Inter and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.

Megan Merrifield-Jones, Gillian Tabor, Jane Williams

Research output: Contribution to journalJournal Articlepeer-review

13 Citations (Scopus)
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Background: Back pain is a significant factor for horses and is challenging for professionals to diagnose, with assessment frequently utilising subjective tools such as manual palpation. Reliable and valid objective measures are required and pressure algometry (PA) has been investigated as an assessment tool, however it has limitations and other more realistic methods may be better suited for the task.
Objectives: To establish inter- and intra-rater reliability for PA, Flexiforce Sensor (FFS) and Manual Palpation for equine epaxial soft tissue, measuring mechanical nociception threshold responses.
Methods: In group 1, ten horses underwent three repeated tests with PA and FFS, and once for manual palpation, with three ACPAT Chartered Physiotherapists in the right thoracic epaxial region. Group 2 followed the same protocol using one ACPAT Chartered Physiotherapist and 22 horses. The order of palpation was randomly applied for each test and each experimenter.
Results: Manual palpation showed excellent inter-rater reliability with no significant differences between scores (p=0.64; ICC 90.0%). PA (p=0.002) and FFS (p=0.025) scores significantly differed between experimenters. Intra-rater testing showed significant differences (p=0.014) with horses increasing sensitivity over repeated PA measures. The FFS showed no significant differences (p=0.347; ICC 94.7%) in repeated measures with excellent reliability and consistency.
Conclusions: PA showed a lack of consistency in intra-rater reliability conflicting with 34 previous research findings, whereas the FFS showed greater reliability in comparison, however, it proved difficult to use in clinical practice. Manual palpation by physiotherapists was shown to have excellent inter-rater reliability when using a categorical scoring system.
Original languageEnglish
Article number102812
JournalJournal of Equine Veterinary Science
Issue numberDecember
Publication statusPublished - Dec 2019


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