The use of outcome measures in equine rehabilitation

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.