Field study of the prevalence of lameness in horses with back pain

Abstract

A population of 805 horses (70 per cent dressage, 20 per cent show jumpers and 10 per cent trotters) with orthopaedic problems was examined for signs of lameness and back problems, irrespective of their original complaints. In the horses with a back problem the prevalence of lameness was 74 per cent, and back problems were diagnosed in 32 per cent of the lame horses. These percentages were significantly higher than those recorded in a control population of 399 horses, of which 20 per cent were lame and 12 per cent had back problems. In the group of horses with orthopaedic problems there was a strong association between lameness and back problems and, in particular, there was a high prevalence of lameness among the horses with back problems.

Full text

PAPERS
&
ARTICLES-
Field
study
of
the
prevalence
of
lameness
in
horses
with
back
problems
M.
A.
A.
M.
LANDMAN,
J.
A.
DE
BLAAUW,
P.
R.
VAN
WEEREN,
L.
J.
HOFLAND
A
population
of
805
horses
(70
per
cent
dressage,
20
per
cent
show
jumpers
and
10
per
cent
trotters)
with
orthopaedic
problems
was
examined
for
signs
of
lameness
and
back
problems,
irrespective
of
their
original
complaints.
In
the
horses
with
a
back
problem
the
prevalence
of
lameness
was
74
per
cent,
and
back
problems
were
diagnosed
in
32
per
cent
of
the
lame
horses.
These
percentages
were
significantly
higher
than
those
recorded
in
a
control
population
of
399
horses,
of
which
20
per
cent
were
lame
and
12
per
cent
had
back
problems.
In
the
group
of
horses
with
orthopaedic
problems
there
was
a
strong
association
between
lameness
and
back
problems
and,
in
particular,
there
was
a
high
prevalence
of
lameness
among
the
horses
with
back
problems.
i('Cicrinut
Rc
coril
21)0)4)
1
5-5,
(
68
((
M.
A.
A.
M.
Lauidmana,
(1)\\1,
N
(ll
S
3
U
trechit
1
lie
Ntlicrt
Iuictis
J.
A.
de
Bl.atiw,
1
5\I,
L.
J.
Hoflanid,
iV
MI,
(t
1t1iC,
/id,'dcl
6(,
1
'41
o
i us
en.
Thlie
Nctlicrtlltids
P.
R.
van
Weeren,
DVx
Si,
P
i
l),
tDepai
itllicit
otf
F1tcItLieC
SCICtiCCS,
tICLIclts
Of
\cutu.
itu
1N11i\l.chtctne,
K
lct'
t
t
ruuet
si
ts,
'u,ill,t,uti
_,
Nt
3584
(
St
Uti-ccliit,'I'lie
Nethelt-latcds
I
fRSFIS
S
suffering
friom
back
paini
sonictinlis
sbowx
signs
of
lamiicness;
cOnv
erselv,
lameness
0ro1
i
atilln
1ai
o
fro
a
limb
mav
Ilbac
a
significant
imlipact
oni
tbc
kinciiatics
of
ai
boisxc's
back
PouL-Celot
alld
othiCt-S
I'
998).
In
11b
iati-al
bcingxS,
inI
jr-ies
SLICli
as
tcar.s
In
ibelC
fctiorotibial
CRciCatC
ligailCnlt
1iaxC
IbCCIn
SI1O\e1n
to
clilangc
tbe
nioveenictit
of-
the
hip
Joinlt
aid
spinal
kitic-
nIal.tiCS
CluLitllg
loco1iiot
intl
(
Blulghcroii
and
otbhcrs
1997),
acid
\'V'olftc
aiiii
othicr-s
(
1
996)
foutiLdt
tbat
55
pet-
cetit
of
people
w
itil
o.stcoartbritis
ot
the
knicc
cxpci
iciiccc
l
hack
paui.
It
bias
allso
beeti
sbown
that
differetices
in
tlic
lc1,tihi
of
a
pCerso
Is
lCes
cati
lead
to
how
back
pain
aiiid
tradiograpbic
cbanges
in
tlbc
Spinie;
cocti
()re
I
tbc
cliffet
cincc
in
lcng,th
h
as
Su11allV
C
esollted
iII
a
I-
CLnctiti(l
if'
tic
lows
back
pain,
(i1
cx
eti.
a
c(ll
plete
resoflItion
o(i
thle
sxI
tiiptolls
(
[ibrg-,b
t
1
983(,oftoil
I
985,
Rossv
()I
d
(itbicrIs
1
9)2,
(,rn
l
cx
20)012).
