Stiftung Tierärztliche Hochschule Hannover Kinetische und ...

Stiftung Tierärztliche Hochschule Hannover
Kinetische und elektromyographische Bewegungsanalyse beim Hund mit
reversibel induzierter Hinterhandlahmheit
INAUGURAL – DISSERTATION
zur Erlangung des Grades einer Doktorin der Veterinärmedizin
- Doctor medicinae veterinariae -
(Dr. med. vet.)
vorgelegt von
Stefanie Fischer
Höxter
Hannover 2013

Wissenschaftliche Betreuung:
1. Prof. Dr. Ingo Nolte
Klinik für Kleintiere
2. PD Dr. Nadja Schilling
Institut für Spezielle Zoologie und
Evolutionsbiologie, Jena
1. Gutachter: Prof. Dr. Ingo Nolte
2. Gutachter: Prof. Dr. Peter Stadler
Tag der mündlichen Prüfung: 27.05.2013
Diese Arbeit wurde im Rahmen des Graduiertenkolleg Biomedizintechnik des SFB
599 (finanziert durch die Deutsche Forschungsgemeinschaft), der
Berufsgenossenschaft Nahrungsmittel und Gastgewerbe Erfurt und der
Hannoverschen Gesellschaft zur Förderung der Kleintiermedizin (HGFK) gefördert.

Meiner Familie

Der erste Teil dieser Arbeit ist bei folgender Zeitschrift online publiziert:
• The Veterinary Journal
Compensatory load redistribution in walking and trotting dogs with hind
limb lameness
Stefanie Fischer, Alexandra Anders, Ingo Nolte, Nadja Schilling
DOI: 10.1016/j.tvjl.2013.04.09
Der zweite Teil dieser Arbeit ist bei folgender Zeitschrift eingereicht:
• PloS One
Adaptations in muscle activity to induced hindlimb lameness in trotting
dogs
Stefanie Fischer, Ingo Nolte, Nadja Schilling

Teile dieser Dissertation wurden als Poster auf folgenden Fachtagungen präsentiert:
• SFB599 Kolloquium 2012
Electromyographical and computerized gait analyses in dogs with and
without hindlimb lameness
• 21. Jahrestagung der Fachgruppe “Innere Medizin und Klinische
Labordiagnostik” der DVG
Muskelfunktionsdiagnostik beim trabenden Hund mit
Hinterhandlahmheit

Inhaltsverzeichnis
Inhaltsverzeichnis
1. Einleitung und Literaturüberblick .................................................................. 11
2. Material und Methoden ................................................................................... 17
2.1. Hunde ........................................................................................................ 17
2.2. Datenaufzeichnung .................................................................................. 17
2.2.1. Kinetische Messungen ........................................................................ 18
2.2.2. Elektromyographische Messungen ..................................................... 18
2.3. Datenanalyse ............................................................................................ 18
3. Studie I ............................................................................................................. 19
3.1. Abstract ..................................................................................................... 20
3.2. Introduction .............................................................................................. 21
3.3. Materials and Methods ............................................................................. 23
3.3.1. Animals ............................................................................................... 23
3.3.2. Study design ....................................................................................... 23
3.3.3. Data collection and analysis ................................................................ 24
3.3.4. Statistical analyses .............................................................................. 25
3.4. Results ...................................................................................................... 25
3.4.1. Load distribution .................................................................................. 25
3.4.2. Symmetry indices ................................................................................ 26
3.4.3. Relative stance duration ...................................................................... 26
3.5. Discussion ................................................................................................ 26
3.6. Conclusion ................................................................................................ 30
3.7. Acknowledgements .................................................................................. 30
3.8. References ................................................................................................ 30
3.9. Tables and Figures ................................................................................... 36
4. Studie II ............................................................................................................ 43
4.1. Abstract ..................................................................................................... 44
4.2. Introduction .............................................................................................. 45
4.3. Materials and Methods ............................................................................. 47
4.3.1. Ethics statement .................................................................................. 47
4.3.2. Animals and experimental design ....................................................... 47
4.3.3. Data collection ..................................................................................... 48
4.3.4. Data analysis ....................................................................................... 49
4.3.5. Statistical analyses .............................................................................. 50
4.4. Results ...................................................................................................... 50
4.4.1. M. triceps brachii (N=7)....................................................................... 50
4.4.2. M. vastus lateralis (N=7) ..................................................................... 51
4.4.3. M. longissimus dorsi (N=5).................................................................. 51
4.5. Discussion ................................................................................................ 52
4.5.1. M. tricpes brachii ................................................................................. 52
4.5.2. M. vastus lateralis ............................................................................... 53

Inhaltsverzeichnis
4.5.3. M. longissimus dorsi ............................................................................ 55
4.6. Concluding remarks ................................................................................. 57
4.7. Acknowledgements .................................................................................. 58
4.8. References ................................................................................................ 58
4.9. Tables and Figures ................................................................................... 66
5. Diskussion ....................................................................................................... 71
6. Zusammenfassung .......................................................................................... 78
7. Summary .......................................................................................................... 81
8. Literaturverzeichnis ........................................................................................ 83
9. Danksagung ................................................................................................... 103

Abkürzungsverzeichnis
Abkürzungsverzeichnis
In dieser Arbeit wurden folgende Kurzformen verwendet:
CoM
EMG
F c
F i
Fx
Fy
Fz
GRF
H c
H i
HD
IFz
L3
L4
MFz
OA
OEMG
PFz
Post op
SD
Körpermasseschwerpunkt
Elektromyographie
Kontralaterale Vordergliedmaße
Ipsilaterale Vordergliedmaße
Mediolaterale Bodenreaktionskraft
Kraniokaudale Bodenreaktionskraft
Vertikale Bodenreaktionskraft
Bodenreaktionskräfte
Kontralaterale Hintergliedmaße
Ipsilaterale Hintergliedmaße
Hüftgelenksdysplasie
Vertikaler Impuls
3. Lendenwirbel
4. Lendenwirbel
Mittlere vertikale Bodenreaktionskraft
Osteoarthrose
Oberflächen-Elektromyographie
Maximale vertikale Bodenreaktionskraft
Nach der Operation
Standardabweichung

Einleitung und Literaturüberblick
1. Einleitung und Literaturüberblick
Lahmheit ist durch eine Funktionseinschränkung einer Gliedmaße gekennzeichnet,
die zu Veränderungen des Bewegungsablaufes bei der Fortbewegung führt. Um
abzuschätzen, welche Kurz- und Langzeitfolgen für den Bewegungsapparat des
Hundes damit verbunden sein können, muss man zuerst verstehen, wie die
Funktionseinschränkung kompensiert wird. Da diese Kompensationsmechanismen
beim Hund noch nicht ausreichend verstanden sind, wie im Folgenden ausgeführt
wird, die Kenntnis der veränderten Gangparameter jedoch die Grundlage für
weiterführende medizinische Maßnahmen und neue therapeutische Ansätze
darstellt, ist es notwendig, weitere Untersuchungen durchzuführen.
Die Bewegungen des Hundes und damit auch deren Veränderungen aufgrund einer
Lahmheit werden mittels folgender etablierter Gangparameter bzw. Techniken
beschrieben:
Als sogenannte metrische Gangparameter werden die zeitlich-räumlichen
Charakteristika der Bodenkontakte aller Gliedmaßen anhand von Länge und Dauer
des Schrittzyklus sowie seiner Subphasen —Stand- und Schwingphase— und der
relativen Abfolge der Fußungen zueinander beschrieben. Eine bewährte
Darstellungsform der zeitlichen Parameter sind beispielsweise die Fußfallmuster
nach Hildebrand (HILDEBRAND 1966; Abb.1).
Abb. 1: Fußfallmuster eines gesunden Hundes in Schritt und Trab (Mittelwert ± Standardabweichung).
Ein Schrittzyklus beschreibt die Zeit vom Auffußen bis zum Wiederauffußen derselben Gliedmaße; Die
schwarzen Balken zeigen die mittlere Zeit (±SD), die sich die Gliedmaße innerhalb eines Schrittzyklus
in der Standphase befindet. H c : kontralaterale Hintergliedmaße, F c : kontralaterale Vordergliedmaße,
F i : ipsilaterale Vordergliedmaße, H i : ipsilaterale Hintergliedmaße (aus Studie I, Abb. 1).
11

Einleitung und Literaturüberblick
Das Teilgebiet der Kinematik beschreibt die zeitlich-räumlichen Beziehungen der
Körperabschnitte zueinander bzw. zum Raum. Anhand von kinematischen Daten
lassen sich die Bewegungen der einzelnen Segmente, sowie unterschiedliche
Winkelparameter der zu untersuchenden Gliedmaßen erfassen (DECAMP et al.
1993; ALLEN et al. 1994; RAGETLY et al. 2010). Hiermit kann z. B. gezeigt werden,
ob es beim lahmenden Hund in bestimmten Gelenken zu einer vermehrten oder
verminderten Extension bzw. Flexion kommt, was wiederum Auswirkungen auf das
gesamte Gangbild des Hundes haben kann.
Kinetische Gangparameter stellen einen weiteren Teilbereich dar. Die während der
Lokomotion vom Hund auf den Boden ausgeübten Kräfte werden als
Bodenreaktionskräfte erfasst. Zur besseren Veranschaulichung werden sie in ihre
drei orthogonalen Vektoren zerlegt: vertikal (Fz), kraniokaudal (Fy) und mediolateral
(Fx) (BUDSBERG 1987; MCLAUGHLIN 2001). Die Bodenreaktionskräfte geben
Aufschluss über die Richtung und Höhe der externen Kräfte, die während der
Standphase auf die Gliedmaße einwirken. Hierbei wird insbesondere die vertikale
Kraft Fz zur quantitativen Beurteilung einer Lahmheit und zur Evaluierung der
Gewichtsumverteilung zwischen den Gliedmaßen herangezogen.
Einen zusätzlichen Analysebereich liefert die Elektromyographie (EMG). Obwohl
kinesiologisches EMG zu den Standardmethoden der Bewegungsanalyse in der
Humanmedizin gehört, wird es in der Veterinärmedizin noch so gut wie nicht
verwendet. Als der „Motor“ von Bewegungen ist die Muskulatur aber von
besonderem Interesse und daher in die Funktionsanalyse des Bewegungsapparates
einzubeziehen. Die EMG gibt Auskunft über das Aktivitätsmuster der Muskeln
während unterschiedlicher Bewegungen. Das Rekrutierungsmuster ausgesuchter
Muskeln kann beispielsweise nicht-invasiv mittels oberflächenelektromyographischer
Aufzeichnungen (OEMG) beurteilt werden.
Von den genannten Möglichkeiten der Bewegungsbeurteilung konzentrieren sich die
Untersuchungen der vorliegenden Arbeit auf die Veränderungen der zeitlichräumlichen
Charakteristika der Bodenkontakte, der vertikalen Bodenreaktionskräfte
(Fz) aller Gliedmaßen und des Aktivierungsmusters ausgewählter Muskeln beim
lahmenden Hund im Vergleich zum physiologischen Gangbild. In der vorliegenden
12

Einleitung und Literaturüberblick
Arbeit wird der Fokus speziell auf die Gangveränderungen bedingt durch eine
Hinterhandlahmheit gelegt, da mehr als die Hälfte der muskuloskelettalen Probleme
beim Hund durch Gelenkserkrankungen der Hintergliedmaße verursacht werden (v.a.
Hüfte und Knie; JOHNSON et al. 1994). Bezogen auf diese drei Analysebereiche —
Metrik, Kinetik, EMG— lässt sich der aktuelle Kenntnisstand für Hunde mit
Hinterhandlahmheit folgendermaßen zusammenfassen:
Veränderungen von zeitlich-räumlichen Gangparametern wurden bisher entweder in
Bezug auf die Schrittlänge (z. B. DECAMP et al. 1996; RAGETLY et al. 2010;
SANCHEZ-BUSTINDUY et al. 2010), die Schrittdauer (z. B. RAGETLY et al. 2010)
oder die Schrittfrequenz (z. B. BENNETT et al. 1996; DECAMP et al. 1996)
untersucht. Eine Abnahme der Schrittlänge im betroffenen Bein (DECAMP et al.
1996; SANCHEZ-BUSTINDUY et al. 2010), sowie eine Abnahme der Schrittdauer
der geschädigten im Vergleich mit der klinisch gesunden Gliedmaße (RAGETLY et
al. 2010) wurde bei Hunden mit kranialem Kreuzbandriss festgestellt. Bei Hunden mit
Hüftgelenksdysplasie (HD) kam es im Vergleich mit der Kontrollgruppe in der stärker
erkrankten Gliedmaße zu einer Zunahme der Schrittlänge (BENNETT et al. 1996).
Eine Differenzierung von Stand- und Schwingphase wurde bisher nur vereinzelt
vorgenommen (z. B. VILENSKY et al. 1994; BENNETT et al. 1996; RAGETLY et al.
2010; DE MEDEIROS et al. 2011; BÖDDEKER et al. 2012). Hier zeigten alle Hunde
mit kranialem Kreuzbandriss eine verkürzte Standphasendauer der betroffenen
Gliedmaße (VILENSKY et al. 1994; RAGETLY et al. 2010; DE MEDEIROS et al.
2011; BÖDDEKER et al. 2012). Hunde mit HD zeigten im Vergleich mit der
Kontrollgruppe weder eine Zu- oder Abnahme in der Standphasendauer noch der
Schrittfrequenz (BENNETT et al. 1996). Komplette Fußfallmuster, die sowohl
Veränderungen der Stand- und der Schwingphase als auch zeitliche Beziehungen
zwischen allen Extremitäten und die Abfolge der Fußungen bei einer
Hinterhandlahmheit aufzeigen, gibt es bisher nicht.
Bisherige kinetische Studien haben in Bezug auf die veränderte Belastungssituation
bei Hunden mit Hinterhandlahmheit entweder nur die betroffene Hintergliedmaße
untersucht (z. B. CROSS et al. 1997; HOELZLER et al. 2004; CONZEMIUS et al.
2005; EVANS et al. 2005; MADORE et al. 2007; PUNKE et al. 2007) oder beide
13

