Jones
inclined treadmill at an average speed of 5.2 m/s, V.O2 increased        et al., 2006).
from a mean of 17.7 L/min on the flat to 31.1 L/min on the slope            It has been reported that major horse race times and records
(mean change of 13.4 L/min; 76%, p <0.001) (Thornton et al.,             improved by 5–7% around 1900 when jockeys adopted a crouched
1987). The addition of a load when doing the inclined exercise did       posture. When animals carry loads, there is a proportionate increase
not significantly add to the oxygen cost of the exercise. Thorough-      in metabolic cost, and in humans this increase in cost is reduced
breds exercising on a treadmill at speeds of 1–13 m/s also showed        when the load is elastically coupled to the load bearer. Pfau et al.,
a substantial increase in V.O2 when the treadmill slope was elevated     (2009) showed that jockeys move to isolate themselves from the
from 0–5% and 10% (Eaton et al., 1995a). Exercising on a 10%             movement of their mount, which would be difficult or impossible
slope can double the energy expenditure at some speeds.                  with a seated or upright, straight-legged posture. This isolation
   When trotting on an inclined treadmill over a range of speeds,        means that the horse supports the jockey’s body weight but does
V.O2max is higher during inclined than level running (McDonough          not have to move the jockey through each cyclical stride path. This
et al., 2002) and a greater volume of muscle would have to be            posture requires substantial work by jockeys, who have near-
recruited to generate an equivalent force for body support, which        maximum heart rates during racing.
is reflected in significant increases in the EMG intensity (IEMG) of
muscles (Wickler et al., 2005). In addition, normal training in Stan-
dardbreds resulted in a significant adaptation of quantitative needle    Maximum aerobic power
electromyography (QEMG) parameters. Compared with normal                 When V.O2 no longer increases despite an increase in workload, the
trained controls, intensively trained Standardbreds showed a stron-      horse is defined as having reached V.O2max. This value represents the
ger adaptation (e.g. higher amplitude, shorter duration and fewer        ‘gold standard’ measure for maximum or peak aerobic power. Thor-
turns) in QEMG variables resembling potentially synchronization          oughbred horses have mean V.O2max values around 150–170 mL/kg/
of individual motor unit fiber action potentials (Wijnberg et al.,       min (Evans & Rose, 1987; Rose, et al., 1990a), easily twice the values
2008).                                                                   for elite human athletes (69–85 mL/kg/min), 1.5 times those of
   Wickler et al. (2004) found that the costs of swinging the limbs      greyhounds (100 mL/kg/min) and 3 times those of racing camels
in the horse are considerable and the addition of weights to the         (51 mL/kg/min) (Derman & Noakes, 1994). Oxygen consumption
distal limb can have a profound effect on not only the energetics        can be calculated by the following equation:
of locomotion but also the kinematics, at least in the hind limb.                                V.O2 = CO i (a-v )O2
Thus, they proved that the use of weighted shoes, intended to
increase animation of the gait, increases the metabolic effort of        where CO = cardiac output (heart rate • stroke volume) and (a-v)
performance horses a disproportionate amount. The additional             O2 is the arterio-mixed venous oxygen difference.
mass also increases the joint range of motion and, potentially, the         The horse’s tremendous ability to achieve a higher V.O2max than
likelihood of injury.                                                    other athletic species is related to its massive heart rate response
   The terrain of endurance rides and cross-country tracks in three-     and ability to substantially augment its circulating red blood cell
day events ensure that much work up and down gradients will be           mass, and therefore oxygen-carrying capacity, during exercise
performed and this will play a large role in determining energy          (Thomas & Fregin, 1981). Trends indicate that top human athletes
expenditure. Little investigation has been done regarding the effect     (e.g. runners, cyclists and cross-country skiers) will generally have
of a downhill gradient on energy expenditure in horses but in            higher V.O2max values; however, there is considerable variation
humans the energy cost of moving down a slope decreases up to a          between athletes of similar ability (Derman & Noakes, 1994). In
certain steepness and then becomes more expensive compared to            horses, a positive correlation between running speed and V.O2max
level exercise (Åstrand & Rodahl, 1986).                                 has been described and this correlation became stronger as the
   The effect that duration of exercise has on V.O2 has not been         distance ran increased with an increase in distance run (Harkins
frequently investigated. Rose and Evans (1986) monitored cardio-         et al., 1993). It was suggested that faster horses utilize more oxygen
respiratory and metabolic alterations during 90 min of submaximal        during maximal exercise intensity.
exercise in Standardbreds. The horses trotted on a slope of 2% at
3 m/s. Many of the respiratory variables measured, including V.O2,
reached a steady state within 5 min of the start of exercise and
                                                                         Anaerobic power
remained stable for the duration of the exercise period. Oxygen          Anaerobic energy supply becomes significant when exercise inten-
consumption from 5 min onwards did not alter significantly until         sity is at a level beyond that which aerobic pathways can accom-
a slight decrease was identified at 90 min. It was proposed that fluid   modate alone. The faster glycolytic pathways may be recruited under
                                                                                                                                                  427
       18       Metabolic energetics
                                                                                                     250
                                   Muscle glycogen
                                    concentration                                                                 VO2 demand
         Percentage of                                             Muscle
          type II fibers                                      buffering capacity                     200
                                                                                                                  VO2 max
                                     Anaerobic
                                                                                   VO2 (ml/kg/min)
                                      capacity                                                       150
             Muscle                                                Rate of
           fiber area            Muscle concentration          glycogenolysis                        100
                              of high-energy phosphates
                                                                                                          0
                                                                                                                  0    2         4     6     8    10     12      14    16   18   20
                                                                                                     A                                       Speed (m/s)
      two conditions: when energy demand increases so rapidly that the
      slower aerobic systems cannot match the supply rate required; or
      when the total energy demand exceeds what the aerobic pathways
      are capable of supplying at peak capacity. Workloads at intensities                            250
      beyond that provided for by V.O2max have been referred to as supra-
      maximal intensities. This level of energy utilization is experienced
      by racing Thoroughbreds, Standardbreds and Quarter Horses during                               200                    Anaerobic capacity
      competition. Shorter duration races, e.g. Quarter Horse 400-m
      sprints, rely predominately on the rapid supply of energy by anaero-
                                                                                   VO2 (ml/kg/min)
      bic means (Eaton, 1994). Anaerobic power is considered a finite                                150
      capacity and not a rate because the supply of substrates for anaero-
      bic phosphorylation is limited. Factors that influence anaerobic                               100                    Aerobic contribution
      capacity are depicted in Figure 18.5.
         Theorizing that anaerobic capacity is a function of the area of
      type II fibers in the locomotor muscles, McMiken (1983) stated that                                50
      to measure maximal anaerobic capacity one should calculate the
      type II fiber area and the activities of anaerobic pathway enzymes
      in the muscle. Maximum accumulated oxygen deficit (MAOD) has                                        0
                                                                                                              0             30             60               90        120        150
      been investigated as a measure of anaerobic capacity in horses                                 B                                           Time (s)
      (Eaton et al., 1992, 1995b; Eaton, 1994) following preliminary
      studies indicating its usefulness in humans (Mebø et al., 1988; Scott        Fig 18.6  Determination of maximum accumulated oxygen deficit (MAOD).
      et al., 1991).                                                               (A) Initially, the V.O2 versus speed plot is generated by performing a
         Oxygen deficit refers to the deficiency in V.O2 that occurs at the        standardized incremental exercise test on an inclined treadmill. The V.O2max
      commencement of exercise until the responding cardiorespiratory              is 175 mL/kg/min, and for this horse to exercise at an intensity of 125% of
      system meets the oxygen demand of the tissues (Åstrand & Rodahl,             V.O2max, by extrapolation it can be seen that the V.O2 demand would be
      1986). The total oxygen deficit that accumulates during exercise at          219 mL/kg/min. To exercise at this supramaximal intensity the horse would
      supramaximal intensities is the MAOD and this is the difference              need to run at 15 m/s. (B) This figure demonstrates the relationship
      between the oxygen demand and the actual V.O2 achieved. The O2               between V.O2 and time for the horse exercising at 125% of V.O2max. The
      demand is calculated by extrapolating from the linear relationship           previously calculated O2 demand is drawn in as the dotted line at 219 mL/
      between V.O2 and speed at submaximal intensities (Fig. 18.6). To             kg/min. At the onset of the exercise there is a lag in V.O2 but it quickly
      determine MAOD, horses on a treadmill are rapidly accelerated to             reaches V.O2max. The exercise ceases when the horse can no longer keep
                                                                                   pace with the treadmill. The difference in the O2 demand and the actual
      speeds equivalent to supramaximal intensities (defined as a percent-
                                                                                   oxygen uptake is defined as the MAOD and is a measure of the anaerobic
      age of V.O2max measured in a previous exercise test and extrapolated
                                                                                   capacity.
      from the V.O2 versus speed plot) (Rose et al., 1988; Eaton et al.,
                                                                                   Adapted from Eaton (1994).
      1995b). The V.O2 is measured at frequent intervals until the horse
      fatigues. The area between the O2 demand and the V.O2 curve is the
      MAOD (Eaton et al., 1995b) (Fig. 18.6).
                                                                                     In humans, the power vs time-to-fatigue (P:TTF) relationship has
         For exercise intensities requiring 105–125% V.O2max the MAOD
                                                                                   been used as an accepted method for assessing anaerobic work
      was similar at 31 mL O2 equivalents per kg of bodyweight but the
                                                                                   capacity and this relationship has now been investigated in horses
      proportion of energy supplied by anaerobic processes increased
                                                                                   (Lauderdale & Hinchcliff, 1999). In humans, the relationship is best
      from 14 to 30% (Eaton et al., 1995b). V.O2max was not correlated to
                                                                                   described by the hyperbolic equation:
      MAOD, suggesting that anaerobic capacity is unlikely to be depen-
      dent on the rate of oxygen uptake. Eaton and colleagues (1995b)                                        t = W9/(P 2ØPA )
      proposed from their results that anaerobic energy supply would               where t is the time to fatigue (s); P is power (watts); ØPA is power
      contribute less than 30% of the total energy input in Thoroughbred           asymptote, or critical power, which represents the maximum sus-
      and Standardbred races, which is considerably lower than previ-              tainable power output or anaerobic threshold, and W9 is a constant
      ously suggested (Bayly, 1985). Using peak blood or plasma lactate            representing anaerobic capacity or the finite amount of work that
      concentrations as an indicator of anaerobic capacity appears limited         can be performed above ØPA (Fig. 18.7). Similarly to humans, the
      because of the many variables like function of monocarboxylate               P:TTF relationship in Standardbreds is best represented by a hyper-
      transporters (MCT) as lactate carriers (Koho et al., 2006) that affect       bolic function; however, the technique needs to be validated against
      lactate concentrations including rates of flux between fluid                 the more traditional MAOD measure of anaerobic capacity before
      compartments.                                                                its usefulness in horses as a predictor of fitness and anaerobic
428
                                                                                                                                   Energy expenditure
                                                                                 or oxygen debt. The EPOC may only account for a small fraction of
                                                                                 the net total oxygen cost (NTOC) of exercise. In humans exercising
                                                                                 at 30–70% of V.O2max for up to 80 min the EPOC was only 1.0–
                                                                                 8.9% of the NTOC of the exercise (Gore & Withers, 1990). In the
                                                                                 only comprehensive study to date in horses, Rose and colleagues
                                                                                 (1988) measured oxygen debt as the area under the O2 recovery
Time-to-fatigue (s)
                                                                                                                                                           429
                  18                        Metabolic energetics
                                                                                                         No. of observations
                                                                                                    10                         does in humans. In horses and humans, there is a discontinuity at
                                    8                                                                                          the walk-trot (run) transition and data for other species do not
                                                                                                                               permit generalization. Duty factor (DF) in humans is >0.5 in
                                                                                                    5                          walking (pendulum mechanics) and <0.5 when running (spring
                                    4                                                                                          mechanics). However, this is not true in many species that have DF
                                                                                                                               >0.5 at the lowest speeds where they use spring mechanics, includ-
                                                                                                                               ing horses performing the tölt (Biknevicius et al., 2006). Appar-
                                    0                                                               0
                                        0       1       2       3         4        5        6   7                              ently, different energy-conserving mechanics (i.e. pendulum and
                                                                                                                               spring) used in different gaits reflected in differences in energetics
                                                                                                                               and/or stride parameters.
                                                                                                                                  The effects of training and athletic activities on the economy of
                                               Walk                               Gallop                                       equine locomotion need to be considered. Endurance horses forced
                                                                   Trot                                                        to use extended gaits for prolonged periods may fatigue more
                                                                                                                               rapidly than if they were to move at their natural speed for each
                                                            Running speed (m/s)
                                                                                                                               gait. Clearly, it becomes a matter of achieving the right balance of
       Fig 18.8  Economy of locomotion. The oxygen cost to move a unit distance                                                speed and energy consumption to complete the distances and be
       (rate of oxygen consumption divided by speed) declined to a minimum and                                                 successful in such events. Standardbred trotters and pacers may be
       then increased with increasing speed in a walk and trot. It also declined to a                                          able to work at a wide range of speeds using a single gait without
       minimum in a gallop but the treadmill did not go fast enough to observe                                                 any loss of economy (Thornton, et al., 1987; Eaton, 1994).
       any increase at higher galloping speeds. The minimum oxygen cost to
       move a unit distance was almost the same in all three gaits. The histogram
       shows gaits when a horse was allowed to select its own speed while                                                      Fatigue
       running over ground. The three speeds chosen coincided with the                                                         Fatigue is a complex and intricate physiological response to exercise,
       energetically optimal speed for each gait.                                                                              leading to the inability to sustain further activity at the current
       From Hoyt, D.F., Taylor, C.R., Gait and the energetic of locomotion in horses. Reprinted by
                                                                                                                               intensity. Fatigue can be categorized as structural, acute or chronic.
       permission from Macmillan Publishers Ltd, Nature Publishing Group, ©1981.
                                                                                                                               Structural fatigue refers to biomechanical failure of tissues, for
                                                                                                                               example tendons, ligaments and bone, which inadequately adapt
                                                                                                                               to the stresses placed upon them. Chronic fatigue is a function of
                                                                                                                               prolonged conditions such as chronic anemia and starvation. Acute
       treadmill. Rates of oxygen consumption increased curvilinearly with                                                     fatigue is directly related to energy production in the muscle and
       speed for walking and trotting. The maximum speed of the tread-                                                         occurs in events requiring maximal work effort for short periods,
       mill prevented sufficient data from being obtained for galloping                                                        e.g. Thoroughbred or Standardbred racing. It has been labeled
       velocities. Gait transitions occurred at speeds when the oxygen con-                                                    anaerobic fatigue (McMiken, 1983) and has different causal factors
       sumption was similar for the two gaits, but when the ponies were                                                        to those that limit aerobic performance in endurance type events.
       forced to exercise at an extended gait beyond the normal range of                                                       Fatigue appears to involve central (psychologic/neurologic) and
       speeds, oxygen consumption was higher (Hoyt & Taylor, 1981).                                                            peripheral (muscular) contributions (Hodgson & Rose, 1994a).
       Thus, there was a speed for each gait where the energy cost of loco-                                                    Overtrained horses can become listless and ‘sour’ with a decline in
       motion was minimal and this cost was similar for the walk, trot and                                                     performance that may be partly a manifestation of psychological
       gallop (Hoyt & Taylor, 1981) (Fig. 18.8). So, at the optimal speed                                                      fatigue. Rivero et al., (2008) differentiate overtraining syndrome
       of each gait, the amount of energy consumed to move a given dis-                                                        (OTS) from over-reaching, a term used for horses that, after suffer-
       tance is much the same. When a horse was allowed to move at its                                                         ing a loss of performance without an obvious clinical reason,
       natural pace, it did so by selecting speeds within each gait around                                                     recover their performance within 1 or 2 weeks. When inadequate
       the most energy efficient speed (Hoyt & Taylor, 1981). The optimal                                                      training stress is applied and recovery time is insufficient, perfor-
       value for economy was similar to the 0.122–0.133 mL O2/kg/m                                                             mance reduction and chronic maladaptation occurs. Overtraining
       values derived elsewhere for flat treadmill exercise (Taylor et al.,                                                    syndrome (OTS) is known as a complex condition, which often
       1980; Thornton et al., 1987).                                                                                           afflicts horses in top training. Peripheral causes of fatigue have been
          Griffin et al. (2004) found that the absolute walk–trot transition                                                   studied more widely as they are easier to define. Recently, De Graaf-
       speed increased with size, but it occurred at nearly the same Froude                                                    Roelfsema et al., (2009) induced overtraining (performance
       number. In addition, horses spontaneously switched between gaits                                                        decreased nearly 20% compared with controls and did not improve
       in a narrow range of speeds that corresponded to the metabolically                                                      after 4 weeks of detraining) by intensified training and found that
       optimal transition speed. These results support the hypotheses that                                                     endocrinological and behavioral alterations occurred before periph-
       the walk–trot transition is triggered by inverted-pendulum dynam-                                                       eral adaptations for example in the muscles (De Graaf-Roelfsema
       ics and occurs at the speed that maximizes metabolic economy. Of                                                        et al., 2009).
       interest, some overtrained Standardbreds made a transition to                                                              Fatigue in response to high-intensity exercise is likely due to a
       canter rather than continue trotting during a standardized exercise                                                     combination of factors including depletion of the phosphagen
       test (De Graaf-Roelfsema et al., 2009). Nevertheless, Hoyt et al.,                                                      pool (ATP and CP), decreased intracellular pH, and possibly
430
                                                                                                                              Training programs
                                                                                                                                                     431
       18      Metabolic energetics
      equine research centers for ongoing studies of exercise physiology       to determine V.O2max is a standardized rapid incremental test on a
      and for the diagnosis of poor performance conditions, in particular      10% treadmill incline (Rose et al., 1990b) and the repeatability of
      dynamic upper airway obstructions. In addition, treadmills are now       results is good (Evans & Rose, 1988a; Seeherman & Morris, 1990).
      commonly used in training stables as a complementary training            Oxygen uptake can improve quickly with the onset of training but
      tool and by stud farms to walk and trot yearlings for conditioning       relative training intensity, when kept constant and submaximal,
      prior to sale.                                                           does not appear to affect the rate of change of V.O2max (Knight et al.,
         Most current knowledge concerning the physiologic response of         1991).
      the horse to exercise has come from numerous treadmill-based
      studies. Cardiovascular, respiratory, metabolic, hematologic, ther-
      moregulatory, hormonal, musculoskeletal and locomotory changes
                                                                               Lactate analysis
      in the horse, exercising over various intensities and durations, have    Response to training and the relative intensity of an exercise session
      been thoroughly examined.                                                can be assessed by the simple measurement of blood or plasma
         Treadmill exercise is not equivalent to track exercise (Sloet van     lactate, during or after exercise (Milne et al., 1977). Lactate increases
      Oldruitenborgh-Oosterbaan & Clayton, 1999). The effects of air           at an exponential rate with increasing workload, and fitter horses
      movement, track surface and rider impact are not duplicated on the       show a slower accumulation during submaximal exercise. The VLA4
      treadmill and horses have no forward momentum on the treadmill           is often calculated to compare fitness between horses and response
      because the moving belt provides the driving force (Rose & Hodgson,      to training. Classically, the VLA4 has been considered to approximate
      1994b). So the amount of work performed by a horse on the tread-         the anaerobic threshold, mirroring the metabolic transition from
      mill is quantitatively different from work on the track. For a track     predominantly aerobic to anaerobic energy sources, and this calcu-
      exercise test, horses require only a short habituation period and can    lated value increases with improved fitness (Hodgson & Rose,
      be worked in their standard manner, often with the usual rider or        1994b). Plasma lactate values are 30–50% higher than whole blood
      driver (Sloet van Oldruitenborgh-Oosterbaan & Clayton, 1999).            lactate (Rose & Hodgson, 1994b). However, because of great inter-
      Nevertheless, there are clear advantages to studying responses to        individual variation in lactate distribution between plasma and red
      exercise on the treadmill. A consistent exercise surface, controlled     blood cells (RBCs) after exercise and in the rate of lactate influx into
      environmental conditions, precise control over intensity of exercise     RBCs, there is no consistent relationship between the two lactate
      and ease of measuring physiologic variables to monitor fitness are       reservoirs (Pösö et al., 1995; Väihkönen & Pösö, 1998). Recent
      all strong indications to pursue treadmill-based studies (Rose &         evidence suggests that whole blood lactate concentrations should
      Hodgson, 1994b; Sloet van Oldruitenborgh-Oosterbaan & Clayton,           be measured when estimating the accumulation of lactate from
      1999). By positively inclining the treadmill, a horse can be exercised   exercising muscle, to minimize variation due to factors that influ-
      at its maximum power output at a relatively slower speed than if it      ence transport of lactate from plasma into RBCs (Väihkönen et al.,
      were on a flat plane (Sexton & Erickson, 1990). This potentially         1999). If whole blood is to be used, the sample should be imme-
      reduces the risk of musculoskeletal injury because speeds above          diately deproteinized to halt post-collection production of lactate
      12–13 m/s are unnecessary, but the steeper the slope the greater the     within the RBC (Ferrante, 1995); however, storage at 0°C for up to
      effects on gait and mechanics. It is suggested that muscles may be       an hour before deproteinization does not affect the lactate concen-
      recruited differently when the horse is exercised on a slope versus      tration (Ferrante & Kronfeld, 1994).
      the flat (Sloet van Oldruitenborgh-Oosterbaan & Barneveld, 1995).           Whether plasma or whole blood lactate is assessed, one method
      A slope of 10% (5.71°) is recommended for treadmill testing as           should be adhered to by the laboratory or investigator, to reduce
      most horses will reach their maximum oxygen uptake at speeds of          variability in measurements. Post-exercise blood and plasma lactate
      10–12 m/s compared with 14–15 m/s on the flat (Rose & Hodgson,           concentrations were significantly correlated with race performance
      1994b). It is desirable to standardize the incline that exercise         for Thoroughbreds undergoing a submaximal treadmill exercise test
      tests are performed on, to allow better comparison between studies       (Evans et al., 1993). Harkins and colleagues (1993) found the VLA4
      from different institutions (Sloet van Oldruitenborgh-Oosterbaan         to be one of the best correlates of running speed for Thoroughbreds.
      & Clayton, 1999).                                                        This was a negative correlation, indicating that faster horses attained
         Significant differences in locomotor and metabolic variables have     a plasma lactate of 4 mmol/L at a lower velocity than did slower
      been reported in studies comparing track versus treadmill exercise       horses. The faster horses also had the highest peak lactate concentra-
      (Sloet van Oldruitenborgh-Oosterbaan & Clayton, 1999) and                tions, implying that plasma lactate concentrations of faster horses
      future research may continue to elucidate the etiology of these dif-     rise more rapidly and to higher levels than do those of slower
      ferences. Currently, treadmill tests are preferable for most research    horses. However, no correlation was found between performance
      purposes but track tests may be of greater importance when examin-       and post-exercise blood or plasma lactate concentrations taken after
      ing locomotor variables and fitness of sport horses (Sloet van           maximal activity during a field trial (Evans et al., 1993).