'I'bee
finidinios
ini
humalina
medicitie
aIr
iln
lihc
ssith
cnipir-
ical
clilcal
seterinarv
wisdom,
wx
hicb
f.ls
Ibgt
field
thlat
bfack
11jr11i
iiCS
iI
orei
asc
(if
tel
1scondary
1
(1
poipi
In
tIle
lowser
11111bs
Jettfcott
1979,
1999,
C
auLsiII
1997,
HaulcSrSIC
1
997,
fillis
1999).
Iijdlflim1
l
enexcixcs
in
lioircs
hai1s
beenI
reported
to
affect
ties-
inel-tetllSion
nios
enments
(
PoIirceC(it
lldi
OtfieCrS
998
alid
aal
iotatiotil
of-
the
black
(
Buc1liler
atid
otflr-s
1996),
anild
back
profbifcms
may
also
be
itidLuced
by
forelimb
pr(b)lems
(tCauviln
99/)
l
Tiese
prolelmsIlls
tyi
d
induce
CICle
Signs
Of
lanileneiss,
hUt
snbCinical
l.anIlenIsS,
CaLused,
to-
ilstallcc,
Ilv
ililbalanced
slloc-
ing,
hais
also
beenl
Irpo-rtedt
to
lcad
to
b.Ick
probIftiles
(
Ridtgw
av
aticd
Hariliatl
1
999).
Anotber
cilLasC
ot
back
pain
is
sacroiliac
os
eload
(
Jeffcott
197-5).
In
1oth1i
tore-
azid
lidlililb
lauiieniss,
adlaptations
of
the
m11ov0eillemlt
of
its
flead
calil
help
tbe
horse
to
r-Ceduc
the
load
oni
tIle
l11tiie
fiullb
()
BuIClilnc-
aild
othier-s
1
996).
Oni
the
otllr-
liaiid,
spinal
injuries
call
c.auISe
gyait
abnortiiaflities
01
lower
liIimb
lauiiuiecss
as
tIle
lion-sc
tt-ics
to
pr
otect
its
soie
ticck
or
back
(I
fauIssleCr
1
997).
AlthougLl
it
is
coilsider-ed
that
lalile-
iess
s
oftteti
related
to
black
probculls,
thlat
is,
back
proflem
s
1ixV
Ctuxe
lailciicss
oih
la.tlletiess
MliaV'
c.tLuSC
back
probtlis,
lard
ex
idetice
is
scarce;
(t11s
OItle
stUds
lias
icillollstratecl
a
51)
petC
cCilt
prc\xalcICC
of
sooft
tissuLe
daiiag,e
iti
the
back
of
latiie
hlor
ics
(Gillis
1999).
It
hias
bccii
stated
tllit
a
lhor-se's
flack
shldilCi
be
extiiiiinied
as
a
statidard
lefeiietit
of(it
clilpiete
Iatiti+clss
cxamlinlationi
(
Stasbak
2002a),
)bit
tlici
c
15
iio
scieititiic
exidetice
tIlhat
thir-c
is
a
quantll
itative
refationsliip
betssween
aiiiciiecss
ztid
blacl..
r
0111bellCs.
'I'hiis
papei-
decrcribes
ai
ills
xvstigatioil
of
the
presvalenice
(it
liuiibt
latiietiecs
in
horses
ss
ithi
back
problenis
aiid
the
pr
i-a-
letice
of
back
probleics
in
lame
hoires,
ill
a
popufatitioll
(f
lorses
ss
itli
orthopedic
prolifemiis.
A
pOPLIlation
of
it
orses
liitig
e.xaMiited
1iefr'-C
pulr-chiase
wsas
Used
to
deter-iiiitic
the
pt
craletice
of
ltaiitciess
atid
back
flrobtIlcs
in
11
a
ioriial
i()o-
ulatioll.
TI
he
aiMli
otf
the
StUdy
xxas
to
compare
the
prevalence
ci'
Ihaick
paini
in
late
lihol-ss
svithl
its
pie
valenice
iII
hiol-ses
ssithi
1io
recognlised
olrthopacdic
co(lchiti(li.
MATERIALS
AND
METHODS
Horses
The
805
blors
xs'itl
all
a
'rtbiopaledic
plroblcii
wet
r
cxaliliiltcd
llCtx\sCcll
Jaliuars'
2)()(
atid
Mlarch
2()1,
atid
linidCr
c\vlt
a
fc-tl
latililclcs
cxatiliniationi
atid/oIr
a
fu-ill
hack
examinitio
nwti
xxitlitil
sevxcii
das
x.