Einleitung und Literaturüberblick
Hintergliedmaßen verglichen (z. B. BUDSBERG et al. 1988; VOSS et al. 2008;
RAGETLY et al. 2010; BÖDDEKER et al. 2012; SEIBERT et al. 2012). Bei den
genannten Studien wurde die jeweils betroffene Gliedmaße weniger belastet (Fz
vermindert), wohingegen die kontralaterale Hintergliedmaße, sofern untersucht,
vermehrt belastet wurde (Fz erhöht). Ob es bei einer Hinterhandlahmheit auch zu
einer Gewichtsumverteilung auf die Vordergliedmaßen kommt, ist aufgrund der
widersprüchlichen Befundlage ungeklärt (z. B. ja: DUPUIS et al. 1994; nein: RUMPH
et al. 1993; RUMPH et al. 1995; JEVENS et al. 1996; KATIC et al. 2009).
Zahlreiche EMG-Studien haben in der Vergangenheit die Aktivitätsmuster einer
Reihe von Gliedmaßen- und Rückenmuskeln beim gesunden trabenden Hund
beschrieben (NOMURA et al. 1966; TOKURIKI 1973; GOSLOW et al. 1981;RITTER
et al. 2001; CARRIER et al. 2006; CARRIER et al. 2008; SCHILLING et al. 2009;
SCHILLING u. CARRIER 2009; SCHILLING u. CARRIER 2010; DEBAN et al. 2012),
aber nur wenige Studien haben die Veränderungen der Muskelrekrutierung in
Adaptation an eine Lahmheit untersucht (HERZOG et al. 2003; ZANEB et al. 2009;
BOCKSTAHLER et al. 2012a). OEMG bietet im Gegensatz zum intramuskulären
EMG eine weniger invasive Methode, welche in der Humanmedizin routinemäßig
angewendet wird (SUTHERLAND 2001). In der Veterinärmedizin gibt es nur
vereinzelt OEMG-Studien, die die Muskelrekrutierung von gesunden (LAUER et al.
2009; BOCKSTAHLER et al. 2009) und lahmen Hunden (BOCKSTAHLER et al.
2012a) untersucht haben. In der zuletzt genannten Arbeit wurden die
Rekrutierungsmuster des M. vastus lateralis, des M. biceps femoris und des M.
glutaeus medius von gesunden und an Hüftgelenksarthrose (OA) erkrankten Hunden
verglichen. Bei den Hunden mit OA zeigte sich in allen drei Hinterbeinmuskeln
während der frühen Schwingphase eine verminderte Aktivität und während der
frühen Standphase im M. vastus lateralis und im M. glutaeus medius eine höhere
Aktivität. Kommt es bei einer Hinterhandlahmheit auch zu einer
Gewichtsumverteilung nach kranial, ist zu erwarten, dass die Muskulatur der
Vorderextremitäten ebenfalls Veränderungen im Rekrutierungsmuster aufzeigt.
Darüber hinaus hat keine der bisher vorliegenden OEMG-Studien den Rücken in die
Untersuchung mit einbezogen. Daher bleibt die Rolle der Rückenmuskulatur bei der
14

Einleitung und Literaturüberblick
Kompensation einer Hinterhandlahmheit offen. Zusammenfassend lässt sich
feststellen, dass es beim lahmen Hund keine Studien gibt, welche die
Aktivierungsmuster der ausgewählten Muskeln aller vier Gliedmaßen sowie des
Rückens simultan untersucht haben.
Ziel der vorliegenden Arbeit ist es, einen Beitrag zum Verständnis der
Lahmheitskompensation des Hundes zu leisten. Hierfür sollen im Hinblick auf eine
Hinterhandlahmheit die Veränderungen in ausgewählten metrischen, kinetischen und
elektromyographischen Parametern untersucht werden. Folgende Fragen stehen in
dieser Arbeit im Vordergrund: 1) Sind bei einem Hund mit Hinterhandlahmheit
zeitliche Verschiebungen im Schrittzyklus aller vier Gliedmaßen festzustellen?
Hierfür werden Fußfallmuster erstellt, welche die Veränderungen der zeitlichen
Gangparameter von Stemm- und Vorschwingphase sowie die Folge der
Bodenkontakte darstellen. 2) Wird zur Entlastung der betroffenen Gliedmaße das
Gewicht ausschließlich zur kontralateralen Extremität verlagert oder sind alle vier
Gliedmaßen in ihrer vertikalen Kraft verändert? Zur Beantwortung dieser Frage
werden maximale und mittlere Kraft sowie der Impuls von Fz von allen vier
Gliedmaßen synchron analysiert. 3) Inwiefern ändern sich die Aktivierungsmuster
ausgewählter Bein- und Rückenmuskeln? Hierzu sollen erstmalig die Veränderungen
der Rekrutierungsmuster vom M. triceps brachii, M. vastus lateralis und M.
longissimus dorsi in Bezug auf zeitliche Verläufe und die Amplitudenhöhe untersucht
werden. Die Ergebnisse dieser Arbeit können durch ein besseres Verständnis der
Kompensationsmechanismen des Hundes neue Ansätze für Therapien und
Rehabilitationsmaßnahmen (z. B. Physiotherapie) liefern.
Alle Gangparameter sind von der Geschwindigkeit bzw. der Gangart abhängig.
Beispielsweise steigt die maximale vertikale Kraft mit zunehmender Geschwindigkeit
an (z. B. BUDSBERG 1987; RIGGS et al. 1993; MCLAUGHLIN u. ROUSH 1994;
DECAMP 1997; RENBERG et al. 1999; BERTRAM et al. 2000; MCLAUGHLIN 2001;
EVANS et al. 2003; MÖLSA et al. 2010; VOSS et al. 2010). Da eventuell Lahmheiten
visuell nur im Trab, aber nicht im Schritt auszumachen sind (QUINN et al. 2007;
VOSS et al. 2007), ist anzunehmen, dass sich die jeweiligen
Kompensationsmechanismen zwischen den Gangarten unterscheiden. Aus diesem
15

Einleitung und Literaturüberblick
Grund werden die beiden symmetrischen Gangarten, die auch bei der klinischen
Lahmheitsevaluation herangezogen werden —Schritt und Trab— bei der
Untersuchung der oben genannten Fragen berücksichtigt.
Die Veränderungen im Bewegungsablauf beim lahmenden im Vergleich zum
nichtlahmenden Hund wurden mit Hilfe der computergestützten Ganganalyse unter
Verwendung eines instrumentierten Laufbandes dokumentiert, das die gleichzeitige
Erfassung der metrischen, kinetischen und elektromyographischen Daten erlaubt.
Um einen direkten Vergleich der physiologischen und pathologischen Werte bei ein
und demselben Individuum zu ermöglichen und somit die Variabilität in den
Ergebnissen aufgrund von Grad und Ursache der Lahmheit oder auch Alter,
Körpergröße und Körperbau zu reduzieren, wurde hier das Modell der induzierten
Lahmheit herangezogen, und es wurden ausschließlich Hunde einer Rasse —dem
Beagle— eingesetzt. Den Hunden wurde dafür eine mittelgradige, reversible, distale
Hinterhandlahmheit mit Hilfe einer „Stein im Schuh“-Methode induziert. Dies
ermöglicht die genaue Bestimmung des Lahmheitsgrades und legt eine genaue
Lokalisation für die Ursache der Lahmheit fest, welche sich bei allen untersuchten
Probanden leicht reproduzieren ließ.
Die Ergebnisse dieser Arbeit werden in zwei getrennten Studien präsentiert, um eine
angemessene Einordnung der einzelnen Befunde in die vorhandene Datenlage und
eine eingehendere Diskussion dieser zu erlauben. Dabei werden in der ersten Studie
die in dieser Arbeit erhobenen kinetischen und metrischen Daten mit den
Ergebnissen bereits publizierter Arbeiten verglichen, welche Hunde mit klinischen
und induzierten Lahmheiten ganganalytisch untersucht haben. Es wird diskutiert
inwiefern die Ergebnisse auf den klinisch lahmen Hund übertragen werden können
und welche Auswirkungen Lahmheiten generell auf die Belastung der übrigen
Gliedmaßen haben. Die zweite Studie konzentriert sich auf die Veränderungen in
den Aktivierungsmustern der ausgewählten Bein- und Rückenmuskeln, die mit einer
Lahmheit einhergehen. Hierzu werden die erstmalig mittels OEMG erhobenen
Aktivierungsmuster des M. triceps brachii und des M. longissimus dorsi zuerst mit
vorhandenen Befunden intramuskulärer Ableitungen verglichen, um das methodische
Vorgehen für diese beiden Muskeln zu verifizieren. Anschließend werden die
16

Material und Methoden
Unterschiede im Rekrutierungsmuster aller untersuchten Muskeln zwischen
gesunden und lahmenden Hunden diskutiert und in die aktuelle Befundlage
eingeordnet.
2. Material und Methoden
2.1. Hunde
Insgesamt wurden in dieser Studie neun klinisch gesunde Beagle mit einem Alter von
4 ± 1 Jahren (Mittelwert ± Standardabweichung) untersucht. Das mittlere
Körpergewicht der zwei weiblichen und sieben männlichen Hunde betrug 15,1 ± 1,1
kg. Alle Hunde gehörten zur Beagle-Population der Klinik für Kleintiere der Stiftung
Tierärztliche Hochschule Hannover. Die Hunde wurden allgemein und orthopädisch
untersucht, um eine Lahmheit bzw. eine eventuell vorliegende Erkrankung am
Bewegungsapparat auszuschließen. Zu Beginn der Studie wurden die Beagle an das
Laufen auf dem Laufband gewöhnt und die Datenaufzeichnung startete, sobald sich
die Hunde gleichmäßig und entspannt auf dem Laufband bewegten. Zur reversiblen
Lahmheitsinduktion wurde eine mit Watte gepolsterte Styroporkugel (Durchmesser
von 9,5 oder 16 mm) zwischen Haupt- und die Vorderballen positioniert und mittels
Mullbinde und Klebeband für die Dauer der Untersuchung unter der Pfote der
rechten Hintergliedmaße fixiert (s. Abb.1 in Abdelhadi et al. 2012). Alle
Untersuchungen wurden in Übereinstimmung mit dem Deutschen Tierschutzgesetz
durchgeführt und durch das Niedersächsische Landesamt für Verbraucherschutz und
Lebensmittelsicherheit (LAVES) geprüft und genehmigt (Nr. 12/0717).
2.2. Datenaufzeichnung
Die simultane Aufzeichnung der metrischen, kinetischen und elektromyographischen
Daten erfolgte im Schritt (0,9 m/s) und im Trab (1,4 m/s) jeweils zuerst ohne und
dann mit induzierter Hinterhandlahmheit auf einem instrumentierten Laufband.
17

Material und Methoden
2.2.1. Kinetische Messungen
Die Aufzeichnung der kinetischen Daten erfolgte durch vier in das Laufband
integrierte Kraftmessplatten (Model 4060-08, Bertec Corporation, Columbus, Ohio,
USA). Es wurden die Bodenreaktionskräfte (Aufzeichnungsrate 1000 Hz) in vertikaler
(Fz), kraniokaudaler (Fy) und mediolateraler (Fx) Richtung für jede Gliedmaße
separat aufgezeichnet. Die vertikale Bodenreaktionskraft wurde zur objektiven
Bestimmung des induzierten Lahmheitsgrades herangezogen.
2.2.2. Elektromyographische Messungen
Oberflächenelektromyographische Ableitungen wurden vom M. triceps brachii an
beiden Vordergliedmaßen, vom M. vastus lateralis an beiden Hintergliedmaßen und
vom M. longissimus dorsi auf Höhe L3/L4 beidseits unter der Verwendung von
selbstklebenden Oberflächen-Gelelektroden (H93SG; Arbo; Tyco Healthcare,
Deutschland) durchgeführt. Hierfür wurde das Hautareal über dem zu
untersuchenden Muskel rasiert, gereinigt und entfettet, bevor die Elektroden an den
mittels skelettaler Landmarken definierten Stellen angebracht wurden (Abb. 1 in
Studie II). Die Ableitfläche der Elektroden betrug 1,6 cm im Durchmesser und der
Elektrodenabstand war 2,5 cm. Die Oberflächenelektroden wurden immer von dem
gleichen Untersucher an der vorher definierten Lokalisation angebracht, um die
Variabilität der Platzierung zwischen den Hunden so gering wie möglich zu halten.
2.3. Datenanalyse
Die Auswertung der kinetischen und elektromyographischen Daten wurde anhand
von 10 aufeinanderfolgenden Schrittzyklen pro Hund und Gangart durchgeführt. Die
in Vicon Nexus (Vicon Motion Systems Ltd, Oxford, UK) aufgezeichneten vertikalen
Bodenreaktionskräfte und elektromyographischen Daten wurden zuerst zeitnormiert
und dann in Microsoft Excel (Excel, Microsoft Corp, Redmond, Wash, USA) für die
weitere Bearbeitung exportiert. Das weitere Vorgehen bei der Datenaufbereitung und
die jeweilige statistische Auswertung sind detailliert in Fischer et al. subm. (Studie I
und II) beschrieben.
18