      Oldruitenborgh-Oosterbaan & Clayton, 1999).                                 Recent research (Lindner et al., 2010) defined the maximum
                                                                               lactate at steady state (maxLASS) in horses based on the definition
                                                                               by Heck et al. (1985) and showed that not V4 but V2 most closely
      Oxygen consumption                                                       resembles the maxLASS in horses. They defined maxLASS as the
      The measurement of V.O2 by the exercising body is the single most        maximal speed at which the [LA] does not change by more than
      important step in the evaluation of exercise capacity. In the horse,     1 mmol/L between the 5th and the 25th min of exercise at a con-
      various mask systems have been investigated and an open-flow             stant pace. More research is needed to confirm this conclusion,
      mask without valves is the currently accepted apparatus. Bayly and       though it has already been shown that training of endurance horses
      colleagues (1987) compared flow-through mask systems with                at V2 for 4 weeks was able to significantly improve the V4 during
      valved masks and found a funnel-shaped, valveless flow-through           standardized exercise tests (Trilk et al., 2002).
      system to have the least impedance on airway function at flow rates
      of 6300 L/min. Evans and Rose (1988b) investigated a valved mask
      system and showed a negative influence on arterial blood gases,
                                                                               Heart rate
      namely an exacerbation of exercise-induced hypercapnea and               Heart rate is measured to monitor exercise intensity on the basis
      hypoxemia. Respiratory frequency was lower when the mask was             that there is a linear relationship between heart rate and work per-
      worn but arterial acid–base tensions and heart rate were minimally       formed in the range of 120–210 beats per min (bpm) (Persson,
      affected. The respiratory effects were attributed to alveolar hypoven-   1983). The velocity at a heart rate of 200 bpm (V200) has been used
      tilation (Evans & Rose, 1988b). The most appropriate exercise test       to assess fitness and response to training but care should be taken
432
                                                                                                                                   Training programs
when evaluating this variable (Rose & Hodgson, 1994a). Conflict-          gluteal muscle was used as the preferred site of sampling and con-
ing reports on the correlation between V200 and V.O2max have been         tinues to be favored today although other muscles, e.g. the semi-
published (Evans & Rose, 1987; Rose et al., 1990a) but this is attrib-    tendinosis, biceps femoris, and lateral vastus have been examined.
uted to the dissimilar numbers of horses tested in each study and         The latter muscle has the advantage to be able to compare muscle
it is accepted that the two variables are significantly positively cor-   histochemistry and histopathology with quantitative needle elec-
related. The usefulness of V200 to assess response to training in the     tromyography (QEMG) parameters in the conscious horse
field using Thoroughbreds has been confirmed (Kobayashi et al.,           (Wijnberg et al., 2008) as for instance the gluteal muscle has very
1999). A number of heart rate meters are available with generally         poor basal motor unit action potentials (MUPs). Examination of
good accuracy (Evans & Rose, 1986; Rose & Hodgson, 1994b;                 muscle tissue has allowed fiber typing and evaluation of responses
Holopherne et al., 1999). Telemetered electrocardiography is the          to exercise and training, particularly alterations in substrate utiliza-
favored technique in treadmill laboratories. To achieve accurate          tion and the oxidative capacity of muscle. One concern with the
heart rate values good electrode contact with the skin is required,       use of muscle biopsies is the degree of variation in samples from
and this can be difficult to maintain in the galloping horse. Electrode   very similar sites. A standardized approach to the muscle biopsy
gels can enhance contact and glue adhesives can hold electrode            procedure in French trotters has been described, incorporating
casings firmly on the skin (Hill et al., 1977; Rose & Hodgson, 1994b).    anatomical landmarks, age, sex and hip width of the horses (Valette
                                                                          et al., 1999). Interestingly, muscle fiber composition has been cor-
                                                                          related with locomotor patterns in horses (stride frequency and
Blood gases                                                               stride length) (Rivero & Clayton, 1996, Rivero et al., 2006) and
Respiratory disorders that may interfere with the transport of oxygen     therefore may indirectly influence the economy of locomotion.
from the atmosphere to the pulmonary vasculature can be assessed          Furthermore, epaxial muscle biopsy characterized histopathologi-
for their significance by measuring arterial blood gas tensions. Arte-    cally and by electron microscopy is a good option in diagnosing
rial blood samples are normally collected from a catheterized trans-      back problems in horses when clinical examination and imaging
verse facial artery during a treadmill exercise test. Values should be    techniques do not provide a precise diagnosis (Quiroz-Rothe et al.,
corrected for central venous blood temperature. Hypoxemia and             2002) (Fig. 18.9). In addition, urinary excretion of organic acids,
hypercapnea are recognized responses to high-intensity exercise           glycine conjugates and acylcarnitines (Westermann et al., 2008b),
(Bayly et al., 1983, 1987) and the severity of hypoxemia increases        needle electromyography (EMG) (Wijnberg et al., 2002, 2003,
with training (Christley et al., 1997). There is a strong negative cor-   2008) and proteomics (Bouwman et al., 2010) are attractive
relation between minimal arterial oxygen content and VO2max in            additional tools to evaluate myopathy besides increased plasma
trained horses, indicating the importance of assessing both vari-         muscle enzyme activities (like CK) and histological evaluation
ables before interpreting blood gas data (Christley et al., 1997).        of muscle biopsies.
Horses with functional airway obstructions may have a greater                Using modern cDNA microarrays, Barrey et al., (2006) showed
degree of hypoxemia or hypercapnea when approaching, and at,              that genes are modulated in leucocytes in relationship with perfor-
maximal exercise intensities compared to normal horses (Rose &            mance and clinical status of the horses. It appeared that the gene
Hodgson, 1994a). The degree of hypoxemia in normal Thorough-              ontology classification showed that more genes were up-regulated
breds performing a standardized treadmill exercise test was not           in successful than in disqualified endurance horses. More genes
correlated with their running speed on an 800 m track (Harkins
et al., 1993).
Blood volume
The Evans blue dye technique of measuring the plasma volume
(PV) in horses was first described by Persson in 1967. It is a simple
and highly reproducible technique with a coefficient of variation
of 3–4%. To ensure an accurate assessment of the plasma volume,
the splenic erythrocyte pool must be mobilized either by intense
exercise or an epinephrine injection. A post-exercise hematocrit is
preferred and is typically measured for blood volume calculations.
A major determinant of the oxygen-carrying capacity of the horse
is the red cell volume (RCV), which can be calculated from the
hematocrit and PV. Evaluation of the hematocrit alone as an indi-
cator of RCV can be misleading due to variations in PV. Plasma
volume increases in response to training in all species studied
(Oscai et al., 1968; Persson, 1968; McKeever et al., 1985, 1987).
Total blood volume (TBV) has been positively correlated with
fitness level and may be a useful measure of such as long as varia-
tions due to body size, age, sex and breed of horse are taken into
account (Persson, 1968). A significant positive correlation has also
been found between TBV and racing performance in Standardbred
trotters (Persson, 1968). During a single high-intensity exercise
bout TBV increases substantially in the horse mainly due to the
release of red cells from the splenic reservoir. It remains to be elu-
cidated whether PV or RCV can be used to predict performance in           Fig 18.9  Electron micrograph of lateral vastus muscle transverse section
horses.                                                                   from a 12-year-old Warmblood mare illustrating normal mitochondria.
                                                                          Mitochondria are no longer the once-thought uniform ATP-producing
                                                                          organelles, identical in all organisms, but are rather diverse and adapted to
Muscle biopsy                                                             distinct conditions. Next to the classical aerobic mitochondria, which
Needle biopsy of skeletal muscle was first described in the horse         contain a respiratory chain and use oxygen as a final electron acceptor,
more than 35 years ago by Lindholm and Piehl (1974). The middle           anaerobically functioning mitochondria were identified.
                                                                                                                                                          433
       18      Metabolic energetics
      were down-regulated in the disqualified horses. Some genes were            disorder, such as long-term increased CRH secretion raised by
      expressed in relationship with the clinical phenotype observed in          chronic stress or indirectly by increased secretion of an ACTH inhib-
      the disqualified horses: rhabdomyolysis and hemolysis. Recently,           itory factor that counteracts the action of CRH raised by chronic
      Eivers et al., (2010) investigated the adaptive changes in mRNA            social stress as described by Alexander et al. (1996) in chronic
      expression to training in equine skeletal muscle biopsies by real-         socially stressed horses.
      time qRT-PCR for a panel of candidate exercise-response genes                 Pituitary growth hormone (GH) is usually secreted in an episodic
      following a standardized incremental-step treadmill exercise test in       manner as a result of a delicate interaction between the two hypo-
      a group of untrained Thoroughbred horses. Significant differences          thalamic peptides, GH-releasing hormone (GHRH) and somatosta-
      in gene expression were detected for several genes 4 h after exercise.     tin (SRIF). GH stimulates the liver to produce insulin-like growth
      Investigation of relationships between mRNA and velocity at                factor (IGF-1), which mediates most of the effects of GH via the
      maximum heart rate and peak postexercise plasma lactate concen-            IGF receptor family. Defects in the function of the GH-IGF-1-axis
      tration revealed significant associations with postexercise gene           could, in theory, be located at any level from the hypothalamus
      expression, and between plasma lactate concentration and basal             down to the target receptors in skeletal tissues. Diagnostic tests for
      gene expression. These findings highlight the roles of genes respon-       assessing the function of the GH-IGF-1 axis include measurements
      sible for the regulation of oxygen-dependent metabolism, glucose           of multiple serum GH concentrations, single serum IGF-1 concen-
      metabolism, and fatty acid utilization in equine skeletal muscle           tration, and various endocrine challenge tests, for example, with
      adaptation to exercise.                                                    GHRH. GH pulsatility characteristics can be determined from the
                                                                                 GH data series by visual identification of presumptive pulses.
                                                                                 However, this method is not very objective. Therefore, computerized
      Hormone profile                                                            algorithms have been developed in order to analyze GH hormone
      In general, stress occurs when body homeostatic balance is dis-            pulsatility and regularity (Veldhuis et al., 2008). Because monitor-
      turbed (Sapolsky et al., 2000; Selye 1951). When the body experi-          ing the pattern of spontaneous GH secretion is labor-sensitive and
      ences environmental or internal stressors it responds by secreting a       difficult, challenge tests to measure GH ‘secretory reserves’ are often
      whole array of hormones to reestablish homeostatic balance. Regen-         used instead. GH deficiency and GH insensitivity also influence the
      erative processes continue after restoration of homeostatic balance        serum concentrations of IGF-1 and IGF-2 and their binding pro-
      such that, if the same stressor were imposed again, the homeostatic        teins, which makes the latter good indices of GH status. Further-
      mechanisms would not be displaced to the same extent, resulting            more, the serum concentrations of IGF-1 and IGF-2 are relatively
      in overcompensation (Selye, 1951). The overcompensation is seen            constant during the day, so that stimulation tests or multiple sam-
      as positive stress.                                                        plings are not necessary (De Graaf-Roelfsema et al., 2011).
         The hormonal events during reestablishment of homeostasis due
      to (exercise) stress can be divided into two phases. Initially, a cata-
      bolic phase can be distinguished, with decreased tolerance of effort,      Effects of exogenous GH
      characterized by reversible biochemical, hormonal and immuno-              It is well known that GH has anabolic effects, and its consequent
      logical changes. The two main hormonal axes activated in this phase        abuse is a concern in many sports, including horse racing. The avail-
      are the sympathetic-adrenal medullary (SAM) axis and the                   ability of reGH in Australia has attracted the attention of horse
      hypothalamic-pituitary-adrenocortical (HPA) axis (Armstrong &              racing authorities worldwide and urged the development of
      van Heest, 2002). An anabolic phase follows with a higher adaptive         methods for the detection of its abuse (De Kock et al., 2001). The
      capacity and enhanced performance capacity, in which both the              availability of reGH also attracted the attention of researchers to
      GH-IGF-I axis as well as the gonadal-axis are activated (Urhausen          determine the responses to administration of reGH in horses.
      et al., 1995). When homeostatic balance is not restored, the body             The biological responses to reGH administration in adult horses
      experiences chronic stress which induces chronic activation of the         are similar to those common in other species: hyperglycemia,
      endocrine system and possibly ending in a neuroendocrine disorder          hyperinsulinemia, insulin resistance, decreased plasma urea nitro-
      like the overtraining syndrome.                                            gen concentrations, increased plasma IGF-I and IGFBP-3 concentra-
         So far, no single diagnostic parameter has been identified for          tions (De Kock et al., 2001, Julen Day et al., 1998, Malinowski
      overreaching and the overtraining syndrome in humans or equines            et al., 1997, Popot et al., 2001, Smith et al., 1999, Thatcher and
      and so far a combination of different (hormonal) parameters                Thompson 2002).
      appear to be the best indicators of overreaching/overtraining (Hug            Beneficial effects of reGH administration reported to date in adult
      et al., 2003, Rivero et al., 2008). Standardized exercise tests are sug-   horses include increased nitrogen retention, muscularity and granu-
      gested to provide a way to detect subtle changes in hormonal               locyte numbers in aged mares (Malinowski et al., 1997).
      responses in the individual, which may make an important contri-              No effects of reGH administration were found in age-related
      bution to the detection of early overtraining (Rivero et al., 2008).       declines in various immune parameters in adult horses (Guirnalda
         Alterations in functioning of the HPA axis has been described in        et al., 2001), on modulation of the in vitro biomechanical properties
      trained, overreached and overtrained horses. Several mechanisms            of superficial digital flexor tendon (SDFT) (Dowling et al., 2002a)
      underlying the alterations in functioning have been suggested,             or on second intention wound healing (Dart et al., 2002). Also no
      among them diminished adrenocortical sensitivity to adrenocorti-           effects were found on aerobic capacity or exercise performance in
      cotropic hormone (ACTH) and a decreased negative feedback sen-             geriatric mares (McKeever et al., 1998) or on exercise capacity or
      sitivity (Golland et al., 1999; Marc et al., 2000; Hamlin et al., 2002;    indices of fitness in young Standard bred horses in training (Gerard
      Persson et al., 1980). However, so far only ACTH challenges were           et al., 2002).
      used to study the alterations in the HPA axis in horses during (over)         ReGH administration had a negative effect on the biomechanical
      training. Recently, the influences of overtraining on the function of      properties of healing SDFT (Dowling et al., 2002b) and peripheral
      the HPA axis using a corticotropin releasing hormone (CRH)-                insulin sensitivity (De Graaf-Roelfsema et al., 2005). Long-term
      stimulation test were investigated (De Graaf-Roelfsema et al.,             administration of reGH in foals did not influence body weight, long
      2008). The main finding was a reduction in the ACTH response to            bone growth and other body sizes. Generally, basal glucose concen-
      administration of CRH in the overtrained group. This finding was           tration and insulin response to glucose infusion were higher in
      not accompanied by significant differences between the control and         reGH treated foals. Endogenous GH secretion in response to GH
      overtrained group in plasma cortisol concentrations after CRH              secretagogue (EP51389) was significantly reduced in treated foals.
      administration. It was hypothesized that the decrease in pituitary         The prolactin and thyroid-stimulating hormone (TSH) responses to
      sensitivity must have been caused by a more centrally located              TRH were not altered by reGH treatment. Mean serum IGF-1
434
                                                                                                                           Thermoregulatory consequences of exercise
concentrations were not significantly higher in the reGH treated                                 to be the underlying mechanism for the observed changes in GH
group. However, there was a significant increase of IGF-1 in the first                           pulsatility pattern. A 4-week recovery period did not normalize the
5 weeks of treatment in foals receiving reGH compared to controls.                               pulsatile growth hormone secretion, thereby excluding over-
At necropsy, many internal organ weights were increased, but little                              reaching as its cause.
effect on histopathologic characteristics was found in the same foals
(Capshaw et al., 2001; Kulinski et al., 2002).
                                                                                                 Thermoregulatory consequences of exercise
Endogenous GH responses to exercise
                                                                                                 During the production of energy for locomotion the mechanical
The GH-IGF-I response to exercise is well described in humans                                    efficiency of the processes described above is ~20%. That is, one-
(Wideman et al., 2002; Birzniece et al., 2011), but not in horses.                               fifth of the energy produced goes into exercise with the remaining
Nevertheless, some studies provide information about the acute                                   80% given off as heat. Given that the mass-specific maximal
changes in GH-IGF-I axis due to a bout of exercise (Cartmill et al.,                             oxygen uptake of horses is at least 2-fold higher than in man, at a
2003; Thompson et al., 1992, 1994). To induce a significant plasma                               given workload, the metabolic heat load in horses is considerably
GH concentration elevation post-exercise, horses should perform                                  higher. Further, relative to body mass, the surface area available for
exercise of at least 10 min duration with intensity above the lactate                            dissipation of heat in horses is approximately 50% of that in man
threshold (50–70% VO2max) to overcome autonegative feedback.                                     (Hodgson et al., 1993; Hodgson et al., 1994). On the other hand,
There is no indication that exercise modifies IGF-1 concentrations                               the horse’s efficient thermoregulatory mechanisms provide for
in plasma in trained adult horses (Popot et al., 2001; Noble et al.,                             effective transfer of heat from contracting skeletal muscle to the
2007).                                                                                           environment.
   De Graaf-Roelfsema et al., (2009) successfully used the resting                                  Also, the horse can selectively cool the brain during exercise or
nocturnal pulsatile growth hormone secretion pattern to detect the                               heat exposure by cooling the venous blood within the cavernous
(over)training status of Standardbreds in an experimental setting                                sinuses during respiration (McConaghy et al., 1995). The primary
(Fig. 18.10). The overtrained horses altered their resting pulsatile                             physiological mechanisms driving heat loss during exercise are an
growth hormone secretion with an increase in the number of con-                                  increased proportion of cardiac output directed toward the cutane-
centration peaks, a smaller peak secretion pattern with a prolonged                              ous circulation and an increased rate of sweat secretion. Sweating
growth hormone half-life, and an increased approximate entropy                                   and cutaneous evaporation are the most important heat dissipatory
(ApEn). The increased irregularity of nocturnal GH pulsatility                                   mechanisms in horses, accounting for 65–70% of heat loss during
pattern is indicative of a loss of coordinated control of GH regula-                             prolonged exercise (Hodgson et al., 1993; Hodgson et al., 1994).
tion. Longer phases of somatostatin withdrawal were hypothesized                                    Sweating rates of 20–55 g/m2/min have been measured on the
                                                                                                 necks and backs of exercising horses; for a 500-kg horse these rates
                                                                                                 correspond to sweat fluid losses of 6–15 L/h. When expressed in
            5                                                                                    terms of sweating rate per unit area of skin, these rates are 2- to
                                                                                                 3-fold greater than those reported for human subjects (McCutcheon
            4                                                                                    & Geor, 2000; McCutcheon & Geor, 2004).
                                                                                                    Unsurprisingly, the thermal responses to exercise are affected by
            3                                                                                    ambient conditions. Under conditions of high heat (>30°C) and
GH (µg/l)
                                                                                                                                                                          435
                 18               Metabolic energetics
12 180.0
                             10                                                                                              160.0
                                                                            Unfit       Fit
                                                                                                                             140.0
      Lactate (mmol/liter)
                             80
                                                                                                                             120.0
                                                                                                        V02max (ml/kg/min)
                             60                                  VLA4          VLA4
                                                                                                                             100.0
                                  Anaerobic threshold
                             40                                                                                               80.0
20 60.0
                                                                                                                              40.0
                              0
                                        100       200      300        400     500                                             20.0
                                                        Velocity (m/min)
                                                                                                                               0.0
       Fig 18.11  Training increases the Vla4 and moves the lactate curve to the                                                     Before          After
       right. Good performers have significantly higher Vla4 than poor performers,
       which makes it a valid parameter to assess fitness in Standardbred horses.                        Fig 18.12  Training usually increases VO2max between 10 and 25%.
       From Hinchcliff et al. (2004) and Lindner (2010).                                                 Percentage improvement depends on the initial fitness of the horse and
                                                                                                         type of the horse. The figure shows improvement of VO2max after 4 weeks of
                                                                                                         aerobic training in untrained small (blue bars) and midsize (red bars) ponies,
                                                                                                         and in detrained TB. (Green bars, mean ± SEM.)
       part because the selective brain cooling mechanism maintains                                      Adapted from Katz et al. (2000).
       hypothalamic temperature approximately 1°C lower than central
       blood temperature during exercise (McConaghy et al., 1995).
          Clinical experience has indicated that poor physical conditioning,                             on performance has been heavily investigated but continues to be
       prolonged exercise (e.g. endurance races; speed and endurance test                                an area of considerable controversy; comparison between studies is
       of a 3-day event) in hot environments, lack of heat acclimatization,                              difficult and at this time meaningful conclusions cannot be drawn.
       and dehydration are factors that may increase the risk of exertional                              Well-thought-out training programs tailored to the horse’s particu-
       heat illnesses in horses. Horses with a history of anhydrosis are                                 lar activity are important for preparing the horse for athletic
       obviously at higher risk for development of exercise-associated heat                              endeavors (Fig. 18.11). Every program should have an initial low-
       illnesses.                                                                                        intensity foundation phase to allow body tissues to adapt to the
                                                                                                         stresses placed upon them. The economy of locomotion refers to
                                                                                                         the optimal gait at a given speed of exercise at which the energy cost
                                                                                                         is least and this gait is naturally chosen by freely moving horses.
       Conclusions                                                                                       The measurement of V.O2max remains the single most important
                                                                                                         assessor of a horse’s relative fitness (Fig. 18.12). Fundamental dif-
       It is imperative that anyone with an interest in the horse as an                                  ferences between track and treadmill exercise tests make both
       athlete should understand equine energy production and utiliza-                                   methods of performance evaluation attractive; however, because of
       tion. Both aerobic and anaerobic pathways of energy supply are                                    more controllable conditions treadmill exercise tests continue to be
       necessary for all forms of exercise. Evidence suggests that the aerobic                           favored. The emphasis is on further development and evaluation of
       system has a much greater role to play than previously thought, in                                procedures that can be readily and reliably applied to the field
       short-duration, supramaximal exercise bouts. The effect of nutrition                              situation.
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                                                                                                               CHAPTER               19 
                                                                                                                                                  443
       19      Mechanical analysis and scaling
                                                       X,Y
                                                                                                M
                                                         a, α
                                                                                                 P
GRF
         An indication of the potential applications of inverse dynamic        properties, mass (m), location of the center of mass and moment
      analysis can be obtained from examples in the human literature. A        of inertia (I), of the segments are constant (Winter, 1990). In
      well-known finding is that knee extensor moments during gait are         mechanical terms the moment of inertia is the rotational equivalent
      significantly reduced after anterior cruciate ligament injury. Inverse   to the mass. While the mass determines the resistance to linear
      dynamic analysis provides a tool to monitor the patient’s progress       accelerations, the moment of inertia determines the resistance to
      during rehabilitation and decide when surgical treatment is required     angular accelerations. The force needed for a certain (linear) accel-
      (Andriacchi & Birac, 1993). Using out-of-sagittal plane joint            eration equals the mass times the acceleration (F = m · a). In a
      moments, it has been shown that a certain bracing method reduces         similar way the moment needed for a certain angular acceleration
      the medial compartment loads in the knee joint (Lindenfeld et al.,       equals the moment of inertia times the angular acceleration (M =
      1997). Especially noteworthy is the success of gait analysis, includ-    I · α). This moment of inertia is determined by the spatial distribu-
      ing inverse dynamic and joint power analysis, in surgical decision       tion of the mass within the segment. The mass of the segment
      making for children with cerebral palsy (Rose et al., 1993). In          equals the total mass between the joints; it represents not only
      research, useful information for understanding of injury mecha-          the bone but also the soft tissue surrounding it. The mass of
      nisms and design of joint replacements is obtained from inverse          all segments together is therefore equal to the body mass of the
      dynamic analysis of muscle and joint forces during various activities    horse. Figure 19.2 gives a graphical representation of a linked-
      (Paul, 1971; van den Bogert et al., 1999). Similar clinical applica-     segment model.
      tions can be found for horses when using inverse dynamics to                The action of the muscles is represented by the moment they
      analyze equine gait. It has, for example, been used successfully         generate around the joint. This moment generating function is
      to analyze the influence of heel wedges in horses with tendinitis        explained in Figure 19.3. If a muscle is activated it generates a tensile
      (Clayton et al., 2000).                                                  force at the bones. Due to this force the bones are compressed at
         Before such applications are possible, it is imperative that valid    the joint. This causes a bone-to-bone force from both bones onto
      test protocols are established and normative data are collected          each other. So, because of the muscular activity there are two forces
      (Ounpuu et al., 1991). Movements of horses are remarkably planar         acting on each bone: from the muscle at the attachment site and
      and the function of most muscles, especially those in the distal         one from the other bone at the joint. Since these two forces are
      limbs, is limited to flexion and extension in the sagittal plane.        equal in magnitude and opposite in direction they form a couple.
      Therefore, two-dimensional analysis is sufficient for most purposes.     The moment associated with this couple equals the force times the
      This chapter presents in detail the procedure for inverse dynamic        distance between the two forces. Since the two forces are equal in
      analysis for sagittal plane movement, with specific reference to         magnitude and opposite in direction they cancel each other out and
      development of protocols for equine applications. Some applica-          the muscle action can be represented by the moment (Elftman,
      tions require a full three-dimensional analysis. A short introduction    1939). In a similar way the forces exerted by ligaments can also be
      of this more complex analysis therefore concludes this chapter.          represented by moments. It should be noted that the bone-to-bone
                                                                               force of Figure 19.3 does not represent the complete joint contact
                                                                               force; it is only the part of this force that is caused by the activity
      Inverse dynamic analysis                                                 of the muscle.