Approximatclx
7()
per
cti
t
of
tlietii
sscc
xrtic
w
ia
-
Ilood
hol-seCs
uIsed
fot
drcssagc,
2(1
pct
ccnt
\\scrc
wxx
arbiilolnods
ulsed
fcir
slios
jUtlmpinig
atid
I()
per
ccilt
ssrec
troltters.
Lameness
examination
All
the
cOIrscs
ss'cr
exatiiiticd
lis
cxpriticiccd
xctctrnz
iltiariiS
hlio
CNcx
aliatcd
the
dc(rec
(if
ltaiicicss
acccirdillti
the
cllii
cal
lhaiieuicss
score
(if
the
Ailici-jC.II1
Associatiioti
(if
l'cUinl
Puractitioniers
()
S\t))
(T
fabihc
1),
fir-st
at
a
tr-ot
il
a
stralglit
lilhc,
atid
tlicii
wbeicn
cit-cled
cn
a
hard
(gIrasvcl)
atid
olii
a
soft
suLr-
face.
TIe
site
of
tbe
laiiietiess
xwasx
fut
1tiet-
locallsxed
lbv
nierve
blocks
aild/oir
iltra-a-articuLlar-
atiaestliesia
(
Cartcr
aiti
oIogan
1996,
Stasliak
20(02a)
.
A
hlaiie
biorsc
xasx
def-iicd
as
onct
w\ith
laiiicixcss
(if
at
feast
2
OLIt
o)f
5
at
a
tr
ot
ill
a
straluigit
liiti,
or-
circhihg
c0ii
a
hlard
azich/oh-
soft
sLIrfatcc,
atnid/or
oiiC
xiicli
imiprocwd
cl
at
least
50
per
cciiit
a1f-tce-
a
nci-vrc
hilock
aicd/o-r
iltra-articlfar
alliastlicsia.
Back
examination
A
I-Lill
histor'
ws'as
recorded
f(or
eaclh
liirse.
The
examiiniatioti
of
the
bacck
star-ted
svithi
ati
ilispcctiol
atiid
pal
pationi
for
the
fireslice
of
ocieliia,
by'pCrtotlic
iicLiscles,
atrophiy,
iwpertro-
phix'
auid
fiv
pCIrsclsitiv
its
(
Jefflcott
1
975
Stasliak
1
996,
2()()2a,
1h,
C(
Tx
ill
199)7,
\altierIg
1
999).A
tfirst
itilpiessioti
of
thic
illcix
Ilicuits
ot
the
licitse's
back
auid
ciitubs
hald
alreacld'
hiect
obtaitied
dci-uritig
the
cxatiliiiaticiui
for
laiiieciess.
Rigilditx
of
the
sp
iie,
x
Ilicli
oax
1
iccoiiC
apparCcIlt
aS
a
slitcirttied
strid(
e
at
the
xxTalk,
was
the
pFriticipal
itidicatioui
for
a
tcuL-tfie
examiniia-
tioul
(
Jcffcott
1
975,
(
Cis
iii
1
997
\'alhberg
1999,
Stasbiak
2t002a,
b).
'I
lic
tips
ot
the
dorsa.l
spilOLUS
prIoCCSSCS
xN'CIC
peIcuissecd
to
exauiiiuie
the
deeper
parts
ot
the
xelrtebra.
Repeatablhc
paill
reactiois
xx
crc
ta
keni
to
iuidicaite
a
prioblciii,
atich
if
ther
c
swas
anvx'
itidicatioil
ot
a
probleuii
the
esaiiliuiiatioii
swas
cciiuiti
cd
l)i
tcstiti,
the
coirso-
aitic
xvenitrclilexiconi
ot
the
hack,
biv
stu
okitig
a
blillit
illStliLt11iCilt
ahilo
sidce
the
xertciral
dCOItlitiI
frcoiii
the
xxwithiers
to
the
base
cif
the
tail;
f-roiii
the
sswitliers
to
the
crcOiup
this
sicuthcl
iilduce
xvenitrofexicon
of
the
hack,
aticd
ovxcr
the
crcicp
it
siiuhold
iiiduce
dcirsoflcxicii.
Ani
refIucLtiliCC
to
flex
its
back
xas
a
recoi-ded,
as
sv'ere
lip
pciscrisitix
c
rcspoitses
alicd
differ-eiices
betsween
the
righit
aiid
lct-t
sidc
(
jcttfcott
1
975,
Stasliak
200(2a,
hi).