Studie I
3. Studie I
Die folgende Studie wurde am 08.10.2012 bei The Veterinary Journal eingereicht.
Akzeptiert am 12.04.2013.
Compensatory load redistribution in walking and trotting dogs with hind limb
lameness
S. Fischer a , A. Anders a , I. Nolte a , N. Schilling b *
a
University of Veterinary Medicine Hannover, Foundation, Small Animal Clinic,
Hannover, Germany
b
Friedrich-Schiller-University, Institute of Systematic Zoology and Evolutionary
Biology, Jena, Germany
* Corresponding author
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3.1. Abstract
This study evaluated adaptations in vertical force and temporal gait parameters to
hind limb lameness in walking and trotting dogs. Eight clinically normal adult Beagles
were allowed to ambulate on an instrumented treadmill at their preferred speed while
the ground reaction forces were recorded for all limbs before and after a moderate,
reversible, hind limb lameness was induced. At both gaits, vertical force was
decreased in the ipsilateral and increased in the contralateral hind limb. While peak
force increased in the ipsilateral forelimb, no changes were observed for mean force
and impulse when the dogs walked or trotted. In the contralateral forelimb, the peak
force was unchanged, but the mean force significantly increased during walking and
trotting; vertical impulse increased only during walking. Relative stance duration
increased in the ipsilateral hind limb when the dogs trotted. In the contralateral fore
and hind limbs, relative stance duration increased during walking and trotting, but
decreased in the ipsilateral forelimb during walking. Analysis of load redistribution
and temporal gait changes during hind limb lameness showed that compensatory
mechanisms were similar regardless of gait. The centre of mass consistently shifted
to the contralateral body side and cranio-caudally to the side opposite the affected
limb. These biomechanical changes indicate substantial short- and long-term effects
of hind limb lameness on the musculoskeletal system.
Keywords: Canine, Gait analysis; Hind limb lameness; Force plate
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3.2. Introduction
More than half of the musculoskeletal problems in dogs are caused by joint diseases
affecting the hind limb (i.e. hip and knee; Johnson et al., 1994) and are commonly
associated with alterations in the gait (i.e. lameness) due to the animal’s effort to
unload the affected limb. The biomechanical consequences of orthopaedic diseases,
such as hip dysplasia and cranial cruciate ligament rupture, have been evaluated by
investigating the load bearing characteristics of either the affected hind limb only
(Gordon et al., 2003; Hoelzler et al., 2004; Conzemius et al., 2005; Evans et al.,
2005; Madore et al., 2007) or both hind limbs (Budsberg et al., 1988; Voss et al.,
2008; Ragetly et al., 2010; Böddeker et al., 2012; Seibert et al., 2012). Fewer studies
have evaluated the effects of hind limb lameness on the forelimbs (Rumph et al.,
1993, 1995; Dupuis et al., 1994; Jevens et al., 1996; Katic et al., 2009).
Nevertheless, unloading one limb causes biomechanical adaptations in all remaining
limbs and results in an irregular gait pattern and a compensatory redistribution of limb
loading.
During the standard orthopaedic examination, dogs are usually ambulated at different
speeds and gaits to diagnose lameness. Since locomotor forces increase with speed
and depend on gait (Riggs et al., 1993; McLaughlin and Roush, 1994; Renberg et al.,
1999; Evans et al., 2003; Voss et al., 2010), not only may lameness be more
apparent during trotting compared to walking (Quinn et al., 2007; Voss et al., 2007),
but the compensatory mechanism used by the animal may differ. Additionally, the
fundamental biomechanical differences between walking and trotting (i.e. legs
behaving like inverted pendula vs. ‘pogo sticks’; Cavagna et al., 1977) may result in
differences in the locomotor adaptations to lameness. Previous studies have
evaluated induced hind limb lameness in trotting dogs (O’Connor et al., 1989; Rumph
et al., 1993, 1995; Dupuis et al., 1994) or clinical lameness in walking dogs
(Budsberg et al., 1988; Katic et al., 2009; Böddeker et al., 2012). It is uncertain if
dogs show the same locomotor adaptations to hind limb lameness when walking and
trotting.
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In dogs, as in most quadrupedal mammals, fore and hind limbs play different
functional roles during locomotion (Gray, 1968). The forelimbs exert a net-braking
force, while the hind limbs exert a net-propulsive force during steady state locomotion
(Budsberg et al., 1987; Riggs et al., 1993; Bertram et al., 1997; Lee et al.,1999).
Forelimbs function as compliant struts (Carrier et al., 2008), whereas hind limbs
function as levers (Schilling et al., 2009). Regardless of gait, the forelimbs bear a
greater proportion of the dog’s bodyweight (BW) in comparison with the hind limbs
(Budsberg et al., 1987; Rumph et al., 1994; Bertram et al., 2000; Bockstahler et al.,
2007; Voss et al., 2010). Therefore, when the function of a limb is partially lost, the
dog’s mechanism to cope with this loss has been expected to differ depending on
whether a fore or a hind limb is affected (Roy, 1971; Leach et al., 1977). To gain a
better understanding of the compensatory load-shifting mechanisms in lame dogs,
we induced a moderate, reversible, load-bearing hind limb lameness in Beagles while
they were walking and trotting on an instrumented treadmill, and evaluated the
changes in the ground reaction force (GRF) and temporal gait parameters. Force
plate analysis was used because it is an accurate and objective way of evaluating
limb function and provides a reproducible measurement of the load bearing
characteristics of the limbs. Inducing hind limb lameness allowed for a direct
comparison of the gait parameters between sound and lame dogs and the precise
determination of the degree and cause of lameness.
The aims of this study were: (1) to determine changes occurring in the vertical GRF,
i.e. peak vertical forces (PFz), mean vertical forces (MFz) and vertical impulse (IFz),
as well as the temporal gait parameters (i.e. footfall pattern, relative stance duration)
in all four limbs; (2) to determine whether the observed locomotor adaptations
differed between the gaits; and (3) to determine whether the compensatory
mechanisms in response to hind limb lameness differed from the ones used to cope
with forelimb lameness. To address the latter, we compared our results with the ones
from a previous study (Abdelhadi et al., 2013), which used the same experimental
design and therefore allowed for a direct comparison of load redistribution strategies.
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3.3. Materials and Methods
3.3.1. Animals
Eight Beagles aged 4 ± 1 years (mean ± standard deviation, SD) were used in this
study. The sample size sufficient for this study was determined using Win Episcope
2.0 with a level of confidence of 95%, a power of 80% and the outcome measures
PFz, MFz and IFz (Thrusfield et al., 2001). The BW (mean ± SD) of the two females
and six males was 15.2 ± 1.1 kg. All dogs belonged to the Beagle population of the
Small Animal Clinic of the University of Veterinary Medicine, Hannover, Germany.
Inclusion criteria were absence of lameness (see results) and orthopaedic
abnormalities in the previous clinical examination. Before data collection, the dogs
were habituated to ambulating on the treadmill. Data collection started as soon as the
dogs were walking and trotting smoothly and comfortably. All experiments were
carried out in accordance with the German Animal Welfare guidelines of the State of
Lower Saxony (approval number 12/0717).
3.3.2. Study design
To allow for comparison of the compensatory load redistribution mechanisms in
forelimb vs. hind limb lameness, the same experimental protocol as in Abdelhadi et
al. (2013) was used in the current study, but lameness was induced in the right hind
limb (i.e. ipsilateral hind limb, Hi). Before inducing lameness, each Beagle walked
(0.9 m/s) and trotted (1.4 m/s) on a horizontal treadmill. Despite the short temporal
overlap in ground contacts between the forelimbs at the faster gait (duty factor, D >
0.5; i.e. running walk according to Hildebrand (1966); Fig. 1), from a mechanical point
of view, this gait represented a trot (i.e. using spring-mass mechanics; Cavagna et
al., 1977) and will subsequently be referred to as trot. The selected speeds were
determined during the habituation sessions, as were the preferred speeds for the
dogs at the respective gait. At these speeds, the dogs ambulated smoothly and
comfortably matched the treadmill speed, which allowed us to record single limb
forces (see below).
After recording the control trials, a moderate and reversible hind limb lameness was
induced using a small sphere, which was coated with cotton gauze and taped under
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the paw with adhesive tape and bandages. The size of the sphere (9.5 or 16.0 mm in
diameter) depended on the degree of lameness it induced in a given dog. The
degree of lameness was evaluated based on the GRF data. To be able to compare
our data with previous results (Abdelhadi et al., 2013), we aimed at an unloading of
~30–40% with regard to PFz (in %BW) compared with the sound condition.
3.3.3. Data collection and analysis
Data collection and analysis are described in detail in Abdelhadi et al. (2013). A
treadmill with four separate belts and force plates underneath each belt (Model 4060-
08, Bertec) was used to record single limb GRF (sampling rate 1000 Hz). Data were
recorded and evaluated to ensure a sufficient number of valid steps using Vicon
Nexus (Vicon). Control data comprising at least 5–10 trials, each lasting up to 30 s
and covering between 48 and 65 strides, were recorded for each dog while walking
and trotting comfortably at the selected speed. After a break of approximately 15 min,
lameness was induced and the data collection repeated. To evaluate kinetic
changes, 10 valid consecutive strides were selected for each dog, gait and condition.
Mean ± SD for PFz, MFz and IFz were calculated for all four limbs. Additionally,
relative stance duration (i.e. duration of stance phase as percentage of total stride
duration = D), as well as symmetry indices for the vertical forces of the fore and hind
limbs, were determined. After manual identification of the footfall events in Vicon
Nexus using the GRF, the force data were time normalised to 100% of the stance
duration of the respective limb and transferred to Microsoft Excel for further analysis.
The vertical force parameters were then normalised to the dog’s BW using the
following equation:
GRFs (%BW) = Fz * 100/(BM *9.81).
These BW-normalised data were used to compare the load-bearing
characteristics among the four limbs before and after lameness was induced (Steiss
et al., 1982):
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% BW bearing = Fz of the limb/total Fz of all limbs*100.
Symmetry in the vertical force and temporal variables was quantified using the
following equation (Herzog et al., 1989):
(3) SI = 100*(Xi – Xc)/(0.5*(Xi + Xc)).
In this equation, X represents the mean value of PFz, MFz or IFz of the ipsilateral (i)
and the contralateral (c) limbs from the 10 steps. Footfall patterns and D were
evaluated to test for significant differences in the temporal gait parameters due to
lameness. A stride cycle begins with the contact of the affected limb (ipsilateral hind
limb, Hi) and ends with its subsequent touch-down. Therefore, one locomotor cycle
comprises one complete stance and one complete swing phase of the reference
limb.
3.3.4. Statistical analyses
Data were tested for normal distribution using the Kolmogorov–Smirnov test. The
significance of the differences in PFz, MFz and IFz between the sound and lame
conditions was determined using one-way analysis of variance (ANOVA) for repeated
measures, followed by a post hoc Tukey test. Paired t tests were used to compare
relative stance durations between sound and lame conditions. P values

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peak in the m-shaped force curve (Fig. 2). In the contralateral hind limb, PFz, MFz
and IFz increased significantly at both gaits. Additionally, PFz increased significantly
during walking and trotting in the ipsilateral forelimb, while no significant changes
were observed in MFz and IFz. While PFz remained unchanged, MFz significantly
increased during both walking and trotting in the contralateral forelimb. In this limb,
IFz increased during walking, but not during trotting (Fig. 3).
3.4.2. Symmetry indices
For the sound condition, no asymmetry was detected between the right and left
forelimb, or between the right and left hind limb, either during trotting or during
walking (Table 2). After lameness was induced, asymmetry significantly increased in
all GRF parameters of the hind limbs during walking and trotting. Symmetry indices
for PFz and IFz for the forelimbs indicated significant changes for walking but not for
trotting.
3.4.3. Relative stance duration
In the lame condition, relative stance duration significantly increased in the ipsilateral
hind limb while the dogs were trotting; thereby lift-off was significantly delayed (Table
3; Fig. 1). Relative stance duration was significantly increased in the contralateral
forelimb and hind limb during walking and trotting compared to the sound condition.
This increased stance duration was associated with a significant later lift-off of the
contralateral forelimb during walking and of the contralateral hind limb during trotting.
Relative stance duration significantly decreased in the ipsilateral forelimb during
walking.
3.5. Discussion
Prior to the induction of lameness, we observed no significant differences in GRF
values (PFz, MFz and IFz) between the two forelimbs and the two hind limbs in
walking and trotting dogs. Correspondingly, the calculated symmetry indices were in
the normal range (