      Linked segment model
      For the inverse dynamic calculations a simplified model of the
                                                                               Inverse dynamic calculations
      horse is used. This model is called a linked-segment model since it      In inverse dynamic calculations the movement of the linked
      consists of rigid segments, which are linked to each other. The seg-     segment model is used to calculate the underlying forces (Elftman,
      ments can rotate in the joints that link the segments. In a two-         1939; Winter, 1990). The calculations are based on the principles
      dimensional model, these joints are assumed to be ideal hinge            of Newton’s laws of motion. In order to apply these principles the
      joints: there is no friction, there is no translation possible and the   linked segment model is split into separate segments. The interac-
      only movement is a pure rotation around a fixed point, the center        tion between the segments is summarized in a net joint force and
      of rotation. Since the segment is assumed to be rigid, its length, or    a net joint moment. The net joint force is the resultant of all forces
      the distance between the joints, is constant. Furthermore the inertial   between the two segments. The net joint moment is the sum of the
444
                                                                                                                                                                   Mechanical analysis
m,l
                        m,l
                                    m,l
                                                                          m,l           m,l
                                    m,l
                       m,l
                                          m,l                               m,l
                                                                                              m,l
                             m,l
                             m,l            m,l
                                                                                  m,l                  m,l
                       m,l                                            m,l                     m,l
                                      m,l
                                                                                                                                                                                    Mfet
                                                                                                                                                                           COR
                                                                                                                                                                FXfet
                                                                                                                               -FYcoffin       -Fcoffin
                                                                                                                                                                COM
                                                                                                                                                                            FYfet
                                                                                                                                                                    Ffet
                                                                                                                                                            G
                                                                                                                                                  -FXcoffin
                                                                                                                             COR
                                                                                                                                  -Mcoffin
                                                                                                    GRF      GRFY
Fig 19.3  Muscle activity causes a bone-to-bone force at the joint. The
muscle action can thus be represented by a moment.
                                                                                                                    FXcoffin                          Mcoffin
moments of all muscles and ligaments crossing the joint. All
moments and forces acting on each segment are depicted in a free
body diagram. The moments are the net joint moments at both                                                              COM
joints. The forces are the gravitational force, the net joint forces at
both joints and, sometimes, an external force. The most important
external force is the ground reaction force (GRF) acting on the hoof                                                     G
segment during stance. Other external forces can be the weight of a
rider or the force needed to pull a load. All those external forces are
measured. Furthermore, the linear and angular accelerations are                                                      Fcoffin               FYcoffin
calculated from the (measured) movements of the segments. The                                   GRFX          POA
inverse dynamic calculations can then start by analyzing either the
most proximal or the most distal segment.                                         Fig 19.4  Free body diagrams of the hoof and pastern segments. POA,
   The free body diagram of the most distal segment, the hoof                     point of application of the COM (segmental center of mass); COR, joint
segment, is drawn in Figure 19.4. The amplitude and direction of                  center of rotation.
                                                                                                                                                                                           445
          19   Mechanical analysis and scaling
                                     8000 N                                      from the hoof on the pastern is the opposite of the coffin joint
                                                                                 moment. The net joint force at the fetlock joint can now be calcu-
                                                         Mcoffin                 lated in a similar way as was previously done for the coffin joint.
                                                                                 The horizontal acceleration is used to calculate the horizontal com-
                                                      COR                        ponent of the net joint force and the vertical acceleration is used to
                                                             FXcoffin            calculate the vertical component (see Fig 19.6):
                                          COM                            3.0cm
                                                                                                           ΣFX = mpast ⋅ aXpast
      Y                                                                                                    ΣFY = mpast ⋅ aYpast
                                                                        4.5cm    Finally, the angular acceleration is used to calculate the net joint
                                                      FYcoffin                   moment:
                         1750 N       POA                                                                   ΣM = Ipast ⋅ α past
                                                                                 After the pastern segment, the metacarpal segment can be analyzed
                                              0.2cm                              in the same manner, again using the principle of action and reac-
                                      0.8cm                                      tion. This can be continued, segment after segment, until the most
                                                                                 proximal segment, most often the head segment. The only forces
                                                                                 on this segment are the gravitational force and the net joint force
                               X
                                                                                 at the distal side. The only moment is the distal net joint moment.
      Fig 19.5  Free body diagram of the hoof segment.                           In theory these forces and this moment should balance the linear
                                                                                 and angular accelerations of the final segment. However, most often
                                                                                 a residual force and moment are found. This is caused by measure-
                                                                                 ment errors and non-rigidity of the segments. Although errors are
                                                                                 present in all calculated joint forces and moments, they are largest
      the coffin joint moment and force are not yet known. They are              for the final joint since they accumulate during the calculations. In
      therefore drawn in an arbitrary direction. After the calculations the      order to prevent this accumulation of errors, and to remove the
      real direction and magnitude will be known. According to Newton’s          residual moment and force at the final segment, an alternative
      second law the sum of all forces on the segment must equal its mass        method has been developed (Kuo, 1998). This method solves
      times acceleration:                                                        the equations for all segments simultaneously. Because there are
                                 ΣFX = mhoof ⋅ aXhoof                            more equations than there are unknown forces and moments,
      where the subscript x denotes the horizontal components of the             they cannot be solved exactly. However an approximate solution
      force (see Fig. 19.4), mhoof is the mass of the hoof segment and aXhoof    can be calculated using a least squares method. In this way the
      is the horizontal acceleration of the center of mass of the hoof.          errors are distributed evenly over all joints. The errors of the final
      Using this equation the horizontal components of the net joint             joint are therefore smaller than in the segment-after-segment
      force can be calculated from measurements, as is illustrated in            approach, however, the errors of the distal joints will be larger.
      Figure 19.5. Complete formulas can be found below. A similar               Furthermore, the simultaneous least squares method is only useful
      equation can be written for the vertical direction to calculate the        if the whole horse is analyzed. If only part of the horse is analyzed,
      vertical component of the net joint force at the coffin joint:             e.g. only one limb, both methods will give the same result.
                                 ΣFY = mhoof ⋅ aYhoof
      where the subscript Y denotes the vertical components of the force         Measurement of input variables
      and acceleration. Of course, the gravitational force (G) should now
                                                                                 In order to perform inverse dynamic calculations several input vari-
      be taken into account.
                                                                                 ables are needed. These variables can be sub-divided into three
         All forces, except the gravitational force, generate a moment rela-
                                                                                 categories: inertial properties, movement data and external force
      tive to the center of mass. The magnitude of the moment is deter-
                                                                                 data. The inertial properties are mass, moment of inertia and loca-
      mined by the amplitude of the force and its perpendicular distance
                                                                                 tion of the center of mass for all segments. These properties have
      from the center of mass. Moments that tend to rotate the segment
                                                                                 been measured in cadaver segments and are represented as regres-
      counterclockwise are defined positive whereas moments that tend
                                                                                 sion equations (van den Bogert et al., 1989; Buchner et al., 1997).
      to rotate clockwise are defined negative. For the hoof of Figure 19.4
                                                                                 This allows scaling to horses of different size by using individual
      this means that positive moments tend to flex the coffin joint. Note
                                                                                 body mass and/or segment lengths. The position of the center of
      that this association between flexion or extension and the sign of
                                                                                 mass is represented in a segment-based coordinate system. The
      the moment is dependent on the way the free body diagram is
                                                                                 origin of this coordinate system is located at the proximal joint
      drawn since it is reversed for mirrored images. The sum of the net
                                                                                 center of rotation, the x-axis runs through the distal joint center of
      coffin joint moment and the moments of all forces must equal the
                                                                                 rotation and the y-axis is perpendicular to the x-axis and points
      moment of inertia times the angular acceleration of the hoof
                                                                                 cranially or dorsally (Fig. 19.7).
      segment (αhoof):
                                                                                    The movement data consist of the position of the joints and the
                                  ΣM = Ihoof ⋅ α hoof                            angular and linear acceleration of all segments. The measurement
      From this equation the net joint moment can be calculated. Now             of position data is discussed in Chapter 2. However, for inverse
      all forces and moments acting on the hoof segment are known and            dynamic calculations not only the joint angles but also the position
      the analysis of this segment is complete. The calculations can be          of the joints should be known. The easiest way to measure these
      continued by analyzing the next segment, the pastern segment. The          positions is by putting the markers on the joint centers of rotation
      movement of the pastern joint is often neglected and the remaining         (Leach & Dyson, 1988). Joint moments are sensitive to joint center
      part of the digit is represented by one segment.                           location, so it is important to know the inaccuracies introduced by
         The free body diagram of the pastern segment (Fig. 19.4, upper          this procedure. Alternatively, two markers are applied to each
      part) contains the moment and force acting from the hoof on the            segment and the position of the joint center of rotation relative to
      pastern. According to Newton’s third law (action equals minus reac-        these markers is determined in a separate measurement with addi-
      tion) the force from the hoof on the pastern is the exact opposite         tional markers on the joints. For some joints this procedure can
      of the force from the pastern on the hoof. Similarly, the moment           limit the skin movement artifacts because the markers can be
446
                                                                                                                                       Mechanical analysis
                                                                                   Mfet                Fig 19.6  Free body diagram of the hoof and pastern
                                                                             COR                       segment.
                                                                              FXfet
                                                                                               5.0cm
                                                    7989 N
                                                                     COM
                                                                              FYfet
                                                                 G                          6.0cm
                                       1750 N
                                                 COR
                                         211 Nm
                                                                     4.0cm
                                                         7.0cm
                            8000 N
211 Nm
                                          COR
Y                                                   1750 N
                                 COM
                             POA           7989 N
              1750 N
applied on places with minimal skin movement (van Weeren et al.,                      system. This can be performed in a separate session to prevent
1992a). Further discussion of the skin movement problem in                            interference with the normal data collection.
equine movement analysis may be found in Chapter 2 of this
volume. After the movements are measured they must be differenti-
ated twice to obtain the accelerations. This can be done with a                       Net joint moment and muscle force
spline function, as described in Chapter 2, or with a finite difference
                                                                                      The net joint moment is generated by the muscles. The polarity of
method (see below). When using the finite difference method exces-
                                                                                      the moment indicates whether flexors or extensors are active,
sive noise must first be removed from the data (see Fig. 2.5). This
                                                                                      whereas the amplitude is a measure of the amount of activity. Based
can be done by filtering or by averaging several trials.
                                                                                      on the net joint moments the activity of muscle groups (flexors and
   The external force data consist of the amplitude, direction and
                                                                                      extensors of the different joints) can be analyzed. However, some-
point of application of the external forces, most often the GRF. The
                                                                                      times it is desirable to estimate forces of individual muscles.
GRF can be measured with a force plate, force shoe or instrumented
                                                                                      Depending on the number of muscles crossing the joint, the muscle
treadmill as described in Chapter 2. For inverse dynamic calcula-
                                                                                      forces can either be calculated or estimated from the net joint
tions not only the magnitude and direction of the GRF must be
                                                                                      moment (Fig. 19.8).
measured but also the point of application. Force plates, although
                                                                                        In some joints there is only one muscle that can flex the joint.
very accurate with respect to the force amplitude, often have system-
                                                                                      The deep digital flexor muscle (DDF), for instance, is the only
atic errors in the point of application (Bobbert & Schamhardt,
                                                                                      muscle that can flex the coffin joint. (The navicular ligaments can
1990). These errors can be corrected with a calibration procedure
                                                                                      generate a flexor moment but only if the joint is (hyper) extended.)
in which static loads are applied at known positions. Instrumented
                                                                                      In a flexed joint the moment generated by DDF will equal the net
treadmills or force shoes give the opportunity to measure consecu-
                                                                                      coffin joint moment:
tive strides. However, the accuracy of these systems should be evalu-
ated carefully.                                                                                                Mcoffin = FDDF ⋅ dDDF
   The movement and GRF data must be aligned and synchronized.                        where dDDF is the moment arm of the deep digital flexor – the per-
Some motion analysis systems can capture the force data directly                      pendicular distance between the joint center of rotation and the line
and do not need additional synchronization. For other systems                         of action of the muscle (Fig. 19.8, Fig. 19.9A). This moment arm
synchronization pulses from the video camera can be sampled                           can be measured from radiographs (Jansen et al., 1993) or from
simultaneously with the force data to synchronize the force data.                     longitudinal sections of an in vitro limb. For some muscles the
Alternatively, a counter operated by the force sampling equipment                     moment arm depends on the joint angle. A model containing the
and visible in the camera image can be used to synchronize the                        origin, insertion and possible curvatures of the muscle can then be
motion data. The coordinate systems of the force plate and motion                     used to calculate the moment arm from the joint angles (van den
analysis systems can be aligned by putting markers on the edges of                    Bogert & Sauren, 1989). When calculating FDDF from Mcoffin using
the force plate and measuring them with the motion analysis                           the equation above, it is assumed that there is no other active
                                                                                                                                                              447
       19         Mechanical analysis and scaling
                     1
                                                                                                                                                                          4
                                                                     3                  6
                                                                                                                                                                     13
                                                                         7
                                                                                                                                                                                5
                                                                                        8
                                                                                                                                                                14
                                                                 z
                                                         C
                                                   y
                                                       A
                                                             x                                                                                                    15
                                                                                    9
                                                                                   10
                                                        B                                                                                                       16
                                                                              11                                                                             17
                                                                         12                                                                                18
      Fig 19.7  Definition of the segments and their coordinate systems. Red lines represent the segment boundaries. The schematic enlargement shows the
      coordinate system. The z axis is used only in three-dimensional analyses.
      Reprinted from Buchner, H.H.F., Savelberg, H.H.C.M., Schamhardt, H.C., Barneveld, A., 1997. Inertial properties of Dutch Warmblood horses. J. Biomech. 653–658, with permission from
      Elsevier.
                                                                              FDDF                     force. This type of analysis has shown that desmotomy of the distal
                                                                                                       accessory ligament causes a decrease in the DDF force that does not
                                                  211 Nm                                               disappear within 6 months (Buchner et al., 1996; Becker et al.,
                                                                                                       1998).
                                                 COR
                                                                                                          For joints with only one muscle at each side, the calculation of
                                             3.3 cm                                                    muscle force is simple. However, most joints, e.g. the hip joint of
                                                                                                       Figure 19.9B, are crossed by more than one muscle. In order to
                                                                                                       calculate muscle forces from the net moments at these joints,
                                                                                                       assumptions must be made about the distribution of the moment
                                                                                                       among the available muscles. To estimate muscle forces the
                                                                                                       moments are most often distributed in such a way that a certain
                                                                                                       criterion or cost function is minimized. Computer algorithms are
                                                                                                       available to solve the distribution problem by minimizing a given
                                                                                                       cost function. This procedure is called optimization. Some com-
      Fig 19.8  Deep digital flexor force.                                                             monly used cost functions are the sum of all muscle forces, the sum
                                                                                                       of the squared or cubed muscle forces and the highest muscle force.
                                                                                                       In order to correct for size differences between the muscles the force
                                                                                                       is sometimes replaced by stress: muscle force divided by physiologi-
      muscle or force-generating ligament at the coffin joint. The antago-                             cal cross-sectional area. Other cost functions might include mea-
      nistic muscles (the digital extensors) are assumed to be inactive. If                            sures for muscle fatigue, energy costs or joint contact forces
      these muscles, contrary to the assumption, are active they will gen-                             (Crowninshield & Brand, 1981; Dul et al., 1984; Glitsch & Baumann,
      erate an extensor moment, which should be compensated by the                                     1997).
      DDF. The actual FDDF will then be higher than the calculated force.                                 A major problem in optimization is that it is difficult to validate
      The calculated force is therefore the lower limit of the actual muscle                           the cost function. The real muscle forces can only be found when
448
                                                                                                                                               Mechanical analysis
FDDF
                                                                                                  FTR1
                                                                                                                 FRO1                 FRO2
                                   Mcoffin
                                                                                   FOT
                                 COR                                                                 FSV3
                                dDDF                                                                                                            FTR2
FSS
                                                                                                                                        FSV1
                                                                                                                        FSV2
               Mcoffin = FDDF • dDDF
                                                           dST
                                                     dSM         FBI
                                                    dBI
FSM
FST
                                                                        Fig 19.9  Different ways to estimate muscle forces (F) from net joint moments
                                                                        (M) and muscular moment arms (d). (A) With only one muscle the force can be
                                                                        calculated from the moment. (B) With several muscles, optimizations are needed
                                                                        to distribute the moment. (C) The muscles of the shoulder synsarcosis generate
     FGM * dGM + FGS * dGS + FBI * dBI + FST * dST + FSM * dSM = Mhip   both the net moment and the net forces. Muscles with large origins are
                                                                        represented by several (numbered) force vectors; in the formulas the influence of
                               while e.g.                               these vectors are summed. BI, biceps femoris; COR, coffin joint center of rotation;
             FGM2 + FGS2 + FBI2 + FST2 + FSM2 is minimized              DDF, deep digital flexor; GM, gluteus medius; GS, gluteus superficialis; OT,
                                                                        omotransversarius; RO, rhomboideus; SM, semimembranosis; SS, subscapularis;
B                                                                       ST, semitendinosus; SV, serratus ventralis; TR, trapezius.
the cost function represents the principles by which the nervous               These more sophisticated dynamic optimization models, as opposed
system solves the distribution problem. These principles, however,           to static optimizations that do not consider muscle properties (both
are not known. Another problem is that realistic boundary condi-             based on inverse dynamic analysis of movement!), have not been
tions must be included in the optimizations. For each muscle, the            used other than in research, presumably because more complicated
force it can generate is limited to a certain maximum. This maximum          calculations are required. However, they will result in more realistic
is influenced by the momentary length and the contraction velocity           estimates of muscle force. In rare cases, results from optimizations
of the muscle fibers. Predicted forces should of course not exceed           have been compared to direct measurements using invasive
this maximum force. Furthermore, muscle force can only increase              methods. In cats, the load sharing among synergistic muscle was
and decrease gradually, muscles cannot be either ‘on’ or ‘off’               not correctly predicted by static optimization (Herzog & Leonard,
momentarily. Dynamic models of muscle in which these properties              1991) when compared to tendon force transducer data.
are incorporated can be used in optimization based on inverse                  Most muscles can be represented by moment generators. This is
dynamics (Thunnissen, 1993).                                                 possible because the bones are connected by joints that can be
                                                                                                                                                                     449
       19       Mechanical analysis and scaling
      modeled as hinge or ball joints and can generate the bone-to-bone          estimated by static optimization of muscle forces and compared to
      force at a known joint center. However in the shoulder synsarcosis         measurements from an instrumented prosthesis (Brand et al.,
      there is no joint (Dyce et al., 1987). Therefore the muscles of the        1994). It was found that the model calculations overestimated
      shoulder synsarcosis are not moment generators. Furthermore, the           the joint contact force, mainly due to incorrect moment arms in
      movement of the scapula and relative to the trunk is not limited to        the model.
      rotation around a fixed point. Due to the absence of a joint, sub-
      stantial translations are also possible. The linked-segment model
      will become more realistic if the hinge joint between scapula and          Continued calculations: power
      trunk is replaced by a free movement and the muscles are repre-            The muscles are the motors of the body. The moments and forces
      sented by force generators. The net moment and net force can still         generated by the muscles have been analyzed in the previous para-
      be calculated relative to a fixed point on the scapula – this can be       graphs. However, a motor does not only generate moments or
      any point, for instance the center of mass. However, the point of          forces; it also produces or converts mechanical energy. The muscles
      application of the net force on the trunk is not fixed any more. The       obtain their energy from the oxidation of foods and convert it to
      forces of the muscles can still be calculated exactly if there are three   mechanical energy. The energy is distributed over the segments and
      active muscles in the model (since there are three equations of            is used internally, to accelerate or elevate the segments, or externally,
      motion for a body segment), or using optimization methods if               e.g. to overcome air resistance or to pull a load. Energy production,
      there are more than three. The only difference in the equations is         distribution and use can be analyzed with calculations based on
      that the muscles should not only generate the net moment between           inverse dynamic results. If a force acts on a moving object, energy
      scapula and trunk but also the net force. Therefore the position of        is produced or absorbed. The amount of energy equals the force
      the muscle should not be represented by the moment arm but by              times displacement of the point of application in the direction of
      its actual line of action between trunk and scapula (Fig. 19.9C).          the force. Power is the time derivative; it equals energy production
                                                                                 divided by time, which is equal to force times velocity of the point
                                                                                 of application:
      Net joint force and joint contact force
                                                                                                          P = FX ⋅ v X + FY ⋅ v Y
      The net joint force, calculated from the equations of motion, rep-
                                                                                 For rotational movements the power equals moment times angular
      resents the sum of all forces between the two segments. It should
                                                                                 velocity (P = M · ω). Note that power will be calculated in Watts if
      not be confused with the joint contact force, which can be measured
                                                                                 the moment is expressed in Newton-meters and the angular velocity
      between the bones in the joint. The joint contact force is only one
                                                                                 in radians per second. In power analyses of linked-segment models,
      of the forces between the segments; other forces are the muscle and
                                                                                 the powers associated with all forces and moments on the segments
      ligament forces. The real contact force therefore equals the differ-
                                                                                 are calculated. The sum of these powers equals the rate of change
      ence between net joint force and the summed muscle (and liga-
                                                                                 of the kinetic and potential energy of the entire system. This power
      ment) forces (see Fig. 19.10):
                                                                                 balance follows from Newton’s laws of motion and may be used to
                               Fcontact = Fnet − ΣFmuscle                        determine the contributions of each joint to the movement of the
      When calculating the joint contact force, the forces of all active         entire system (van Ingen Schenau & Cavanagh, 1990).
      muscles should be taken into account. In calculating muscle forces           For most forces and moments the power calculation is straight-
      from the net joint moment it is often assumed that there are no            forward. However, the GRF needs special attention. The point of
      antagonistic co-contractions. This is implied by most of the static        application of the GRF shifts forward during stance. It is tempting
      optimization methods. These co-contractions will cancel each other         to multiply the velocity of this shift with the GRF to obtain the
      out with respect to the joint moment and are therefore ‘invisible’         power. However this is not the powerflow associated with the GRF
      to a mechanical analysis. However both muscles add a bone-to-              (van Ingen Schenau & Cavanagh, 1990). On a hard, non-deformable
      bone force and increase the joint contact force. Ignoring antagonis-       surface the GRF does not perform work. The GRF is a distributed
      tic co-contractions therefore results in an underestimation of the         force, which is summarized to one resultant force with a certain
      joint contact force. Similarly, the joint contact force will be influ-     point of application. In Figure 19.11 the GRF is represented as five
      enced by the way the net joint moment is distributed over muscles          smaller forces acting on different positions of the hoof surface.
      with different moment arms. Muscles with a larger moment arm               During stance the amplitude of these five partial forces changes,
      need a smaller force to generate a similar moment than muscles
      with a smaller moment arm. The joint contact force will therefore
      be smaller if the contribution of muscles with a larger moment arm
      is higher. In humans, the contact force in the hip joint was
                                                                 6394 N
                                        FXcontact
                                                           45°
FYcontact
                                                                                 Fig 19.11  Shifts and movements of the point of application of the GRF on
                                                                                 a hard surface (above) and on a deformable surface (below). (See text for
      Fig 19.10  Joint contact force.                                            details.)
