Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, Denmark.
PLoS One. 2020 Dec 15;15(12):e0243819. doi: 10.1371/journal.pone.0243819. eCollection 2020.
In veterinary practice, a thorough gait examination is essential in the clinical workup of any orthopedic patient, including the large population of dogs with chronic pain as a result of osteoarthritis. The traditional visual gait examination is, however, a subjective discipline, and systems for kinetic gait analysis may potentially offer an objective alternative for gait assessment by the measurement of ground reaction forces. In order to avoid unnecessary testing of patients, a thorough, stepwise evaluation of the diagnostic performance of each system is recommended before clinical use for diagnostic purposes. The aim of the study was to evaluate the Tekscan pressure-sensitive walkway system by assessing precision (agreement between repetitive measurements in individual dogs) and overlap performance (the ability to distinguish dogs with lameness due to osteoarthritis from clinically healthy dogs). Direction of travel over the walkway was investigated as a possible bias. Symmetry indices are commonly used to assess lameness by comparing ground reaction forces across different combinations of limbs in each dog. However, SIs can be calculated in several different ways and specific recommendations for optimal use of individual indices are currently lacking. Therefore the present study also compared indices in order to recommend a specific index preferable for future studies of canine osteoarthritis. Forty-one clinically healthy dogs and 21 dogs with osteoarthritis were included in the study. High precision was demonstrated. The direction of travel over the walkway was excluded as a possible bias. A significant overlap was observed when comparing ground reaction forces measured in dogs with osteoarthritis compared to clinically healthy dogs. In some affected dogs, symmetry indices comparing contralateral limbs differed from clinically healthy dogs, but in general, the overlap performance was insufficient and, consequently, general use of this method for diagnostic purposes in dogs with osteoarthritis cannot be recommended.
在兽医实践中,彻底的步态检查对于任何骨科患者的临床评估都至关重要,包括因骨关节炎而长期遭受慢性疼痛的大量犬类患者。然而,传统的视觉步态检查是一种主观的学科,运动学步态分析系统通过测量地面反力,可能为步态评估提供一种客观的替代方法。为了避免对患者进行不必要的测试,建议在临床应用之前,对每个系统的诊断性能进行彻底的、逐步的评估。本研究旨在通过评估重复性(在个体犬中重复测量之间的一致性)和重叠性能(区分因骨关节炎而跛行的犬与临床健康犬的能力)来评估 Tekscan 压敏步态分析系统。研究了在步态分析系统上的行进方向,作为可能的偏差因素。对称性指数常用于通过比较不同犬只的不同肢体的地面反力来评估跛行。然而,SI 可以通过几种不同的方式计算,目前缺乏对个体指数的最佳使用的具体建议。因此,本研究还比较了指数,为犬骨关节炎的未来研究推荐了一个特定的首选指数。本研究纳入了 41 只临床健康犬和 21 只骨关节炎犬。结果显示具有高度精确性。排除了在步态分析系统上的行进方向作为可能的偏差因素。在比较骨关节炎犬和临床健康犬的地面反力时,观察到了显著的重叠。在一些受影响的犬中,比较对侧肢体的对称性指数与临床健康犬不同,但总体而言,重叠性能不足,因此不能推荐该方法用于诊断犬骨关节炎。
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