Liaterotlxicoii
coiiiliicd
xxwith
axial
rcotatioti
of
cach
spinialf
segmeuIlt
xs\as
tested
attet-
the
liolrsc
had
ficeCn
sedated
ws'itli
I)0
tg/kg
detoiiilliice
hl
idroclilcoridc
(Douiiossedaui;
l'fizer
Aiiniial
Heazlthi)
acdrilinstelec
iitra-
venoushx,
li
puullillig
the
hiaSe
of
its
tail
tcis\Tards
the
examiniuer
The
Veterinary
Record,
August
7,
2004
165
group.bmj.com on July 15, 2011 - Published by veterinaryrecord.bmj.comDownloaded from

wsithlicon
hand
whilc
the
other
hand
was
hldcc
at
the
lesvel
oft
the
dot
sall
spillOus
pro(CeSSeS
to
Op)pose
the
pulingM,
tIhuS
Ci
e
attn
aFwngnioin
(I
Ig
1).F1C
heopposing
hanld
Wsas
Lused
b1)t1h
to
ix
the
cranial
vcertebra
anid
to
assess
the
later-oflex
ott
and
r
otation
of
the
segment.
To
test
the
mohility
o-f
the
SuICCeSSIVCe
splinal
segi-ments,
the
opposing
hand
wsaS
runli
dossni
ft
0111
9
to
1L6.
Anv
distitnctIv
Iiniiited
range
()f
niiotion,l
anl
aIsvilitlietric
range
of
1mot1ion
anid/or
hy
perrnohility
of
onec
or-
miore
spinal
segniei-ts
wsas
ecor-ded.
'I
he
sacroiliac
joint
ssas
examinted
bs
ssalkitig
the
hiorse
backssarcls
atid
bv
lethtig
It
ssalk
In
smiall
clircles
In
bctli
ldirecc
tionis.
lorses
that
did
liot
ssalk.
hack
sv
i-ictriiecalls,
aild/or-
did
ilot
cir(1ss
tleic
r
hindlimhs
whlcl
clircliti
s
eeI
urC'
fLltheCt
exatii-
tidc(.
'I'lie
miohilitv
of'
the
sacroiliac
joinit
was
tested
hs
puISh1
ilg(
theC
tuIber
coxae
towsatds
tile
ipsilateral
t
-ont
foot,
to
cceetcmineiii
the
railge
(lf
miotioti
(If
the
'olint;
thils
also
testedi
tIle
OtattiOl
Ot
tllc
11-Imbos,acral
W'lilt.
A
horse
ssas
conisider-ed
to
hav
e
a
b
Ad
pr-oblem
if'
it
shlowscd
Ot1c
or-
tiorme
of
Ile
follosmvitlg
signis:
reCpeatahle
palIn
uIpoti
pa-lpatiol;
t,epeatablcl
paull
LIpot
perCuISSIM-I;
a
limiited
ranlcw
(If
tllotiotl
of
otie
(It
11101-
eSpitnal
segmenclts
or
otf
tIle
sa
ithac
(I'i
tt;
115
pet
bii
ack
tItuLSCleS;
tt
(ledetia
sw'thit
the
black.
lI-tses
that
shusscd
ti'one
o)f
thecse
sighs
buIt
ssCetC
fOL11tic
to
have
a
problem
Itn
tile
cers
cal
part
4thofli
spitie
ss
ereC
eXCLdICIdec
tr(l01til
SthesUdV.
Control
horses
'I'C
CIecltt
(II-
gr
oup
c(StClite
Of
399
hiot
ses
ss'ch
dlcrs
ee
xatii
tiedCiet
eC_-
put
IChlase,
bCt\VCC1
eenlatirv
2001)
atid
Nosvetiiber
2(001I
'Ilies
were
exatiiitiecli
in
the
sanless
was
as
the
licIrses
wsitli
mortloaedic
pt
obllleiis,
e\cept
that
atis
lamei
1l(11
ses
55vere
tl(0
Itrlietlll
examinitld
ssitli
tiersve
blocks
atidm
(Inrtitaatrtictt11lat
atiaesthecsia,
atiid
the
black
examiiitationt
wSas
muiited
to
fpalpa-
tio(ti
atich
soltleictileIS
pet
cLISSIOlII.