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2007), which indicated symmetrical load distribution between the two forelimbs and
the two hind limbs. The values of this study compared well with previous
observations in dogs (Budsberg et al., 1993; Fanchon and Grandjean, 2007; Voss et
al., 2008). Each forelimb bore about 30% and each hind limb about 20% of the dog’s
BW. Comparison with previous results (Budsberg et al., 1987; Jevens et al., 1993;
Rumph et al., 1994; Bertram et al., 2000; Bockstahler et al., 2007) confirmed that the
Beagles in the current study were sound and affirmed that the data collected before
hind limb lameness was induced were valid as a control.
In most published studies in which hind limb lameness was induced in dogs, the
vertical GRF parameters (PFz, MFz and IFz) were significantly lower in the affected
limb (Fig. 3) and IFz and PFz were increased in the contralateral hind limb (O’Connor
et al., 1989; Rumph et al., 1993, 1995; Dupuis et al., 1994; Jevens et al., 1996), the
exceptions to these studies being Budsberg (2001) and Ballagas et al. (2004).
However, adaptations in the vertical GRF parameters in forelimbs varied among
studies (Fig. 3). Similar to the observations in induced lameness, most clinical
studies observed a decrease in GRF values in the affected hind limb and an increase
in these values in the contralateral hind limb, while the results for the forelimbs varied
again among the studies (Fig. 3). Taken together, comparison of the results from this
study with clinical studies shows that the load redistribution pattern observed in
walking dogs which were lame due to stifle disease was most comparable with the
results from this study.
A confounding factor when comparing different studies is that one or more
parameters critical to the recorded gait parameters may vary. For example, speed,
gait or breeds have been shown to affect GRF characteristics (Riggs et al., 1993;
McLaughlin and Roush, 1994; Renberg et al., 1999; Evans et al., 2003; Mölsa et al.,
2010; Voss et al., 2010, 2011). Furthermore, differences in data collection (e.g. force
plates in a walkway vs. instrumented treadmill) or the degree and cause of lameness
(e.g. location within the limb or induced vs. clinical lameness) may have an impact on
the compensatory load shifting. For example, unloading of the affected limb in dogs
with induced stifle joint lameness due to transaction of the craniate cruciate ligament
or synovitis (33–81% reduction in PFz; O’Connor et al., 1989; Rumph et al., 1993,
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1995; Dupuis et al., 1994; Jevens et al., 1996; Budsberg, 2001; Ballagas et al., 2004)
generally produced a greater effect than in dogs with clinical stifle or hip joint
lameness (2–18%; Budsberg et al., 1988; Hofmann, 2002; Katic et al., 2009;
Böddeker et al., 2012). This may partially explain why the locomotor adaptations to
hind limb lameness observed in this study, inducing a 34 ± 9% reduction in PFz,
compared better with the more severe lameness studied previously (Dupuis et al.,
1994).
To limit variability in the results introduced by differences among patient populations
and the experimental setting, and to allow for the direct comparison between the
sound and the lame condition in the same individual, lameness was induced in this
study instead of enrolling patients. Furthermore, the induced lameness model
controlled for the cause and degree of lameness. Therefore, in contrast to clinical
patients, which may only show lameness during faster gaits when greater locomotor
forces act and thus the level of discomfort and pain increases, the degree of
unloading was the same during walking and trotting in this study, forcing the animal
to redistribute loading for both gaits.
Despite profound mechanical differences between the two gaits studied, such as the
inverted pendulum vs. the spring-mass behaviour of the legs and thus differences in
the trajectory of the centre of mass (CoM) of the body (Dickinson et al., 2000), the
load redistribution was comparable in this study. In both gaits, the BW was shifted to
the contralateral side and cranially. Only one difference was observed; IFz increased
in the contralateral forelimb during walking, but did not significantly change during
trotting (Fig. 3). Similarly, in dogs with induced forelimb lameness, load redistribution
was comparable between walking and trotting (except PFz in the contralateral
forelimb; Abdelhadi et al., 2013). Therefore, all other factors being equal (e.g. cause
and degree of unloading, breed), dogs which walk and trot at their preferred speeds
appear to redistribute the loading of the limbs in a similar way.
Furthermore, during both walking and trotting, relative stance duration increased in
both limbs contralateral to the affected limb. However, gait-dependent differences
were observed in the stance adaptations of the ipsilateral limbs; relative stance
duration decreased in the forelimb during walking and increased in the hind limb
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during trotting. The shorter contact time, associated with a larger peak force, most
likely acted as a compensatory mechanism so that the mean force and impulse in the
ipsilateral forelimb could be maintained. The longer contact times of both hind limbs
during trotting resulted in a reduction of the shared swing phase of the hind limbs.
During walking, the significant increase in the relative stance duration of the
contralateral forelimb was first and foremost due to a later lift-off. Since this later liftoff
is associated with a greater limb retroversion (S. Fischer unpublished
observations), the paw of the contralateral forelimb would be placed closer to the
CoM, which may facilitate the unloading of the affected hind limb (Roy, 1971).
Compared to the sound condition, relative stance duration of the affected hind limb
decreased significantly during walking, but not during trotting.
In dogs, the cranio–caudal body mass distribution has been shown to vary slightly
among breeds, but the forelimbs consistently bear a greater percentage of BW than
the hind limbs. In the Beagles, as in other mesomorphic breeds, the forelimbs bear
~60% and the hind limbs ~40% of the BW (Rumph et al., 1994; Bertram et al., 2000;
Katic et al., 2009; Abdelhadi et al., 2013). Due to this difference in loading, the dog’s
mechanism to cope with fore vs. hind limb lameness was expected to differ
(O’Connor et al., 1989; Rumph et al., 1993, 1995; Dupuis et al., 1994; Jevens et al.,
1996; Katic et al., 2009). However, the comparison of the changes in the vertical
GRF values and the temporal gait parameters shows some striking similarities.
Since the same experimental design, cause and degree of lameness were used, the
results of the present study are comparable with those of Abdelhadi et al. (2013); in
both studies, there were reductions in PFz at walk (35 ± 9% vs. 34 ± 4%,
respectively) and trot (33 ± 9% vs. 34 ± 12%), respectively. While the ipsilateral hind
limb showed no change when forelimb lameness was induced, PFz increased in the
ipsilateral forelimb in hind limb lameness. However, this increase was combined with
a decreased stance duration, which resulted in unchanged MFz and IFz, similar to
the results for the ipsilateral hind limb in forelimb lameness (Abdelhadi et al., 2013).
Thus, changes in load redistribution and temporal gait variables were very similar
and appeared not to be dependent on whether a forelimb or a hind limb was affected.
These observations suggest that: (1) ground contact times decreased in the limb
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ipsilateral to the affected limb and increased in the contralateral limbs; and (2) the
CoM was shifted to the contralateral body side and to the rear in forelimb lameness
and to the front in hind limb lameness.
3.6. Conclusion
The lameness model used in this study controlled several parameters, which
probably introduce variability in the results and permitted precise determination of the
degree and cause of lameness. When all variables are comparable, dogs ambulating
at their preferred speeds redistribute the load among the limbs and adapted their
temporal gait parameters regardless of the gait and whether a forelimb or a hind limb
is affected. Dogs unloaded the affected limb and shifted the CoM to the contralateral
side and cranio- caudally to the side opposite to the affected limb.
3.7. Acknowledgements
The authors wish to thank J. Abdelhadi, A. Fuchs, V. Galindo-Zamora and D.
Helmsmüller for discussions and their assistance in the data collection and analyses.
This study was supported via a scholarship to SF by Modul Graduiertenkolleg
Biomedizintechnik des SFB 599 funded by the German Research Foundation (DFG)
(to IN), Hannoversche Gesellschaft zur Förderung der Kleintiermedizin e.V. (HGFK),
and the Center of Interdisciplinary Prevention of Diseases related to Professional
Activities (KIP) funded by the Berufsgenossenschaft Nahrungsmittel und
Gastgewerbe, Erfurt and the Friedrich-Schiller-University Jena (to NS).
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Renberg, W.C., Johnston, S.A., Ye, K., Budsberg, S.C., 1999. Comparison of stance
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Riggs, C.M., DeCamp, C.E., Soutas-Little, R.W., Braden, T.D., Richter, M.A., 1993.
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Rumph, P.F., Kincaid, S.A., Baird, D.K., Kammermann, J.R., Visco, D.M., Goetze,
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Rumph, P.F., Kincaid, S.A., Baird, D.K., Kammermann, J.R., West, M.S., 1995.
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Schilling, N., Fischbein, T., Yang, E.P., Carrier, D.R., 2009. Function of extrinsic
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Seibert, R., Marcellin-Little, D., Roe, S.C., DePuy, V., Lascelles, B.D., 2012.
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3.9. Tables and Figures
Tab. 1. Load distribution indicated by peak vertical forces (PFz), mean vertical forces
(MFz), and vertical impulse (IFz) in % bodyweight (BW) for the sound condition
and when lameness was induced in the right hind limb (ipsilateral hind limb, H i ).
Significant at * P

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Tab. 2. Symmetry indices for the sound condition and when lameness was induced
in the right hind limb (i.e., ipsilateral hind limb). Perfect symmetry is given at SI=0.
Negative values indicate that the respective parameter was greater for the
contralateral than the ipsilateral limb; positive values indicate the opposite. Significant
at * P

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Tab. 3. Relative stance duration (D) in sound dogs and when lameness was induced
in the right hind limb (ipsilateral hind limb, H i ). Significant at * P

