In-Shoe Force Measurements and Hoof Balance

½Q1Š 1 2 3 4 5 6 7 8 9 ½Q4Š 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 In-Shoe Force Measurements and Hoof Balance Patrick T. Reilly ABSTRACT - Keywords: Horse; Hoof; Force; Load; Balance INTRODUCTION The term balance has been used as a general term to describe an ideal for hoof trimming, positioning, loading, and gait. The exact definition of balance is rather unclear because there are numerous descriptions presented in the published data. Furthermore, beyond the basic term, subcategories exist for the description of balance as either static or dynamic. Numerous methods have been advanced that are intended to result in a balanced foot. However, these protocols can produce different results, depending on the reference points used. For example, one publication describes a foot as balanced when the ground surface of the hoof is perpendicular to the axis of the limb (when viewed from the front), the medial and lateral hoof walls are equal in length, and the coronet is parallel to the ground. Although these reference points might seem to be reasonable while trimming a hoof, a closer examination shows a disturbing result: these three reference points would result in a different trim 71% of the time because the limbs and feet of most horses showed consistent asymmetry. Dynamic assessment of the horse further confounds the issue because factors such as impact pattern and limb interference provide more reference points to be considered and lessen the probability of obtaining a standard definition of a balanced foot. There have been attempts to examine the horse in its natural state to elicit more information about the ideal hoof. Although the value of this information has been debated at length, an undeniable result is that the hoof shape varies based on the environment in which the horse lives, and on the individual horse. Ponies living in Pennsylvania have different hooves compared with those of mustangs living in arid climates, and both differ from feral horses ½Q3Š From the New Bolton Center, PA. Reprint requests: Patrick T. Reilly, New Bolton Center, 382 West Street Road, Kennett Square, PA 19348. 0737-0806/$ - see front matter Ó 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.jevs.2010.07.013 living in areas with soft footing. Furthermore, these environmental conditions may vary considerably from the conditions experienced by many of the domestic horses in the care of farriers. Thus, the value of these feral-horse models is not fully understood. The addition of a rider and the unique demands of each equine athletic discipline further change the forces on the hoof, and are likely to change the idea of balance considered for each animal. It is important to note that these influences on balance, although potentially dramatic, are external to the horse. As such, the concept of balance as one size fits all is doubtful. Finally, the term balance has ramifications for the entire animal and not just the individual digit. Conformation is not consistent within a particular horse, because a pair of feet is often categorized as uneven or mismatched. There is no consensus in the published data regarding the merits of allowing dissimilar feet to remain so, or in using trimming and shoeing to minimize these differences. Furthermore, the influence of time within a shoeing cycle has been shown to have a significant effect on the structures of the foot, unavoidably influencing the concept of ideal balance. MEASURING LOADING FORCES One of the goals of our study group has been to examine the loads experienced by the ground surface of the hoof under various conditions. The equipment used for data collection includes the following: 1. F-scan mobile in-shoe force measuring system (Tekscan, Cambridge, MA, USA). Sensor mats are cut to the shape of the hoof and placed between hoof and shoe. 2. Sigafoos Series I horse shoe (Sound Horse Technologies, Unionville, PA, USA). An instrumented foot is shown in Figure 1. The system is calibrated according to the manufacturer s directions before each study. The sensor cuff is mounted over a polo wrap on the outside of the cannon. For trials without a rider, the data collector is carried alongside the horse by the horse handler. In trials involving a rider, the data logger is attached to the rider s belt. For our studies on hoof balance, force at the solar surface of the hoof was recorded at rest and during the walk and the trot. Data were collected in intervals of 8 seconds at a collection rate of 200 frames/s. The data were analyzed using the F-shoe mobile research software (version 6.33). 55 56 57 ½Q2Š 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 Journal of Equine Veterinary Science Vol -, No- (2010) 1