Data
analysis
Falcli
o)f
the
hiot
ses
ssas
placedl
Itn
otie
oif
the
(111(1mvitig
cate-
gOt
tes:
hack
priobletll
atdIc
lathe;
hack
proI)lcmti
hUt
no0t
lamei;
10o
biackl
pir(Ibletm
but
latii;
or
nio
hack
pro(bIleti
andic
ot
latiie.
h
1I-SCLI"
s
itaecd
tests
ss
ere
uISed
1(1
ctlipatre
the
pr-opot
tiomi
(if
lame
hot
imses
atliotig
the
hor-ses
wsith
olrthol(clpeic
Problems
sshIiclh
also
had
back
pt
(ltlletils,
ssTithl
theC
prop()[Irti(It
ott
lame
1l01(St
ssIll
theC
COtitrol
pO(lpulat
icli,
atiid
also
the
pi-opottictioi
olf
11(11ses
wsitli
a1
back
ptr(lbletm
atmotmg
the
lcIrises
wsith
(Irthi(paedic
pr(olllletis
wshiclh
wsetc
also
lame,
wsith
thec
pro()
pmlt
tiot
(If
tile
colitilt(I
ll(ltses
wshic
hlIad
a
back
probileti
si)ss
M(.01
fOr
WI
ticdoisss;
5155S).
RESULTS
)f
the
80311(11
ses
ssitli
0tliopaeduic
pr
(Ib1etms,
43-f
339
pet-
Cetit
sset
e
la1iie
ssithLIut
a
back
pro)b1ecm,
-2
(8-9
pet-
cetit
had
EI0
L~v
l
f
,
A-
FIG
1:
Method
for
examining
lateroflexion
Grade
Description
2
3
4
5
Lameness
not
perceptible
under
any
circumstances
Lameness
difficult
to
observe;
not
consistently
apparent
regardless
of
circumstances
such
as
weight
carrying,
circling,
inclines
or
hard
surface
Lameness
difficult
to
observe
at
a
walk
or
trot
in
a
straight
line;
consistently
apparent
under
some
circumstances
such
as
weight
carrying,
circling,
inclines
or
hard
surface
Lameness
consistently
observable
at
a
trot
under
all
circumstances
Lameness
obvious;
marked
nodding,
hitching
and/or
shortened
stride
Lameness
obvious;
minimal
weight
bearing
in
motion
or
rest;
inability
to
move
a
ilack
ptrobletm
huLIt
ssere
soIutnd
208
2rn8
per,
cenit)
ssvere
Ilame
atid
la'ld
a
fiack
prolilemi,
atid
91
(
11
3
per-
cetit
ssI-
erels(Iid
atid
cild
tiot
hasve
a
back
proillecm.
Inti
101l
18(1
34.8
per-
cetit
tad1(
a
back
pt(oblcmt
anid
642(9
pet-
cettt)
ssvetc
lathc
aTIble
2).
Of
the
399
contirol
l
horses,
58
(
14-5
per
cetit)
ssetre
Iatiiei
(otiv,
27
(6-8
per-
cetit
liad
a
tiack
ptrobIleti
(otly,
21)
f)
pct
cetit
liad
a
hack
prolbletm
atid
sset
e
laniii
atil
294
(3
Pet,
cetit
swetre
sottid(
atiicl
did
liot
lasve
a
b,tck
prolbleti.
ItII
total,
4
11
8
pet-
cetit)
of
thcse
hiorses
ladic
a
black
problbeti
aniid
1
9-
pet
cetit)
\ss
erc
laiiie
lalie
3).
WlIeiCI
Coltlpat
-itig
tile
t\Vs
IpcOptLIatiotIS
'Fable
4),
the
pro-
poIrtoi(iot
(Iflaiiie
llIrises
ationig
the
liolt
ses
ssitli
a
back
ptroIl
letii
hIn
tile
liolrses
wsitli
ati
(ortliolpaedhic
problleti
(208
(if
2811,
(I
43
per-
cetit)
\
ssas
sigtnificantlyl
higher
tliati
tile
pro(portioti
(I
at
iie1
11(1SeS
III
theC
CoItltr(l
popdtla'tiOIti
-8
Of
39c),
(It
1
9-5
per.
cetit)
P<
0.001I
'I
lie
satice
applies
to1
tIle
pt
dopoIri(tio
(If
liosctsess
withli
back
probIcnltls
atmotig
the
latie
hiot
ses
iti
the
olrthlopaediCg
(1(1(01.
(2118
(if642
oi-d
31.4
pet-
cetit
1,
coitmparct
edwith
tile
ptroporttiOIti
(I
-lIses
ssitli
ba,ck
probIcnetis
'ItI
theclti
tOill1
pOlpdLati(lti
(4
(If
399,
(it
1
18
per-
cetit)
(P,_0-001
1)
Table
5).
