Outcome measures and their importance for effective equine back pain rehabilitation

Abstract

Effective rehabilitation and strategies to prevent equine back pain are required due to the frequency of dysfunction impacting performance and welfare. Reliable and valid measures should be used establish a baseline in pain and dysfunction levels, and used to monitor change during rehabilitation, as well as support future research assessing the efficacy of treatment interventions. Such measures are collectively known as outcome measures and can include specific objective markers of impairments such as reduced range of motion, or pain on palpation. The aim of this narrative review is to discuss the options and tools available to use as outcome measures in relation to the treatment and rehabilitation of back pain in the horse. In this paper, the outcome measures critically discussed relate to conformation and standing posture, muscle dimensions, palpation, range of motion, objective gait analysis, functional analysis, owner reported outcome measures and pain scales. Recommendations are made to assist with selection of a suitable outcome measure. In conclusion, complex laboratory-based analysis systems are available as gold-standard objective systems, although realism for clinical practitioners working in the field limits their use. There is a requirement for new outcome measures that are not subject to observer bias nor time or financially consuming, however it is possible to use those available currently to assist in clinical decision making for the benefit of the horse.