Goniometry: is it a reliable tool to monitor passive joint range of motion in horses?

Abstract

SummaryReasons for performing study: Simple objective assessment tools are essential to monitor the clinical efficacy of therapeutic interventions used in equine orthopaedics and rehabilitation. In human medicine, goniometry is a validated tool to quantify restrictions in joint range of motion (ROM); however, the technique is not validated in horses. Objectives: To validate 2 different goniometry techniques for the measurement of passive flexion of the fetlock, carpus and hock by examining; 1) the intra-and inter-tester reliability; 2) the differences between 2 goniometry techniques and 3) differences between standing and anaesthetised horses. Methods: The study is composed of three parts: 1) the intraand inter-tester reliability was examined on 10 horses, where each horse was assessed by 5 pairs of testers measuring ROM with a universal goniometer; 2) the differences between 2 goniometry techniques were examined on 14 horses, each assessed by 2 investigators (either working in pairs with one investigator holding the limb and the other measuring the joint angle, or working individually at the same time holding and measuring); 3) on 6 horses, the differences between standing and anaesthetised horses were assessed by 2 investigators with the same techniques as described above. Nonparametric tests (Mann-Whitney, Wilcoxon sign-rank) and Intraclass Correlation Coefficient (ICC) were used for statistical analysis (P<0.05). Results: 1) The intra-tester reliability was high to excellent (ICC 0.8-1) and the inter-tester reliability low to average (ICC 0.1-0.5); 2) significant differences in joint ROM were registered in carpus and hock when measuring in pairs compared to singly and 3) significant differences in joint ROM were registered measuring anaesthetised compared to standing horses. Conclusions: As shown in human studies, goniometry is a promising tool in documenting passive flexion of fetlock, carpus and hock, if used by the same investigator. However, additional studies are needed for further validation.evj_254 676..682

Disease prevalence in geriatric horses in the United Kingdom: Veterinary clinical assessment of 200 cases

“…However, ROM has not been established as a reliable indicator of joint pathology, published normal values are not available and it is not known if reduced ROM is associated with pain in horses. Measurement of ROM by goniometry has been reported as a valid and reliable way of assessing passive ROM in horses (Liljebrink and Bergh 2010) and ROM measured by goniometery was significantly correlated with subjective assessment of joint flexion in the current study. The majority of animals had reduced ROM in at least one of the joints assessed.…”

Effects of low and high dose intraarticular tiludronate on synovial fluid and clinical variables in healthy horses—a preliminary investigation

“…Joint angle of maximum flexion was decreased at multiple time points compared to baseline measurements in HDT treated, HDT control, LDT treated, and LDT control joints (Table 2). All differences were <10°, and are unlikely to be clinically significant (Liljebrink & Bergh, 2010). …”

“…However, differences in angulation of <10° are unlikely to be clinically significant (Liljebrink & Bergh, 2010). …”

Joint Mobilization and Manipulation for the Equine Athlete

“…Goniometry is often used to objectively quantify and document the amount of flexion or extension present at an articulation. 6 The objectives of soft tissue and joint mobilization are typically to reduce pain, restore tissue compliance, and to improve overall tissue mobility and joint range of motion. 2 Manipulation is more often used to address localized pain and joint stiffness, with less focus on the surrounding soft tissues.…”