2 PT Reilly Vol -, No- (2010) 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 print & web 4C=FPO Figure 1. Left: The in-shoe membrane (green sheet), positioned between hoof and shoe. A removable wedge (black material, attached here to the medial shoe branch) allows changes to be made in hoof balance in the mediolateral and dorsopalmar planes. Right: Cables and data recorders attached to the horse and tack. The Tekscan in shoe force measured membrane shown positioned between the hoof and the Sigafoos Series I Glue on horseshoe (Sound Horse Technologies). Removable wedges (left) allows the adjustment of hoof balance in the medial-lateral and dorsal-palmar planes. Data collectors were, attached to the riders waist, the saddle, or carried next to the horse, depending on the testing conducted (This is a two-part photo, showing an instrumented foot on the left and how the cables and data recorder are attached to the horse on the right). CASE 1: RADIOGRAPHIC AND VISUAL ASSESSMENT OF BALANCE A 16-year-old Quarter Horse mare was trimmed and shod, with hoof balance assessed radiographically using both lateromedial and level dorsopalmar views. Specifically, on the dorsopalmar view, the coffin joint space was determined to be even in width across the joint, and the distal margin of P3 was parallel to the ground (ie, the vertical distance from distal P3 to the ground was equal on medial and lateral sides). The desired position of the shoe and sensor was also confirmed radiographically. A low palmar (abaxial sesamoidean) nerve block was performed just before data collection. Measurements were then made at rest and with the horse walking and trotting on a hard surface. As Table 1 shows, 65% of the force was located in the medial side of the hoof at rest. This disparity in load was reversed at the walk, with the horse showing a lateral loading pattern. On an average of six strides at the walk, 66% of the force at midstance was located in the lateral side of the hoof. However, at the trot, force was equally distributed between the medial and lateral sides of the hoof at Table 1. Force distribution between medial and lateral sides of the hoof in case 1 Gait Medial (% of force) Lateral (% of force) Rest 65% 35% Walk 34% 66% Trot 50% 50% Before data collection, the hoof was balanced in the medial-lateral plane using radiographic guidance (see text). Force distribution at mid-stance is shown for the foot at rest (ie, standing still) and at the walk and trot. With the hoof balanced in the medial lateral plane using the reference points of coffin joint spacing and a parallel solar margin of the distal phalanx in the medial lateral plane, distribution of force on the medians of the hoof at mid-stance differentiated by gait. midstance. Visually, this mare showed a lateral loading pattern when viewed from front at the walk. Next, a urethane wedge was attached to the medial side of the shoe (as shown in Fig. 1). Wedge height was gradually adjusted until the hoof appeared to land evenly (ie, both medial and lateral sides landed simultaneously) at the 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216

PT Reilly Vol -, No- (2010) 3 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 print & web 4C=FPO Table 2. Data for the same horse as shown in Table 1 Gait Medial (% of force) Lateral (% of force) Rest 71% 29% Walk 47% 53% Trot 63% 37% This time the hoof was artificially balanced in the medial-lateral plane using a medially placed wedge, so that visually the hoof appeared to land level at the walk (ie, both sides of the hoof appeared to be loaded simultaneously). With the hoof balanced in the medial lateral plane using the reference point of a flat impact at the walk (in the medial lateral plane), distribution of force on the medians of the hoof at mid-stance differentiated by gait. These data represent the same horse and hoof as in Table 1. walk. Forces were again measured at rest and at the walk and trot. As shown in Table 2, altering the visual loading pattern to create an even landing lateromedially was effective at improving lateral-medial loading symmetry at the walk but it created greater load medially at the trot. CASE 2: MOVING WITH A RIDER In a separate study, both the fore feet of a 4-year-old Dutch Warmblood gelding were instrumented as described previously and the forces in both the hooves were measured while riding the horse. The measurements were collected on a firm surface and then in a dressage arena, with the rider performing routine dressage movements appropriate to the horse s level of training. Pertinent results included the following: On a firm surface, 100% of the force at the trot was transmitted to the perimeter of the hoof through direct contact with the shoe (Fig. 2). In the soft footing of the arena, 67% of the force at the trot was transmitted to the perimeter of the hoof through the shoe, and the remaining 33% was spread over the sole and frog. Force was equally distributed between the left and right feet (50% each). Hoof impact in both feet was slightly lateral. At the sitting trot, hoof impact was slightly heel-first. In the extended trot, hoof impact was slightly toe-first. On a 20-m circle at the sitting trot, force was equally distributed between both feet (averaged over 12 strides). Turns affected load distribution between the two feet, with more load placed on the inside limb (e.g. the left fore on a left turn) earlier in the stride and more load on the outside limb (e.g. the right fore on a left turn) in the second half of the stride. On a turn, the position of breakover (originally to the lateral side of the hoof) was moved in the direction in which the horse was turning. Next, the open-heel shoes were removed and replaced over the original sensors with egg-bar shoes (Sigafoos Series Figure 2. Left: A hoof force map, showing the variations in peak force in the region of ground contact. The areas of highest force are shown in red, and the lowest in indigo and violet. In this case, the lateral side of the hoof is on the left (red box) and medial is on the right (green box). Right: Graph of force measurements over multiple strides. In this case, forces in the lateral side of the hoof are shown in red and medial in green. Data collection over multiple strides was compared, averaging multiple strides and comparing regions of the hoof contact area (lateral hoof force in red and medial in green, represented in the hoof force map on [left], and in the graph [right]). The colors of the force map (left) indicate different intensities of peak force for the four strides considered in this trial (This is a two-part graphic of the data; the image on the left shows the color spectrum of loading forces in a horseshoe shape and the image on the right is a line graph of loading forces over several strides). 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324