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Fig. 1. Stride cycle with mean ± standard deviation (SD) stance duration for footfall
patterns of all eight Beagles during walking (A) and trotting (B) for the sound (control)
condition (black bars) and after lameness was induced (grey bars) in the right
hindlimb (ipsilateral hindlimb, H i ). Stance duration was the interval between touchdown
to lift-off of a paw. *Touch-down of the paw of a limb after induced lameness
was shifted significantly during walking (F c P < 0.05) and at trotting (H c P < 0.05; H i P
< 0.01), in comparison with results for that same limb in the sound condition. Stride
cycle was the interval between touch-down to next touch-down of the same limb.
F c = contralateral forelimb. F i = ipsilateral forelimb H c = contralateral hind limb. H i =
ipsilateral hind limb (i.e., affected limb, bold).
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Fig. 2. Vertical ground reaction forces of all eight Beagles during walking (A) and
trotting (B) for the sound (control) condition (black) and after lameness was induced
(grey) in the right hind limb (ipsilateral hind limb, H i ). Plotted are the mean values as
well as the standard deviations (SDs) as error bars. Stance duration was the interval
between touch-down to lift-off of the respective limb.
F c = contralateral forelimb. F i = ipsilateral forelimb H c = contralateral hind limb. H i =
ipsilateral hind limb (i.e., affected limb, bold).
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Fig. 3. Summary of the results of this study and previous studies illustrating the
changes in the GRF parameters due to induced (A) and clinical (B) hind limb
lameness. Triangles pointing upwards indicate a significant increase in the respective
parameter and limb. Triangles pointing downwards indicate a significant decrease of
the parameter. Horizontal bars represent no change. Solid symbols illustrate the
observations for the walk, open symbols for the trot.
F c = contralateral forelimb. F i = ipsilateral forelimb H c = contralateral hindl imb. H i =
ipsilateral hind limb (i.e., affected limb, bold). PFz = peak vertical force. MFz = mean
vertical force. IFz = vertical impulse.
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4. Studie II
Die folgende Studie wurde am 04.02.2013 bei PloS One eingereicht.
Manuskript Nummer: PONE-S-13-06194
Adaptations in muscle activity to induced hindlimb lameness in trotting dogs
S. Fischer a , I. Nolte a , N. Schilling b *
a
University of Veterinary Medicine Hannover, Foundation, Small Animal Clinic,
Hannover, Germany
b
Friedrich-Schiller-University, Institute of Systematic Zoology and Evolutionary
Biology, Jena, Germany
*Corresponding author
Short title: Muscle activity adaptations to hindlimb lameness
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4.1. Abstract
Muscle tissue has a great intrinsic adaptability to changing functional demands.
Triggering more gradual responses such as tissue growth, the immediate responses
to altered loading conditions involve changes in the activity patterns. Because a loss
of limb function is associated with marked deviations in the gait pattern,
understanding the muscular responses in laming animals will provide further insight
into their compensatory mechanisms as well as help to improve treatment options to
prevent musculoskeletal sequelae in chronic patients. Therefore, this study evaluated
the changes in muscle activity in adaptation to a moderate, load-bearing hindlimb
lameness in two leg and one back muscle using surface electromyography (SEMG).
In eight sound adult dogs that trotted on an instrumented treadmill, bilateral, bipolar
recordings of the m. triceps brachii, the m. vastus lateralis and the m. longissimus
dorsi were obtained before and after lameness was induced. Consistent with the
unchanged vertical forces as well as temporal parameters, neither the timing nor the
excitement changed significantly in the m. triceps brachii. In the ipsilateral m. vastus
lateralis, peak activity and integrated SEMG area were decreased, while they were
significantly increased in the contralateral limb. In both sides, the duration of the
muscle activity was significantly longer due to a delayed offset. These observations
are in accordance with previously described kinetic and kinematic changes as well as
changes in muscle mass. Alterations in the activation patterns of the m. longissimus
dorsi concerned primarily the unilateral activity and is discussed regarding known
alterations in truncal and limb motions. The results of this study using a transient
hindlimb lameness model indicate that SEMG is a valuable diagnostic tool to detect
muscular adaptations to altered functional demands. Hence, it should be further
established in basic and clinical veterinary medicine in order to improve therapeutic
and rehabilitative management of orthopedic patients.
Keywords: gait analysis, canine, electromyography, Canis
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4.2. Introduction
Muscle is one of the most plastic tissues in the animal body. Its great phenotypic
plasticity allows it to adapt to various tasks and respond to changing functional
demands throughout life (reviewed in [1]). While immediate responses to altered
functional requirements involve for example changes in muscle recruitment and
activation patterns, more gradual adaptations include quantitative and qualitative
changes in gene expression as well as tissue growth and remodeling [2,3]. When
diseased or injured, however, an animal must immediately respond to the new
situation to ensure survival and this is first and foremost accomplished by
adaptations in muscular recruitment.
To cope with the loss of limb function, animals have evolved compensatory
strategies, and the resulting lameness is marked by deviations of the animal’s gait
from the physiological pattern. Locomotor adaptations to lameness include changes
in kinetics and kinematics as well as muscle activity. While the changes in the ground
reaction forces (GRF) (e.g., hindlimb lameness in dogs [4-9]) or the motion patterns
(e.g., [10-17]) are comparatively well established, adaptations in muscle activity have
only been studied marginally. Nonetheless, the consistently observed redistribution of
body weight and the dynamic shift of the position of the center of body mass (CoM)
alters the loading of the limbs and the trunk and must be met and are accomplished
by changes in muscle function. Because such changes in muscle function trigger
more gradual tissue responses [3] and muscles are the primary determinant of joint
loading, stimulating skeletal remodeling or joint degeneration [18], understanding the
adaptations in muscle activity to altered functional demands will provide insight into
their short- and long-term effects on the musculoskeletal system.
One mean to evaluate muscle function is to record the electrical signal associated
with the activation of the muscle fibers (i.e., electromyography, EMG). Besides its
widespread use in basic physiological and biomechanical studies, EMG is a standard
tool in medical research, sport sciences and rehabilitation in humans with nowadays
hundreds of publications a year [19]. Compared to that, EMG seems still in the
fledging stages in veterinary medicine [20]. EMG has been used in numerous studies
to document the activity of a series of limb and back muscles in sound dogs for
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example during trotting (e.g., [21-30]), but only very few studies used it to evaluate
muscular adaptions to lameness [18,31,32]. To limit the invasiveness during data
collection, supracutaneous recordings using surface electrodes are nowadays
commonly obtained for human patients [33]. In animal patients, surface
electromyography (SEMG) has only recently been used to study muscle function in
sound [34-36] and lame horses [31] as well as in sound [37,38] and lame dogs [32].
Compared to human subjects, cooperativeness and tolerance to skin manipulation,
but also the substantial differences in skin properties (e.g., tightness) may have
hindered the use of SEMG as a diagnostic tool in animals so far.
To establish the changes in muscle activity in adaptation to a partial loss of limb
function, we recorded the activity patterns in two limb and one back muscle in dogs
before and after a moderate load-bearing hindlimb lameness was induced. Bipolar
SEMG recordings were obtained bilaterally while the dogs trotted on a horizontal
treadmill. To accommodate changes in the work performed and the forces
transmitted, muscle recruitment may be modulated in its timing and/or its intensity
[30]; therefore, we evaluated both parameters in the current study. The two limb
muscles examined –m. triceps brachii, m. vastus lateralis– are part of the extensor
groups of the elbow and knee that serve to resist gravity (i.e., ‘antigravity muscles’;
39]) and are first and foremost active during the stance phase [23]. We hypothesized
that changes in limb loading will be reflected by changes in the muscles’ activation
patterns. Specifically, we expected the greater vertical force reported for the hindlimb
contralateral to the affected limb ([9] and references therein) to result in an increased
activity of the contralateral m. vastus lateralis. Conversely, the reduced loading of the
affected hindlimb should be associated with a decreased activity of the ipsilateral m.
vastus lateralis. It has been discussed controversially whether or not the load-bearing
characteristics of the forelimbs are affected by hindlimb lameness (summarized in
[9]), but our own results from a related study showed no consistent changes in the
vertical force. Therefore, we hypothesized, that the activity of the m. triceps brachii
would not significantly change.
As in other quadrupeds, the epaxial muscles in dogs play a central role in stabilizing
and mobilizing the trunk; that is, they stabilize the trunk against inertial loading,
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provide a foundation for the production of mechanical work by the limbs, and
integrate the coordinated action of the limbs [24,27,29]. Particularly the lumbar region
functions to provide a firm base for extrinsic hindlimb muscle action by stabilizing the
pelvis and controlling the forces transmitted between the limbs and the trunk [28].
Because in laming animals, both the forces exerted by the limbs as well as pelvic and
truncal motions are altered in order to shift the CoM away from the affected limb, we
expected the activity pattern of the lumbar epaxial muscles (i.e., the m. longissimus
dorsi) to be significantly different after lameness was induced.
4.3. Materials and Methods
4.3.1. Ethics statement
Data collection for this study was carried out in strict accordance with the German
animal welfare guidelines. All experiments were approved by the ethics committee of
the State of Lower Saxony (No 12/0717).
4.3.2. Animals and experimental design
Eight adult and clinically sound individuals (7 males, 1 female; mean±SD: 4±1 years;
15.1±1.2 kg) of the Beagle population of the Small Animal Clinic of the University of
Veterinary Medicine Hannover Foundation (Germany) participated in this study. The
simultaneously recorded ground reaction forces as well as the previous clinical
examination confirmed that all dogs were sound [9].
After habituation, data collection started as soon as the dogs trotted smoothly and
comfortably on the horizontal four-belt treadmill that was equipped with a force plate
underneath each belt (Model 4060-08, Bertec Corporation). Treadmill speed was set
at 1.4 m/s for both lame and sound trials. This speed represented the preferred (i.e.,
steady-state) trotting speed of the dogs and was determined during the habituation
period. Control data were collected after warm-up and before a reversible moderate
supporting lameness was induced in the right hindlimb by evoking pressure on the
paw sole (reduction in peak vertical force: 33±9%). Lameness was induced using a
small sphere of 9.5 or 16 mm in diameter, which was coated with cotton and taped
under the paw of the right hindlimb (for details, see [40]). The body side on which
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lameness was induced is hereafter referred to as ipsilateral in contrast to the
contralateral, sound body side. After data collection, dogs ambulated on the treadmill
again without any sign of residual lameness.
4.3.3. Data collection
Bipolar recordings were obtained bilaterally from the m. triceps brachii, the m. vastus
lateralis and the m. longissimus dorsi using SEMG. After gentle preparation of the
skin (i.e., clipping, shaving, cleaning, degreasing), disposable Ag-AgCl electrodes
with a circular uptake area of 1.6 cm in diameter and an interelectrode distance of 2.5
cm were applied (H93SG, Arbo). Electrode placement was the same for each
individual before and after lameness was induced because the data for the control
and the lame conditions were recorded in the same session. The same experimenter
(SF) applied all electrodes to ensure consistency in the recording sites between body
sides and among individuals.
For the m. vastus lateralis, electrode placement followed the recommendations by
Bockstahler and colleagues [38]. That is, the midpoints of the lines connecting the
posterior superior iliac spine and the patella and the patella and the trochanter major
were determined. Then, the electrodes were placed dorsal and ventral of the line
connecting these two midpoints (Fig. 1). Electrodes for the m. triceps brachii were
positioned halfway along the line connecting the Tuberculum majus humeri and the
olecranon. Muscle activity of the m. longissimus dorsi was recorded at the lumbar
level L3/L4. Electrode location was midway between the vertebral articulation of the
last rib and the most cranial aspect of the iliac crest and about a finger’s breadth
lateral to the spinous processes. After placement, the electrodes were connected to
the transmitters (Zero wire EMG, Aurion), which transferred the signal wireless to a
PC. Electromyographic signals were recorded simultaneously with the GRF using
Vicon Nexus (Vicon motion systems Ltd.). Data were sampled at 2,000 Hz, amplified
1,000 times and collected in the range from 10 Hz to 1.000 Hz. The transmitters were
carefully secured with tape and hair clips to minimize motion artifacts. But, despite
thoroughly securing the electrodes and transmitters, not all recordings could be
evaluated in each individual.
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4.3.4. Data analysis
To allow for the direct comparison between muscle activity and limb function, as
indicated by its load-bearing characteristic, the same 10 strides as evaluated in a
previous study were analyzed herein [9]. Touch down and lift off were manually
defined in Vicon Nexus using the vertical component of the GRF (sampling rate
1,000 Hz); force threshold was set at 13 N. SEMG data were high-pass filtered at 20
Hz, low-pass filtered at 300 Hz, and subsequently smoothed using a moving window
of 10 ms. SEMG signals were time-normalized to the same stance and swing phase
durations to facilitate comparisons of timing with reference to footfall events (i.e.,
each phase covered 50% of the stride cycle resulting in altogether 201 bins per
sampled stride; for details see 30]. These filtered and time-normalized data were
then exported to Microsoft Excel for further analysis.
To evaluate differences in timing and intensity of the muscle activity, data analysis
follows previously established protocols (see [30] and references therein). Briefly,
SEMG signals were amplitude-normalized using the muscle’s average activity during
the sound condition. For this, the mean activity was determined for the control data
and then, each bin of both the sound and the lame trials was divided by this mean.
By normalizing the values for each dog to the mean activity of the control prior to
generating the statistics for all dogs, the pattern from one dog did not overwhelm the
pattern from another (e.g., because of differences in signal strengths due to different
skin properties etc.). From these data, grand averaged curves were calculated for
each muscle and each dog.
For each dog and muscle, the time of the peak activity was ascertained and
compared between conditions. Furthermore, on- and offset times of the muscle
activity were determined using a threshold that was twice the baseline activity of the
control data. For this, first, baseline activity was established by averaging the values
from a fraction (i.e., 20 bins) of the stride cycle when the muscle was inactive. This
period of inactivity was determined by visual inspection and covered the values
between 75% and 84% of the stride cycle in the m. triceps brachii, 39% to 49% in m.
vastus lateralis and 17% to 27% (N=3) or 50% to 59% (N=2) in the m. longissimus
dorsi. The respective muscle was considered active when the SEMG amplitude was
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above this threshold for 7.5±9.5% of the stride cycle (i.e., 15±20 bins); except the
ipsilateral m. vastus lateralis, for which a longer period was chosen because of the
greater fluctuations of the EMG signal due to cross-talk (see discussion). Conversely,
muscle activity ended when the amplitude was below the threshold for 7.0±5.0% of
the stride cycle (i.e., 14±10 bins). The period of time the activity had to be above or
below the threshold varied somewhat among subjects and muscles due to
differences in the baseline activity and was therefore crosschecked visually.
Additionally to comparing the timing of the muscle activity, recruitment intensity was
compared between control and induced-lameness data using peak activity and
integrated SEMG area (i.e., the sum of the bins of the phase- and amplitudenormalized
signal when the muscle was active). To further specify significant
differences in muscle activity between sound and lame conditions, we compared the
signal on a bin-by-bin basis. For this, the difference between the muscle’s activity in
the sound and the lame condition was calculated and then compared with the
hypothesized difference of zero by computing 97.5th and 2.5th percentiles of the
difference when averaged across dogs. If these percentiles encompassed zero, the
null hypothesis was accepted. If they failed to encompass zero (i.e., both 97.5th and
2.5th percentiles were greater than or less than zero), the null hypothesis was
rejected and the change in muscle excitation across conditions significant.
4.3.5. Statistical analyses
Wilcoxon signed rank tests were used to compare integrated SEMG area, peak
activity as well as the timing of the muscle activity. Because of the lower sample size,
paired t-tests were used to compare the data for the m. longissimus dorsi. In this
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The m. triceps brachii showed a biphasic activation pattern. A first activity was
observed between late swing and late stance phase. The second burst started
shortly before lift off and lasted throughout the first half of the forelimb’s stance phase
(Fig. 2). Compared with the sound condition, neither the integrated SEMG area nor
the timing of the muscle activity were significantly changed in the ipsi- or the
contralateral forelimb when hindlimb lameness was induced (Tab. 1).
4.4.2. M. vastus lateralis (N=7)
The m. vastus lateralis was active during most of the stance phase; its activity started
during the last quarter of the swing phase and lasted till about 40% of the stride cycle
(Fig. 2). Compared with the activity during the sound condition, excitation decreased
significantly by 16±15% (mean±SD) in the ipsilateral and increased significantly by
66±43% in the contralateral hindlimb after lameness was induced (integrated SEMG
area, Tab. 1). Accordingly, maximum amplitude changed significantly in both
hindlimbs. While peak activity occurred significantly later in the contralateral limb, its
timing was unchanged in the ipsilateral limb. In both hindlimbs, the duration of the
activity increased significantly due to a delayed offset (ipsilateral by 13±6%,
contralateral by 29±23% of the respective stride cycle). The bin-wise comparison
shows that the increase in activity occurred mainly during the second half of the
stance phase in the contralateral limb, while the change in activity in the ipsilateral
muscle occurred during the first half of stance (Fig. 2). A second and smaller activity
was observed during the first third of the swing phase. This activity was excluded
from the analysis because it most likely represents cross-talk (see discussion).
4.4.3. M. longissimus dorsi (N=5)
The m. longissimus dorsi was active during the second half of the stance phase and
during the second half of the swing phase (Fig. 2). Thus, its pronounced biphasic
activity ended around lift off and touch down, respectively. Compared to the sound
condition, the first and greater burst associated with the stance phase started later
and reached its maximum activity later in the contralateral m. longissimus dorsi (Tab.
1). Furthermore, peak activity of the second burst was significantly smaller in the
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contralateral side. All other EMG parameters did not significantly change when
hindlimb lameness was induced.
4.5. Discussion
4.5.1. M. tricpes brachii
The m. triceps brachii showed a biphasic activity with a first burst of activity starting
shortly before touch down and lasting throughout most of the stance phase and a
second activity starting shortly before lift off and ending about halfway through swing
phase. Comparisons with previous results from trotting dogs show that the first
activity observed in this study agrees well with intramuscular recordings [21-23].
When dogs trot, both the long and the lateral head become active prior touch down
and remain active till mid-stance or during the first two thirds of the stance phase,
respectively [21-23]. Therefore, the first activity observed in the current study using
SEMG likely represents a compound signal from the activity of at least the long and
the lateral heads of the m. triceps brachii. Whether also activity of the accessory
head, situated deep and adjacent to the lateral head [41], plays a role is open as no
recording from this head exists. Because it is eccentrically, the muscle’s activity
around touch down has been suggested to control the passive flexion of the elbow
joint induced by gravitational forces and allow for elastic energy storage; the
subsequent concentric activity extends the elbow joint and thereby provides
propulsion during the stance phase [23].
In contrast to previous intramuscular EMG (IEMG) in dogs [21,23] and other
mammals (e.g., cat [42], horse [43], goat [44]), a second activity associated with the
early swing phase was observed in the current study. A function of the biarticular,
long head of the m. triceps brachii in shoulder flexion has been suggested based on
its topography [41] and shortening pattern [23]. This together with the fact that the
timing of the second burst coincides with the flexion of the shoulder joint after lift off
(e.g., [23,45,46]) suggests that this activity may be associated with shoulder flexion
during the first half of swing. That the long head was inactive during early swing
phase in previous IEMG recordings may be due to differences in electrode
placement. EMG is a compound signal composed of the summed action potentials of
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the muscles fibers located close to the recording site. Therefore, the recorded signal
depends on the number and kind of motor units near the electrode, and differences in
electrode location result in considerable differences in the recorded signal (e.g.,
within the muscle or in vs. on its surface, [47]). Additionally, this second burst could
be the result of cross-talk. SEMG does not record the signal directly from the muscle
as does IEMG; thus, the electrodes potentially detect more than one muscle signal.
Both, the activity pattern [21-23] and the anatomical position [41] of the m. brachialis
relative to the electrodes are consistent with the second activity recorded herein.
Furthermore, skin movements relative to the underlying muscles may lead to slightly
different electrode locations during the course of a stride, thus detecting activity from
neighboring muscles depending on the inertia of the skin. Dogs, in particular, have
loose skin and therefore skin movements likely facilitate cross-talk in this species.
After lift off, the inertia of the skin places the electrodes slightly more cranially (pers.
observ., SF) so that activity, for example, from the m. brachialis is potentially
recorded.
After lameness was induced, neither the intensity nor the timing of the activity was
significantly different. Accordingly, only minor changes in the vertical force and the
temporal gait parameters were observed in the companion study using the same
experimental approach as this study [9]. In agreement with our results in dogs, no
kinematic changes occurred in the forelimbs in trotting horses with a transient
hindlimb lameness [48] and the recruitment of a forearm muscle (i.e., the m. extensor
digitorum longus) was also not significantly different in hindlimb lame horses
compared with non-lame horses [31].
4.5.2. M. vastus lateralis
The main activity of the m. vastus lateralis muscle observed from the last 20% of the
swing to ca. 40% of the stance phase compares very well with previous
intramuscular recordings in trotting dogs [21-23] and other mammals (e.g., cat
[49,50]; horse [51-53]). This corroborates the previously suggested landmarks for the
electrode positioning for this muscle [32,38]. However, compared with intramuscular
recordings, our SEMG recordings showed an additional, small activity between lift off
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and about 30% of the swing phase. Because this activity was not observed using
IEMG, it possibly is, as mentioned above, either the result of differences in the
specific electrode location or of cross-talk (e.g., due to skin movement). After lift off,
the inertia of the skin may place the electrodes slightly more caudally so that activity
from the m. biceps femoris is recorded. Furthermore, the m. vastus lateralis is part of
the quadriceps muscle group of which both the m. vastus intermedius as well as the
m. rectus femoris muscles are in close proximity to the m. vastus lateralis [41].
Activity patterns of all three, the m. biceps femoris caudal, the m. vastus intermedius
and the m. rectus femoris, coincide with the burst observed during early swing in the
current study [22,27,30,54].
After lameness was induced, excitation of the ipsilateral m. vastus lateralis was
significantly reduced. Consistent with that, the affected limb bears a smaller
proportion of the body weight in hindlimb lame dogs [4-9]. Furthermore, the timing of
the muscle’s activity was changed; that is, muscle activity ended slightly but
significantly later during stance. Analysis of the temporal gait parameters showed
that the stance duration was significantly increased in the hindlimb in which lameness
was induced, consistent with an increased period of activity [9]. But, the prolonged
stance phase may not solely explain the later offset as we performed a stride phasenormalization.
However, without more detailed analyses of the kinematic changes
associated with hindlimb lameness, interpretation is hampered.
Contrary to this study, Bockstahler and colleagues [32] report a significantly greater
activity in the clinically worse limb compared with the contralateral limb in dogs with
hip osteoarthritis. They make an increased necessity to stabilize the stifle during
early stance and to ovoid pain responsible for the greater excitation. Additionally, the
dogs enrolled in the study were patients and thus the time for habituation may have
been limited. Unfamiliarity with the experimental situation (e.g., [55]) as well as
‘protective guarding’ for example in anticipation of pain (e.g., [56-58]) lead to
substantial changes in muscular recruitment such as greater muscle activity.
Alternatively, not mutually exclusive to the above, recruitment patterns and the
changes thereof may vary depending on whether a distal, supporting lameness (this
study) or a proximal lameness due to osteoarthritis [32] exists.
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Compared to the sound condition, both the intensity and the duration of the activity of
the m. vastus lateralis were significantly increased in the contralateral limb after
lameness was induced. Accordingly, this limb bears a greater proportion of the body
weight in trotting dogs when lame and its stance duration is significantly increased
(e.g., [4-9]). As the bin-wise comparison shows, muscle excitation was primarily
increased during the second half of stance; that is, when the hindlimb exerts
propulsive forces and the muscles activity is concentrically to produce knee
extension [23,45,46]. Therefore, the increased activity during the second half of
stance is most likely associated with the pronounced production of knee extension to
propel the body forward. Accordingly, in dogs with hindlimb lameness, the sound limb
produces a greater share of the propulsive forces in order to compensate for the lost
function of the other limb [59,60].
In accordance with the reduced recruitment of the m. vastus lateralis in the affected
limb, several studies have reported a substantial loss in muscle mass in the
quadriceps group in chronic hindlimb lame patients [61-65]. Because the sound limb
did serve as a control in these studies, potential hypertrophy due to the
compensatory greater activity in the contralateral hindlimb remains to be evaluated.
4.5.3. M. longissimus dorsi
The mid-lumbar SEMG recordings of this study showed the typical biphasic activity
with a greater burst associated with the ipsilateral stance phase and a smaller one
occurring during the ipsilateral swing phase well-documented for the m. longissimus
dorsi in several mammals (e.g., dog [21,22,24,28,29]; cat [66]; horse [34,35,67-69]).
Because our results agree well with previous recordings from this muscle, the
anatomical landmarks used are well-suited electrode positions. Nevertheless, it
should be kept in mind that the activity patterns of the mid-lumbar m. longissimus
dorsi and m. multifidus are very similar [24,28]. Therefore, potential cross-talk can not
be easily detected and the recorded signal potentially represents the summed activity
of these two epaxial muscles.
Because the activity on one body side coincides with the activity on the other side,
bilateral activity results. Bilateral activity is required to mobilize and stabilize the trunk
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in the sagittal plane [29]. Manipulations of the locomotor forces in trotting dogs
showed that the bilateral activity stabilizes the trunk against the inertia of the CoM
(‘sagittal rebound’, [24]) and the vertical components of the extrinsic hindlimb
muscles (e.g., limb retractors, [28]). Assuming that dogs manage hindlimb lameness
like horses, the reduced vertical acceleration of the CoM associated with the lame
hindlimb’s stance phase and the compensatory increase of CoM motions during the
sound hindlimb’s stance [70,71] should result in diagonally opposite but alike
changes of the two bursts. For example, an increased need to stabilize the trunk in
the sagittal plane can be expected to be associated with an increased first burst of
the ipsilateral and an increased second burst of the contralateral muscle (i.e., the two
bursts which coincide on the two sides). Because the corresponding bursts did not
show concordant changes after lameness induction, rather all significant changes
concerned the unilaterally greater activity, changes in the forces acting in the sagittal
plane seem to be too small to result in substantial changes in the muscle activity in
this study.
In sound trotting dogs, the unilaterally greater activity acts to stabilize the trunk in the
transverse plane against gravitational forces and in the horizontal plane against the
horizontal components of the extrinsic hindlimb muscles [28]. Pronounced long-axis
rotations of the pelvis and the trunk towards the sound side were observed in lame
horses and suggested as one mean to unload the affected limb [70,72]. To produce
these rotations, increased activity of the epaxial as well as the extrinsic limb muscles
(i.e., the m. gluteus medius) contralateral to the affected side can be expected
[28,27]. Although not significant, the results of this study show an increased first
activity of the m. longissimus dorsi contralateral to the lame limb. Increased activity of
m. gluteus medius is furthermore expected because of the changes in limb trajectory;
that is, hindlimb lame animals such as horses skew their limbs medio-laterally in
order to move the sound limb more directly under the CoM [48]. In agreement with
that, greater activity was observed in this muscle in lame horses during walking [31].
Because the unilateral epaxial muscle activity is also associated with the stabilization
of the pelvis against the action of the ipsilateral protractor and the contralateral
retractor of the hindlimb [28], changes in timing and/or the amplitude of limb motions
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likely cause changes in the epaxial muscle activity. Unfortunately, no detailed
kinematic analyses are available for dogs with a distal, load-bearing hindlimb
lameness. In horses, however, the sound hindlimb’s protraction is delayed [48],
consistent with the delayed onset and peak activity of the m. longissimus dorsi
observed herein.
4.6. Concluding remarks
SEMG is well suited if the activity of a muscle group rather than of a single muscle is
of interest and intramuscular recordings are available for reference (e.g., to assess
cross-talk). Nevertheless, using well-defined skeletal landmarks for reproducible
electrode locations and comparing experimental conditions directly with one another,
an interpretation of the changes in muscle activity is possible despite potential crosstalk
and skin movements. The results of this study show that changes in timing
and/or the amplitude of muscles’ activities in adaptation to the partial loss of a limb’s
function are detectable in dogs using SEMG. These changes were consistent with
previously described alterations in kinematic and kinetic gait parameters as well as in
muscle mass in chronically lame patients. Because changes in the functional
demands and thereby in activity lead to phenotypic changes of the muscle due to its
great intrinsic plasticity, understanding muscular adaptations to changes in the
locomotor patterns (e.g., due to lameness) will help to improve treatment options and
rehabilitative exercises (e.g., developing targeted muscle training to avoid atrophy).
Furthermore, because joint loading is primarily determined by muscular forces and
joint stabilization via co-contraction may result in changed joint loading, despite
similar kinematics and/or an unloading of the limb indicated by the GRF [73],
understanding alterations in muscle activity is critical to assess potential changes in
the internal forces. Thus, analyzing muscle activity patterns provides diagnostic
insight into gait changes in addition to the well-established kinetic or kinematic
parameters. At present, kinesiological EMG is on the fringe of veterinary medicine,
but its proven benefit as a tool in basic and applied research, physiotherapy,
rehabilitation, and sports training in humans should encourage a broader
establishment and application in veterinary sciences.
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4.7. Acknowledgements
The authors wish to thank J. Abdelhadi, A. Anders, A. Fuchs, V. Galindo-Zamora,
and D. Helmsmüller for discussions and their assistance in the data collection and
analyses. We also thank S.M. Deban and C. Anders for helping with the design of the
data analysis. L. Harder helped with Figure 1. This study was supported by the
Graduiertenkolleg Biomedizintechnik of the SFB 599 funded by the German
Research Foundation (scholarship to SF) and the Hannoversche Gesellschaft zur
Förderung der Kleintiermedizin e.V. (both to IN) as well as the Berufsgenossenschaft
Nahrungsmittel und Gastgewerbe Erfurt (to NS). This study represents a portion of a
thesis submitted by the first author as partial fulfillment of the requirements for a
Doctor of Veterinary Medicine degree.
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4.9. Tables and Figures
Tab. 1. Timing of the on- and offset (on, off) and the peak (tmax) of the muscle
activity (mean±SD in % of the stride cycle) as well as peak activity (max) and
integrated SEMG area (mean±SD) for all muscles on the body side on which
hindlimb lameness was induced (ipsilateral) and the muscles on the opposite side
(contralateral). Note that in case of the limb muscles, only the main activity
associated with the stance phase was evaluated. For the back muscle, the two bursts
were analyzed separately plus the summed activity (area 1+2). Sample size was N=7
for the leg and N=5 for the epaxial muscles. Significant differences between sound
and lame conditions at * p

