References
The use of outcome measures in equine rehabilitation
Abstract
Background:
The ideal goal of equine rehabilitation following injury or surgery is to return the horse to a level of function that either meets or exceeds the previous performance level, and monitoring progress is important within rehabilitation. Outcome measures (OM) are used extensively in human practice and research, especially patient reported outcomes (PRO). PROs generally consist of a series of questions and observation of functional tasks, use of which may be challenging in equine practice.
Aim:
The aim of this study was to evaluate the use of OMs by physiotherapists in equine musculoskeletal rehabilitation.
Methods:
A questionnaire was used to investigate how those involved with the treatment and training of horses measure progress and outcomes during rehabilitation.
Results:
71 physiotherapists responded, comprising 51 chartered physiotherapists and 20 physiotherapists without prior human training, with an average of 9.25 years in equine practice; 82.2% reported OM use. When asked to define an OM, 72.5% of chartered physiotherapists and 40% of physiotherapists without prior human training, matched a pre-set definition correctly. The benefits of OM use were reported consistently as a method of objectively monitoring progress and used to adapt treatment plans. The barriers to OM use were lack of OM validation and reliability and time constraints. However, OMs were mainly subjective, such as visual assessment of lameness, palpation and muscle symmetry.
Conclusion:
In conclusion, confusion exists regarding what an OM is, and OM use is reported but often refers to subjective assessment method. A validated equine musculoskeletal rehabilitation score is required to support clinical practice.
The ideal goal of equine rehabilitation following injury or surgery is to return the horse to a level of function that either meets or exceeds the previous performance level. Musculoskeletal rehabilitation programmes may include a combination of interventions such as thermal therapy, electrotherapy, exercise therapy and manual therapies (Buchner and Schildboeck, 2006). Monitoring progress of the patient is important within rehabilitation, and this should be achieved using methods that are able to reliably judge the change in the horse from the initial assessment and onward through the course of treatment. A test used to objectively determine if there has been meaningful change in health status during a course of treatment is known as an outcome measure (OM) (Hefford et al, 2011). Using standardised and validated OMs in clinical practice is an explicit requirement of human physiotherapy practice (Chartered Society of Physiotherapy (CSP), 2017), and the Government's NHS white paper Equity and Excellence; Liberating the NHS (Dept of Health, 2010) recommends the use of OMs wherever practical. It is unknown if practitioners, including chartered physiotherapists working with animals, and more specifically horses, use OMs within practice.
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