The Lameness Exam:
Your horse can't tell you where he hurts. Our skilled lameness clinicians will use their years of skill and education to localize the source of the lameness. This might be as simple as palpating an abnormal area or eliciting a pain response after manipulating a specific area. Alternatively, it may involve regional analgesia of nerves and/ or joints to eliminate the lameness and localize the source of unsoundness to a particular area.
Equinosis Lameness Locator™:
Whilst the trained eye is adept at localizing lameness there are occasions when the eye cannot see enough to identify subtle lameness. Or, a permanent record of a horse's soundness is required. Occasionally, multiple limb lameness cases may require a more objective technique to identify all the sources of lameness. For these cases, we are delighted to offer the Lameness Locator.
The Lameness Locator™ is a wireless computer-assisted motion analysis system used to objectively detect and evaluate lameness patterns in the horse. Using sensors non-invasively placed on the horse, body movement data is wirelessly transmitted to a computer for analysis and storage. The system is able to detect asymmetries in gait that may not be seen by the human eye.
The resulting Lameness Locator® analysis report can be used to help determine whether a lameness exists, which limb or limbs are involved, the severity of the lameness, and the phase of stride (impact, mid-stance, or push off) that the lameness is most severe. This information can be used to help localize the lameness, guide further diagnostics and asses the response to therapy.
Conditions where the Lameness Locator™ is helpful:
Horses with mild lameness
Horses with apparent multiple limb lameness
Horses with apparent compensatory lameness
Quantifying the effectiveness of nerve and joint blocks
Confirming the incidental nature of equivocal imaging abnormalities
Developing a further diagnostic approach based on type of lameness (impact, pushoff) exhibited
Documenting soundness in pre-purchase evaluations
Please follow this link to read further about this exciting method for objectively quantifying lameness
In short, it is a computerized device for objectively recording and evaluating lameness: specifically, from which limb does the lameness arise? Good lameness vets have well-trained eyes and other senses which they couple with their years of experience and response to nerve blocks and other tools to localize the source of lameness but this is all subjective and there is lots of research to suggest that disagreement exists between vets' opinions even when they are experienced: especially when the horse is only mildly lame. It comes down to 'what is the difference between subjective and objective' and this is where this machine shines.
In a subjective exam, we think or feel that we have an answer. In a subjective exam we have an opinion but we don't really have anything firm to hang our hats on that someone couldn't come along and dispute based on their opinion. In an objective exam, however, we can have facts and figures that not only give more insight but tend to result in everyone agreeing.
In a subjective exam, we think or feel that we have an answer. In a subjective exam we have an opinion but we don't really have anything firm to hang our hats on that someone couldn't come along and dispute based on their opinion. In an objective exam, however, we can have facts and figures that not only give more insight but tend to result in everyone agreeing.
The problem with humans is our eyes:
The veterinarian's eyes, no matter how well trained or experienced, can only process about 20 frames per second so will miss some key pieces of information that the horse is trying to show us during a lameness examination. The computerized sensors can process around 200 frames a second so they see much more and, equally importantly, the computer then makes a permanent recording of these movements which is a huge advantage over our eyes. With the recorded data we can compare pre and post blocking, pre and post rehab, without trying to remember what we thought the horse moved like previously.
The veterinarian's eyes, no matter how well trained or experienced, can only process about 20 frames per second so will miss some key pieces of information that the horse is trying to show us during a lameness examination. The computerized sensors can process around 200 frames a second so they see much more and, equally importantly, the computer then makes a permanent recording of these movements which is a huge advantage over our eyes. With the recorded data we can compare pre and post blocking, pre and post rehab, without trying to remember what we thought the horse moved like previously.
How does it work?
Simple. (Simple for us who now have this machine commercially available to us: not simple for Professor Keegan who spent over 20 years developing the technology!). 3 wireless sensors get taped to the 1) poll, 2) hip, and 3) the right front pastern. 2 sensors measure the vertical change as the horse jogs and the pastern sensor is a gyroscope that allows the computer to orientate results of the other 2 sensors. The horse jogs in hand for 40 to 60 strides whilst the sensors transmit to the handheld tablet and, within 30 seconds, we have a graphic readout of the symmetry of the horse. We say symmetry because that is what the horse is showing us and the machine is measuring. It is up to us, as clinicians, to determine lameness from this. The entire exam takes about 5 minutes.
What is it useful for?
Any lameness evaluation can benefit from this technology but not all examinations require it. Subtle lamenesses are perfect candidates as our eyes are often not sufficiently sensitive to pick up the source of pain in such cases: the machine is. We now often use this technology as a new 'next step' prior to a bonescan because we can now look at 'numbers' on the screen and have confidence to block a horse that we may not have previously felt comfortable blocking because it was too subtle. We also use the Lameness Locator in multi-limb lamenesses which are often referred to us because a conventional clinical approach to diagnosis may not have worked. Prepurchase examinations are perfect candidates as we can create a permanent record to demonstrate soundness at the time of purchase or to identify subtle lameness that our eyes have not detected but that may be lurking under the surface. Similarly, horses that have received time off and are recovering from injury can be followed using this technology. It is unreliable to remember how lame a horse was 30 days previously. This technology allows us to directly compare objective gait measurements at different time points and we have found this to be extremely useful.
Do we use it frequently?
Absolutely. Since we purchased our unit in 2012 we have performed examinations on hundreds of horses. It doesn't take the place of our regular lameness exam but it is a hugely beneficial adjunct to our exams.
Is there a downside?
Not related to the procedure itself. However, some clinicians incorrectly believe that the computer 'gets confused' by multi limb lameness. This is not true. The veterinarian interpreting the results may get confused and this is where caution needs to be used with this technology. The Lameness Locator does not replace the expert eye of a clinician. It should be used to augment it. The manufacturer does a great job of training veterinarians but there is no requirement for training to purchase this equipment. This means that any vet, anywhere, could buy a lameness locator and that's where the danger is: it should only be used by experienced lameness clinicians who are also well trained in this technology. In human medicine the acronym VOMIT (victim of modern imaging technology) has been coined to describe patients who receive an incorrect diagnosis or treatment because the clinician incorrectly interpreted the objective data at hand. This is entirely possible with the lameness locator so it must be stressed that this is a wonderful tool if it is used as the adjunct to a thorough lameness examination: it should be part of the examination but never lead the examination.