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contralateral
ipsilateral
sound lame sound lame
M. triceps brachii
on 94.6±1.9 95.0±1.6 n.s. 94.0±1.8 93.5±2.6 n.s.
off 68.0±4.7 68.6±3.8 n.s. 71.5±3.1 71.7±3.0 n.s.
tmax 11.9±8.7 10.3±8.4 n.s. 7.2±2.6 15.8±10.4 n.s.
max 2.4±0.8 2.5±1.0 n.s. 2.4±0.7 2.3±0.8 n.s.
area 183.2±4.8 209.4±31.3 n.s. 183.0±4.6 187.5±32.7 n.s.
M. vastus lateralis
on 85.0±2.5 88.1±1.3 n.s. 85.6±2.5 83.9±2.8 n.s.
of 31.8±5.6 40.4±6.3 * 34.0±2.6 38.3±2.3 *
tmax 18.1±3.0 21.7±3.9 * 17.8±4.9 20.5±8.5 n.s.
max 2.2±0.3 3.0±0.8 * 2.4±0.7 1.3±0.4 *
area 102.1±21.4 164.0±25.2 * 108.5±18.7 92.3±26.7 *
M. longissimus dorsi
on 26.9±1.9 29.5±3.5 * 27.9±2.0 25.8±1.9 n.s.
off 45.3±1.7 46.5±2.1 n.s. 45.1±2.7 44.3±1.9 n.s.
tmax 32.9±2.6 37.7±2.0 * 33.9±2.5 32.4±4.0 n.s.
max 2.7±0.4 3.3±0.9 n.s. 2.9±0.4 2.7±0.5 n.s.
area 70.1±6.6 74.7±12.3 n.s. 69.6±15.5 75.8±13.1 n.s.
1st
on 81.6±2.9 83.6±3.7 n.s. 80.9±2.7 81.6±3.9 n.s.
off 93.1±2.5 94.0±2.3 n.s. 92.9±1.6 92.7±1.7 n.s.
tmax 88.6±2.4 90.2±1.0 n.s. 85.6±2.4 86.4±2.7 n.s.
max 2.0±0.2 1.7±0.3 * 1.9±0.4 1.7±0.3 n.s.
area 36.8±7.9 29.3±15.7 n.s. 36.5±11.6 32.5±7.6 n.s.
2nd
area 1+2 106.9±12.3 104.1±26.9 n.s. 106.0±20.5 108.3±19.2 n.s.
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Fig. 1. One of the subjects partially instrumented to illustrate the electrode
positioning (for details on the skeletal landmarks, see Material & Methods).
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Fig. 2. Activity patterns of the m. triceps brachii, m. vastus lateralis, and the m.
longissimus dorsi shown as time-normalized SEMGs (median plus upper and lower
quartiles for each of the 201 bins) across the dogs and 10 strides per dog for the
sound (black) and the lame (grey) conditions. Graphs on the left represent the
recordings from the body side contralateral to the lame side; graphs on the right
show the activity patterns from the muscles ipsilateral to the lame side. Numbers in
parenthesis after the muscle names indicate sample size. Each x-axis shows the
stance and swing phase normalized to 50% of the stride cycle in all recordings. The
x-axis for the m. triceps brachii refers to the stride cycle of the forelimbs; the x-axes
of the m. vastus lateralis and the m. longissimus dorsi refer to the footfall events of
the hindlimbs. Each plot has a single y-axis and is scaled to the maximum amplitude
observed for that particular recording site; hence SEMG amplitudes can be
compared between sound and lame conditions within a given plot. Grey and black
blocks above the SEMG traces indicate bin-by-bin differences in amplitude between
both conditions, with the color indicating the condition with significantly greater
amplitude; no block indicates no differences. The arrows indicate significant
differences in the muscle activity between sound and lame conditions: Horizontal
arrows point to changes in timing of the on- or offset (bottom of the graph) and the
maximum activity (top of the graph). Vertical arrows indicate significant changes in
SEMG area. Stars indicate significant differences in peak activity.
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70

