Original ResearchA Randomized Blinded Crossover Clinical Trial to Determine the Effect of an Oral Joint Supplement on Equine Limb Kinematics, Orthopedic, Physiotherapy, and Handler Evaluation Scores
Introduction
Most horses are required to perform an athletic function. As athletic and nonathletic horses have a high incidence of lameness and orthopedic problems [1], [2], [3], [4], [5], [6], [7], [8], veterinarians, owners, riders, and trainers often select oral nutraceuticals or “joint supplements” to potentially improve performance or manage low-grade orthopedic problems [9], [10]. In vitro work suggests a rationale for use of various constituents of joint supplements, and clinical experience suggests that there may be benefits to oral administration of some products. However, there are very few well-designed studies investigating the clinical effects of joint supplements [11], [12], [13].
Investigation of the effect of a supplement can be challenging. Previous equine clinical studies evaluating oral joint supplements have largely been limited to owner assessment of improvement, sometimes without a control group and often in variable exercise. Controlling for these variables and using blinded assessment in a crossover design makes it more feasible to investigate the effect of a supplement. Horses with altered comfort levels could potentially demonstrate alterations in behavior and ease of work, flexibility, and muscle tone which could be assessed by blinded graded evaluation of these parameters. In addition, assessment of alterations in gait and movement can be done subjectively and objectively. Using a grading scale for lameness is an accepted method of detection of alterations in gait and loading, and recent studies have shown that specific gait features are detected by experienced evaluators [14], [15]. There may therefore be a potential benefit to grading of specific gait features. More objective evaluation of gait in horses with lameness has demonstrated that there are alterations in limb kinematics compared with horses without lameness [16], [17]. It would therefore be expected that use of a supplement that altered a horse's gait, and reduced lameness, would be detectable using subjective evaluation and also objective evaluation specifically investigating gait features that are associated with lameness.
The aim of this study was to determine the effect of an oral joint supplement (supplement S) on clinical orthopedic parameters, limb kinematics, and on physiotherapy and handler evaluation parameters in horses with low-grade lameness (≤4/10) using each horse as its own control. It was hypothesized that supplement S would result in reduced lameness grade, improved grade for gait parameters, altered limb kinematics, better physiotherapy range of motion (ROM) and muscle tone, and improved handler grading of movement.
Section snippets
Materials and Methods
The study was approved by the Ethical Review Committee of the Animal Health Trust (project number: AHT 21-2013) and had informed owner consent. In accordance with the recommendations from the Ethical Review Committee, horses were excluded from the study if they were in poor body condition had health problems or a > 4/10 lameness.
A power calculation indicated that a sample size of 19 horses was required to detect a difference at a significance level of P < .05 for hock angles based on data from
Clinical Orthopedic Evaluation
At the start of the study, 71% of the horses were graded 1–4/10 lame and the remainder were not graded as lame. More horses were graded as lame on the right hindlimb than any other limb (right hind n = 10, left hind n = 1, right fore n = 3, left fore n = 3). Nineteen limbs had a mild positive response to flexion, eight limbs had a moderate response, and two limbs had a severe positive response to flexion. Nine limbs showed circumduction during swing, 12 limbs had toe drag, 13 limbs had
Discussion
The findings from this study support the proposed hypotheses. Supplement S was associated with improvement in many variables under observation including: reduced lameness grade, improved grade for gait parameters, better physiotherapy ROM and muscle tone, higher handler grading of movement, and altered limb kinematics. In addition, there appeared to be an improvement in the physiotherapy parameters with time and an effect of individual limbs (primarily lame limbs) on the tested parameters. Due
Conclusions
The findings from this study indicate that supplement S was associated with reduced lameness grade, improved ridden and groundwork scores in horses in work, and improved “ease of movement” in the field for horses at pasture rest. In addition, supplement S was associated with improved grades on physiotherapy assessment with time. This may suggest a potential benefit to use of supplement S in clinical patients, including those at pasture rest, in work or during rehabilitation.
Acknowledgments
The authors are grateful to Science Supplements and the Animal Health Trust for funding. The authors are also grateful for World Horse Welfare for their assistance with this study and to Science Supplements for providing supplement S and the placebo control.
Conflict of interest: V.A. and R.C.M. have been involved with Science Supplements on a consultancy basis in the past.
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2021, Veterinary Clinics of North America - Equine PracticeCitation Excerpt :However, it remains still unclear whether such results obtained in a joint inflammation–induced model are comparable with naturally occurring joint inflammation in horses. Feeding a commercial product containing chondroitin sulfate 162 g/kg, glucosamine 190 g/kg, vitamin C 80 g/kg, methylsulphonylmethane 256 g/kg, DHA 66 g/kg, and EPA 34 g/kg improved lameness grade, ridden and groundwork scores, and “ease of movement,” when compared with feeding a placebo.85 However, a main limitation of this study was that 30% of the horses were not lame and the rest of the horses had a low lameness score with an unknown lameness diagnosis.
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