Ths
igureI'S
Shiow
that
there-
wsas
a
str-i(lcige
assoIc'ai(t
lbetwseeni
latiieieiiss
anic
flack
proillemis
atiimlng
the
hiorses
wsith
oIrthl(paedlic
proic(leils
thiati
atiinti
the
conttroll
lloirses.
Intitlic
ft
IISt
pO(Ikuai(tio,
2018
(11
the
28(1
hloIrses
sswith
a
back
problletm
1
3pet
cetit)
(ss
ete
1s(
1aiiie,
a
sigtifihc,titly
hiigliet
proporI
titiiop
(1O(1)(11
thiani
amonoti
thc
conltrolh
lhi(ses
(21)
(If
47
41-6
per
cetit
1.
DISCUSSION
It
la"s
(Ofteni
bieei
Sdtgge1StCd
that
back
pro(bflemls
canl
CauLSe
a
hor
sc'
pout-
pcI-rh
urtitncc,
wsthi
l,ttticttcss
tIlcitig
altolther
po(S-
silileScad9se
(Ctt(Issthursttt
9
l,
JefiCott
1980,
efcIt
ati
I)aII
1981),
Rooniev
1982,J(auinII
997,
1IliuSSCler
ntd
otheris
1999,
Matirtin
atid
klidce
1999).
Ilis
StuIds
s\',as
chesigoied
tol
snesti-
ga,I-te
the
c
litilcal
Imlpressiont
that
thiet
e
is
a
closce
elatioliisliip)
betsseeti
black
ptrobleiis
aticl
chironic
haiiieneiiss.
If
there-
swcetc
till
SdIChI
reClattiMish1ip
the
pres
,aletice
Of
hItmetieSS
III
hor1SeS
wit11
hack
pt
oblcleiis
WO(Idld
lie
expectedi
to
lie
abodit
theC
SamllC
als
ini
ati
dttiselectdh
p)opdIktlaioI
Of
bIt
iitl-1
lid01
SeS,
SdtCIl
aIS
theC
399
ss
[dCli
ssTI-
et
eCieiii
exatiiinecd
beforei-
pu.rchase
ad(i
ssctre
Llised
as
a
conitrol(h
grLdIP
lot1
Cdl111par'is0li.
AhthIouughl
thi
iS
grIocIp
c(Intainced
io(lhaniii
hi(rses
anic
iio
lioi-ses
ssitli
cheat-
biack
prob
Ieiiis,
thils
mtidcetrei-prcsel-itatio(iIi
tias
hitsve
beetiI
cdltipeilsaltcdh
Back
problem
Yes
No
TotalI
Yes
208
434
642
Lame
N
o
72
9
1
163
Total1
280
525
805
166
~~~~~~~~~~~~~~~~~~The
Veterinary
Record,
August
7,
2004
,.\
Al\,-l
1(
rr",
166
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PAPERS
&
ARTICLES
Back
problem
Yes
No
Total
Yes
20
58
78
Lame
No
27
294
321
Total
47
352
399
Horses
with
Control
back
problems
(0)
horses
(%)
Yes
208
(74-3)
78
(19-5)
Lame
No
72
(25-7)
321
(80.5)
Total
280
399
I
by
horses
with
mild
orthopaedic
signs
which
had
not
been
recognised
by
the
owner.
In
comparison
with
other
studies,
the
present
study
had
the
advantage
that
all
the
horses
were
examined
by
the
same
veterinarians,
at
the
same
location
and
according
to
the
same
criteria
for
lameness
and
back
prob-
lems.
The
prevalence
of
lameness
in
the
control
group
(19-5
per
cent)
was
higher
than
previously
reported,
possibly
because
the
earlier
studies
focused
on
thoroughbred
racehorses
and
calculated
the
days
lost
due
to
lameness
in
relation
to
the
total
number
of
training
days
(Rossdale
and
others
1985,
Olivier
and
others
1997).
Furthermore,
in
these
studies,
lameness
was
diagnosed
by
the
owner
or
trainer
rather
than
by
a
veterinar-
ian.
The
same
applies
to
an
American
study,
which
reported
that
on
any
given
day
approximately
5
per
cent
of
all
horses
would
be
lame
(Kane
and
others
2000).
The
back
examinations
consisted
of
an
anamnesis,
inspec-
tion,
palpation,
percussion
and
test
for
spinal
flexibility.
Poor
performance
was
the
major
complaint
in
most
of
the
orthopaedic
cases
and
the
others
were
thought
to
have
back
or
lameness
problems.