Diskussion
5. Diskussion
Bei eingeschränkter Funktion einer Gliedmaße versuchen Tiere, durch Umverteilung
der Last und veränderte Rekrutierung von Muskeln den partiellen Verlust dieser
Gliedmaße zu kompensieren. Diese Studie untersuchte ausgewählte metrische,
kinetische und elektromyographische Parameter, um die
Kompensationsmechanismen von Hunden mit einer Hinterhandlahmheit besser
verstehen zu können. Hierfür wurden Beagle im Schritt und im Trab auf einem
instrumentierten Laufband untersucht und ausgewählte metrische, kinetische und
elektromyographische Gangparameter vor und nach Induktion einer distalen
Stützbeinlahmheit verglichen.
Da bei der Fortbewegung der gesamte Körper als Einheit funktioniert und lokale
Beeinträchtigungen Auswirkungen auf den kompletten Organismus haben können,
ist es sinnvoll, nicht nur eine einzelne Gliedmaße, sondern den Körper insgesamt zu
betrachten. Analysen der Auswirkungen von Lahmheiten auf das Bewegungsmuster
erfolgten bisher jedoch hauptsächlich unter Betrachtung der betroffenen sowie
eventuell noch der kontralateralen Gliedmaße. Beispielsweise wurde bei dem
Vergleich von zwei Operationsmethoden bei Hunden mit Kreuzbandriss nur die
betroffene (z. B. CONZEMIUS et al. 2005) oder beide Hintergliedmaßen (z. B.
BÖDDEKER et al. 2012) untersucht, um den Heilungsverlauf zu evaluieren. Um
jedoch Aussagen über die Auswirkungen einer Hinterhandlahmheit auf die Funktion
der übrigen Extremitäten und insbesondere des Rumpfes machen zu können, ist
eine Betrachtung des Gesamtbildes notwendig. Roy (ROY 1971) vergleicht dieses
Zusammenspiel der Körperteile mit einem Symphonieorchester: „All parts must
blend into a harmonious pattern — from the gentle sway of the head and tail for
balance to the coordinated efforts of each limb and body muscle to accomplish its
special function. Conversely, also like an orchestration, if all movements are not
attuned to a whole a major fault should be evident.” Somit ist eine gemeinsame
Betrachtung aller an der Fortbewegung beteiligten Körperteile von großer
Bedeutung. In dieser Arbeit wurden daher alle vier Gliedmaßen und der Rücken
gemeinsam betrachtet.
71

Diskussion
Bei Bewegungsanalysen von gesunden und auch erkrankten Hunden kann man
verschiedene Parameter zur Quantifizierung des Gangbildes bzw. seiner
Veränderungen im Vergleich zur physiologischen Norm heranziehen. Zumeist
werden Daten der Metrik, der Kinetik, der Kinematik und des EMG beurteilt.
Bisherige Studien haben meist nur einen dieser Parameter betrachtet und für die
Interpretation des Gesundheitsstatus genutzt. Beispielweise bei Hunden mit
kranialem Kreuzbandriss wurden die Veränderungen in der vertikalen
Bodenreaktionskraft (z. B. O`CONNOR et al. 1989) oder der Kinematik der
Hinterextremitäten (z. B. DECAMP et al. 1996) untersucht. Da aber bei einer
Bewegungstrajektorie ganz unterschiedliche externe und interne Kräfte wirken
können oder auch die gleiche Bewegung durch unterschiedliche Aktivierungsmuster
der Muskulatur erzeugt werden kann, sollten möglichst viele Parameter gemeinsam
betrachtet werden, um die physiologische Beanspruchung und Benutzung der
betroffenen Extremität zu prüfen. Dies ist aber nur durch die Integration der Befunde
verschiedener Analysetechniken möglich, die im Erkenntnisgewinn über die
Betrachtung einzelner Parameter hinausgehen. Dem sind oft pragmatische Grenzen
gesetzt. Um alle genannten Aspekte —Metrik, Kinetik, Kinematik, EMG— simultan
aufzeichnen zu können, müssen viele technische Voraussetzungen gegeben sein,
was nicht immer geleistet werden kann. Bei der vorliegenden Arbeit ist es gelungen,
drei dieser Komponenten —die Metrik, die Kinetik und das EMG— für die
Untersuchung der Kompensationsmechanismen beim Hund mit Hinterhandlahmheit
parallel aufzuzeichnen, um so den komplexen Vorgang der Fortbewegung des
Hundes beurteilen zu können.
Anhand der erfolgten Untersuchungen können wir bestätigen, dass es bei einer
Lahmheit an einer Hintergliedmaße zu einer Entlastung des betroffenen Beines und
zu einer kompensatorischen Umverteilung der Last auf die kontralaterale Seite
kommt. Die maximale und mittlere vertikale Kraft, sowie der vertikale Impuls zeigten
eine signifikante Verminderung in der betroffenen und eine signifikante Erhöhung in
der kontralateralen Hintergliedmaße. Diese Veränderungen der vertikalen Kräfte
stimmen mit vorangegangenen Studien überein (PFz: BUDSBERG et al. 1988;
RUMPH et al. 1993; DUPUIS et al. 1994; RUMPH et al. 1995; JEVENS et al. 1996;
72

Diskussion
HOFMANN 2002; BÖDDEKER et al. 2012; MFz: BÖDDEKER et al. 2012; IFz:
BUDSBERG et al. 1988; RUMPH et al. 1995; BUDSBERG 2001; HOFMANN 2002;
BALLAGAS et al. 2004; BÖDDEKER et al. 2012). Bezüglich der zeitlich-räumlichen
Veränderungen im Schrittzyklus konnten wir feststellen, dass es im Trab in dem
betroffenen Hinterbein zu einer Verlängerung der Stemmphasendauer und damit
verbunden zu einem späteren Abfußungszeitpunkt gekommen ist. Genauso
veränderten sich die genannten Parameter in der kontralateralen Hintergliedmaße.
Bei Hunden mit kranialem Kreuzbandriss zeigte sich hingegen in der betroffenen
Gliedmaße eine verkürzte Dauer der Standphase (VILENSKY et al. 1994; RAGETLY
et al. 2010; DE MEDEIROS et al. 2011; BÖDDEKER et al. 2012).
Weiterhin konnte anhand der durchgeführten Untersuchungen gezeigt werden, dass
es nach Induktion einer Hinterhandlahmheit auch zu einer Umverteilung der
vertikalen Bodenreaktionskräfte auf die Vordergliedmaßen kam (ipsilateral: Erhöhung
PFz; kontralateral: Erhöhung MFz und IFz). Ähnliche Beobachtungen wurden nur in
der Studie von Dupuis et al. (DUPUIS et al. 1994) gemacht, hier zeigte sich
allerdings eine Erhöhung von PFz nicht nur in der ipsilateralen, sondern auch in der
kontralateralen Vordergliedmaße. MFz und IFz wurden in der zuletzt genannten
Studie nicht untersucht. Die meisten Forschungsarbeiten, die Hunde mit induzierter
Hinterhandlahmheit betrachtet haben, konnten, sofern untersucht, keine
Veränderung der vertikalen Bodenreaktionskräfte in den Vordergliedmaßen
detektieren (z. B. RUMPH et al. 1995; JEVENS et al. 1996). Eine Vergleichbarkeit
bewegungsanalytischer Studien ist durch verschiedene Aspekte limitiert.
Beispielweise sind verschiedene technische Ausstattungen —Laufband vs.
Kraftmessplatte— verwendet worden, oder es wurde eine unterschiedliche Stärke
des Entlastungsgrades in der betroffenen Gliedmaße induziert. Diese
unterschiedlichen Voraussetzungen können u.a. ein Grund für die ungleichen
Ergebnisse in Bezug auf die Umverteilung der Kräfte auf die Vordergliedmaßen sein.
Um diese Ergebnisse auch auf den orthopädisch erkrankten Hund übertragen zu
können, müssen Vergleiche mit Studien gemacht werden, welche klinisch lahme
Hunde untersucht haben (Abb. 3 in Studie I). Beispielsweise die Arbeit von Hofmann
(HOFMANN 2002) zeigte in Bezug auf PFz und IFz Übereinstimmungen mit unseren
73

Diskussion
Ergebnissen. In gemeinsamer Betrachtung der bisherigen Befunde kann gesagt
werden, dass anhand der kinetischen Ergebnisse die distal induzierte
Hinterhandlahmheit im angewandten Lahmheitsmodell mit der klinischen Lahmheit,
welche ursächlich im Knie lokalisiert ist, am ehesten vergleichbar war, wobei man
auch hier die vorher aufgeführten Limitierungen bedenken muss.
Aufgrund der oben genannten Ergebnisse in Bezug auf die veränderte
Standphasendauer eignet sich das in dieser Arbeit angewendete Lahmheitsmodell
jedoch nicht zum Vergleich mit klinischer Lahmheit, welche durch einen kranialen
Kreuzbandriss bedingt ist. Nach Induktion der Lahmheit kam es im M. vastus lateralis
der kontralateralen Gliedmaße zu einer Erhöhung der Amplitude und zu einer
verlängerten Aktivität. Im betroffenen Bein zeigte der M. vastus lateralis eine
Verminderung der Amplitude und ein längere Aktivität im Vergleich zum nicht-lahmen
Zustand. Im Gegensatz dazu zeigte die vorangegangene EMG-Studie von
Bockstahler et al. (BOCKSTAHLER et al. 2012a), dass in der betroffenen Gliedmaße
bei Hunden mit Hüftgelenksarthrose eine vermehrte Aktivität im M. vastus lateralis
vorherrschte. Die Ergebnisse der zuletzt genannten Studie können z.B. auf eine nicht
ausreichende Habituation der Patienten an die Situation auf dem Laufband
zurückzuführen sein. Hier kann es durch die Unsicherheit der Hunde in der
Versuchssituation zu einem erhöhten Muskeltonus gekommen sein (z. B. CHAPMAN
et al. 2007).
Anhand der gemeinsamen Betrachtung aller erhobenen Parameter —Metrik, Kinetik
und EMG— lassen sich folgende Schlüsse ziehen. Durch vorherige Untersuchungen
ist bekannt, dass der M. triceps brachii als Antigravitationsmuskel (ARMSTRONG et
al. 1982) und Extensor in den Vordergliedmaßen agiert und in der Standphase aktiv
ist (GOSLOW et al. 1981). Da die Veränderungen der vertikalen
Bodenreaktionskräfte und auch der zeitlichen Komponenten beider
Vorderextremitäten geringgradig waren, hat es hier keine signifikante Auswirkung auf
das Rekrutierungsmuster des M. triceps brachii gegeben.
Der M. vastus lateralis als Teil des M. quadriceps femoris ist in der Standphase aktiv
(GOSLOW et al. 1981) und wirkt den vertikal wirkenden Kräften als
Antigravitationsmuskel (ARMSTRONG et al. 1982) und Extensor der Gliedmaße
74