4 PT Reilly Vol -, No- (2010) 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 II shoes, Sound Horse Technologies, Unionville, PA). The trotting trials were repeated to compare the two shoes. As compared with the open-heel shoes, the egg-bar shoes increased the force in the caudal half of the hoof by 6% and increased the force in the medial half of the foot by 3%, although the overall force in the hoof was unchanged. DISCUSSION The concept of hoof balance as an absolute value seems to be an illogical premise. Although certain aspects of balance are intrinsic to the limb and to the animal, there also exist external factors which have the potential to affect the landing of foot and loading of the limb. In case 1, the gait clearly affected the distribution of force across the hoof, regardless of the reference point used (static radiographic symmetry or dynamic visual landing symmetry). In case 2, the application of egg-bar shoes affected the distribution of force across the hoof, moving it slightly to the caudal and medial aspects of the foot. Denoix et al showed the ability of the egg-bar shoe to increase the loaded position of the hoof in soft footing, a change that would be expected to increase the compressive force on the heels in a manner similar to a wedge pad. The increase in force on the medial side of the hoof in our study is also supported by Denoix s results, in which the egg-bar shoe increased support on the medial side of the hoof. The results of Wilson et al. suggest that the application of a heel wedge changes the loading of the distal limb joints, thus affecting most definitions of hoof balance. This effect would be similar to the positional change associated with an egg-bar shoe in soft footing. The second case is further enlightening because it illustrates the effect of the sport or activity on the concept of hoof balance. The effect of the rider and his commands to the horse (e.g. sitting trot, extended trot, circles, turns, etc.) measurably changed the distribution of force in the hoof. FINAL THOUGHTS Hoof balance is affected by numerous variables, which might explain the reason we have been unable to reach a consensus in centuries of farrier teachings about the best method of achieving balance. Relatively new reference points (most notably radiography) have attempted to define hoof balance on the basis of internal anatomical features; however, these static determinations still fail to consider the dynamic factors which change the forces acting on the horse s hoof during motion. An interesting parallel to the goals and challenges of equine biomechanics may be reported in the field of human podiatry and biomechanics, particularly those pertaining to athletic footwear. Although performance, injury prevention, and comfort are the primary considerations, achieving each of these goals involves a certain measure of compromise, especially when the footwear is designed for multiple athletic endeavors. Consequently, the role of research is to reduce the amount of compromise required. Perhaps we would do well to consider the achievement of hoof balance as a compromise of several factors rather than an absolute ideal, and look to research tools such as those presented in this study to help us design better footwear for the horse. RECOMMENDED READING ½Q5Š Butler KD. The prevention of lameness by physiologically-sound horseshoeing. Proc Am Assoc Equine Pract 1985;31:465e475. Curtis S. Farrierydfoal to racehorse. Newmarket, Ontario, Canada: R & W Publications; 1999:1e11. Bach O, Butler D, White K, Metcalf S. Hoof balance and lameness: improper toe length, hoof angle, and mediolateral balance. Compend Contin Educ Pract Vet 1995;17:1275e1282. Bach O, White K, Butler D, Metcalf S. Hoof balance and lameness: foot bruising and limb contact. Compend Contin Educ Pract Vet 1995;17: 1505e1506. Turner T. The use of hoof measurements for the objective assessment of hoof balance. Proc Am Assoc Equine Pract 1992;38:389e395. Kane AJ, Stover SM, Gardner IA, Bock KB, Case JT, Johnson BJ, et al. Hoof size, shape, and balance as possible risk factors for catastrophic musculoskeletal injury of thoroughbred racehorses. Am J Vet Res 1998;59: 1545e1552. Balch OK, White D, Butler D, Metcalf S. Hoof balance and lameness: foot bruising and limb contact. Compend Contin Educ Pract Vet 1995;17: 1503e1509. Parks A. Form and function of the equine digit. Vet Clin North Am Equine Pract 2003;19:285e307. Wilson AM, Seelig TJ, Shield RA, Silverman BW. The effect of foot imbalance on point of force application in the horse. Equine Vet J 1998;30: 540e545. Lafortune M. The role of research in the development of athletic footwear. J Foot Ankle Res 2008;1(Suppl 1):K3. DOI 10.1186/1757-1146-1- S1eK3. 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452

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