The
criteria
used
to
decide
whether
a
horse
was
lame
or
had
a
back
problem
were
chosen
arbitrarily;
on
the
grading
system
of
the
AAEP
(Table
1)
only
horses
with
lameness
of
grade
2
or
above
were
considered
lame
and
91
(1
1
3
per
cent)
of
the
orthopaedic
cases
that
scored
negative
for
both
back
problems
and
lameness
did
not
meet
this
criterion.
Other
horses
had
a
swelling
on
a
leg,
but
were
found
not
to
be
lame.
In
addition
some
horses
that
had
been
considered
lame
by
their
owners
were
also
found
not
to
be
lame.
The
horses
with
these
low
grades
of
lameness
were
excluded
so
that
only
unequivocal
cases
of
lameness
were
included.
It
was
also
con-
sidered
that
these
low
grades
of
lameness
would
be
less
likely
to
have
a
significant
impact
on
the
spinal
motion
of
the
horse
than
the
higher
grades.
However,
this
intuitive
feeling
can-
not
be
substantiated
on
the
basis
of
the
data.
It
was
even
more
difficult
to
derive
the
criteria
for
back
problems,
because
no
scientifically
based
criteria
for
a
back
problem
exist.
However,
in
the
authors'
experience,
the
cri-
*
ii].
SIS
Lame
horses
(%)
Control
horses
(%)
Back
Yes
208
(32.4)
47
(11-8)
problem
No
434
(67-6)
352
(88-2)
Total
642
399
teria
used
have
provided
good
indications
of
back-related
dis-
orders
in
the
sense
that
many
of
the
horses
have
responded
positively
to
specific
treatments
of
the
back,
whether
by
med-
ical
treatment,
physiotherapy
or
chiropractic
manipulations.
Furthermore,
many
of
the
horses
diagnosed
with
a
back
prob-
lem
showed
signs
commonly
described
in
the
literature,
including
difficulties
in
jumping
or
performing
high-level
dressage
exercises,
rearing,
bucking,
progressive
or
sudden
changes
in
temperament,
resentment
of
grooming,
saddling
or
mounting,
and
resistance
to
one
or
both
hind
legs
being
lifted
for
shoeing
(Jeffcott
1975,
Stashak
1996,
Cauvin
1997).
In
examinations
of
a
horse's
back
much
emphasis
is
placed
on
spinal
mobility.
In
terms
of
lateroflexion,
in
normal
horses
the
range
of
motion
increases
from
T2
to
T
1
I
to
13
and
decreases
from
T
13
to
L5;
from
L6
to
S1
there
is
virtually
no
lateroflex-
ion.
Lateroflexion
should
be
symmetrical
to
the
left
and
right
(Jeffcott
and
Dalin
1980,
Townsend
and
others
1983,
1986,
Licka
and
Peham
1998,
Faber
and
others
2000,
200
la,
b).
All
the
horses
with
one
or
more
signs
of
a
back
problem
at
one
or
more
sites
were
classified
arbitrarily
as
having
a
back
prob-
lem;
this
was
considered
to
be
the
best
way
to
ensure
that
the
horses
were
examined
and
classified
in
a
uniform
way,
in
the
absence
of
a
gold
standard
for
the
'normal'
horse.
In
the
examination
for
lameness,
the
horses
that
had
only
a
positive
flexion
test
were
excluded.
A
few
recent
studies
have
cast
doubt
on
the
value
of
a
positive
flexion
test
in
an
other-
wise
clinically
sound
horse
(Ramey
1997,
Busschers
and
van
Weeren
2001).
From
the
beginning
of
the
study,
the
lameness
of
many
of
the
horses
appeared
to
originate
from
more
than
one
site
and/or
more
than
one
leg,
and
it
was
therefore
decided
not
to
record
the
site
or
sites
of
the
lameness.
Although
no
causal
relationship
has
been
established,
it
is
clear
that
there
was
a
close
connection
between
the
occur-
rence
of
back
problems
and
lameness,
a
connection
which
may
be
the
result
of
two
basic
mechanisms
that
may
result
in
various
clinical
signs:
first,
asymmetrical
and
therefore
non-physiological
loading
of
the
spine
when
one
fore-
or
one
hindlimb
is
affected,
or
when
one
forelimb
and
the
con-
tralateral
hindlimb
are
affected;
and
secondly,
non-physio-
logical
loading
of
the
spine
when
both
fore-
or
both
hindlimbs
are
affected.
Keegan
and
others
(2000)
demon-
strated
that
lameness
induced
in
a
lower
forelimb
leads
to
increased
protraction
and
decreased
retraction;
in
the
case
of
a
mild
bilateral
lameness,
this
will
be
apparent
in
both
limbs,
but
it
will
not
usually
be
recognised
as
lameness
by
the
owner.
