Gomez Alvarez C B, Bobbert M F, Lamers L, Johnston C, Back W, van Weeren P R
Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, NL-3584 CM Utrecht, The Netherlands.
Equine Vet J. 2008 Mar;40(2):147-52. doi: 10.2746/042516408X250184.
There are no detailed studies describing a relationship between hindlimb lameness and altered motion of the back.
To quantify the effect of induced subtle hindlimb lameness on thoracolumbar kinematics in the horse.
Kinematics of 6 riding horses were measured during walk and trot on a treadmill before and during application of pressure on the sole of the left hindlimb using a well-established sole pressure model. Reflective markers were located at anatomical landmarks on the limbs, back, head and neck for kinematic recordings. Ground reaction forces (GRF) in individual limbs were calculated from kinematics to detect changes in loading of the limbs.
When pressure on the sole of the hindlimb was present, horses were judged as lame (grade 2 on the AAEP scale 1-5) by an experienced clinician. No significant unloading of this limb was found in the group of horses (unloading was observed in 4 animals, but was not detectable in the other 2), but statistically significant effects on back kinematics were detected. The overall flexion-extension (FE) range of motion (ROM) of the vertebral column was increased at walk, especially in the thoracic segments. Axial rotation (AR) ROM of the pelvis was also increased. At trot, the FE ROM was decreased only in the segment L3-L5-S3. During the stance phase of the lame limb, the segment T6-T10-T13 was more flexed and the neck was lowered at both gaits; the thoracolumbar segments were more extended at walk and trot. There were no significant changes in the stride length or protraction-retraction angles in any of the limbs.
Subtle hindlimb lameness provoked slight but detectable changes in thoracolumbar kinematics. The subtle lameness induced in this study resulted in hyperextension and increased ROM of the thoracolumbar back, but also in decreased ROM of the lumbosacral segment and rotational motion changes of the pelvis.
Even subtle lameness can result in changes in back kinematics, which emphasises the intricate link between limb function and thoracolumbar motion. It may be surmised that, when chronically present, subtle lameness induces back dysfunction.
目前尚无详细研究描述后肢跛行与背部运动改变之间的关系。
量化诱导产生的轻微后肢跛行对马的胸腰段运动学的影响。
使用成熟的足底压力模型,在对6匹骑乘马的左后肢足底施加压力之前和期间,在跑步机上测量它们在行走和小跑时的运动学数据。在四肢、背部、头部和颈部的解剖标志处放置反光标记,用于运动学记录。根据运动学数据计算各肢体的地面反作用力(GRF),以检测肢体负荷的变化。
当后肢足底受压时,一位经验丰富的临床医生判断马匹跛行(美国马医协会1-5级评分中的2级)。在这组马匹中,未发现该肢体有明显的负荷减轻情况(4匹马出现负荷减轻,但另外2匹马未检测到),但检测到对背部运动学有统计学意义的影响。在行走时,脊柱的整体屈伸(FE)运动范围(ROM)增加,尤其是在胸段。骨盆的轴向旋转(AR)ROM也增加。在小跑时,FE ROM仅在L3-L5-S3节段减小。在跛行肢体的站立阶段,在两种步态下T6-T10-T13节段更加屈曲,颈部低垂;胸腰段在行走和小跑时更加伸展。任何肢体的步长或前伸-后缩角度均无显著变化。
轻微的后肢跛行引起了胸腰段运动学的轻微但可检测到的变化。本研究中诱导产生的轻微跛行导致胸腰段背部过度伸展和ROM增加,但也导致腰骶段ROM减小以及骨盆旋转运动变化。
即使是轻微的跛行也会导致背部运动学的变化,这强调了肢体功能与胸腰段运动之间的复杂联系。可以推测,当长期存在轻微跛行时,会导致背部功能障碍。