title: Evaluation of mild lameness in horses trotting on a treadmill by clinicians and interns or residents and correlation of their assessments with kinematic gait analysis.
abstract: OBJECTIVE
  To estimate sensitivity and accuracy of subjective evaluation of mild lameness in horses during treadmill locomotion and to correlate subjective evaluation with kinematic analysis.
  
  
  METHODS
  19 lame and 5 clinically normal horses.
  
  
  METHODS
  Lameness was evaluated by subjective score and kinematic analysis before and after palmar digital nerve block (PDNB). Evaluations were made by 6 clinicians and 7 interns or residents. Within- and between-observer agreement analyses (kappa values) were calculated and compared, using a Student's t-test. Pearson's product-moment correlation coefficients were calculated between clinician's change in score and the change in kinematic variables after PDNB.
  
  
  RESULTS
  Within-observer agreement was within the range expected for conditions of moderate diagnostic difficulty. Within-observer agreement was higher for clinicians than for interns or residents. Between-observer agreement was acceptable for scores within 1 value of each other. Between-observer agreement of change in lameness score after PDNB was poor. When kinematic variables were ranked with each clinician's subjective change in score, only 2 were among the top 3 for the majority of clinicians. Asymmetry of vertical head movement between contralateral forelimb stance phases and the point of maximum hoof height during swing decreased as lameness subjectively improved.
  
  
  CONCLUSIONS
  Mild lameness may be difficult to evaluate during treadmill locomotion. Although clinicians were more repeatable in their subjective evaluation of lameness than interns or residents, they were not more reliable at detecting the true state of lameness.
  
  
  CONCLUSIONS
  Lack of agreement between clinician scoring of mild lameness emphasizes the need to use more objective measures for quantifying lameness.
authors.affiliation: Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia 65211, USA.
authors.forename: K G
authors.initials: KG
authors.lastname: Keegan
authors.forename: D A
authors.initials: DA
authors.lastname: Wilson
authors.forename: D J
authors.initials: DJ
authors.lastname: Wilson
authors.forename: B
authors.initials: B
authors.lastname: Smith
authors.forename: E M
authors.initials: EM
authors.lastname: Gaughan
authors.forename: R S
authors.initials: RS
authors.lastname: Pleasant
authors.forename: J D
authors.initials: JD
authors.lastname: Lillich
authors.forename: J
authors.initials: J
authors.lastname: Kramer
authors.forename: R D
authors.initials: RD
authors.lastname: Howard
authors.forename: C
authors.initials: C
authors.lastname: Bacon-Miller
authors.forename: E G
authors.initials: EG
authors.lastname: Davis
authors.forename: K A
authors.initials: KA
authors.lastname: May
authors.forename: H S
authors.initials: HS
authors.lastname: Cheramie
authors.forename: W L
authors.initials: WL
authors.lastname: Valentino
authors.forename: P D
authors.initials: PD
authors.lastname: van Harreveld
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D005080:Exercise Test / Q000662:veterinary; D005552:Forelimb / Q000503:physiopathology; D005684:Gait; D006734:Horse Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006736:Horses; D007794:Lameness, Animal / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009716:Numerical Analysis, Computer-Assisted; D015588:Observer Variation; D012680:Sensitivity and Specificity