450
                                                                                                                                      Mechanical analysis
whereas their position stays constant. This causes the point of appli-    two adjacent segments. When adding the powers of the different
cation of the resultant GRF to shift forward. However, none of the        segments the powers associated with the net joint forces cancel each
partial forces generates power since their velocity is zero. The resul-   other out. The only power, therefore, is the power associated with
tant force, which is simply the summation of all partial forces, does     the net joint moment. At each joint the powers for the two segments
not generate power. In reality there are, of course, more than five       are summed to one joint power. This power equals the net joint
partial forces, but the same reasoning applies. On a deformable           moment multiplied by the difference in angular velocity between
surface, like sand, the situation is different. When the hoof pene-       the segments:
trates the surface the point of application not only shifts due to
                                                                                               Pjoint = Mjoint ⋅ (ω prox − ω dist )
amplitude changes but also moves due to hoof movements. The
position of the five partial forces changes and they generate power       This power is generated by the muscles crossing the joint and is
(see Fig. 19.11). Therefore, on deformable surfaces, power can be         therefore a measure of the activity of the muscles. The joint powers
associated with the GRF. This power is related to the movement of         of all joints can be summed to obtain the total power production.
the surface; it equals the velocity of the hoof surface times the         This power is used for external power production (e.g. pulling a
amplitude of the GRF. This power is used to deform the surface.           load, air resistance) and kinetic and potential energy changes of the
This example illustrates that valid power results are only obtained       segments. Power production at the joints can therefore be compared
if a force is multiplied by the velocity of a point on a physical body    with external power losses due to air resistance, friction, etc. In
to which the force is applied. The velocity of a point that is not        human research this approach has been applied successfully in
rigidly attached to a mass is not suitable.                               movements where most of the power is used externally and where
   When analyzing the powers of the linked-segment model, two             internal loss of power is minimal. Examples can be found for bicy-
different approaches are used: a segment oriented approach                cling, swimming and speed skating (van Ingen Schenau & Cava-
(Elftman, 1939; Winter & Robertson, 1978; Robertson & Winter,             nagh, 1990). In walking and running the external power production
1980) and a joint-oriented approach (van Ingen Schenau & Cava-            is very small; most power is used to accelerate and decelerate the
nagh, 1990). The segment-oriented approach is used to analyze             limbs and to provide a shock-absorbing support against gravity.
internal use and the distribution of energy, or power-flow, whereas       Apart from the high-speed gallop, where air resistance might
the joint-oriented approach is used to analyze power production and       become substantial, the same holds for the gaits of a horse. Although
external use. In the segment-oriented approach two power-flows are        it is not useful to apply this approach to the equine walk and trot,
distinguished at both the proximal and distal end of the segment:         it can be used when the external power output is substantial, e.g.
the power-flow associated with the net joint force and the power-         in pulling a load, during accelerating and in jumping.
flow associated with the net joint moment. The power-flow associ-            Apart from the external power production the joint-oriented
ated with the net joint force is a passive power-flow from the            analyses might give insight into muscle function during movement
adjacent segment, or, if negative, a passive power-flow into the          (de Koning et al., 1991; Devita & Skelly, 1992). Positive joint power
adjacent segment. At the joint, the passive power-flow into               indicates power production that might originate from concentric
the proximal segment equals the passive power-flow out of the             activity of the muscles crossing the joint. Large positive power pro-
distal segment (or reversed). This is caused by the fact that the net     duction peaks indicate important propulsive muscles whereas
joint forces on the distal and proximal segments are each other’s         timing of the different peaks indicates the coordination of the
opposites while the velocities at the point of application, the center    movement. Furthermore, negative joint power indicates power
of rotation, are equal. The power-flow associated with the net joint      absorption, which might be related to eccentric muscle contraction.
moment is an active power-flow generated by the muscles. At the           These contractions are assumed to be a major cause of muscle sore-
joint, the angular velocities of the two segments are normally dif-       ness and a risk for muscle injuries (Jones & Round, 1990). Power
ferent and therefore the power-flow associated with the net joint         analyses can therefore be used to find muscles that are at high risk
moment is different for the two segments. This difference is gener-       for injuries. This type of analysis has been used for the equine
ated (or absorbed) by the muscles.                                        forelimb during walk (Colborne et al., 1998). Moment peaks of the
   All four power-flows, passive and active proximal and distal flow,     carpal and fetlock joints were of similar magnitude whereas the
can either be positive or negative. Most often some of them are           coffin joint moment was much smaller. The carpal joint power was
positive whereas others are negative and power-flows from one             almost zero due to the small movements of this joint. The fetlock
segment to the other. However the sum of the four flows is not            joint had alternating periods of power absorption and production
always zero. If the sum is positive, the energy of the segment            whereas the coffin joint predominantly absorbed power.
increases. This energy is converted into potential or kinetic energy         The two approaches, segment-oriented and joint-oriented power
as the height or the velocity of the segment increases. Similarly, a      analyses, are closely related. They emphasize different aspects of the
negative power-flow is converted from potential and/or kinetic            power balance. The joint-oriented approach emphasizes the exter-
energy when the height and/or velocity decreases.                         nal power production and the places where this power is produced
   Using this kind of analysis the power-flow within the limb can         whereas the segment-oriented approach emphasizes the power-flow
be analyzed. This has been done for the distal front limb during          within the body and the internal use (see Fig. 19.12). In both
walk (Colborne et al., 1997). During the major part of the stance         approaches power production and absorption have simply been
phase the power-flow of the metacarpal and pastern segments was           related to concentric and eccentric contraction of muscles at the
distal to proximal. This probably reflects the propulsion of the          joint. However the biological reality is a bit more complex for two
proximal part of the body. During final stance the power-flowed in        reasons: elastic structures can temporarily store energy and most
at both ends of the segments and was probably used to accelerate          muscles cross more than one joint (van Ingen Schenau & Cavanagh,
and elevate the segments for the swing phase. Care must be taken          1990).
with this kind of analysis because results are dependent on the              Elastic structures, like tendons and ligaments, store energy when
velocity of the coordinate system in which the movements are              elongated. This energy is released when they return to their normal
represented. This will influence the results when measuring on            length. The long and stiff tendons in the distal limbs of horses are
a treadmill. We recommend that the analysis be performed only             able to store substantial amounts of elastic energy (Alexander &
in a coordinate system attached to the ground, which implies a            Bennet-Clark, 1977). Furthermore, the deep palmar ligament of the
moving coordinate system for treadmill analysis.                          carpus might also absorb a substantial amount of energy during
   In the joint-oriented approach of power analyses the power-flows       hyperextension of the carpus. Power absorption is therefore not
of all segments are summed (van Ingen Schenau & Cavanagh,                 always associated with eccentric muscle contraction but can also be
1990). The power associated with the net joint force is opposite for      caused by elastic energy storage in tendons and ligaments. The
                                                                                                                                                            451
       19       Mechanical analysis and scaling
      subsequent power production can originate from the release of              as rigid struts over which the body vaults – the kinetic energy and
      elastic energy instead of concentric muscle contraction. If elastic        potential energy changes are each other’s opposites. In the bounc-
      properties of tendons are known, and tendon force is estimated             ing gaits like trot, the limbs act as springs and the body center of
      from inverse dynamic analysis, the amount of energy storage can            mass moves like a bouncing ball – the kinetic and potential energy
      be estimated separately.                                                   increase and decrease simultaneously. Equine gallop might have
         Power production and absorption are usually analyzed at a joint         both bouncing and pendulum aspects (Minetti et al., 1999). Apart
      level but many muscles span more than one joint. These muscles             from this classification of gaits, attempts have been made to relate
      can therefore absorb power at one joint and simultaneously produce         the changes in mechanical energy to metabolic energy consump-
      power at another joint. This has, for instance, been described for         tion (Cavagna & Kaneko, 1977; Minetti et al., 1999). The major
      the gastrocnemius muscle in human vertical jumping: at the end of          problem is that when moving at a constant speed the mechanical
      push-off, the muscle generates positive power at the ankle and nega-       energy at the end of the stride equals the mechanical energy at the
      tive power at the knee. This function of biarticular muscles is            beginning of the stride and no net work is performed. Neverthe-
      referred to as power transport between joints (Gregoire et al., 1984).     less, to enable analysis, negative and positive changes of energy of
      It is assumed to be a major function of these muscles. Power trans-        the segments are treated differently. Either all positive changes are
      port can take place during isometric contraction without power             added, ignoring negative powers, or different efficiencies are used
      production by the transporting muscle. Therefore, no muscle fibers         to add positive and negative power production. However the effi-
      are needed to transport power and tendons can also transport               ciencies of positive and negative muscular work are speculative.
      power. In the lower limbs of horses there are several more or less         Furthermore, energy can be stored temporarily in elastic structures
      tendinous bi- or polyarticular muscles. It has been hypothesized           or it can be transferred between segments and probably also
      that the proximal muscles generate the power and that this power           between limbs. The relative importance of these processes is not
      is transported to the distal joints by the tendinous biarticular           known. Results of internal power analyses, therefore, are largely
      muscles (van Ingen Schenau, 1994). The major advantage of this             dependent on the assumptions of internal power transport, energy
      system is that the lower limbs are very lightweight while the joints       storage and efficiency. This necessitates careful validation of the
      can still be actively moved and can contribute to the propulsion.          mechanical energy analysis, and estimation of error bounds due to
         The lower limbs undergo large accelerations during gait; if             assumptions regarding power transfer, efficiency and elastic storage
      they are lightweight the accelerations will cost less energy and           (Thys et al., 1996).
      can be performed more rapidly, enabling a faster and more eco-
      nomical gait.
         To prevent the problems with biarticular power transport, power
                                                                                 Accuracy of inverse dynamic calculations
      production can also be analyzed at the level of the muscles, using         All direct and indirect measurements of biological variables are
      the muscle force estimation methods described previously. The esti-        influenced by certain sources of errors and, therefore, have a
      mated muscle force is multiplied by the contraction velocity of the        limited accuracy. Inverse dynamic calculations are no exception to
      muscle. The contraction velocity can be obtained from kinematic            this rule. The errors influencing the accuracy of inverse dynamic
      data (Riemersma et al., 1988; van den Bogert et al., 1988) or by           calculations can be subdivided in two categories: errors in the mea-
      multiplying the joint angular velocity by the moment arm of the            surement of input variables and errors originating from model
      muscle. For human cycling, energy expenditure predictions obtained         assumptions. The most important measurement errors are caused
      from power analysis at the muscle level differed greatly from predic-      by estimation of the inertial properties from in vitro data, misalign-
      tions using power analysis at the joint level (Neptune & van den           ment of markers with the joint rotation center, skin displacement
      Bogert, 1998). This is due to the fact that joint power does not           relative to the underlying bones, the use of noisy data to calculate
      consider power transport by biarticular muscles or antagonistic            accelerations, inaccuracies in the measurement of the point of
      co-contraction. Estimates of energy expenditure should therefore           application of the GRF and misalignment of force and movement
      not be obtained from analyses at the joint level but from analyses         data. Further details on some of these inaccuracies may be found
      at the muscle level. Power analysis at the joint level can still be used   in Chapter 2. The major assumptions influencing the accuracy of
      to describe and analyze the control of movement.                           the calculations are the rigidity of the segments and the fixed rota-
         Apart from the segment-oriented and joint-oriented approaches           tion point. If muscle forces are calculated, two major assumptions
      there is a third power analysis approach, which is used in gaits           are often added: the absence of antagonistic co-contractions and
      without substantial external power production. This approach does          the cost function used to distribute the moment among the avail-
      not use the joint moments and forces but focuses on mechanical             able muscles. The influence of all these errors and assumptions on
      energy changes. During a stride cycle both the potential and the           the final accuracy depends, of course, on the magnitude of the
      kinetic energy of the segments change constantly. Based on com-            errors. This magnitude is determined by the equipment used and
      parison of patterns of these energy changes gaits have been classi-        the conditions of the actual measurements. However, some general
      fied as either inverted pendulum or bouncing gaits (Cavagna &              considerations can be made on the order of the errors and their
      Kaneko, 1977). In inverted pendulum gaits like walk, the limbs act         influence on the final results.
452
                                                                                                                              Mechanical analysis
   The assumptions of a fixed rotation center can be questioned for        distribution between the medial and lateral compartments of the
the stifle and carpal joints, whereas the alignment of the markers         knee (Lindenfeld et al., 1997).
with the rotation center is difficult in the coffin joint and the proxi-      Extension of inverse dynamic analysis to three dimensions is
mal joints. Even relatively small errors in the coffin joint marker        mathematically straightforward (Vaughan et al., 1992; van den
placement can seriously influence the results for this joint because       Bogert, 1994). The equation of motion for force is the same, with
of the small moment arms in the hoof segment. Radiographs                  the only difference that force is now a vector with three, rather than
should therefore be used to validate and, if necessary, correct this       two components. The equation of motion for moments has an extra
marker position. Due to similar small moment arms, measurement             term in three dimensions, and uses a matrix I for the moment of
errors in the point of application of the GRF relative to the hoof         inertia rather than a single scalar value:
will also seriously influence the coffin joint results (Bartel et al.,
                                                                                                  ∑ M = I ⋅ α + ω × (I ⋅ ω)
1978). These errors can arise from systematic errors in the point of
application or from misalignment of the coordinate systems of the          Joint moments M are vectors in three dimensions, as are angular
force and movement data. The systematic errors in the point of             velocities w and angular accelerations α. In the force equation,
application should be corrected (Bobbert & Schamhardt, 1990)               vectors are usually expressed in a global, ground-based coordinate
and the two coordinate systems should be aligned carefully.                system. In the moment equation, however, all vectors and matrices
Although the errors in the point of application, in the alignment          must be expressed relative to a segment-fixed coordinate system.
and in the marker placement will influence the accuracy for other          The final term is proportional to the square of the magnitude of the
joints, the relative influence is much smaller due to the larger           angular velocity and accounts for centrifugal effects when the axis
moment arms.                                                               of rotation is not aligned with an axis of symmetry (principal axis)
   The accuracy of the inertial properties differs for the proximal        of the body segment. Note the cross product symbol ‘×’, which
and distal segments (Buchner et al., 1997). In general the proxi-          makes this moment perpendicular to the axis of rotation. The
mal segments have a large mass, are not quite rigid and it is diffi-       inertia matrix I is a 3 × 3 matrix which is diagonal (only three ele-
cult to separate them from each other. The distal limb segments,           ments are non-zero) when the axes of the segment coordinate
in contrast, have a small mass, are quite rigid and the boundary           system are aligned with the principal axes; otherwise I has 9 non-
between these segments is clear. Therefore, the inertial data for          zero elements that reflect the non-symmetrical distribution of the
the distal segments is quite accurate and does not seriously influ-        mass. Three-dimensional inertial properties for equine segments
ence the accuracy of the results. Furthermore, the accelerations of        have been measured with respect to anatomically defined coordi-
the distal segments are very small, at least during stance, and            nate systems (Buchner et al. 1997). When expressed in a suitable
errors in the inertial data or the accelerations hardly influence the      segment-fixed coordinate system, the three components of the
results for these segments. Similarly, the total ignorance of the          moment vector M can be interpreted as flexion–extension,
accelerations, as is done in a quasi-static analysis, seems to be          abduction–adduction and internal–external rotation moment,
acceptable for these segments. During the swing phase, however,            respectively. The angular velocity vector w must be decomposed
the results are determined completely by the accelerations. Errors         along the same three axes in order to obtain the joint power by
in these accelerations or the inertial data seriously influence the        taking the dot product of moment and angular velocity.
accuracy. Skin displacements for the distal joints are small and              Instrumentation for collecting three-dimensional movement and
will not influence the accuracy. However, for the proximal joints          GRF data is now standard equipment in biomechanical laborato-
they are very large, influence the accuracy and should be cor-             ries. However, problems arise from modeling assumptions and the
rected, using the available correction algorithms (van Weeren              standardization of the experimental protocol. These problems may
et al., 1992b).                                                            lead to inaccuracies that are, in some cases, larger than the magni-
   The effect of random errors on the final results can be determined      tude of the results of the calculations. In those cases, a three-
with Monte Carlo simulation (van den Bogert et al., 1994). In this         dimensional analysis does not provide useful additional information
simulation the analysis is performed multiple times, with multiple         compared to a sagittal plane analysis.
copies of the input data that are modified by adding random errors            In the experimental protocol, three markers must be attached to
according to known probability distributions. The standard devia-          each segment in order to obtain all six degrees of freedom (three
tion of these multiple results provides an estimate of the error in        translations and three rotations) for each segment. It is no longer
the final result. Systematic errors, such as skin movement, are not        possible to have markers coincide with the joint center in three
random and should be modeled as a hypothetical function of time            dimensions, since the joint center is inside the body. Markers must
or joint angle in such an error analysis.                                  therefore be attached to standardized anatomical landmarks, rela-
                                                                           tive to which the location of the joint center is known. Suitable
                                                                           protocols have been developed for human analysis (Bell et al.,
Three-dimensional analysis                                                 1990; Vaughan et al., 1992), and first attempts have been made for
The methodology presented above applies to a two-dimensional               equine analysis (Nicodemus et al., 1999).
analysis, usually in the sagittal plane. Movement of horses seems             Soft tissue movement may be more of a problem in three dimen-
remarkably planar, but for some applications the small medio              sions because of the indirect method for locating joint centers. Joint
lateral movements may also be important. In trotters, these out of         moments are known to be sensitive to errors in the joint center loca-
plane movements were reproducible, highly individual, and pre-             tion (Burdett, 1982). Also, three markers may not be representative
sumably related to performance (van Weeren et al., 1993). It is            of the motion of the entire body segment when the segment under-
therefore conceivable that analysis of the sources of those move-          goes complex soft tissue movements during impacts. This may lead
ments is useful. Furthermore, the magnitude of out-of-plane                to errors in the inertial terms of the equations of motion, the terms,
moments is presently unknown. In human walking, it has been                which are proportional to masses and moments of inertia. On seg-
shown that a two-dimensional analysis underestimates the average           ments such as the thigh, using more than three markers should be
joint power at the hip by 23% because the hip abductor moment              considered. Least-squares techniques can then provide the best esti-
is ignored (Eng & Winter, 1995). Similar underestimations might            mate of three-dimensional rigid segment movement that is consis-
be obtained in horses and a full three-dimensional analysis should         tent with data from all markers (Soderkvist & Wedin, 1993). Note
be undertaken to determine for which movements and which appli-            that there are two conflicting requirements for a marker placement
cations the out-of-plane moments can be neglected. Finally, out-of-        protocol: for location of joint centers, markers should closely follow
plane moments might provide useful information about joint                 the bone movement; for accurate estimation of inertial forces,
loading. In humans, adductor–abductor moments reflect load                 markers should follow the ‘average’ of the mass distribution, of
                                                                                                                                                    453
       19       Mechanical analysis and scaling
                                                                                       Mfet
                                                                       FXfet     COR
                                                                                                                                                                      ypast -yfet
                                         -FYcoffin      -Fcoffin
                                                                   COM
                                                                                  FYfet
                                                                          Ffet
                                                                   G                                                                                              ypast -ycoff
COR -FXcoffin
                                     -Mcoffin
                 GRF      GRFY                                                                                                                      Xfet -Xpast
                                                                                                                             Xcoff -Xpast
                                                             Mcoffin
                                 FXcoffin       COR                                                                        COR
                                                                                                                                             yhoof -ycoff
                                    COM
yhoof -yGRF
                               Fcoffin            FYcoffin
                  GRFx     POA
                                                                                                                      Xcoff -yhoof
       A                                                                                      B         XGRF -Xhoof
Fig 19.13 Free body diagrams of the hoof and pastern segments. (A) Free body diagrams; (B) x and y coordinates of the points of application of the forces.
      which the muscles can be an important component. Different                                  Formulas for inverse dynamic calculations
      marker sets for these two calculations should be considered.
         Accelerations for certain out-of-plane movements in the horse                            Hoof segment
      may be small relative to the errors associated with differentiation
                                                                                                  The sum of all forces on the segment must equal its mass times
      of noisy movement data (see Chapter 2). It is therefore important
                                                                                                  acceleration. In the horizontal direction this gives the following
      to have good estimates of these errors, so that the accelerations that
                                                                                                  equation:
      are smaller than the noise can simply be neglected, rather than
      introduce extra noise into the results.                                                                  ∑ FX = mhoof ⋅ aXhoof ⇔ GRFx + FXcoffin = mhoof ⋅ aXhoof
         In modeling, the body is typically represented as rigid segments
                                                                                                  or:
      linked by ball joints. For estimation of muscle forces, three
      moment arms must be known for each muscle, one for rotation                                                     FXcoffin = mhoof ⋅ aXhoof − GRFX
      about each axis of the segment coordinate system. Three-                                    For symbols see Figure 19.13 and the symbol list below.
      dimensional models of the muscle path from origin to insertion                                For the vertical direction the gravitational force (G) should be
      (e.g. Brand et al., 1982) are typically used to determine the instan-                       taken into account:
      taneous moment arms, as well as the orientation of muscle force
      vectors during movement. Interactive software tools are now avail-                                   ∑ FY = mhoof ⋅ aYhoof ⇔ GRFY + FYcoff = Ghoof = mhoof ⋅ aYhoof
      able to develop such models of the three-dimensional musculosk-                             or:
      eletal anatomy (Delp & Loan, 1995).
                                                                                                                          FYcoffin = mhoof ⋅ aYhoof − GRFY − mhoof ⋅ g
         Many joints in horses and humans are hinge joints where rota-
      tions other than flexion and extension are prevented by the articu-                         The sum of the net coffin joint moment and the moments of all
      lar surfaces and ligaments. Such joints have an axis of rotation                            forces must equal the moment of inertia times the angular accelera-
      rather than a center of rotation. The ‘joint center’ used for the                           tion of the hoof segment:
      inverse dynamic analysis lies on this axis; typically, the midpoint of                                                                ∑ M = Ihoof ⋅ ahoof
      the part of the axis within the bone is used. The moment compo-
      nents associated with internal–external rotation and abduction–                             or:
      adduction components do not represent muscle function.                                              Mcoffin + GRFX ⋅ (yhoof − yGRF ) + GRFY ⋅ ( xGRF − xhoof )
      Interpreting these moments as muscle moments may lead to severe                                       + FXcoffin ⋅ (yhoof − ycoff ) + FYcoffin ⋅ ( xcoff − xhoof ) = Ihoof ⋅ α hoof
      overestimation of muscle forces and joint loading (Burdett, 1982;
                                                                                                  or:
      Glitsch & Baumann, 1997). Instead, these moments can indicate
      load distributions in articular contact and ligaments (Lindenfeld                                 Mcoffin = Ihoof ⋅ α hoof − GRFX ⋅ (yhoof − yGRF ) − GRFY ⋅ ( xGRF − xhoof )
      et al., 1997).                                                                                              − FXcoffin ⋅ (yhoof − ycoff ) − FYcoffin ⋅ ( xcoff − xhoof )
454
                                                                                                                                              Scaled energetics of locomotion
Geometric scaling
                                                                                                        PROBLEM
  Xi
                                                                                                        The first problem to be handled is the most elementary. Assume that
                                                                                                        animal B is in all aspects twice as large as animal A. A consequence is
                                                                                                        that B can take steps that are twice as a long as A. Can it also run
Xi-1                                       ∆t                    ∆t                                     twice as fast? And what stride frequency will it use?
                              ti-1                     ti                  ti+1
                                                                                                      In a first approximation it will be assumed that the bigger animal
Fig 19.14  Finite differences can be used to calculate velocity and                                   is just an enlarged version of the smaller one, that all linear mea-
acceleration.                                                                                         sures (leg length, leg diameter, trunk circumference, etc.) are
                                                                                                                                                                                  455
       19       Mechanical analysis and scaling
      Fig 19.16  Geometric scaling. Two horses of different size, but with the   This leads to:
      same proportions.