This
limb
movement
will
force
the
back
into
lordo-
sis,
resulting
in
overloading
of
the
spine,
which
in
turn
may
lead
to
impingement
of
the
spine
or
even
to
the
clinical
con-
dition
known
as
'kissing
spines',
especially
in
the
T8
to
L2
region.
Apart
from
the
results
of
Gillis
(
1
999),
the
only
study
so
far
that
relates
a
clinical
back
problem
to
a
problem
in
the
limbs
reported
just
the
opposite
effect
in
young
horses
with
bilateral
stifle
damage
which
were
diagnosed
as
having
kyphosis
that
only
improved
after
resolving
the
stifle
problem
(Jeffcott
1980).
Buchner
and
others
(1996)
stated
that,
in
the
case
of
a
hindlimb
lameness,
asymmetric
propulsion
results
in
an
asymmetric
movement
of
the
spine,
leading
to
deviation
of
the
head
and
unilateral
axial
rotation
of
the
spine;
the
horse
will
most
probably
compensate
by
keeping
the
contralateral
back
muscles
tight,
but
in
the
long
run
this
may
result
in
hypertrophy
and/or
spasm
of
the
back
muscles
and
even
in
an
increased
rigidity
of
the
capsule
of
the
facet
joints.
In
the
case
of
a
forelimb
lameness,
the
horse
will
try
to
decrease
the
vertical
velocity
of
its
trunk
at
the
impact
of
the
lame
limb
and
during
the
ensuring
stance
phase
by
keeping
the
trunk
higher
above
the
ground
(Buchner
and
others
1996),
but
this
is
possible
only
if
the
contralateral
leg
and
subsequently
the
back
are
loaded
asymmetrically
and
more
heavily,
which
in
turn
may
cause
chronic
ailments.
The
Veterinary
Record,
August
7,
2004
0
(_,I:]
RSW
3
iT.
RR
F
P]
B
&I
FJ
RTW
T
iTe
0
I
167
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PAPERS
&
ARTICLES
It is
concluded
that,
provided
consistent
examination
tech-
niques
are
used,
the
results
of
this
study
confirm
the
clinical
impression
that
there
is
a close
relationship
between
clinically
diagnosed
back
problems
and
diagnosed
lameness
in
horses
with
signs
of
back
problems.
This
finding
is
considered
to
be
of
clinical
significance
and
appears
to
justify
a
thorough
lame-
ness
examination
of
horses
with
alleged
back
problems.
Conversely,
although
the
relationship
is
less
strong,
the
back
should
not
be
forgotten
when
examining
chronically
lame
horses.
ACKNOWLEDGEMENTS
The
authors
would
like
to
thank
Jan
Evers,
a
manual
therapist
with
the
Bodegraven
Equine
Clinic,
for
his
valuable
clinical
input
and
advice.
They
would
also
like
to
acknowledge
vet-
erinarians
Bart
Veldeman,
Teun
Sterk,
Dick
van
de
Vegt
and
Hans
de
Groot
for
the
cases
they
brought
in.
References
BUCHNER,
H.
H.
F.,
SAVELBERGH,
H.
H.
C.
M.,
SCHAMHARDT,
H.
C.
&
BARNEVELD,
A.
(1996)
Head
and
trunk
movement
adaptations
in
horses
with
experimentally
induced
fore-
or
hindlimb
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Equine
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journal
28,
71-76
BULGHERONI,
P.,
BULGHERONI,
M.
V.,
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L.,
GUFFANTI,
P.
&
GIUGHELLO,
A.
(1997)
Gait
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E.
&
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WEEREN,
P.
R.
(2001)
Use
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gender,
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height
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G.
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&
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P.
M.
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Use
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E.
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Assessment
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533
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C.
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Backs
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SCHAMHARDT,
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R.,
JOHNSTON,
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L.
&
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A.
(2000)
Basic
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matics
of
the
vertebral
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of
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walking
on
a
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American
Journal
of
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Research
61,
399-406
FABER,
M.
J.,
JOHNSTON,
C.,
SCHAMHARDT,
H.
C.,
VAN
WEEREN,
P.
R.,
ROEPSTORFF,
L.
&
BARNEVELD,
A.
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a)
Basic
three-dimensional
kine-
matics
of
the
vertebral
column
of
horses
trotting
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American
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62,
757-764
FABER,
M.
J.,
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2004 155: 165-168Veterinary Record
M. A. A. M. Landman, J. A. de Blaauw, L. J. Hofland, et al.
horses with back problems
Field study of the prevalence of lameness in
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