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GAITSMART
CASE STUDY
Lameness Diagnosis Support with GaitSmart Pegasus
www.gaitsmart.com [email protected] +44 (0) 1438 822822
On Tuesday 22nd March 2016, Diana Hodgins and Steve Goode from GaitSmart went to meet with Rick Farr MRCVS
and Nicki Pursey MRCVS from Farr and Pursey Vet Practise in Tring to demonstrate the GaitSmart Pegasus system. Rick
had a horse in mind for the demonstration, Lenny, an 18-year-old Welsh Cob Section D owned by Stephen Jones. Lenny
had shown movement issues, which would be classified as lame, but the actual cause of the problem had proved hard
to identify.
Lenny had previously been blocked up to the hock, but had a varying blocking pattern & it was therefore inconclusive.
One of the main reasons that Rick wanted to use the GaitSmart Pegasus gait analysis system, was to help differentiate
improvement as a result of a block. Also, it had been made even more difficult to visually recognize any improvement
as Lenny had quite significant muscle asymmetry.
The process that we agreed was that we would analyse Lenny with the GaitSmart Pegasus system so that we had a
baseline movement profile for comparison. Rick then planned to use a tibial peroneal block on Lenny, following which
we would analyse Lenny again. GaitSmart Pegasus can be used anywhere and on any surface and we had a nice long
paved area in the yard and we agreed that this would be the area for “running up”.
We prepared Lenny for the gait analysis. We placed boot style wraps on Lenny for the cannon sensors, and hock straps
for the hock sensors. Once these were in place, we synchronized the sensors and placed them into the pockets on the
straps. Stephen then walked and trotted Lenny up and back.
We could see that Lenny was not moving as he should, but it was not possible to distinguish the exact cause of the
problem with the naked eye.e prepared Lenny for the analysis. We placed boot style wraps for the cannon sensors,
and hock straps for our hock sensors, and then we placed the sensors into the pockets on the straps. Stephen then
walked and trotted Lenny up and back. We could see that Lenny was not moving as he should, but it was not possible
to distinguish the exact cause of the problem with the naked eye.
Figure 1 - Lenny on one of his many trot-ups!
GAITSMART
CASE STUDY
Lameness Diagnosis Support with GaitSmart Pegasus
www.gaitsmart.com [email protected] +44 (0) 1438 822822
Figure 2 - Excerpt from GaitSmart Pegasus report - Lenny 1st analysis
Once Lenny had completed his walk and trot we removed the sensors and analysed the data. The whole process only
took a few minutes. As you could see from the excerpt from the report in figure 2 above, there was a noticeable
difference in movement between left and right hock and left and right tibia.
Rick then proceeded with the next phase, which was to administer a right tibial peroneal block (nerve block). First,
Rick sedated Lenny to help with any discomfort. Once the sedative had taken effect, Rick then administered the
blocking injections.
Lenny was left to stand for a period of time so that the block could begin to take effect. When the time was up, we
synchronized the GaitSmart Pegasus sensors again and we placed them back into the retaining pockets on the straps.
Stephen then repeated his walk and trot which allowed a visual inspection while the sensors were capturing movement
data. Once again, it was not possible to see any differences in Lenny’s movement, so we waited for the GaitSmart
Pegasus report.
GAITSMART
CASE STUDY
Lameness Diagnosis Support with GaitSmart Pegasus
www.gaitsmart.com [email protected] +44 (0) 1438 822822
Figure 3 - Excerpt from GaitSmart Pegasus report 2 - Lenny following tibial-peroneal nerve block
As you can see from the report excerpt in figure 3 above, the situation had not really changed. There was still a
noticeable asymmetry in the hocks and while the right tibia (green) achieved a lower maximum flexion, you can see
that the action is still being timed later. GaitSmart Pegasus provided us with objective data to support the diagnosis
process and to help Rick decide on his next steps.
Rick then decided to apply a femoro-tibial block (a block that affects the next section of the leg above the hock) see
figure 4 below.
Figure 4 - Rick applying the femoro-tibial nerve block to Lenny
GAITSMART
CASE STUDY
Lameness Diagnosis Support with GaitSmart Pegasus
www.gaitsmart.com [email protected] +44 (0) 1438 822822
Rick said that he would like to analyse Lenny 10-15 minutes post block and then at approximately 40 minutes post
block.
After 10 to 15 minutes, we synchronized the GaitSmart Pegasus sensors and we placed them back in the retaining
pockets on the straps. Stephen, once again, had the honours of running Lenny up and down the yard for our visual
inspection and once again, it was still inconclusive as to what improvement, if any, had been made.
Figure 5 - Excerpt from GaitSmart Pegasus report 3 - Lenny 1st analysis post femoro-tibial nerve block
We connected the sensors back to the GaitSmart Pegasus software and reviewed the report. Once again, as you can
see from the report excerpt in figure 5 above, there was very little change from the previous report.
We then had to wait a further 25 – 30 minutes and then analyse Lenny again. Once again, the sensors were
synchronized and placed back on Lenny. Stephen walked and trotted Lenny up and down the yard again. As before,
we could not achieve a consensus on any improvement in Lenny, while in hand, and we certainly could not quantify
improvement or deterioration.
There appeared to be a noticeable clinical improvement following the stifle block, but again the significant muscle
asymmetry makes it difficult to ascertain and introduced doubt into the process. The advantage of using the GaitSmart
Pegasus sensor-based system is to eliminate elements of scepticism, judgement or clinician error.
GAITSMART
CASE STUDY
Lameness Diagnosis Support with GaitSmart Pegasus
www.gaitsmart.com [email protected] +44 (0) 1438 822822
Figure 6 - Excerpt from GaitSmart Pegasus report 4 - Lenny 2nd analysis post femoro-tibial nerve block
We removed the sensors from Lenny and connected them back to the GaitSmart Pegasus software and, as you can
see in figure 6 above, Lenny was now back moving as we would have expected. His hock angles were symmetrical and
both were following the profile that we would expect for a sound horse. The tibias also demonstrated a nice
symmetrical movement and they also showed the small increase in angle, prior to maximum flexion, that we would
have expected to see.
GaitSmart Pegasus was able to show, using accurate, objective data, exactly what improvement had been achieved
with the nerve block.
This identified to Rick that the area of concern was the stifle. Rick is now planning to radiograph the stifle joint, in
addition to looking at the soft tissue structures of the stifle with ultrasound. This examination the next day confirmed
that Lenny’s problem was indeed in the stifle and treatment has begun.
GaitSmart Pegasus provides objective data to underpin the diagnosis and treatment of the veterinarian with objective
data. GaitSmart Pegasus can show you detail that it is not possible to see with the human eye. GaitSmart Pegasus also
allows you to see exactly what all other limbs are doing at any point during the stride. When a horse is trotting, allowing
refresh time for the human eye, it is just not possible to see everything that you need to see to gauge the detail of the
movement, deterioration or improvement.
The demonstration took place over a 2-3 hour period and in that time, we performed 4 detailed gait analyses, which
only took a few minutes more than the regular trot up would have taken. GaitSmart Pegasus is the only system that
can do this.
We would like to thank Stephen and Lenny, as well as Rick and Nikki from Farr and Pursey Equine vets.