                                                                                                                  t1       l1
                                                                                                                     =
                                                                                                                  t2       l2
      proportional to a single length measure. An example is given in            Time and temporal variables should thus be scaled as the square
      Figure 19.16. The big horse has been obtained by enlarging the             root of height. A consequence is that speed and velocity should be
      small one on a photocopier. For the reference length, the height at        scaled inversely with the square root of height:
      the withers will be taken and denoted as l. A second assumption to                                  v1 l1 / t1 l1         l2   l
      be made relates to the consideration of which two categories of                                       =       =              = 1
                                                                                                          v2 l2 / t1 l2         l1   l2
      forces are the most important to our problem? For overground
      locomotion, the answer is acceleration forces (= ma) and gravita-          A method to account for this scaling with size is to use so-
      tional forces (= mg) (Hof, 1996).                                          called dimensionless numbers, the definition of which is given in
         Having made this assumption, our scaling should now be made             Table 19.1.
      such that for animals of different sizes ma and mg should scale in            It can easily be verified that these numbers are indeed dimension-
      proportion. One reason is that forces are vector quantities, they have     less by noting that the factors in the denominator have the same
      both a magnitude and a direction, and the direction of the forces          units as the quantity in the numerator. The dimensionless number
      should be the same irrespective of the size. The constant of gravity       for speed (or sometimes the square of it, which can be confusing)
      g is practically the same (9.81 m/s2) anywhere on earth, and as long       is known as the ‘Froude number.’ Examples of the possibilities of
456
                                                                                                                                            Scaled energetics of locomotion
these dimensionless numbers are given in Figures 19.17 and 19.18,                               A practical application was given by Back et al. (1995) in a study
both from Alexander (1977). Figure 19.18 gives dimensionless                                  in which kinematic variables were employed in 4-month-old foals
stride length (the distance traveled in a complete walking stride) as                         in order to predict the same variables in adult (26-month-old)
a function of dimensionless speed for a number of very diverse                                horses.
animals. It can be seen that by using dimensionless numbers, i.e.
by accounting for geometric scaling, the differences due to size are
eliminated. The data for all animals could be expressed in a single                            ANSWER
formula:
                                                                                               If animal B is twice as big as animal A, it will make strides twice as
                              λˆ = 2.3vˆ 0.6                                                   long. Animal A, on the other hand, can make faster steps. Unjust as it
Figure 19.18 shows a diagram with the gaits adopted as a function                              is, it turns out that A does not make the steps with twice the
of speed. It can be seen that all animals change from walking to                               frequency of B, but at a rate proportional to the square root of 2, i.e.
trotting or running at a dimensionless speed of around 0.8. They                               about 1.4 times as quickly. As a consequence, a corresponding speed
change from trot to gallop somewhere between 1.3 and 2.0.                                      of B, e.g. the speed at which the horse changes from walk to trot or
    An example might be helpful. Imagine the Shire going along with                            from trot to gallop, is 1.4 times as fast as in A. If horses of unequal
the Fallabella at a speed of 2.5 m/s (9 km/h). Dimensionless speed                             size are to be compared, speeds and temporal variables should thus
for Shire is 2.5/ 1.91 × 9.81 = 0.58, a walking speed. Dimensionless                           be corrected by a factor equal to the square root of the ratio of the
speed for Fallabella, on the other hand, is 2.5/ 0.80 × 9.81 = 0.89,                           respective heights at the withers.
and it will be trotting. A small dog, with a height of 30 cm, may gallop
at this speed, as its dimensionless speed 2.5/ 0.3 × 9.81 = 1.46.
The mouse (height 5 cm), which is chased by the dog, has
vˆ = 2.2/ 0.05 × 9.81 = 3.1, and is galloping at top speed. Stride
                                                                                              Differences in proportion
length λ of the big horse can be estimated from the above equation
as λ = 1.91 × λˆ = 1.91 × 2.3 × (0.58)0.6 = 1.91 × 1.65 = 3.16 m. Stride                       PROBLEM
frequency is thus 2.5 / 3.16 = 0.79 strides/s. The mouse, at the other
extreme, will have a stride length of only 23 cm, but a stride fre-                            Horses of different breeds are not just bigger or smaller copies of
quency of 11 strides/s.                                                                        each other, there are substantial differences in morphology. This
                                                                                               section will explore what difference it makes whether a horse is
                                                                                               compact or slender. Which type can carry heavier loads?
   5
                                                                                              In the preceding section the scaling was purely geometric: every
                                                                                              measure was multiplied by the same scaling factor. When looking
                                                                                              at a picture of various horse breeds, it is obvious that this is only
^                                                                                             an approximate picture. Even a layman can see differences in the
λ 2
                                                                                              proportions of Shetland ponies and Thoroughbreds, and the expert
                                                                                              can distinguish many dozens of breeds. In a purely geometric
                                                                                              scaling, as used in the previous section, it will hold that mass (m)
   1
                                                                                              is specific mass times volume, while volume is proportional to l0 to
       0           0.2                   0.5                1        2              5         the third power. The overall relation can be written as m ∝ l03.
                                                                                                 In the subsequent parts of this chapter some mathematics cannot
                                                   u^                                         be avoided. Many of the scaling relations that follow will be
Fig 19.17  Relationship between stride length and speed. Dimensionless                        expressed in the so-called allometric form, as functions of the form
stride length plotted against dimensionless speed in logarithmic                              y = axb. As a reminder, some properties of functions with exponents
coordinates. Walk, orange circles; trot, red circles; canter, blue squares. The               have been given in Table 19.2.
line gives the regression. Data are from Muybridge (1887) on horses, mostly                      One factor that distinguishes between breeds is whether they are
with riders.                                                                                  of slender or compact build. This might be expressed in a ratio
Alexander, R. McNeil; Principles of Animal Locomotion. ©2003 by Princeton University Press.   d/l0, in which d is a characteristic width measure, e.g. the thickness
Reprinted by permission of Princeton University Press.                                        of the midshaft of a forelimb or the circumference of the trunk, and
Gazelle W T G
Cat W T G
Mouse T G
Kangaroo P H
             0                   1                              2             3                 4
                                                                u^
                                                                                                                                                                                   457
       19      Mechanical analysis and scaling
                                                                                    and the general trend suggests that elastic similarity scaling is fol-
       Table 19.2  Some properties of power functions, as used
                                                                                    lowed. Within the horse family, however, the differences in d/l0 ratio
       in this chapter
                                                                                    between breeds are more interesting than a general trend over the
                                                                                    widest possible range of animal sizes.
                                   ax b ⋅ cx d = acx b+d
                                                                                       A second application for the above equation is to assess maximum
                                   xa                                               acceleration or sprinting power. According to Newton’s second law
                                      = x a −b
                                   xb                                               a = F/m, and thus maximum acceleration should scale according to
                                                                                    the above equation.
                                   n
                                       xb = xb/n
                                                                                       While data on the height l0 and the mass are commonly available,
                                   ( x a )b = x ab                                  a problem is to find data on a measure related to thickness d. A way
                                                                                    to circumvent this problem is to use the body mass equation and
                                   x0 =1
                                                                                    replace d in the subsequent equations by m1/ 2l0−1/ 2. This results in the
                                                                                    alternative forms:
                                                                                    Supported force:
      l0 is a characteristic length measure, such as the height at the withers,                             Fs ∝ m3 / 2l0−5 / 2   force factor
      as used in the first section. If the form of our horses may be approxi-
                                                                                    and:
      mated with a stack of cylinders, this leads to the following propor-
      tionalities for volume or body mass and surface area, respectively:                                 Fs
                                                                                                             ∝ m1 / 2l0−5 / 2     force/weight
                                                                                                          mg
                                Body mass: m ∝ d l0        2
458
                                                                                                                                  Scaled energetics of locomotion
their weight. When the force/weight ratio is calculated, however, it                          Kangaroo rat               Spring hare         Pony
appears to remain quite constant during the growth process, from                              Ground squirrel            Dog
57 kg at birth to an almost full-grown 534 kg.
                                                                                      5
   The proportionalities also indicate that, although large horses can
draw or carry heavier loads than small ones (high force factor),
small ones are stronger per kg of body weight. This may explain                       4
why donkeys and mules are favored as pack animals over larger
horses. On the other hand, for drawing a heavy cart or plowing,                       3
large horses with thick legs are best. Even without the help of bio-
                                                                               WN–1
mechanics, equine experts have known this for ages. The Shire horse
in Figure 19.15, for example, is said to descend from the horses that                 2
carried the knights in their heavy armor in the Middle Ages. It stands
out more as a riding than a pulling horse, in contrast to the Belgian.                1
                                                                                      0
                                                                                          0      1         2         3        4       5            6         7         8
 ANSWER                                                                                                                  Speed (ms–1)
 In this section the consequences of the fact that animals have                Fig 19.19  Energy consumption per newton of body weight, as a function
 different proportions of thickness and length were considered.                of speed for (in order of size) a kangaroo rat, a ground squirrel, a spring
 Muscle force is proportional to cross-sectional area of the muscle.           hare, a dog and a pony.
 When this effect is accounted for, it turns out that:                         Kram, R., Taylor, C.R., 1990. Energetics of running: a new perspective. Reprinted by permission
 1.	 large animals are stronger than small ones, but that this increase        from Macmillan Publishers Ltd, Nature Publishing Group, ©1990.
     is less than proportional to body weight, therefore;
 2.	 large animals can carry less load per kg of body weight.
     These two effects are expressed in, respectively, a force factor
 Fs and the force divided by body mass Fs/m. The latter factor                 When Kram and Taylor (1990) first published this figure, the phe-
 explains why an ant can carry many times its body weight, while               nomenon had already been known for a considerable time.
 a horse cannot. Table 19.3 gives both factors for a growing                   (Kram and Taylor used body weight mg instead of body mass m,
 Warmblood foal.                                                               which is more correct, but makes their formulae somewhat more
                                                                               difficult to compare with those of others.) It is to their merit that
                                                                               they provided an interpretation, by observing that while E*trans /mg
                                                                               decreases, step length lc increases by about the same factor (Fig.
                                                                               19.20B). The latter will not come as a great surprise to the atten-
Energy cost of locomotion                                                      tive reader, as step length lc will be proportional to leg length or
A running horse consumes energy; this is obvious to the observer               height l0, and in geometric scaling it would hold that l0 ∝ m1/3.
and to the horse. The laws of mechanics do not provide an easy                 In fact the exponent is slightly less, 0.30. This may be because of
answer, however, to the question how much energy is needed per                 the fact that small animals run with more angulated legs, while
meter of progression. According to Newton’s first law, in an ideal             big animals keep their legs straighter. The overall consequence is
frictionless world the cost of locomotion on the level should be nil.          that the product (E*trans lc)/mg is constant (Fig. 19.20C), and
Only uphill locomotion would require energy equal to mgΔh, body                is equal to 0.183± 0.045  J/N or m. This means that for all
weight (mg) times rise (Δh). Going upward with a speed of rise vrise           animals the energy cost per newton of body weight is the same
would thus require a power:                                                    per step: for each step an energy is needed equal to what is
                                                                               required to make an upward movement of about 20  cm (0.183±
                                 Prise = mgvrise
                                                                               0.045  m):
For level walking, theory is of no help, and we should rely on mea-
surement. A convenient way to measure energy consumption is to                                                      *
                                                                                                                  Ptrans           mg
measure oxygen consumption and recalculate this to the power of                                                          = 0.183 ⋅
                *                                                                                                   v              lc
transport Ptrans   in watts. In the following an asterisk (*) will be used
to denote work and energy values derived from oxygen consump-
                                                                               This is a comprehensive summary of a great amount of data. It
tion. Figure 19.19 gives data on running for animals of different
                                                                               nicely sums up why large animals need less energy to cover a certain
sizes, in which power has already been divided by body weight (in
                                                                         *     distance; it is simply because they can make bigger steps. It further
newtons, N). Two things are apparent from this figure: first, Ptrans
                                                                               suggests that animals with long legs have an advantage, a fact that
increases linearly with speed in running, without intercept of the
                                      *                                        breeders of whippets and racing horses will readily admit. To give
vertical axis. This means that Ptrans    divided by speed v, i.e. the energy
                                                                               an explanation for these simple facts, on the other hand, is not so
per meter traversed, E*trans, is independent of speed. The second
                                                                               easy. In the following section some considerations will be given.
aspect is that E*trans depends on size; after dividing by body mass m
                                                                                  One reservation should be made at this point. Kram and Taylor
it is smaller for big animals (see Fig. 19.20A). With m in kg and
                                                                               (1990) found their experimental relationship from experiments on
E*trans in J, the relation can be expressed as: cost of transport per unit
                                                                               widely different animals (see Fig. 19.19). The decrease of energy
of body weight, in running; step length, defined as the distance the
                                                                               consumption per unit mass and distance and the increase of step
body moves forward in a single foot contact; the product of both,
                                                                               length with body size (Fig. 19.20) are undoubtedly valid for the
E*trans1c /mg, is constant and equal to 0.183/pm 0.045 J/N. Same
                                                                               range of animals studied. More recent work (Griffin et al., 2004)
animals as shown in Figure 19.19:
                                                                               has shown that such a relation does not apply within a species. They
                        E*trans /m = 8.8m−025                                  determined cost of transport for horses of three different sizes
Another way to express the same relationship is:                               (Table 19.4). It turns out that among horses cost of transport is
                                                                               practically independent of body mass over the ranges encompassing
                           *
                         Ptrans                                                all horse breeds. The cost for trotting is least in the Arabian
                                = E*trans = 8.8m0.75
                           v                                                   racing horse.
                                                                                                                                                                                 459
        19                    Mechanical analysis and scaling
                10
                                                                                                         There is not a simple mechanical reasoning to predict how much
                                                                                                         energy is needed for horizontal overground locomotion. It can be
                                                                                                         measured experimentally in a reasonably simple way, however, by
                                                Slope = –0.25                                            assessment of oxygen consumption. It turns out that big animals
      N–1 m–1
                                                                                                         consume less energy (or oxygen) per kilogram of body mass and per
                1.0
                                                                                                         meter traveled. This can be expressed in a remarkably simple way: the
                                                                                                         (gross) energy needed to make a simple step is equal to body weight
                                                                                                         times 20 cm, irrespective of size.
                0.1
                        0.1               1           10          100          1000          10,000
                A                                                                                       Muscle work and power
                1.0
                                                                                                         This section attempts to provide some arguments for the decrease in
                                                                                                         energy consumption per meter and per kg, as presented in the
                                                                                                         previous one. This will require quite a complicated reasoning that
                                                                                                         may be omitted on first reading.
      m
                0.1
                                                Slope = 0.30
                                                                                                        Muscles can exert force, and when they are allowed to shorten,
                                                                                                        they can do work: force times shortening. The unit of work is the
                                                                                                        joule (J). The rate at which the work is done is called power, mea-
            0.01                                                                                        sured in watts (W) or joule/s. The relations between force, work
                        0.1               1           10          100          1000          10,000     and velocity in muscle are depicted in Figure 19.21. When a
                                                                                                        muscle shortens at a certain speed, the force it develops decreases
                B
                                                                                                        according to the so-called Hill relation (Hill, 1938), (Fig. 19.21A).
                                                                                                        As long as there is no lengthening or shortening, the muscle devel-
                1.0                                                                                     ops its ‘isometric’ force F0. With increasing shortening speed
                                                                                                        muscle force becomes less, until at a speed v0 force has decreased
                0.8                                                                                     to zero. In lengthening (negative speed in the figure), force can
                                                                                                        increase somewhat above isometric, maybe 20–40%. This relation
                0.6                                                                                     has often been observed in all kinds of muscle. It explains the
      N–1
460
                                                                                                                                               Scaled energetics of locomotion
1.0 0.10
0.8 0.08
          0.6                                                         0.06
  F/F0
                                                               F/F0
          0.4                                                         0.04
0.2 0.02
              0                                                           0
                  0   0.2   0.4          0.6       0.8   1.0                  0   0.2                  0.4          0.6          0.8     1.0
          A                       v/v0                                B                                      v/v0
0.4 0.8
          0.2                                                          0.4
                                                               Q
A+av
          0.1                                                          0.2
                                               A
              0                                                           0
                  0   0.2   0.4          0.6       0.8   1.0                  0   0.2                  0.4          0.6          0.8     1.0
          C                       v/v0                                D                                      v/v0
Fig 19.21  Force, velocity and power in muscle. (A) Muscle force as a function of shortening speed is shown relative to, the force in an isometric contraction.
Shortening speed expressed relative to the muscle’s maximum shortening speed. (B) Mechanical power (work per unit time). (C) Energy production in the
form of activation heat, shortening heat and mechanical power Fv. (D) Efficiency of work production. Only the efficiency of muscle force production is
shown, from ATP to, the processes leading to ATP production reduce the maximal efficiency to about 25%.
0.5–1.0 m. For an 80-kg human, the legs have mass of about 30 kg.                                101
Assuming that muscle mass is 20 kg, one would predict an energy
output of 20 × 20 = 400 J and a jumping height of 400/(80.10) =
0.50 m. This is exactly the height well-trained volleyball players can
jump in a standing jump. Horses seem to perform better; they are
reported to jump up to 2.00 m. Taking into account the height of
the trunk in standing, ca. 1 m, a rise of 1 m is still performed. Such
jumps will be made only after a run, however, and with a run and
a fiberglass jumping pole humans can reach almost 6 m. (With a                                   100
final running speed of 10 m/s, the human athlete has gained a                                       10-2                  10-1         100          101       102         103
kinetic energy of 1 2mv2 = 4000 J. This corresponds to a rise in center                                                                 Body mass (kg)
of gravity of 5.0 m.)                                                               Fig 19.22  Maximal shortening speed divided by muscle fiber length, of
   Maximum shortening speed v0 is proportional to muscle length:                    slow (soleus, blue circles) and fast (extensor digitorum longus, red circles)
a longer muscle contains more sarcomeres in series. In physiology                   muscles of mouse (data points on left), rat (data points in center) and cat
it is therefore usual to give relative muscle speed in muscle lengths               (data points on right). Bigger animals have slower muscles per unit muscle
per second: v/l0. In Figure 19.22 a number of data on the maximum                   Fv length F0v0. The lines are drawn according to the equation below. No
muscle shortening speed v0/l0 have been given for animals of differ-                liability is accepted for extrapolations of these data to the size of horses.
ent sizes, and for a fast muscle (extensor digitorum longus) and a                  Data from Close (1972).
                                                                                                                                                                                 461
       19      Mechanical analysis and scaling
      slow muscle (soleus). It can be seen that maximum shortening                                                         Speed records
      speed consistently decreases with size of the animal:                                         20
                                      v0 /l0 = c v m−0.16                                           18
      with cv = six muscle lengths/s for slow muscles like soleus and                               16
                                                                                                                                                           A
      cv = 14 for fast muscles and body mass in kg. For horses between
      200 and 1000 kg one might thus expect v0/l0 to be 2–2.6/s for slow,                           14                                         B
      and 4.6–6.0/s for fast muscles.                                                               12
                                                                                      Speed (m/s)
            We will turn our attention at first to the exponent of m. The data
      of Figure 19.22 reflect activities at the cellular level: myosin ATP-ase                      10
      activity. On the other hand, it is very practical. Remember, from
                                                                                                     8
      Table 19.1 that in geometric scaling all speeds should be scaled as                                                                             C
      l10/ 2, and next that m ∝ l3. Taken together, this means that v/l0 should                      6
      scale as m−1/6 = m−0.167, which is in very good agreement with the
      measured data of Figure 19.21. It seems that muscle intrinsic speeds,                          4
      related to enzyme activities, are closely adapted to the speeds that
                                                                                                     2
      can be expected in an animal of the given size. These size-related
      differences are probably genetically determined, as they are already                           0
      present in newborn animals and are rather insensitive to training.                                 0   50     100    150      200     250      300       350
      It is not known whether this size dependency occurs not only                                                           Time (s)
      between species of widely different size but also within species, e.g.
                                                                                      Fig 19.23  Speed records for horse and man. (A) World records of horse
      horses.
                                                                                      racing, 0.25 mile up to 3 miles; (B) course records of the trotting course
            In a similar reasoning as for the work, the maximum mechanical            Duindigt, The Netherlands, distances from 900–3600 m; (C) world records
      power that can be generated by 1 cm3 tissue, area 1 cm2 and length              for men running in 1983, distances 100–2000 m and 30 km (shown at far
      1 cm can now be calculated:                                                     right).
           P(1 cm3 ) = 0.1F0 /l0 = 0.1 ⋅ 20 ⋅ 0.01 ⋅ c v m−0.16 = 0.02 ⋅ c v m−0.16   Data from McWhirter (1984).
462
                                                                                                                                           References
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          D.J., Schamhardt, H.C., 1993. In vivo            Pratt Jr., G.W., O’Connor Jr., J.T., 1976. Force       during walking, running, and skiing. Med.
          tendon forces in the forelimb of ponies at          plate studies of equine biomechanics. Am.           Sci. Sports Exerc. 31, 131–142.
          the walk, validated by ground reaction              J. Vet. Res. 37, 1251–1255.                      Van den Bogert, A.J., Sauren, A.A.H.J., 1989.
          force measurements. Acta Anat. (Basel)           Riemersma, D.J., van den Bogert, A.J., Jansen,         Implementation of curves
          146, 162–167.                                       M.O., Schamhardt, H.C., 1996. Tendon                musculotendinous structures in rigid body
      Jones, D.A., Round, J.M., 1990. Skeletal                strain in the forelimbs as a function of gait       dynamics. In: van den Bogert, A.J. (Eds.),
          muscle in health and disease. Manchester            and ground characteristics and in vitro             Computer simulation of locomotion in the
          University Press, Manchester.                       limb loading in ponies. Equine Vet. J. 28,          horse. PhD thesis, University of Utrecht,
      Kram, R., Taylor, C.R., 1990. Energetics of             133–138.                                            pp. 37–55.
          running: a new perspective. Nature 346,          Riemersma, D.J., van den Bogert, A.J.,              Van den Bogert, A.J., Schamhardt, H.C.,
          265–267.                                            Schamhardt, H.C., Hartman, W., 1988.                Hartman, W., 1988. Relationship between
      Kuo, A.D., 1998. A least-squares estimation             Kinetics and kinematics of the equine               simultaneously measured muscle
          approach to improving the precision of              hind limb: in vivo tendon strain and                activation, length, force and power in the
          inverse dynamics computations.                      joint kinematics. Am. J. Vet. Res. 49,              horse. In: Proc. 6th Congr. Europ. Soc.
          J. Biomech. Eng. 120, 148–159.                      1353–1359.                                          Biomech. p C 32
      Leach, D.H., Dyson, S., 1988. Instant centres        Robertson, D.G., Winter, D.A., 1980.                Van den Bogert, A.J., Smith, G.D., Nigg, B.M.,
          of rotation of equine limb joints and their         Mechanical energy generation, absorption            1994. In vivo determination of the
          relationship to standard skin marker                and transfer amongst segments during                anatomical axes of the ankle joint complex:
          locations. Equine Vet. J. (Suppl 6):                walking. J. Biomech. 13, 845–854.                   an optimization approach. J. Biomech. 27,
          113–119.                                         Rose, S.A., DeLuca, P.A., Davis, R.B.D.,               1477–1488.
      Lindenfeld, T.N., Hewett, T.E., Andriacchi, T.P.,       Ounpuu, S., Gage, J.R., 1993. Kinematic          Van Ingen Schenau, G.J., 1994. Proposed
          1997. Joint loading with valgus bracing in          and kinetic evaluation of the ankle after           actions of bi-articular muscles and the
          patients with varus gonarthrosis. Clin.             lengthening of the gastrocnemius fascia in          design of hind limbs of bi- and
          Orthop. 344, 290–297.                               children with cerebral palsy. J. Pediatr.           quadrupeds. Hum. Movem. Sci. 13,
      McMahon, T.A., 1984. Muscles, reflexes and              Orthop. 13, 727–732.                                665–681.
          locomotion. Princeton University Press,          Schmidt-Nielsen, K., 1984. Scaling: Why is          Van Ingen Schenau, G.J., Cavanagh, P.R., 1990.
          Princeton.                                          Animal Size so Important? Cambridge                 Power equations in endurance sports.
      McMahon, T.A., Bonner, J.T., 1983.                      University Press, Cambridge.                        J. Biomech. 23, 865–881.
          On size and life. WH Freeman & Co.,              Schryver, H.F., Bartel, D.L., Langrana, N.,         Van Weeren, P.R., Jansen, M.O., van den
          New York.                                           Lowe, J.E., 1978. Locomotion in the                 Bogert, A.J., Barneveld, A., 1992a. A
      McWhirter, N., 1984. The guiness book of                horse: kinematics and external and internal         kinematic and strain gauge study
          records, Dutch ed. Luitingh, Utrecht. [In           forces in the normal equine digit in the            of the reciprocal apparatus in the
          more recent editions, data on horse racing          walk and trot. Am. J. Vet. Res. 39,                 equine hind limb. J. Biomech. 25,
          are absent.]                                        1728–1733.                                          1291–1301.
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Van Weeren, P.R., van den Bogert, A.J., Back, Vaughan, C., Davis, B., O’Connor, J.,        Winter, D.A., Eng, P., 1995. Kinetics: our
   W., Bruin, G., Barneveld, A., 1992b.          1992. Dynamics of Human gait, first ed.      window into the goals and strategies of the
   Correction models for skin displacement in    Human Kinetics Publishers, Champaign,        central nervous system. Behav. Brain Res.
   equine kinematic gait analysis. J. Equine     Illinois.                                    67, 111–120.
