Veterinarians design rehabilitation programs to help horses return to work after illness, injury, or surgery, building strength slowly over time. They work with horse owners to determine the best course of action based on the owner’s schedule and the horse’s personality, often making decisions or changes based on the horse’s recovery, said Melissa King, PhD, DVM, Dipl. ACVSMR, associate professor of clinical sciences at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences, in Fort Collins.

However, veterinarians have not yet developed a standardized system for assessing the success of a rehabilitation program, despite a need for it, she said when presenting on the topic at the 2024 American College of Veterinary Sports Medicine and Rehabilitation Symposium, held April 11-13 in Naples, Florida.

How to Assess an Equine Rehabilitation Program

“A good rehabilitation plan should be balanced with safety and minimization of risks to prevent reinjury and optimize performance,” said King. When evaluating outcome measures to determine the success of a rehabilitation program tool, King said to consider these parameters:

• Utility.
• Reliability.
• Validity.
• Sensitivity.
• Specificity.
• Responsiveness.

With these criteria veterinarians can measure body structure impairments (whether the horse can move the way he should), body function impairments (his ability to function normally), activity limitations (i.e., whether he can perform normal activity), and participation restrictions, she added.

Measuring a Horse’s Progress During Rehabilitation

Horse owners and veterinarians can use the horse grimace scale, which decodes various equine facial expressions; the composite pain scale, a questionnaire used to assess animal pain; and the ridden horse pain ethogram, a list of behaviors used to recognize equine musculoskeletal pain. These tools help assess a horse’s pain levels and progress during rehabilitation.

Veterinarians can also utilize activity monitors to study the horse’s movement characteristics and posture during stall confinement, said King.

Objective tools, such as wearable technologies combining inertial measurement units (IMU—devices that measure position changes precisely) and artificial intelligence (AI), can quantify lameness in horses for veterinarians through repeated lameness examinations. These tools allow veterinarians to measure a horse’s progress and response to treatment and applied diagnostics, said King. Practitioners can also use a tape measure to quantify the circumference of a limb and monitor effusion (swelling). “Having landmarks for where to measure is critical (for repeatability). Hold consistent tension, and position the horse in the same way each time you measure,” said King.

Take-Home Message

Rehabilitation programs are essential for horses recovering from injury, illness, or surgery. However, veterinarians and researchers have not yet established a system to evaluate the quality and success of these programs. Veterinarians and horse owners should work together to consistently measure a horse’s progress using scales for equine pain levels, regular recheck examinations, and objective tools whenever possible.