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Step by Step Vet Physio Sarah Smith and horse Bertie doing liberty work over poles

My Research

"Objective measurement  should be incorporated into all areas of physiotherapy including within the assessment and treatment of horses…the combined use of pain responses, behavioural changes and objective measures collected during assessment could be considered useful in practice once further validation of these has been conducted"

Tabor,G., & Williams, J. (2020) Objective measurement in equine physiotherapy.

Sarah Smith MSc research 2021 2022

The measurement of forefeet, laterality, gait and level of comfort over a pole exercise in a therapeutic setting. The central aim of the project was to test the ability of smart phone video technology to capture meaningful and repeatable data which could be used to monitor a horse’s reaction to physiotherapy over time. 

We recruited 7 horses aged between 6 and 23 years, 5 geldings and 2 mares. This wasn’t a big enough pool of data to produce statistics that would apply to all horses but was an interesting pilot study.

Videos of the pole exercise were turned into data. Here, one moment in time captured (at 1401ms) by still photograph is shown on the graph as a moment of gait suspension, circled. The graph as a whole shows the horse’s movement over cavaletti 5 and 6 in the photograph.

A horse trotting over poles, with various angles annotated on its legs
A graph demonstrating the various angles of a horses legs over trotting poles
A close up photo of a horses hoof from the side, with various angles annoted onto it.

The Dorsal Wall Hoof Angle (DWHA) was measured using photographs loaded into a phone app and taken on the same day as doing the exercise. This horse has a right fore DWHA of 51.29 degrees.

We recorded whether the horses entered the exercise with the same leg, or alternated, when given sufficient space to adjust striding and make a choice. This horse is using his right leg preferentially throughout.

We used specific “grimace” points on their faces, captured on film, to measure their comfort levels which we found decreased over the period of the exercise.


Two horses new to pole work had scores that increased from no/mild tension to moderate tension. Pole work is tiring!

Step by Step Vet Physio's horse Bertie trotting over poles

Overall Conclusions

  • The smartphone is carried by 99% of those under 35 years and is currently under utilised as a powerful tool in veterinary physiotherapy.

  • The modern smart phone can reliably and simultaneously capture gait, behavioural and laterality  data*. This is true under normal gait assessment conditions (flat ground) as well as over poles. 

  • Laterality was demonstrated in 86% of horses with 43% demonstrating strong laterality.* This means that almost 1 in 2 horses on my client list may have levels of motor asymmetry that may lead to compensatory changes in muscle tone and mass affecting optimal performance. 

  • Carpal (knee) and tarsal (hock) flexion increased in the range 25-50% over poles. Strongly lateral horses showed greater flexion in the leading than trailing limb pair in the trot exercise. This is right fore and left hind in the horse featured above.*

  • There was strong correlation between a high hoof (3 degrees of difference or more) and laterality to the opposite side.* The existing software for processing hoof pictures produces reliable data and together with laterality provide objective markers for identifying asymmetric patterns in the body.

  • Pole exercises need to be carefully targeted to be within the capability of each horse, but are effective in a targeted active range of motion prescription.

The capture and processing of this data is suited to the therapeutic setting and is likely to develop within the Artificial Intelligence (AI) environment in the future. A reference library of video clips and photographs for each horse should be compiled by all physios now for analysis and comparison when AI software become available.

*requires validation by peer reviewed, published studies

Beyond the Project: 2023

Sweden launches This is a scientifically validated equine gait analysis application developed using AI and capturing trot on video using a smartphone from the front and behind and on a 20m circle. Currently only available to veterinary surgeons, there is a vet physio version being developed.

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