   Vet. Sci. 12, 178–192.                     Vaughan, C.L., 1984. Computer                Winter, D.A., Robertson, D.G., 1978.
Van Weeren, P.R., van den Bogert, A.J., Back,    simulation of human motion in                Joint torque and energy patterns
   W., Bruin, G., Barneveld, A., 1993.           sports biomechanics. Exerc. Sport            in normal gait. Biol. Cybern. 29,
   Kinematics of the Standardbred trotter        Sci. Rev. 12, 373–416.                       137–142.
   measured at 6, 7, 8 and 9 m/s on a         Winter, D., 1990. Biomechanics and motor     Yeadon, M.R., Challis, J.H., 1994. The future
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   prerace training. Acta Anat. (Basel) 146,     Wiley, New York.                             research. J. Sports Sci. 12, 3–32.
   154–161.
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                                                                                                                C H A P T ER          20 
Development of a computer model                                         supports, or even entire complex mechanisms such as automotive
                                                                        engines could be examined for fit and accuracy before any real
                                                                        monetary investment was made by the company.
Introduction
Computer modeling is generally defined as the process of creating       Computer modeling and biomechanics
a representation of an object or system within the computer. The
origins lie in tools developed by engineers to assist them in the       Even before solid modeling became an industry standard, ana
industrial design process. These models allowed the engineer to         tomists and biomechanists had recognized the opportunities it
create each component of a product, assemble them ‘virtually’ in        represented. One of the earliest uses of computers to model a mus-
the computer, and ensure a good fit before manufacturing. Using         culoskeletal system represented an approximation of the human
computer mathematical analysis tools, it is also possible to predict    body as a series of rigid links with simple hinge or pin joints
the forces that the component will see and make certain that it will    (Chaffin, 1969). Although this was useful in visualization of human
not fail under that loading.                                            motion, it was not a tool for examining specific bones or joints. It
  For biological systems, computer models are useful for many of        was not until medical imaging devices such as computed tomogra-
the same reasons. Instead of having to perform in vivo studies, a       phy (CT) and magnetic resonance imaging (MRI) scanners were
computer representation of an anatomical structure can be created       used as the basis for the geometry that truly representative anatomy
and examined in ways that would be prohibitively difficult in a live    could be created in a computerized model.
animal. The advantages are obvious; if the model is reliable, it can       After the techniques of modeling had been proven in human
be used to examine many biomechanical systems including the             studies, the veterinary community began to use the same methods
motion of a complex joint, such as the tarsus, the loading and          to explore the complexities of motion in animals. An early equine
motion in regions that are not visible to the human eye, such as        study using the fundamentals of joint motion developed for human
within the hoof capsule, or the loading that causes a bone to frac-     protocols modeled the entire forelimb distal to the metacarpopha-
ture. These can be studied by modeling, which does not require the      langeal joint (Cheung & Thompson, 1993), but subsequent research
use of live subjects.                                                   has typically focused on a single joint, such as the carpus (Les et al.,
                                                                        1997) or fetlock (Thompson & Cheung, 1993).
                                                                                                                                                   467
       20      Modeling, simulation and animation
468
                                                                                                                     Development of a computer model
dynamics (Bobbert et al., 2007) and energetics (Bobbert & Sant-          both clinical and research settings to study the function and dys-
amaria, 2005).                                                           function of the limb at the different joints (Buchner et al., 1996;
                                                                         Clayton et al., 1998). Brown et al. (2003) developed a detailed
                                                                         musculoskeletal model of the distal equine forelimb to study the
Kinetics (dynamics)                                                      influence of musculoskeletal geometry (i.e. muscle paths) and
As stated above, kinematics is a passive observation of how a system     muscle physiology (i.e. force–length properties) on the force-
moves. Dynamics uses kinematic data, combined with additional            and moment-generating capacities of muscles crossing the carpal
information, to evaluate the forces within the system. Having cal-       and metacarpophalangeal joints. They predicted that the suspen-
culated the dynamics, much more complex simulations can be               sory and check ligaments contributed more than half of the total
performed. Two methods are primarily used for the development            support moment developed about the MCP joint in the model.
of dynamic results: inverse dynamics, and forward or direct dynam-       Additional information can be added to the model to increase the
ics. In general, inverse dynamics is a technique by which internal       level of sophistication. For example, knowledge of the orientation
forces are estimated using data from external observations, while        of anatomic structures such as the line of action of tendons can
forward dynamics predicts external forces and motions by prescrib-       allow for a more detailed estimation of internal muscle and tendon
ing internal forces. An application of computer modeling using           forces (Riemersma et al., 1988; Jansen et al., 1993). Merritt et al.
inverse dynamics involves the calculation of net joint moments and       (2008) developed a two-dimensional model of the musculoskeletal
joint powers from knowledge of the kinematics, ground reaction           system of the distal limb region and applied it to kinematic and
forces (GRFs) and morphological data using a link-segment model.         kinetic data from walking and trotting horses. The forces in major
In this type of model, the complex structure of the limbs is simpli-     tendons and joint reaction forces were calculated. The components
fied by representing the limb segments as rigid bodies linked by         of the joint reaction forces caused by wrapping of tendons around
hinge joints (Schryver et al., 1978; Hjertén & Drevemo, 1987;            sesamoid bones were found to be of similar magnitude to the reac-
Clayton et al., 1998; Colborne et al., 1998; Lanovaz et al., 1999)       tion forces between the long bones at each joint. This finding high-
(Fig. 20.2). The musculature that drives the limb has a complex          lighted the importance of taking into account muscle-tendon
geometry and many mechanical and material properties that are            wrapping when evaluating joint loading in the equine distal fore-
difficult to quantify. In order to study the effect of muscle action     limb (Figs 20.3–20.6).
without defining all of the specific parameters of the system, the net      Swanstrom et al. (2005) developed a musculoskeletal model of
muscular action within the limb is represented in the model as net       the Thoroughbred forelimb and a dynamic simulation of the
torques or net joint moments acting at each of the joints. Zarucco       motion of the distal segments during the stance phase of high-speed
et al. (2003) developed and tested an experimental model for             (18 m/s) gallop. The musculoskeletal model was comprised of
in-vivo short-term recording of peak isometric forces of the digital     segment, joint, muscle-tendon, and ligament information. The
flexor muscles in the forelimb of adult horses and thus provided         dynamic simulation incorporated a proximal forward-driving force,
further insight to functional implications of the complex architec-      a distal ground reaction force model, muscle activations, and initial
ture of these muscles. Realistic inertial parameters such as mass and    positions and velocities. A simulation of the gallop after transection
moment of inertia are assigned to each segment of the computer           of an accessory ligament demonstrated increased soft tissue strains
model. Kinematic data and GRFs are measured and used as inputs
to the model. An inverse dynamics solution is used to calculate the
torques required to cause the observed motion and forces. This ‘net
effect’ of muscle action derived from the model can be applied in
                                                                                                                 Metacarpus
                                                                           Interosseous
                                                                            ligament (lL)
                                                                                                               Fetlock joint
                                                                             Superficial
                                                                            digital flexor                           Pastern
                                                                         tendon (SDFT)
                                                                                                                               Coffin joint
                                                                                         Deep digital
                                                                                       flexor tendon
                                                                                                                                    Hoof
                                                                                             (DDFT)
                                                                                                                                                                     469
       20           Modeling, simulation and animation
      in the remaining support structures of the distal forelimb, consis-                         Finite element analysis
      tent with those previously reported from in vitro studies. Forward                          The stress on a structure can be measured through a dynamic analy-
      or direct dynamics utilizes data describing muscle activation pat-                          sis as described above or it can be computed through application
      terns and the force of muscular contraction to determine the posi-                          of mechanical measurement techniques such as strain gauges.
      tion of each segment of the limb. Although this method is                                   Having determined the stress on a structure, it is of great interest to
      theoretically ideal, as it is the most accurate representation of what                      know what effect this might have on the structure in terms of
      is actually occurring in the system, it is practically difficult to                         causing deformation (strain) or stimulating biological adaptation.
      measure these inputs with the accuracy needed to produce a model                            For example, hoof deformation at impact could be used to evaluate
      that represents the internal forces and interactions. A variation on                        how energy is dampened or dissipated. Observation of the habitual
      this type of dynamic analysis was performed for an entire horse in                          patterns of stress in a bone can be related to the way in which that
      1987 using a mechanical mechanism analysis package (Van den                                 bone adapts to its environment and reconstructs itself. The com-
      Bogert, 1989). The horse was represented by a series of rigid bodies                        plexity of these types of calculations makes it almost impossible to
      connected by springs, dampers and torque producers representing                             accurately determine or calculate by hand the way in which forces
      tendons and ligaments. The innovative aspect of this simulation was                         will be distributed across a particular structure.
      that, instead of simply prescribing the motion of a segment by                                 In the field of engineering, this problem has been solved by the
      kinematic data, an intelligent model was created that prescribed the                        development of the process called finite element analysis (FEA) or
      limitations of joints, the reaction forces created by the tension in                        finite element modeling (FEM). To understand the process of FEA,
      ligaments and muscle activations. The model was analyzed and                                consider a very simple piece of geometry, a cube. It is relatively easy
      validated through both kinematic and ground reaction force data.                            to predict the way a cube deforms based on the forces applied and
      However, in order to simulate the entire horse, a number of assump-                         the properties of the material from which the cube is made. A steel
      tions had to be made due to the complexity of the project and the                           cube deforms in a specific way, which is different from an alumi-
      limitations in computer power at the time. The entire system was                            num or wood cube.
      assumed to be purely two dimensional with the segments of the                                  Most objects are more complicated than simple cubes. They are
      horse moving in the sagittal plane. Complex joints, such as the                             made up of very complex surfaces and curves, which make it diffi-
      carpus and tarsus, were approximated as simple hinges, and it was                           cult, if not impossible, to predict how the structure will deform
      necessary to completely ignore certain joints, such as the coffin joint                     under stress. The process of FEA consists of breaking up a piece of
      and the articulation of the spine. In spite of these assumptions, the                       complex geometry into a series of simple shapes, such as cubes or
470
                                                                                                                                                     Development of a computer model
                                                              Walk                                                                  Trot
                                              12                                                                  12
                                              10                                                                  10
10 10
                                               8                                                                   8
                           Force (N/kg bwt)
4 4
                                               2                                                                   2
     Navicular bone
                                               0                                                                   0
                                                   0   20   40      60    80       100                                 0   20    40      60   80       100
                                                            Stance (%)                                                           Stance (%)
                                              80                                                                  80
                                              70                                                                  70
                                              60                                                                  60
                           Force (N/kg bwt)
                                              50                                                                  50
                                              40                                                                  40
                                              30                                                                  30
                                              20                                                                  20
                                              10                                                                  10
    Proximal phalanx                           0                                                                   0
                                                   0   20   40      60    80       100                                 0   20    40      60   80       100
                                                            Stance (%)                                                           Stance (%)
                                              80                                                                  80
                                              70                                                                  70
                                              60                                                                  60
                           Force (N/kg bwt)
                                              50                                                                  50
                                              40                                                                  40
                                              30                                                                  30
                                              20                                                                  20
       Proximal                               10                                                                  10
    sesamoid bones                             0                                                                   0
                                                   0   20   40      60    80       100                                 0   20    40      60   80       100
                                                            Stance (%)                                                           Stance (%)
Fig 20.5  Magnitudes of calculated joint reaction force components from long bones and sesamoid bones in the coffin and fetlock joints for walking and
trotting during the stance phase of the stride. The magnitudes are shown as solid lines with dashed lines to represent ±1SD. The stance phase of the stride
was the time during which the vertical component of the ground reaction force was greater than 50N. 0% of stride was the time of first hoof–ground
contact, 100% of stride was the time of last hoof–ground contact.
Reprinted from Merritt J.S., Davies H.M.S., Burvill C., Pandy M.G., 2008. Influence of muscle-tendon wrapping on calculations of joint reaction forces in the equine distal forelimb, Journal of
Biomedicine and Biotechnology, Hindawai Publishing Corporation, with kind permission from Jonathan Merritt.
pyramids. These subdivisions, called elements, react to stress in a                                               in three directions (up/down, left/right and forward/backward).
mathematically predictable way. The entire structure is represented                                               When we take into account the fact that a finite element model can
by numerous elements, which are each described in terms of the                                                    consist of thousands of these elements, it becomes evident that a
motion of their corners, or in more complex models, the motions                                                   powerful computer is an essential tool in performing this type of
of the midpoints between the corners as well. When the model is                                                   analysis.
analyzed, the deformation of one element defines the force on the                                                   Biological structures are even more complex than most products
next element, and subsequently its force on the next, and so on.                                                  manufactured in industry, making finite element analysis invalu-
The minimal requirement is to analyze each corner of each element                                                 able for predicting their behavior under various loading conditions.
                                                                                                                                                                                                   471
              20             Modeling, simulation and animation
35
30
                        25
      Moment arm (mm)
20
15
10
                         0
                             190    195    200      205      210    215     220
                                          Fetlock angle (degrees)
       For example, by creating a computer model of a particular bone,                             Fig 20.7  FE models, presentation of results. The 5° raised heels (upper
       and applying forces to the bone from data known a priori, the type                          diagram), and 5° lowered heels (lower diagram) shown in lateral view:
       and location of fractures in that bone may be predicted.                                    displacement is shown as deformed geometry, colours represent von Mises
          A number of equine studies have been performed using finite                              stresses with red representing maximum stress and blue representing
       element analysis. One of the earliest was an analysis of the structure                      minimum stress. Red arrows indicate the maximum stress zone in the
       of the hoof. The intent of the project was to examine the role of                           proximal dorsal wall; blue arrows indicate the maximum displacement of
       mechanical factors in lameness and degenerative diseases within the                         the dorsal wall. Comparing the 5° raised heels model with the 5° lowered
       hoof capsule (Hogan et al., 1991). A two-dimensional finite element                         heels model, less stress and smaller deformations are found in the 5° raised
       analysis was performed, and the deformation results were examined                           heels model.
       to determine motions that were not visible through direct observa-                          Reprinted with permission from Hinterhofer, C.H., Stanek, C.H., Haider, H. The effect of flat
       tion. The results indicated that during weight-bearing the coffin bone                      horseshoes, raised heels and lowered heels on the biomechanics of the equine hoof assessed
       moved downward toward the sole, and rotated away from the dorsal                            by finite element analysis (FEA) in Transboundary and Emerging Diseases 2001 (2), 73–82.
       hoof wall (Fig. 20.7). Additionally, approximations of the stresses                         Copyright © 2001, John Wiley and Sons.
       induced in the laminar tissue during loading were determined. The
       stress values within the hoof derived from this and similar studies                         (Hinterhofer et al., 2000) (Fig. 20.7). Maximal displacement was
       have given a much more comprehensive understanding of the behav-                            calculated in the hoof capsule shod with a regular horseshoe
       ior of the hoof. The results were of particular interest because, at that                   without a clip. Minimal displacement was found in the capsule with
       time, there was little direct information describing the motion of the                      a toe clip and 2 side clips placed behind the 3rd nail. All models
       coffin bone with respect to the hoof wall during loading.                                   showed higher displacements when calculated with a loose nail
          Due to improvements in computing capabilities and finite                                 fixation (Hinterhofer et al., 2001).
       element programs, Les et al. (1997) were able to develop a more                                A more complex, thirty-two component finite element model of
       comprehensive three-dimensional model (Fig. 20.8) than that of                              horse and donkey digits with over 106 elements was used to compare
       Hogan et al. (1991). Using CT data, an accurate model of the meta-                          von Mises stress levels in the deep and superficial digital flexor
       carpus was created in the computer, and it was then subdivided into                         tendons in the horse (respectively, 1.34 MPa and 0.56 MPa) and
       a series of hexahedral elements. This model was compared to ex vivo                         the donkeys (respectively, 0.78 MPa and 0.27 MPa). The same
       loading results, and the accuracy of the FEA was validated. This                            model was used to evaluate the effects of weight-bearing on capsular
       study was an excellent example of the opportunities opened up by                            deformation patterns (Collins et al., 2009).
       FEM. Once a particular model has been validated, many different                                Pollock et al. (2008a,b) defined a mathematical model to predict
       loading conditions can be simulated and analyzed within the com-                            strains in the humerus at stance within ± 2 standard deviations of
       puter and an accurate representation of the stress response can                             experimental strains at four of these locations and predicted negli-
       be determined without the need to use additional live subjects.                             gible strains at the remaining two locations, which is consistent
       Hinterhofer et al. (2000, 2001) studied the use of finite element                           with experimental findings.
       analysis in evaluating the effect of trimming and shoeing on hoof
       mechanics in the horse. Stresses are high in the material surround-                         Development of a computer model:
       ing the quarter nails, in the heels and in the proximal dorsal wall.
       Raising the heels by 5° resulted in significantly (p < 0.05) lower
                                                                                                   a horse history
       stress and displacement values. The model with heels lowered by                             Although the end result of computer models can vary greatly
       5° yielded the highest stress and displacement values, and the FE                           between applications, the steps involved in the process are quite
       model with the regular horseshoe lay between the two extremes                               similar. Visualization requires the greatest accuracy in the overall
472
                                                                                                                                             Development of a computer model
Proximal
Medial
                                 Palmar
                                                                                                 A
                                                                                                                                                                                           473
       20      Modeling, simulation and animation
474
                                                                                    Development of a computer simulation: a human perspective
                                                                                                                                                    475
       20      Modeling, simulation and animation
      model is usually difficult because the same experiments cannot be           Statistical analysis showed no significant effect for the population
      done on human subjects. This could be because the experiments            as a whole, confirming earlier results on human subjects. Thus,
      are related to severe injury, because human subjects are not             statistical analysis prevented incorrect generalizations, which could
      sufficiently reproducible, because humans are too fatigable or           have been made when just one model had been used. In this case,
      because the outcome is a variable, which cannot be measured.             the model was sensitive to movement style. Sensitivities to other
      Most invasive research in horses is also precluded by modern             variations within the human population, such as anatomical varia-
      ethical standards.                                                       tions, may be detected or eliminated similarly, by creating a popula-
         How then do we ensure the validity of scientific studies using        tion of models with the appropriate range of parameter values.
      computer models? Only indirect methods are available. For this           Note, however, that modeling and simulation are sometimes used
      reason, the term validation may be too strong and evaluation             specifically to determine the influence of inter-subject variations,
      should be used instead. First of all, a model should be consistent       and in such case the statistical approach is not appropriate. In
      with observations that can be made on humans. When optimiza-             summary, simulation experiments only tell the truth about the
      tion of performance is carried out, and a realistic movement is          model that was used. Generalization to the human population is
      obtained, the model is generally considered to be valid because no       always hazardous and requires extensive validation and careful
      movement data were used to develop the simulation. When solving          examination of the results.
      the tracking problem, it is expected that, after optimization, all
      variables are within two standard deviations of the mean. If this is     Practical applications
      not the case, the model is unable to perform the movement in
      a sufficiently realistic manner. This should be reason to closely        The field of biomechanical movement simulation has matured suf-
      examine the model and make improvements where necessary.                 ficiently to allow its use in answering certain basic and applied
      Passing this test, however, does not guarantee a valid model. Due        questions on human movement, but for the equine species this
      to the redundancy of the locomotor system, the model could have          development is still in its infancy, despite the work of Van den
      found a different solution than the human to achieve the same            Bogert et al. (1989) and Van den Bogert & Schamhardt (1993).
      external movement and force variables. In that case, additional          The best-developed areas of application are gait and sports injuries.
      predictions must be elicited from the model, which can then be           In gait, the functional role of muscles has been identified by solving
      compared to measurements that were not used for development of           the tracking problem in a forward dynamic model, followed by an
      the model. This is especially important when the tracking problem        induced acceleration analysis (Neptune et al., 2001). Minimum
      is solved. We recommend testing the response of the model to             energy optimizations have produced realistic movements, suggest-
      controlled interventions and compare that response to results of the     ing that minimal energy is the governing principle of human gait
      same experiments on humans. Even when the final application is a         (Anderson & Pandy, 2001). In sports medicine, simulation has
      study on severe injuries, it is often still possible to evaluate the     shown how the effect of foot orthoses on knee joint mechanics can
      model dynamics using non-destructive perturbation tests. Care            differ between subjects (Neptune et al., 2000). Simulation has
      must be taken that these experiments test those aspects of the model     perhaps its greatest impact in the area of acute injuries, where no
      that are important for the final application. For development of a       human experimentation is possible, although this would open per-
      model for knee ligament injuries, perturbations of initial conditions    spectives for the use of the equine species being a model for these
      were used to evaluate the validity of the model (McLean et al.,          human injuries. Nonetheless, there is a long history of increasingly
      2003). Finally, a model should not be overly sensitive to errors in      realistic passive human movement simulations in vehicle collisions.
      model parameters. Critical model parameters can be identified by         With active muscle models and optimization in realistic musculo-
      sensitivity analysis: each parameter is adjusted by a small amount       skeletal models, these techniques are now becoming feasible for
      and the change in the results of the simulation is examined. In some     studies on knee and ankle ligament injuries during sports (Wright
      cases, this will show that certain model parameters are too critical     et al., 2000; McLean et al., 2004). Although the basic methodolo-
      and the results of a simulation study would depend entirely on a         gies are quite straightforward, the complexity of modeling required
      random error in such a parameter. In certain cases, optimization         for these applications is still beyond the capabilities of most labo-
      methods are helpful. In a quasi-static model of the knee joint, it       ratories. Van den Bogert & Nigg (2007) expect, however, that com-
      was found that the behavior was sensitive to the lengths of the liga-    mercial and user-friendly software will become available to make
      ments (Blankevoort & Huiskes, 1996). Solving the tracking problem        the technology more accessible in the near future for human appli-
      then eliminated these unknown parameters. Ligament lengths,              cations and eventually on the long run for use in the horse; in
      which minimized the difference between simulated and measured            the equine species animation seems a more likely application in the
      movements, were found and these values were used for subsequent          short term.
      applications of the model.
         Another powerful safeguard against overly sensitive models is
      statistical analysis. Experiments on humans or animals are never         Development of computer animation:
      performed on a single individual because one individual may not
      be representative of the population. Statistical analysis is performed   an equine perspective
      to ensure valid generalizations. When using complex musculo-
      skeletal models, the same principle should apply. These models
      have many degrees of freedom, many natural frequencies, and are
                                                                               Introduction
      often unstable and chaotic. Results from a single model could well       The movement of horses has always been an object of intense inter-
      be completely irrelevant.                                                est, not only in modeling and simulation (Van den Bogert et al.,
         In a simulation study on the effect of shoe hardness on impact        1989; Van den Bogert & Schamhardt, 1993), but also in animation.
      forces in running, both positive and negative responses were found       In the Scientific American of 1861 was a report on a horse race on
      in a group of models (Wright et al., 1998). By examining the model,      stage, in which horses were galloping on a treadmill and a synchro-
      this could be attributed to two mechanisms, which worked in              nously rolling curtain behind the horses was depicting the scenery
      opposite directions. Impact forces tend to increase initially with       from a local racetrack (Fig. 20.12). The early Muybridge experi-
      harder material. This then increases the rate of knee flexion, result-   ments in trying to capture the movement of horses (and other
      ing in a better shock absorption by the body. In subjects with           animals) on film, started over a debate about the question whether
      a certain movement style, the latter mechanism resulted in               trotting horses have an airborne moment where all four hooves are
      overcompensation.                                                        off the ground or not (Muybridge, 1899). To prove this point
476
                                                                                           Development of computer animation: an equine perspective
Fig 20.12 Treadmill for animation: a horse race on stage showing (A) the foreground display and (B) the mechanical background. Scientific American (1861).
