• Open Access

Rater Agreement on Gait Assessment during Neurologic Examination of Horses

Authors

  • E. Olsen,

    Corresponding author
    1. Department of Large Animals Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
    2. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
    3. Structure & Motion Laboratory, The Royal Veterinary College, London, UK
    • Corresponding authors: E. Olsen, Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hojbakkegaard Allé 5, 2630 Taastrup, Denmark; e-mail: eo@sund.ku.dk and R.J. Piercy, Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK; e-mail: rpiercy@rvc.ac.uk.

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  • B. Dunkel,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
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  • W.H.J. Barker,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
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  • E.J.T. Finding,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
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  • J.D. Perkins,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
    2. Structure & Motion Laboratory, The Royal Veterinary College, London, UK
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  • T.H. Witte,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
    2. Structure & Motion Laboratory, The Royal Veterinary College, London, UK
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  • L.J. Yates,

    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
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  • P.H. Andersen,

    1. Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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  • K. Baiker,

    1. School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
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  • R.J. Piercy

    Corresponding author
    1. Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK
    • Corresponding authors: E. Olsen, Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hojbakkegaard Allé 5, 2630 Taastrup, Denmark; e-mail: eo@sund.ku.dk and R.J. Piercy, Department of Clinical Sciences and Services, The Royal Veterinary College, London, UK; e-mail: rpiercy@rvc.ac.uk.

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  • This work has been presented:

    (a) Abstract and poster at the conference of the European College of Equine Internal Medicine (ECEIM), Le Touquet, France, 2013.

    (b) Abstract and oral presentation at the 2013 American College of Veterinary Internal Medicine Forum, Seattle, WA.

    (c) BEVA spring clinical workshop, U.K., April 2013.

    (d) Abildgaard symposium, Taastrup, Denmark, March 2013.

    (e) PhD defence, Taastrup, Denmark, 19 June 2013

Abstract

Background

Reproducible and accurate recognition of presence and severity of ataxia in horses with neurologic disease is important when establishing a diagnosis, assessing response to treatment, and making recommendations that might influence rider safety or a decision for euthanasia.

Objectives

To determine the reproducibility and validity of the gait assessment component in the neurologic examination of horses.

Animals

Twenty-five horses referred to the Royal Veterinary College Equine Referral Hospital for neurological assessment (n = 15), purchased (without a history of gait abnormalities) for an unrelated study (n = 5), or donated because of perceived ataxia (n = 5).

Methods

Utilizing a prospective study design; a group of board-certified medicine (n = 2) and surgery (n = 2) clinicians and residents (n = 2) assessed components of the equine neurologic examination (live and video recorded) and assigned individual and overall neurologic gait deficit grades (0–4). Inter-rater agreement and assessment-reassessment reliability were quantified using intraclass correlation coefficients (ICC).

Results

The ICCs of the selected components of the neurologic examination ranged from 0 to 0.69. “Backing up” and “recognition of mistakes over obstacle” were the only components with an ICC > 0.6. Assessment-reassessment agreement was poor to fair. The agreement on gait grading was good overall (ICC = 0.74), but poor for grades ≤ 1 (ICC = 0.08) and fair for ataxia grades ≥ 2 (ICC = 0.43). Clinicians with prior knowledge of a possible gait abnormality were more likely to assign a grade higher than the median grade.

Conclusion and Clinical Importance

Clinicians should be aware of poor agreement even between skilled observers of equine gait abnormalities, especially when the clinical signs are subtle.

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