In order to objectively quantify the effect of manipulation on back-related locomotion anomalies in the horse, a recently developed kinematic measuring technique for the objective quantification of thoracolumbar motion in the horse was applied in a dressage horse that was suffering from a back problem. In this horse, clinically, a right-convex bending (scoliosis) from the 10th thoracic vertebra to the second lumbar vertebra was diagnosed. As a result, there was a marked asymmetric movement of the thoracolumbar spine. Functionally, there was severe loss of performance. Thoracolumbar motion was measured in terms of ventrodorsal flexion, lateral flexion, and axial rotation using an automated gait analysis system. Measurements were repeated before and 2 days after treatment, before the second treatment 3 weeks later, and at 4 weeks and 8 months after the second treatment to assess long-term effect. At the same time, performance of the horse was assessed subjectively by the trainer as well. Symmetry of movement improved dramatically after the first treatment. After this, there was a slight decrease in symmetry, but 8 months after the last treatment the symmetry indexes for the various joints were still considerably better than during the first (pre-treatment) measuring session. Subjectively, the trainer did not notice improvement until after measurement session 4. Between sessions 4 and 5 (at 4 weeks and 8 months after the second treatment) there was a change of trainer. The new trainer did not report any back problem, and succeeded in bringing the horse back to its former level in competition. It is concluded that manipulation had a measurable influence on the kinematics of the thoracolumbar spine. However, it is recognized that an improvement in symmetry of motion is not equivalent to clinical improvement and that other measures, such as changes in management, may be more decisive.
High knee joint-loading increases the risk and progression of knee osteoarthritis (OA). Mechanical loading on the knee is reflected in the external knee adduction moment (KAdM) that can be measured during gait with laboratory-based measurement systems. However, clinical application of these systems is limited. Ambulatory movement analysis systems, including instrumented force shoes (IFS) and an inertial and magnetic measurement system (IMMS), could potentially be used to determine the KAdM in a laboratory-free setting. Promising results have been reported concerning the use of the IFS in KAdM measurements; however its application in combination with IMMS has not been studied. The objective of this study was to compare the KAdM measured with an ambulatory movement analysis system with a laboratory-based system in patients with knee OA. Gait analyses of 14 knee OA patients were performed in a gait laboratory. The KAdM was concurrently determined with two the systems: (i) Ambulatory: IFS and IMMS in combination with a linked-segment model (to obtain joint positions); (ii) Laboratory: force plate and optoelectronic marker system. Mean differences in KAdM between the ambulatory and laboratory system were not significant (maximal difference 0.20%BW*H in late stance, i.e. 5.6% of KAdM range, P>0.05) and below clinical relevant and hypothesized differences, showing no systematic differences at group level. Absolute differences were on average 24% of KAdM range, i.e. 0.83%BW*H, particularly in early and late stance. To achieve greater accuracy for clinical use, estimation of joint position via a more advanced calibrated linked-segment model should be investigated.
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