Muybridge began his experiments with line triggered cameras.                    disciplines interact and should work together as there are many
His photographs were the first that definitely showed all phases in             cross links between animation for film and animation in the inter-
the horse’s gaits. But the interest in understanding the movement               est of equine medicine.
of quadrupeds has not become any less intense over the later
years (Van de Panne, 2000). Many films and other forms of media
entertainment include the movement of all kinds of (virtual) crea-
tures, either in live-motion or in other forms of special effects. These
                                                                                History
include animated animals, either drawn by hand or by computer,                  As stated above, there has been a large background in the study of
and other CGI (computer generated imagery) effects (Hahn, 2008).                locomotion among scientists. It has only been in the last 120 years
Many older and more modern films have featured animated and                     or so that certain advanced film tools became available to interested
life-like movements of horses and horse-like creatures, such as                 scientists to capture the motion of live animals. As mentioned
Spirit: Stallion of the Cimarron (Dreamworks Animation SKG, Glen-               before, one of the earliest scientists was Eadweard Muybridge
dale CA, USA) and Avatar (20th Century Fox, Los Angeles, USA).                  (Kingston upon Thames, UK: 1830–1904). He is considered one of
On the other hand, veterinary medicine is also becoming more and                the pioneers in the study of animal movement. Muybridge wanted
more interested in understanding, capturing and simulating equine               to analyze the specific footfall sequences of horses in different gaits.
movements. Many different devices have been developed to capture                For this endeavor he used a series of twelve mounted photographic
equine motion and visualize it in a way that makes in-depth analy-              cameras. These cameras were then triggered one at a time as the
sis of equine gaits possible. Thus, subtle lameness and asymmetrical            horse passed them at a walk, trot or canter, thus taking 24 photo-
use of limbs can be detected and treated earlier or more severe                 graphs within the short period of time it took for the horse to pass.
injury may even be prevented. This is an area where many                        Muybridge gained fame with his recording of equine movement on
                                                                                                                                                              477
       20         Modeling, simulation and animation
      photographic film, thus proving horses do have moments in the                          and features such as Betty Boop and Snow White (Walt E. Disney:
      trot and canter strides when all 4 feet are off the ground. He is often                1901 (Chicago)–1966 (Los Angeles)). More recently a computer
      credited as being a pioneer in the science of biomechanics. Although                   replaced the rotoscope, but the principle remained unchanged and
      he started his experiments with an extensive focus on equine                           was a great help for animators in being able to capture difficult and
      motion, his studies have included almost all animals and any move-                     life-like movements, such as dancing. In a way, rotoscoping can be
      ment imaginable. Muybridge was also among the early inventors of                       seen as a component of a larger technique: ‘motion capture’. Already
      precursors of film movement, with his zoöpraxiscope. His photo-                        in classical animation there was a demand for perfecting the move-
      graphs of animal movement and analysis of animal gaits are used                        ment of both animals and humans in drawings, and also a great
      even today as a reference for animators who try to draw correct and                    need for a proper understanding of the placement of limbs, the
      life-like animal motions.                                                              correct footfall and angles of the joints. Muybridge’s photo series
         Animation is also based on the photographic principle of film.                      were helpful, but not sufficient reference material. Animators need
      To the human eye, projected images that follow each other very fast                    a lot of data for reference of locomotion and other actions. This is
      (24 per second), seem to become connected and are perceived as a                       where the motion capture technique appeared on the animation
      single, moving image. Almost everyone will have had some experi-                       scene. It is basically a matter of recording movement in live-action
      ence with this in their youth through flipping books where images                      on film, then translating these movements into a model. This is
      drawn on successive pages of a book are flipped through at a certain                   often done by attaching certain markers (such as reflecting dots or
      speed at which the images seem to come alive and ‘move’. The same                      strips) to certain moving points on the subject’s body and then
      principle applies to an animated film: different images are drawn                      translating the motions of these markers into a model that can be
      and captured on a film frame, with slightly different poses on each                    used for quantitative gait analysis or used to create an animated
      drawing. This means that for every second of animated film, 24                         version of the subject. These recorded movements can be animated
      drawings will have to be made. This traditional way of animation                       characters (Gleicher, 1999).
      is called ‘classical or key frame animation’ (Thornton, 2004). For
      every frame a pencil or ink drawing is made and then inked and                         Modern animation
      captured on one frame of film. When all these separate frames/
      drawings are projected at a speed of 24 frames per second, they                        Besides ‘key frame animation’ there is also the possibility of ‘com-
      become a moving animated film. In these early animation films,                         puter animation’. This form is based upon the same principle as
      there was already much interest in trying to capture the movement                      classical animation, but instead of hand-drawing the image on cells,
      of animals as realistically as possible and different techniques were                  the images are now created in the computer. The advantage of this
      developed for recreating life-like animal movements. In the old days                   is that the computer, being programmed with certain algorithms,
      this implied first filming a desired motion, such as walking or trot-                  can ‘fill in’ missing frames that are between certain key-frames. Key
      ting, and then projecting it and capturing this motion in drawings                     frames are also used in classical animation. They show images of
      by slowing down the film. One of the first developed techniques                        certain key positions of the animated object but movement based
      for helping this process along was called ‘rotoscoping’. This process                  only on key frames is jerky so the moments between keyframes need
      consists of first filming the action played out by real life actors or                 to be filled with images showing intermediate positions between
      animals, projecting the filmed images onto a frosted glass pane and                    the key frame moments. These images are aptly called ‘in-betweens’.
      tracing over them onto paper, frame by frame. The projector used                       One of the advantages of computer animation is that it cuts down
      for the projection of the still images was a rotoscope (Gleicher,                      the time needed to draw the in-betweens. Computers can also be
      1999).                                                                                 used for motion capture techniques.
         The rotoscope was invented in 1915 by animator Max Fleischer
      (Fig. 20.13), who developed it for his animation series Out of the
      Inkwell. It has been used extensively and in many animation films                      Motion capture
                                                                                             Nowadays the basis for motion capture is still the same as in the
                                                                                             early days of classical animation, but a variety of technologies are
                                                                                             available for tracking and recording the real-time motion (Menasche,
                                                                                             1999) using multiple markers placed onto animal models or using
                                                                                             markerless techniques. The resulting data can be used to generate
                                                                                             the movement of a computer-animated model. As Gleicher (1999)
                                                                                             puts it aptly ‘Motion capture creates a representation that distills
                                                                                             the motion from the appearance. It encodes the motion in a form
                                                                                             that is suitable for the kinds of processing or analysis that we need
                                                                                             to perform’. The technique has developed further and further, to a
                                                                                             point where it is now even possible to capture and recreate very
                                                                                             subtle and life-like facial expressions with motion capture tech-
                                                                                             niques. This is what was used in films like Avatar, King Kong and
                                                                                             Lord of the Rings.
                                                                                                There are many advantages to motion capture as compared to
                                                                                             classical animation: the whole process of capturing movement is
                                                                                             more rapid, sometimes even using real-time results. This greatly
                                                                                             reduces the cost of animating complex and long movements and
                                                                                             allows a large amount of data to be collected in a single session. It
                                                                                             facilitates understanding and analyzing complex actions and realis-
                                                                                             tic physical interactions such as secondary motions, weight and
                                                                                             exchange of forces.
                                                                                                Many systems are available for motion capture. There is a distinc-
                                                                                             tion between real-time, on-line systems where the animation is
                                                                                             produced instantly, sometimes also referred to as performance ani-
      Fig 20.13  The rotoscope was invented in 1915 by animator Max Fleischer.               mation, and systems that are not real time (Gleicher, 1999). Real-
      From Cabarga L (1988). The Fleischer Story. Revised Edition. DaCapo Press: New York.   time motion capture may have applications in veterinary diagnostics,
478
                                                                                      Development of computer animation: an equine perspective
                                                                                                                                                       479
       20       Modeling, simulation and animation
      of CGI adapted live-action movement and a digitally animated                     learn and benefit from each other. Seeing how an animated horse
      horse model in a feature film. The way the entertainment industry                is created from the movements of a real one, and how this animated
      and the veterinary world can work together in a mutually beneficial              model can be used to perform actions that the original horse never
      way is shown in the example of the film SINT, a Dutch horror film                did, may help us to see new approaches to clinical gait analysis and
      made in 2010 (http://www.sintdefilm.com) that uses footage of a                  lameness examination.
      live-action galloping horse to create a spectacular chase sequence                  The scenes were storyboarded well ahead of shooting and were
      over the roofs of Amsterdam. It is interesting to briefly discuss how            used as a basis to guide the horse selection and training. A suitable
      this process was created as it vividly demonstrates the intersection             horse was selected on the basis of being easy going and willing to
      of science and entertainment and the way these two disciplines can               keep up a steady rhythm in each gait while being ridden on the
                                                                                       treadmill. For the recording session, the horse was positioned on
                                                                                       the treadmill and the rider was attached to a safety harness. After
                                                                                       some trial runs, the horse and rider were filmed at different gaits
                                                                                       (walk, trot and canter) and from many different angles (Fig. 20.16).
                                                                                       The treadmill area was shielded in green covers to provide an even
                                                                                       green background to facilitate replacing the background with the
                                                                                       rooftops of Amsterdam later on. Additional horses were filmed in
                                                                                       a large film studio, running past a 50 × 10 m green screen, or on
                                                                                       set pieces made to look like rooftops.
                                                                                          The horse and rider and their movements were then cut out of
                                                                                       the (green) environment around them. This was done frame by
                                                                                       frame and created a cut-out figure of horse and rider without any
                                                                                       background. The next step involved matching the camera angle of
                                                                                       the horse footage to footage of the rooftops of Amsterdam. This
                                                                                       involved re-calibrating all the frames using three-dimensional
                                                                                       camera tracking software, resulting in a new virtual camera. The next
                                                                                       stage involved creating a whole new, CGI background involving
                                                                                       rooftops and snow. This CGI background was then filmed with the
                                                                                       virtual camera created earlier. The moving, cut-out horse and rider
                                                                                       were inserted into this newly created background, then moving ele-
                                                                                       ments were added like hoof prints, snow reacting to the horse and
                                                                                       falling snow. Finally, color correction was applied to the whole
                                                                                       sequence. The final result shows a spectacular ride of the horse and
                                                                                       rider galloping over snowy rooftops in Amsterdam, while being
                                                                                       chased by police cars on the streets below (Fig. 20.17).
                                                                                          In addition to footage of the live-action horse and rider in this
                                                                                       chase sequence, a small part of the scene consists of a computer
                                                                                       animated horse model, instead of the live action horse. This is the
      Fig 20.15  Dr. Hilary Clayton rides her horse MSU Magic J, who is wearing a      part where the horse loses its footing and slides down a diagonal
      blanket covered with predefined, anatomical markers, in front of an infrared     rooftop, hitting a chimney, regains its footing and continues on at
      motion capture system to develop an animation of the gaits of dressage           full speed. This was an action that could not safely be performed by
      horses.                                                                          a real horse, so the sequence had to be animated completely. This
      Fig 20.16  Recording on treadmill in small green room: (A) camera stationary setup, (B) treadmill, (C) camera swing setup, (D) light setup and (E) video
      result.
480
                       Development of computer animation: an equine perspective
                                                                                  481
       20      Modeling, simulation and animation
      process is a lot more time-consuming to create and thus more expen-       Relations and hierarchies between the joints are programmed, often
      sive than the live-action movements. A completely animated horse          based on real anatomical ‘laws’. Examples are the directions and
      model can be used to create almost life-like movements, including         ranges of motion and whether the movement of one joint, influ-
      ones that have not been seen before. The creativity and correct ana-      ences movement of other joints. For example, the effect of the
      tomical knowledge of the animators is the essential ingredient in         reciprocal apparatus in the equine hind limb that synchronizes
      making these animated movements, as there often is no example             flexion of the stifle, hock and fetlock joints. After the IK skeleton is
      that makes the desired movement exactly the way it has to be made.        finished, the model can be viewed from any direction as it moves.
         The way to create an animated horse model starts with the basics,      Just having the IK skeleton of a moving horse is not sufficient, so
      often going back to anatomical books. Skrba et al. (2008) provides        the next step involves adding ‘body’ to the model and adding ‘skin’
      an overview of animation methods that are used for quadruped              to the body in a process called modeling, or creating a mesh model.
      animation. The first step involves creating an animation skeleton,        Horse meshes can be created by an artist or bought online. The IK
      often called IK (inverse kinematics) skeletons (Fig. 20.18). These IK     skeleton is bound to a mesh and rules are created determining how
      skeletons are not as precise and detailed as a real skeletal structure,   much of the mesh is influenced by each IK bone. Finally, controls
      but they are a way to control the animated model and making it            are created in a process called ‘rigging’ that enables the animator to
      move according to physical laws. They are a simplified version of         control the horse’s ‘acting’ intuitively.
      the anatomical skeleton; not every joint has to be included, only            After these rules or laws have been programmed, the creative work
      the primary moving joints. Skrba et al. (2008) defines it as a hier-      begins. For each frame it has to be decided which parts of the model
      archy of local reference frames, each frame corresponding to a joint.     need to be moved, in which direction and how much. This is a
482
                                                                                            Development of computer animation: an equine perspective
Fig 20.17  Story board (A) of the rear view and screen shot (B) of the front view of a spectacular scene in which horse and rider gallop over snowy rooftops
in Amsterdam while being chased by police cars on the streets below.
From www.sintdefilm.com.
Fig 20.18  The ‘Rhett’ model by Tim Mayo and Chris Carson. (A) Defining the IK skeleton, (B) adding a mesh body to the skeleton, (C) setting bone influence
rules and (D) tuning rigging controls.
From www.noxlabs.com.                                                                                                                                          483
       20      Modeling, simulation and animation
484
                                                                                    Development of computer animation: an equine perspective
combination of intense anatomical knowledge, lots of data and             If we consider the potentials for veterinary use, then the possibilities
reference materials (often Muybridge’s photographs are consulted          are exciting. Imagine shooting video of a patient with a suspected
for specific gaits and body posturing) and talent of the animator.        lameness, loading it into a computer program and seeing a model
After the main movements have been programmed, the computer               of the movement of that horse and being able to view it from every
can fill in the in-betweens. After this the animation process still       angle or monitoring progression of lameness by comparing or over-
involves a lot of cleaning-up and addition of small details, such as      lapping images taken at different points in time or quantify the
rippling of the skin, light fall, movement of hair, mane and tail, that   reduction of lameness after treatment. As long as we are able to see
give the animation a feeling of reality.                                  the potential in the developments of the entertainments industry
   All this work combined results in a 2-min chase scene with             (Moeslund et al., 2006) and have the ability and willingness to look
footage that was partly shot of a real horse galloping on the tread-      over the boundaries of veterinary medicine, then the possibilities
mill, in the studio and partly made up of an animated horse model.        for future collaborations are endless.
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                                                                                  Index
Page numbers followed by ‘f’ indicate figures   Alias effect, 61, 63f                             Asia Minor, 3
and ‘t’ indicate tables.                        Aliasing, 35, 63                                  Aspartate, 77–78
                                                Allometric form, 457                              Assyrian culture, 3
                                                Amino acids, 77–78, 425–426, 429                  Asymmetry, 359–360, 360f
A                                               AMP deaminase, 285                                Ataxia, 53–54, 188, 188f
Abduction, 37, 38f                              Anaerobic capacity, 283, 290, 427–428, 428f       Athenian Academy, 3
Absolute elevation, 363                         Anaerobic fatigue, 430                            Atlanto-occipital joint, 201
Absolute relative weight, 365–366               Anaerobic glycolysis, 422                         Atlas, 199
Abu Bakr ibn el-bedr al Baytar, 5               Anaerobic pathways, 281–283                       ATP:ADP ratio, 422
Acceleration                                      regulation, 422–423                             ATPase staining technique, 74–75
  calculations, 455, 455f                       Anaerobic phosphorylation, 422                    ATP synthetase, 420
  jumping, 329–330                              Anaerobic power, 427–431, 428f                    Aubin, 91
  in thoroughbred racehorses, 308               Anaerobic threshold, 283, 429                     Auer, Jörg, 23
Accelerometers, 50–52, 51f, 190–191             Analgesia, 193                                    Australia, studies in, 24
Acetylcholine (ACh), 74, 288                    Analog to digital converter (ADC), 61             Auto-correlation, 68
Acetyl coenzyme A (Acetyl CoA), 420             Ancient cultures, 3                               Axis, 199
Actin, 74–75                                    Anconeus muscle, 103                              Axons, 76
Action, 166                                     Andalusian horses, 89–91                          Aysan, Ihsan, 16
Action potentials, 74                           André, Marcel, 17
Active neurophysiological response time, 155    Anesthesia, diagnostic, 192–193
Active optical systems, 479                     Angular limb deformities, 168, 169f
                                                                                                  B
Acupuncture, 407–408                            Angular variables, 37                             Back, 18–19
Adaptation                                      Angular velocities, 453                             anatomy, 199–205, 204f
  functional, 267                               Animal physiotherapy: assessment, treatment and     biomechanics, 205–206
  of muscles, 278–279, 284–287, 285f                       rehabilitation of animals, 382           bones, 199–205, 200f
Adduction, 37, 38f                              Animation, 476–485                                  coordination and locomotion, 206
Adductor magnus/adductor brevis, 128t, 130        history, 477–478, 477f–478f                       effect of the saddle on the motion of,
Adenosine diphosphate (ADP), 74, 419–420,         modern, 478–485                                           342–343
          420f                                    motion capture, 478–479                           function, 199–211
Adenosine triphosphate (ATP), 74, 281–283,        non-optical systems, 479–485, 479f–485f           length, 217–218
          282f, 419–420, 420f, 423, 424t          optical systems, 479                              movement
Adipose tissue, 424–425                         Anterior cruciate ligament injury, 444                 in canter, 209–211, 210f
Advanced non-enzymatic glycation end            Anti-aliasing filter, 63                               in trot, 207–209, 207f–209f, 211
          products (AGEs), 268                  Anti-gravity muscles, 82                               in walk, 206–207, 206f, 211
Advanced placements                             Antique world, 3–4                                  pain/dysfunction, 216–220
  gait classification, 85                       Apsyrtos, 4                                            causes, 384
  racing sports, 308                            Arab conquest, 5                                       clinical signs of, 387
  riding methodology, 357–358                   Arabian horses, 127–129                                differences between horses with and
  trot, 88                                      Ariel Performance Analysis System, 39                       without back pain, 218–219
Aepli, A., 14                                   Aristotle, 3–4                                         effect of head and neck position,
Aerial locomotion, 11                           Arthritis, 167–168, 175                                     219–220, 220f
Aerobic capacity, maximal, 419, 462–463         Arthrogryposis, 253                                    effect of local analgesia, 220
Aerobic glycolysis, 420, 421f                   Arthrosis, 167–168                                     electromyography, 388–389
Aerobic pathways, 281–283, 423                  Articular cartilage                                    functional assessment, 387–388
  regulation, 422–423                             biology, 268–270, 268f–270f                          kinematic examination of horses with
Aerobic phosphorylation, 420                      cross-links, 268                                          back pain, 218
Aerobic power, 426–427, 426f                      developmental aspects, 270–271                       kinematic examination of normal horses,
  maximum, 427                                    effect of exercise on                                     216–218, 217f
Afanasieff, S., 15                                   during growth and development,                    kinematics, 388
Aggrecan, 268                                              271–273, 271f–272f                          objective measurements, 388
Agriculture, advent of, 2                            in young adult animals, 273–274                   patho-anatomical diagnosis, 386–397
Air mountain range, 3                             loading, 268, 269f                                   pressure algometry, 390–394, 390f,
Air resistance, 451                               remodeling, 269–270                                       392t–393t
Akhi Hizam al-Furusiyah wa al-Khayl, 5            response to exercise, 268–274                        prevalence, 384–386
Alexander, R. McNeill, 21–22                      role of, 268                                         ultrasonography, 394–397, 395f–396f
Alexander the Great, 3–4, 4f                    Artificial neural networks (ANNs), 69,              research on, 20
Alfort veterinary school, 6, 20–21, 21f                    191–192                                Back, Willem, 19
                                                                                                                                                 489
       Index
      Back at the knee conformation, 233         Borelli, Giovanni Alphonso, 5–6, 5f             lameness, 182–183, 187–188
      Backin® program, 20                        Borissov, V. M., 15                             net moment, 107, 110f
      Back lifts, 345, 345f                      Bouley shoe, 162, 163f                          net power, 110f
      Badoux, Dick, 16, 19                       Bourgelat, Claude, 6                            three-dimensional forelimb analysis,
      Bagley’s bundle, 73, 79                    Box-walking, 374                                         119–120, 120f
      Balance, 147                               Brachiocephalicus, 101t, 102, 102f, 201       Cartilage see Articular cartilage
      Balance of Borelli, 14f                      neck elevation, 208                         Cartilage oligomeric matrix protein (COMP),
      Bandages, 193                                at walk, 206–207                                       273–274, 294
      Bands, 369                                 Breakover, 122                                Cathepsin B, 273
      Banking, 165                               Breeding, locomotory responses, welfare       Cathepsin D, 273
      Bantoiu, C., 12                                      implications, 376–377               Cave art, 1–3, 2f
      Barneveld, Ab, 20                          Bucephalus, 3–4                               Cavendysh, William, 6
      Barrey, Eric, 20                           Buchmann, J., 12–13                           Center of gravity, 5–6, 14, 14f
      Barrier, G., 12, 13f                       Buchner, Florian, 19                          Central brain mechanisms, 79
      Bar shoes, 162f                            Bucked shins, 309                             Central pattern generators (CPGs), 73, 77–78,
      Baum, Hermann, 12                          Buck knee, 233                                           82, 82f
      Bayer, J., 7, 9f                           Buckle transducer, 49                           environmental constraints, 78
      Bearing phase, 120–122                     Bulk epiphyseal trabecular bone (BETB), 274     extremity movements in tetrapods, 77–78
      Becker, C. K., 19                          Bursae, 201                                     hind limb, 77
      Behavior                                   Bushmen culture, 2                              neural principles, 77, 78f
        in neck dysfunction                      Byzantine Empire, 4                             proprioceptive afferents, 78
        normal grazing, 370                                                                    Cerebellar ataxia, 253
        problem, 375                                                                           Cerebellar nuclei
        response to pain, 391
                                                 C                                             Cerebellum, 79, 82
        stereotypical, 374                       Calcineurin, 288                              Cervical spine
      Belgian studies, 22                        Calf knee conformation, 233, 251–253            facet joints, 386
      Bell boots, 163                            ‘C’ allele, 248                                 intervertebral disc disease, 386
      Bench kneed conformation, 233              Camcorders, 39                                Cervical vertebral stenosis, 188
      Bending force, 47                          Cameras, 61                                   CGI motion capture, 479–482, 480f–483f
      Beta-oxidation, 422                          for optoelectronic systems, 40              Chambon, 345, 345f
      Bethcke, 12                                  for photographic systems, 39                Chateau, Henry, 21
      B4GALT7, 258–259                           Canadian research, 22                         Chestnut, 147
      Biceps brachii, 103–104, 106               Cancellous bone, 275                          Chieffi, Armando, 14
      Biceps femoris, 128t, 129–130, 129f        Canter, 91–92                                 China, 3
