Fetlock Joint Angle Pattern and Range of Motion Quantification Using Two Synchronized Wearable Inertial Sensors per Limb in Sound Horses and Horses with Single Limb Naturally Occurring Lameness

Simple Summary The incidence of disease affecting fetlock joint and associated structures is high in the equine athlete due to the large loads acting on the joint during athletic activity. Therefore, study of the movement of this joint (flexion and extension) is a significant matter of interest. To date, fetlock joint angle pattern and range of motion in horses have been quantified using optical motion capture (OMC). These systems use a number of cameras to film the subject and reconstruct the movement trajectories into a computer model. They are very accurate and precise but require expensive equipment and a laboratory setting. The use of inertial measurement unit (IMU) systems in the field of motion analysis is now widespread. IMU systems use a number of sensors in order to derive the position of the body in the space; they have the advantage of being able to collect kinematic spatio-temporal data when the animal is moving overground with fewer constraints than in a gait lab. To the authors' best knowledge there are no studies using IMUs sensors in order to record relative fetlock joint angles in horses moving overground. In this study, we wanted first to validate the use of IMUs for kinematic detection of fetlock joint movement on the sagittal axis comparing it to the OMC. Then, we intended to discuss fetlock joint range of motion variability quantified by the IMU system under investigation in lame and sound horses. The IMU system was able to record fetlock joint range of motion just as does the bi-dimensional OMC at walk and trot, in both sound and lame horses. IMU system quantification of fetlock joint range of motion confirmed that the variability was mainly due to lameness in our population of horses. Quantifying joint angle patterns with an IMU system instead of using OMC has the advantage of furnishing real-time bio-feedback of kinematic data. The system can handle various equine gaits and clinical and training conditions outside of expensive laboratory circumstances. Fetlock joint angle (FJA) pattern is a sensitive indicator of lameness. The first aim of this study is to describe a network of inertial measurement units system (IMUs) for quantifying FJA simultaneously in all limbs. The second aim is to evaluate the accuracy of IMUs for quantifying the sagittal plane FJA overground in comparison to bi-dimensional (2-D) optical motion capture (OMC). 14 horses (7 free from lameness and 7 lame) were enrolled and analyzed with both systems at walk and trot on a firm surface. All enrolled horses were instrumented with 8 IMUs (a pair for each limb) positioned at the dorsal aspect of the metacarpal/metatarsal bone and pastern and acquiring data at 200 Hz. Passive markers were glued on the center of rotation of carpus/tarsus, fetlock, and distal interphalangeal joint, and video footages were captured at 60 Hz and digitalized for OMC acquisition. The IMU system accuracy was reported as Root Mean Square Error (RMSE) and Pearson Correlation Coefficient (PCC). The Granger Causality Test (GCT) and the Bland-Altman analysis were computed between the IMUs and OMC patterns to determine the agreement between the two systems. The proposed IMU system was able to provide FJAs in all limbs using a patented method for sensor calibration and related algorithms. Fetlock joint range of motion (FJROM) variability of three consecutive strides was analyzed in the population through 3-way ANOVA. FJA patterns quantified by IMUs demonstrated high accuracy at the walk (RMSE 8.23 degrees +/- 3.74 degrees; PCC 0.95 +/- 0.03) and trot (RMSE 9. 44 degrees +/- 3.96 degrees; PCC 0.96 +/- 0. 02) on both sound (RMSE 7.91 degrees +/- 3.19 degrees; PCC 0.97 +/- 0.03) and lame horses (RMSE 9.78 degrees +/- 4.33 degrees; PCC 0.95 +/- 0.03). The two systems' measurements agreed (mean bias around 0) and produced patterns that were in temporal agreement in 97.33% of the cases (p < 0.01). The main source of variability between left and right FJROM in the population was the presence of lameness (p < 0.0001) and accounted for 28.46% of this total variation. IMUs system accurately quantified sagittal plane FJA at walk and trot in both sound and lame horses.