      Biceps tendon, 103                           classification, 86t                         Chondrocytes, 268–270, 272
      Bilateral lameness, 183                      collected, 325–326, 325t, 327f              Chondrodysplasia
      Biomechanics, computer modeling and,         dressage horses, 325–326, 325t, 326f–327f     complex, 254–257, 256t–257t
                 467–472                           extended, 325, 325t                           simple, 257–259, 258f
      Bio signals, 61, 62f                         footfall sequence, 140                      Christian church, 5
      Bits, 343–344, 344f                          forelimb, 113, 115f                         Chubb, 15
      Biventer cervicis, 203                       ground reaction forces, 326, 326f           Cine film, 10–12
      Björck, G., 16                               hind limb, 127, 140–142, 141f               Cinematography, 39
      Blank joint, 270–271                         kinematic analysis, 113                     Circadian rhythms, 372
      Blood gas analysis, 433                      kinematic variables, 114t                   Circulation, 419
      Blood oxygen-carrying capacity, 419          lead change see Lead changes                Citrate, 422
      Blood volume measurement, 433                medium, 325, 325t                           Clayton, Hilary, 22–23
      B-mode ultrasonography, 396                  neck and back movement in, 209–211, 210f    Cleidocephalicus, 201
      Bobbert, Maarten, 20                         pirouette, 326–327, 327f                    Clicking phenomenon, 107
      Body, conformation, 234–236                  rider movements at, 353                     ClinSeat, 53
      Bone(s), 274–278                             transitions                                 Clips, 164
        diaphysis, 274                                to halt, 92–93                           Codamotion, 40
        epiphysis, 274                                to trot, 92–93, 327                      CODA-3® system, 19–20
        extracellular matrix, 274–275                 from walk, 93f                           Coffin bone, 147
        growth plate closure times, 167t              to walk, 92–93                           Coffin joint, 150f
        markers, 33                                working, 325, 325t                            angulation, 156–157
        measuring strain in, 47–48, 48f          Capillaries, increased density, 284–286         in lameness, 178–179, 179f, 179t
        metaphysis, 274                          Capriole, 327                                 COL23A1, 258–259
        mineral densities, 275–277               Carbohydrates, 419–420                        Colborne, Bob, 22–23
        morphology and physiology of, 274–275      storage, 424                                Collagen, 269–270, 270f
        neck and back, 200f, 201                   utilization, 425–426                          bone strength, 274–275
        need for exercise, 275–276               Cardiac output, 419                             cross-links, 268
        response to exercise                     Carnus, Captain, 14–15                          fibrils, 268, 268f, 272–273
            general, 275                         Carpal flexion test, 192                        in tendons, 291, 294, 294f
            in the horse, 276–278                Carpal joint                                  Collateromotion, 116
        strain gauges, 47–48, 48f                  in anesthetized horse, 107                  Collection, 94, 360–366
      Bone spavin, 168, 251–254                    arthritis, 175                                at canter, 325–326, 325t, 327f
      Bony landmarks in kinematic analysis, 33     forelimb analysis, 106–107                    forward stepping of hind limbs relative to
      Borcherdt, Werner, 12                        joint angle, 110f                                      hind quarters, 364
490
                                                                                                                                          Index
  head and neck positions, 361, 361f            Cross correlation (CC), 68                         Distal interphalangeal (DIP) joint
  horse-rider interaction in, 360–366           Cross-links, 268                                     forelimb, 109–110, 112f, 116–119, 117f–118f,
  at trot, 88, 323, 323t–324t, 325f, 361–364,   Croup                                                        121–122
          363t–364t                               conformation, 238                                  hind limb, 137, 139f
  at walk, 88, 322, 361, 362f, 362t               in lameness, 181                                 Distal phalanx, 147
Common digital extensor, 104t, 105              Cryotherapy, 405, 406f                             Domestication
Common digital extensor tendon, 149f            Cutting horses, 335, 335t                            of the horse, 1–2
Compact cortical bone, 275                      Cytochrome c oxidase, subunit 4, isoform 2           of other animals, 2–3
Compensatory lameness, 181–182                           gene (COX4I2), 247                        Dopamine, 77–78
Complementary medicine, 381–382                                                                    Dörrer, H., 12
Complexus, 203                                                                                     Dorsal longitudinal ligament, 201
Computed tomography (CT) analysis,
                                                D                                                  Draw reins, 220, 222, 345
          467–468, 472–473                      Dark Ages, 5                                       Dressage horses, 320–327
Computer animation, 478                         Dartfish, 39, 40f                                    back movement in, 217–218
Computer models/modeling, 467                   Davies, Helen, 24                                    breed selection, 89–91
  applications, 467                             Dawes, H. W., 17                                     canter in, 325–326, 325t, 326f–327f
  and biomechanics, 467–472                     Death rates, 382–383                                    lead changes, 326, 326t
  finite element analysis, 470–472,             Decision making, 69, 69f                                pirouette, 326–327, 327f
          472f–473f                             Decline of horses, 15–16                             capriole, 327
  history of, 467                               Deep cerebellar nuclei, 79                           conformation, 232, 327
  horse history, 472–474, 473f                  Deep digital flexor muscle, 104–105, 104t            effect of training on, 94
  kinematics, 468–469                             force, 447–448, 448f                               gaits, 322–327, 322f
  kinetics, 469–470, 469f–472f                    hind limb, 129f                                    genetics, 320–321
  visualization, 467–468                        Deep digital flexor tendon, 147–148, 149f            half pirouette at walk, 323
  see also Computer simulation                    and coffin joint angle, 156–157                    passage, 324, 324f, 324t
Computer simulation, 474–476, 474f                compressive force on navicular bone, 187,          piaffe, 324–325, 324t
  applications, 476                                       187f                                       rider effects, 321–322
  designing musculoskeletal models,               contraction, 168                                   transitions, 327
          474–476, 475f                           wedges and, 164, 165f                              trot in, 88, 323, 323t–324t, 325f
Conformation, 229–244                           Degenerative joint disease (DJD), 254                walk in, 88, 322, 322f, 322t
  ancient work on, 4                            Degenerative lameness-causing disorders,           Drevemo, Stig, 18
  conformational lameness-causing disorders,              254                                      Dušek, J., 17
          251–253                               Dehydration, 435                                   Dutch Warmbloods, ground reaction force,
  deviations of limb and toe axis, 232–233,     De la Croix, Magne, 14, 15f                                  42
          232f, 233t                            Dendrite bundles, 76–77                            Du Teil, Lenoble, 7
  dressage horses, 327                          Denoix, Jean-Marie, 20                             Dwarfism, 257–259, 258f
  forelimbs, 236–238, 236f–237f, 237t           Dens, 199                                          Dynamic control, 399
  genetics of, 245                              Dermis, 147                                        Dynamic optimization models, 449
  and growth, 230–232                           Descending projections, 78–79                      Dynamics, 443
  head, neck and body, 234–236, 234f,           Desmotomy, 193–194, 194f
          235t                                  De Solleysel, Jacques, 6
  hind limbs, 238–241, 238f–240f                Detraining, 286–287
                                                                                                   E
  history and tradition, 229                    Deuel, Nancy, 23                                   Economy of locomotion, 429–430, 430f
  jumping horses, 332                           Development, 73–84                                 Edison, Thomas, 10–11
  of pacers, 311                                Developmental lameness-causing disorders,          EGA system, 191
  and performance, 246                                    254–257                                  Egg bar shoes, 161–163, 162f, 167
  performance and soundness, 232                Diagnostic anesthesia, 192–193                     Egyptian culture, 3
  predicting performance and soundness by       Diagonal dissociation, 310, 365                    18th Century, 5–6
          analysis of, 241–242, 241f            Dietary alterations, effects on energy substrate   Elastic materials deformation, 47
  quantitative analysis, 230, 231f                        utilization, 425–426                     Elastic recoil, 108, 133, 136
  sport horses, 312                             Differentiation, 63–64, 64f                        Elastic similarity scaling, 458
  subjective evaluation, 229                      definition of, 63                                Elbow joint
  of trotters, 311                                increasing, decreasing and finding local           conformation, 237–238
Constantinople, 4                                         maximum or minimum, 64                     extensor moment, 107
Contact, 358–359                                  phase-plane analysis, 64                           forelimb analysis, 106, 109f
Convolution, 68–69                                physical concept of Newton, 63–64                  joint angle, 109f
Coordinate transformation, 65                     in time and frequency domain, 67                   net moment, 106, 109f
Coordination in sport horses, 315–316           Digestible energy (DE), 423–424                      net power, 109f
Coronet, 147                                    Digit, third, 147                                  Electrocardiography, telemetered, 432–433
Corticospinal tract (CST), 73–74, 79            Digital cushion, 156                               Electrogoniometry, 38–39, 39f
Cost of locomotion, 459–460, 459f–460f,         Digital extensors, 129f                            Electromagnetic kinematic analysis systems,
          460t                                  Digital flexion test, 192                                    40–41
Cow hocked conformation, 232, 254               Digital joints, 119t, 120, 121t                    Electromyography (EMG), 53–55, 73
Craniocaudal hoof balance, 148–150              Digital signal processing (DSP), 61                  amplitude of signal, 55
Creatine kinase, 422                            Diocletianus, Emperor, 4                             back pain diagnosis, 388–389
Creatine phosphate, 424t                        Direct linear transformation (DLT), 36               electrodes, 54
Cretans, 3                                      Distal accessory ligament (DAL), 156–157             the electromyogram, 54–55, 54f
Cro-Magnon race, 1–2                            Distal check ligament, 193–194, 194f                 equipment, 54
                                                                                                                                                    491
       Index
         during locomotion in adult animals, 80–81,   Exercise                                          Flexion tests, 192, 192f
                 80f–81f                                articular cartilage response to, 268–274        Flex-o-meter, 192, 192f
         muscle fatigue, 75                             bone response to, 274–278                       Flexor carpi radialis, 104, 104t
         muscle potentials, 54                          endogenous growth hormone responses to,         Flexor carpi ulnaris, 104, 104t, 107
         myoelectric signals, 54                                435                                     Flexor digitorum lateralis, 128t, 130
         neck and trunk muscles at trot, 207,           energy pathways in, 423, 423t                   Flexor digitorum medialis, 128t, 130
                 208f–209f                              exercise-based treatment techniques,            Flexor digitorum profundus, 128t, 130
         neck and trunk muscles at walk,                        399–401, 401f                           Flexor digitorum superficialis, 128t, 130
                 206–207                                facilitation-based exercise therapy, 401–404,   Flexural limb deformities, 168, 168f
         percutaneous techniques, 54                            402f–403f, 404t, 405f                   Flight arc, 157–158, 158f
         rider skill assessment, 353                    head and neck position                          Flock of Birds, 40–41
         sampling frequency, 61                         impact on welfare, 374                          Flying trot, 91, 91f
         suppleness, 358                                muscles response to, 278–290, 279t              Foals
         surface, 54                                    oxygen uptake, 426–427                             grazing, 370
      Electron transport, 420                           tendons and ligaments response to,                 kinetic activity, 369–370
      Electro-physical intervention, 405–408                    290–296                                    play, 371
      Electrotherapy, 406–407                           thermoregulatory consequences of, 435–436          stretching, 370
      Ellenberger, Wilhelm, 12                        Exercise bands, 404, 405f                         Foot
      Emotional motor system (EMS), 79                Exertional rhabdomyolysis, 253–254                   conformation, 251–253
      Endurance racing, 311–312                       Exo-skeleton motion capture systems, 479,            functional anatomy, 147–148, 149f–150f
      Energetic efficiency, 161–162, 306                        479f                                       nerve supply, 148, 152f
      Energetics of locomotion, scaled see Scaled     Expiration, 95–96                                    proprioception, 148, 153f
                 energetics of locomotion             Extension, 37, 38f                                   uneven, 242, 242f, 251–253
      Energy                                          Extension phase, 80                                  vascular supply, 148, 151f
         cost of locomotion, 459–460, 459f–460f,      Extensor carpi radialis, 103–104, 104t, 107       Footfall sequences, 87f–88f, 90f, 92, 92f, 140
                 460t                                 Extensor digitorum lateralis, 128t                Footing, 164–165, 166f
         expenditure, 426–431                         Extensor digitorum longus, 128t, 130              Force plates, 43–45, 44f
            measuring, 431–435                        Extracellular matrix (ECM), 291                      bad trials, 44
         forelimb, 105                                Extracorpral shock wave therapy (ESWT), 193          calibration, 44
         hind limb, 127, 140                          Extremity muscles, 82                                installation, 44
         pathway in exercising horse, 423, 423t                                                            lameness, 191
         production, 419–423                                                                               selection of, 43–44
         stores, 424, 424t, 451–452
                                                      F                                                    surface materials, 44–45
         use on treadmill, 32                         Facet joints, 201                                    in treadmills, 44–45, 45f
      Energy substrates, 423–426                      Facilitation-based exercise therapy, 401–404,        variables, 44
         effects of dietary alterations on, 425–426              402f–403f, 404t, 405f                  Force shoes, 45–46, 46f, 191
      Enlightenment, 6                                FADH, 420, 421f, 422                              Force transducers, 49
      Eohippus, 267, 369, 370f                        Fat, 424–425, 424t                                Forelimbs, 99–125
      Epidermal lamellae, 147, 149f                   Fatigue, 430–431                                     canter, 113, 115f
      Equestrian sports                                  limb coordination changes, 114–115                computer modeling, 469–470, 469f
         history of, 17                                  in thoroughbred racehorses, 309                   conformation, 236–238, 236f–237f, 237t
         performance in, 305–340                      Fatty acids, 419–420, 424t                           energy storage, 105
         popularity of, 1                                utilization, 422                                  gallop, 114–115
         see also specific sports                     Feeding, 372–373                                     ground reaction force, 99
      Equinalysis, 39                                 Femur, 239, 239f                                     joint angles, 99, 100f, 113f
      Equine Gait Trax Digital Motion Analysis        Fetlock joint, 149f                                  kinematics, 99, 114t, 115–122
                 System, 39                              angulation, 156–157                                  in sport horses, 312, 313f–314f
      Equine motor neuron disease (EMND),                extension, 185                                    lameness, 177, 177f, 177t, 180–182
                 53–54                                   hyperextension, 183                               musculotendinous architecture, 99–105
      Equine myotonic dystrophy, 53–54                      in forelimb lameness, 178–179,                    extrinsic muscles, 101–103, 101t, 102f
      Equine protozoal myelitis, 188                             179f–180f, 179t, 185                         intrinsic muscles, 103–105, 104t
      Equitation science, 377                               reduction in lameness, 185                     net joint moment, 110–111
      Equusense, 51                                   FGFR1/FGFR2, 259                                     protraction, 157
      Ergot, 147                                      Fiberoptic transducers, 49                           sagittal plane analysis, 105–115
      Ethology, 369                                   Fibroblast-like cells, 291                           segments, 100f, 100t
      Euler, Leonhard, 443                            Fibrocartilage, 147–148                              stance phase, 110–111
      Euler angles, 37                                Fibronectin, 273                                     stride, 99
      Europe, 17–22                                   Fibrotic myopathy, 189, 189f                         swing phase, 110
      Eventing, 333–334                               Fibularis tertius, 127, 130                          terminology, 99
        dressage performance, 333                     Filtering                                            three-dimensional kinematics, 115–122
        effect of added weight on jumping, 334,          signal processing, 66–69, 66f                     trot, 106–111, 107f, 116–120, 117f–118f
                 334t                                    special filters, 68–69                            walk, 111–113, 116–120, 117f–118f
        endurance performance, 333–334                Finite difference method, 446–447, 455, 455f      Forging, 235
        speed performance, 333–334                    Finite element analysis (FEA), 470–472,           Forssell, G., 14–15
      Evolution, 369, 370f                                       472f–473f                              Forward dynamics, 443
      Excess postexercise oxygen                      Flavin adenine dinucleotide (FAD), 420            Founder, chronic, 167
                 consumption(EPOC), 429               Fleischer, Max, 478, 478f                         Fourier analysis, 65–66, 66f
      Excitatory amino acids, 77–78                   Flexion, 37, 38f                                  Four point trimming, 152
492
                                                                                                                                       Index
                                                                                                                                               493
       Index
        position, 211–212, 212f–214f, 220–222,          center of pressure, 156–157                     heart bar, 162f, 163
                220f, 221t                              central reference point, 150–152                historical aspects, 147, 148f
           in collection, 361, 361f                     cracks, 166                                     manipulations, 161–164, 162t
           impact on locomotion, 375–376                flight arc, 157–158, 158f                         clips, 164
      Heart bar shoes, 162f, 163                        general anatomy, 147–148, 149f–150f               heel caulks, 164
      Heart rate measurement, 432–433                   ground interaction, 164–165, 166f                 hoof pads, 163
      Heat therapy, 405–406                             horn, 147                                         length of shoes, 162–163, 162f–163f
      Heel caulks, 164                                  impact, 152–156, 155f                             nails, 164
      Heels, 147                                        initial ground contact, 152                       rims, 164
        underrun, 149–150                               interaction with the ground, 137–138              toe grabs, 164
      Hematocrit, 433                                   lameness, 175–176                                 toe of the shoe, 163–164, 163f
      Hemispherical markers, 33                         landing pattern in lameness, 178                  wedges, 164, 165f
      Hereditary equine regional dermal asthenia        length, 161                                       weight of shoes, 161–162, 161f
                (HERDA), 253                            manipulations, 158–161, 159f–160f                 width of shoes, 163
      Hereditary multiple exostoses, 253                mechanics                                       rolled toe/rocker toe, 167
      Heritabilities                                       during locomotion, 152–158                   Seattle, 161–162
        gallop, 90t                                        standing horse, 148–152                    Housing, impact on locomotion, 373
        trot/trotting, 88–91, 90t                       mechanism, 156, 156f–157f                     Howell, A. Brazier, 15
        walk/walking, 88, 90t, 322                      movement in lameness, 177–178                 Humerus, 236–238
      Hethiter, 3                                       nerve supply, 148, 152f                       Hunagdi, Shih, 3
      Hexokinase (HK), 420                              practical applications to performance,        Huns, 2–3
      High-speed video cameras, 39                              166                                   Hunting response, 405
      High-velocity, low amplitude thrust (HVLA)        pressure mats, 52, 52f                        Hyaline cartilage, 147–148
                techniques, 398–399                     proprioception, 148, 153f                     Hydrotherapy, 404
      Hildebrand, Milton, 14, 17                        segments, free body diagram, 445–446,         Hydroxyapatite, 274–275
      Hill muscle model, 475, 475f                              445f–447f, 454–455, 454f              Hydroxylysylpyridinoline, 270f
      Hind limbs, 127–145                               shape, 148–149                                5-Hydroxytryptamine (5-HT), 77–78
        canter, 127, 140–142, 141f                      sliding of, 154–155                           Hypercapnea, 433
        conformation, 238–241, 238f–240f                strain, 156                                   Hyperkalemic periodic paralysis (HYPP),
        energy generation, 140                          three-dimensional analysis, 121t                        53–54, 253–254
        gallop, 127                                     trajectory in lameness, 178                   Hyperthermia, 253
        joint angle-time, 141f                          trimming                                      Hypothalamic-pituitary-adrenocortical (HPA)
        kinematics, 305                                    four point, 152                                      axis, 434
           in sport horses, 312–313                        manipulations, 158–161, 159f               Hypoxemia, 433
        lameness, 177, 181–182, 182f                    vascular supply, 148, 151f                    Hypoxia inducible factor 1, alpha subunit
        musculotendinous architecture, 127–131,         wall, 147                                               (basic helix-loop-helix transcription
                128t, 129f                                 accelerometers, 51                                   factor) gene (HIF1A), 248
        net joint moments, 140                             cracks, 166                                Hyracotherium, 267, 369, 370f
        protraction/retraction, 139–140, 364               growth, 147, 159–160
        rotation, 232–233                                  strain gauges, 48, 48f
        sagittal plane analysis, 131–142, 133t–134t        strains, 156
                                                                                                      I
        segments, 133f, 133t                            see also Horseshoes                           Icelandic horses, 88, 90f
        stay apparatus, 130–131                       Hoof pads, 163                                  I (inverse) K (kinematics) skeletons, 482,
        trot, 127, 133–138, 141f                      Hoof-pastern axis, 148, 154f                               483f–485f
        walk, 134t, 138–140, 141f                     HoofTM System, 52, 52f                          Iliacus, 128t, 205
      Hind quarters lowering, 365, 365f               Hormone profile, 434–435                        Iliocostal system, 203
      Hip joint, 131, 133–135                         Horn, 147                                       Immunodeficiency, combined, 253
        extension, 139                                  tubules, 147                                  Impar ligament, 147–148, 149f
        extensor moment, 134–135                      Horse bands, 369                                Impulsion, 359
        flexion, 139                                  H(orse) INDEX, 43, 191                          Indirect mobilization techniques, 401–402,
        joint angle, 135f                             Horse racing see Racing/racehorses                         402f
        net moment, 134–135, 135f                     Horse-rider interaction, 341–368                Inertial sensors, 50–52
        net power, 135f                                 basic rider movements, 347–353, 347f          Inferior olivary nucleus, 79
      Hittites, 2–3                                     bits, 343–344                                 Infraspinatus, 103
      Hock angles, 239–240, 240f                        collection, 360–366                           Injury
      Hock flexion test, 192                            hind quarters lowering/increased hind joint      prevalence of, 383
      Hoggar mountain range, 3                                  angulation, 365, 365f                    thoroughbred racehorses, 309
      Hoof                                              reins, 345–347                                Inspiration, 95–96
        angle, 158–160, 159f–160f                       rider skill, 353–357                          Insulin, 420
        balance, 147–152, 155f                          rider’s weight influence, 357                 Integration, 64, 64f, 67–68, 68f
           craniocaudal, 148–150                        riding methodology, 357–360                   Intensive management, impact on
           four point trimming, 152                     saddle, 341–343                                          locomotion, 372
           mediolateral, 150–152                      Horseshoes                                      Interference, 166
        bearing surface, 149–150                        bar, 162f, 163, 167                           Interlimb coordination, 85–97
        bony skeleton, 147                              Bouley, 162, 163f                                see also Gaits
        breakover, 157, 157f, 159, 163–164              effect on breakover, 157                      International Conference on Equine Exercise
        capsule, 147, 149f                              effect on hoof mechanism, 156, 157f                      Physiology (ICEEP), 18
        cartilages, 147–148                             egg bar, 161–163, 162f, 167                   Interspinous ligaments, 201
494
                                                                                                                                      Index
                                                                                                                                               495
       Index
496
                                                                                                                                    Index
                                                                                                                                              497
       Index
498
                                                                                                                                            Index
                                                                                                                                                     499
       Index
500
                                                                                                                                        Index
                                                                                                                                                501
       Index
      Vertebral joints, 201                          half pirouette at, 323                         Wehner, R., 12–13, 17
      Vestibular disease, 188                        heritabilities, 88, 90t, 322                   Weight bearing, relative, 365–366
      Vestibular nuclei, 79                          hind limb, 134t, 138–140, 141f                 Welfare
      Vestibulum development, 81                     kinematic analysis, 111–113                     breeding/training locomotory responses,
      Veterinarians, Roman Empire, 4                    three-dimensional, 116–122, 119t                     376–377
      Veterinary College of Philadelphia, 6          kinematic variables, 114t                       effect on management regimes on,
      Veterinary education                           load carrying at, 357                                   373–374
        19th century, 6–15                           medium, 322                                     impact of exercise on, 374
        start of, 6                                  neck and back movement in, 206–207,            Wentink, G. H., 19
      Veterinary medicine, antique cultures, 1, 3            206f, 211, 217–218                     Western sports, 334–335
      Vicon MOTUS, 39                                rider movements at, 349–353                     cutting, 335, 335t
      Vicon MX, 39–40                                   lateral and rotational, 350–353,             gaits, 335, 335t
      Video analysis, head and neck position,                351f–352f                               maneuverability, 334
                215                                     sagittal plane, 349–350, 349f, 350t, 351f    reaction time, 334
      Video cameras, 39                              rider skill in, 354–355, 354f                   stability, 334
      Videography, 39                                running, 88                                    Wheel motion, 61, 63f
      Vienna, 19                                     in a straight line, 116–120, 119t              White line, 147
      Vincent, 6–7, 7f–8f                            stride length, 322                             Wiechert, F., 12–13
      Virtual reality, 468, 468f                     transitions                                    Wilson, Alan, 21–22
      Visible Human Project, 468                        from canter, 92–93                          Winging, 163
      Visualization, computer models, 467–468           to canter, 93f                              Withers
      Von Hochstätter, Conrad, 7                        to halt, 92–93                               height at, 234–235, 235t
      Von Lengerken, 17                                 from trot, 92–93, 327                        in lameness, 180–181
      Von Lettow-Vorbeck, First Lieutenant, 16          to trot, 327                                Wobbler disease, 188, 254
                                                     turning sharply at, 120–122                    Wu, emperor, 3
                                                     velocity, 112
      W                                             Walter, K., 12, 16
      WAAS (Withers Acceleration ASymmetry), 190    Warfare, 15–17
                                                                                                    X
      Wagener, H., 12–13                            Warmbloods                                      Xenophon, 4, 245
      Walk/walking, 88                               conformation, 246                              Xsensor, 53
       in adult animals, 80                          selection for dressage, 89–91
       classification, 86t                           as sport horses, 313–314
       collected, 88, 322, 361, 362f, 362t          Water immersion, 405
                                                                                                    Z
       dressage horses, 322, 322f, 322t             Water jumps, 332                                Zebris system, 41, 41f
       extended, 88, 322                            Weaving, 374                                    ZNF346, 258–259
       footfall sequence                            Wedges, 164                                     Zoöpraxiscope, 10–11
       forelimb, 111–113, 116–120, 117f–118f         heel/toe, 164, 165f                            Zurich, 21
       free, 322                                     in navicular syndrome, 167                     Zurich, studies in, 22f
       ground reaction force, 42–43, 112             side, 164                                      Zwaenepoel, M., 14–15
502