Diskussion
entgegen. Wird nun eine Hintergliedmaße vermehrt bzw. vermindert oder auch
länger belastet, kann dies zu Veränderungen im Rekrutierungsmuster führen. Nach
Induktion der Lahmheit kam es in der betroffenen Gliedmaße zu einer verminderten
Aktivität des M. vastus lateralis in Übereinstimmung mit der verminderten Belastung
dieser Extremität. Im zeitlichen Verlauf des Rekrutierungsmusters zeigte sich
zusätzlich eine verlängerte Aktivität, was durch die verlängerte Standphase dieses
Beines begründet ist. Auch in der kontralateralen Hintergliedmaße können
Verbindungen zwischen den Veränderungen der vertikalen Kräfte, der metrischen
Komponenten und dem Rekrutierungsmuster des M. vastus lateralis hergestellt
werden. Die vermehrte Belastung in diesem Bein geht mit einer erhöhten Aktivierung
des M. vastus lateralis einher. Im lahmen Zustand ist die Standphase dieser
Gliedmaße verlängert, und auch das Rekrutierungsmuster des M. vastus lateralis
zeigt eine verlängerte Aktivität.
Als zentrales Element des Bewegungsapparates kann der Rücken durch eine
Lahmheit ebenfalls in seiner Beanspruchung verändert sein. Der M. longissimus
dorsi zeigt im physiologischen Zustand ein bilaterales Aktivierungsmuster, da sich die
beiden Aktivitätsphasen der rechten und linken Körperseite zeitlich überschneiden.
Diese bilaterale Aktivität während der Lokomotion dient der Stabilisierung des
Rumpfes in der sagittalen Ebene (SCHILLING u. CARRIER 2010). Untersuchungen
beim trabenden Hund mit gezielt veränderten Krafteinwirkungen während der
Lokomotion haben gezeigt, dass die bilaterale Aktivität den Rumpf gegen die
Trägheitskräfte des CoM (`sagittal rebound`; RITTER et al. 2001) und gegen die
vertikalen Kräfte der extrinsischen Hinterbeinmuskulatur (v.a. Retraktoren der
Hintergliedmaße; SCHILLING u. CARRIER 2009) stabilisiert. Bei lahmen Pferden
wurde beobachtet, dass es zu einer verstärkten Rotation des Beckens zur gesunden
Seite kommt, um das betroffene Bein zu entlasten (BUCHNER et al. 1996; GOMEZ
ALVAREZ et al. 2008). Um diese Rotation zu bewirken, müsste es zu einem
Aktivitätsanstieg in der epaxialen Muskulatur, sowie in der extrinsischen
Hinterbeinmuskulatur (z. B. M. glutaeus medius) der gesunden Seite kommen
(SCHILLING u. CARRIER 2009; SCHILLING et al. 2009). Obwohl nicht signifikant,
zeigte sich nach Induktion der Lahmheit eine erhöhte erste Aktivität im M.
75

Diskussion
longissimus dorsi kontralateral zum lahmen Bein. Zusätzlich konnte in diesem
Muskel ein späterer Beginn der Aktivität verzeichnet werden. Hier fehlen beim Hund
kinematische Untersuchungen, die eine verspätete Protraktion der gesunden
Gliedmaße, wie bei Pferden beobachtet (BUCHNER et al. 1996), als Ursache
ausmachen könnten.
Diese Ergebnisse liefern im klinischen Alltag mit orthopädischen Patienten wichtige
Aspekte. Entlastet ein Hund seine Hintergliedmaße um ca. 30%, ist immer zu
bedenken, dass in die klinische Untersuchung nicht nur die betroffene, sondern auch
die kontralaterale Gliedmaße mit einbezogen werden muss. Durch die vermehrte
Belastung bzw. Fehlbelastung des gesunden Hinterbeines kann es bei chronisch
lahmenden Hunden vermutlich zu Folgeerkrankungen wie z.B. Arthrosen,
Meniskusschäden oder frühzeitigen Verschleißerscheinungen in dem involvierten
Gelenk kommen. Obwohl eine kürzlich publizierte Studie (GALINDO- ZAMORA
2012) zeigte, dass vier Monate nach Amputation einer Hintergliedmaße, keine dieser
genannten Veränderungen mittels Magnetresonanztomographie im kontralateralen
Kniegelenk detektiert werden konnten, sind Folgeerkrankungen über die Jahre
hinweg nicht auszuschließen. Diesem Prozess muss mittels gezielter Prävention
entgegengewirkt werden. Zusätzlich kann es bei der veränderten Beanspruchung der
in den Kompensationsprozess involvierten Muskulatur z.B. durch asymmetrische
Rückenbelastung zu schmerzhaften Verspannungen kommen, welche ebenfalls beim
chronisch lahmenden Hund berücksichtigt werden müssen. Die Vordergliedmaßen
benötigen in diesem Fall aufgrund der nur geringgradigen Veränderung in der
Belastung voraussichtlich keine vermehrte Beachtung. Inwiefern sie bei stärkeren
Lahmheitsgraden in die regelmäßigen Kontrollen durch den Tierarzt einzubeziehen
sind, muss durch Untersuchungen von stärker lahmenden Hunden als in der
vorliegenden Arbeit untersucht geklärt werden.
Eine länger andauernde vermehrte oder verminderte Rekrutierung in Muskeln führt
bei Patienten zu veränderten Muskelvolumina. Die chronisch vermehrte oder
reduzierte Belastung einer Gliedmaße kann zu Hypertrophie bzw. Atrophie in
bestimmten Muskeln führen. Für den M. vastus lateralis ist bekannt, dass es bei
Hunden mit kranialem Kreuzbandriss zu einer Atrophie in der betroffenen Gliedmaße
76

Diskussion
kommt (JOHNSON u. JOHNSON 1993; MILLER 1996; INNES u. BARR 1998; CORR
2009; MOSTAFA et al. 2010). Hier wären weiterführende systematische
Untersuchungen zusätzlicher Muskeln von großem Interesse, um für diese Patienten
gezieltes Muskeltraining entwickeln und anbieten zu können. Kommt es durch die
vermehrte Rekrutierung z. B. im M. vastus lateralis zu einer Hypertrophie, ist die
veränderte Krafteinwirkung auf den Bewegungsapparat zu berücksichtigen, da die
umgebenden Muskeln die internen Kräfte und die Momente in den Gelenken
maßgeblich bestimmen (HASLER et al. 1998). So ist zu bedenken, dass durch die
veränderte Muskelrekrutierung auch die betroffenen Gelenke veränderten Kräften
ausgesetzt sind. Die Hypertrophie des M. vastus lateralis kann z. B. dazu führen,
dass der vertikale Druck auf dem Meniskus im Kniegelenk erhöht ist, was zu
Folgeschädigungen in dem Gelenk führen kann.
Obwohl als Standardmethode in der Humanmedizin etabliert, wird kinesiologisches
EMG in der Veterinärmedizin bisher so gut wie nicht verwendet. Die vorliegende
Arbeit zeigt, dass die Aufzeichnung elektromyographischer Daten beim Hund dem
Untersucher post op wichtige Informationen liefern kann, um den Heilungsverlauf zu
beurteilen. Jeder Muskel hat ein physiologisches Aktivierungsmuster, das, wie die
vorliegende Studie gezeigt hat, durch Lahmheiten verändert sein kann. Obwohl der
Hund nach einer Operation bei der visuellen Beurteilung des Ganges wieder gesund
scheint, kann die Muskelrekrutierung dennoch verändert sein. Um beurteilen zu
können, ob das Rekrutierungsmuster wieder in den physiologischen Zustand
zurückgekehrt ist, bietet das OEMG eine Möglichkeit Verlaufskontrollen post op
durchzuführen.
Die synchrone Aufzeichnung verschiedener Gangparameter beim Hund ist durch
unterschiedliche Aspekte limitiert, sollte jedoch weitergeführt werden, um einen
kompletten Funktionsüberblick des Körpers in der pathologischen Lokomotion zu
erlangen und um so die Möglichkeit zu schaffen, neue rehabilitative und
therapeutische Konzepte zu entwickeln, die über die betroffene Gliedmaße hinaus
den gesamten Körper mit einbeziehen.
77

Zusammenfassung
6. Zusammenfassung
Stefanie Fischer
Kinetische und elektromyographische Bewegungsanalyse beim Hund mit
reversibel induzierter Hinterhandlahmheit
Eine Lahmheit ist durch Abweichungen vom physiologischen Gangbild
gekennzeichnet. Wie der Hund einen partiellen Verlust der Funktion einer
Hintergliedmaße kompensiert, ist bisher aufgrund der Betrachtung einzelner Aspekte
des Gangbildes und auch der Unterschiedlichkeit der eingesetzten
Untersuchungstechniken nicht ausreichend verstanden. Ziel dieser Arbeit war, die
Veränderungen ausgesuchter metrischer, kinetischer und elektromyographischer
Parameter in Anpassung an eine Hinterhandlahmheit beim Hund zu untersuchen.
Diese Ergebnisse sollen zukünftig ein besseres Verständnis über die
Kompensationsmechanismen beim Hund liefern und so aktuelle Therapie- und
Rehabilitationsmaßnahmen verbessern.
In dieser Arbeit wurden ausgewählte biomechanische und muskelphysiologische
Gangparameter mit Hilfe der computergestützten Ganganalyse auf einem Laufband
untersucht, um Aussagen über die veränderte Belastung aller Gliedmaßen sowie
über die Anpassung zeitlicher Gangparameter und der Aktivierungsmuster von M.
triceps brachii, M. vastus lateralis und M. longissimus dorsi beim Hund mit distaler
Stützbeinlahmheit der Hinterhand zu erhalten. Um einen direkten Vergleich dieser
Parameter vor und nach Induktion der reversiblen Hinterbeinlahmheit zu
ermöglichen, wurden in Bezug auf Alter, Gewicht und Größe sehr ähnliche Beagle im
Schritt und Trab untersucht. Der Fokus dieser Arbeit lag dabei auf dem Vergleich 1)
der Fußfallmuster für eine Aussage der Veränderungen in den Bodenkontaktzeiten
und der Fußfolge, 2) der vertikalen Bodenreaktionskräfte, um die Umverteilung des
Körpergewichts analysieren zu können, sowie 3) der Aktivierungsmuster von zwei
Gliedmaßen- und einem Rückenmuskel, um Veränderungen im zeitlichen Verlauf
und/oder der Höhe der Aktivierung zu prüfen.
78

Zusammenfassung
Nach Induktion der Lahmheit in der rechten Hinterextremität waren im Schritt und im
Trab die vertikalen Bodenreaktionskräfte (PFz, MFz, IFz) in dieser Gliedmaße
vermindert und im kontralateralen Hinterbein erhöht. Kranial zeigte die ipsilaterale
Gliedmaße eine Erhöhung von PFz und die kontralaterale Gliedmaße ein Ansteigen
von MFz und eine Erhöhung von IFz im Schritt. Im Fußfallmuster zeigte sich im
Schritt in der kontralateralen Vorder- und Hintergliedmaße eine verlängerte
Standphase, vorne verbunden mit einem späteren Abfußungszeitpunkt. Im Trab kam
es ebenfalls in beiden kontralateralen Gliedmaßen zu einer verlängerten Standphase
und zusätzlich auch in der ipsilateralen Hintergliedmaße. In beiden Hintergliedmaßen
war dies mit einem späteren Abfußungszeitpunkt im Schrittzyklus verbunden. Die
elektromyographischen Ergebnisse des M. vastus lateralis als Antigravitationsmuskel
zeigten, dass eine vermehrte Belastung von der kontralateralen
Hintergliedmaße auch zu einer erhöhten Aktivierung in diesem Muskel geführt hat.
Genauso kommt es in der betroffenen Gliedmaße durch die verminderte Belastung
zu einer verringerten Aktivierung im M. vastus lateralis. Die Muskeln zeigten
beidseits eine verlängerte Aktivität, welche vermutlich durch die verlängerte
Standphase in den Hintergliedmaßen bedingt war. Die vermehrte
Muskelrekrutierung kann zu Hyper- und die verminderte Aktivierung zu Atrophie in
den betroffenen Muskeln führen. Der M. triceps brachii zeigte keine Veränderungen
im Rekrutierungsmuster, was anhand der kinetischen Ergebnisse auch erwartet
wurde. Der M. longissimus auf der linken Körperseite zeigte einen späteren Beginn
und ein späteres Auftreten der maximalen Amplitude der ersten Aktivität sowie eine
verminderte maximale Amplitude in der zweiten Aktivität. Diese Veränderungen
gehen vermutlich mit veränderten Rumpf- und Beinbewegungen einher. Der rechte
M. longissimus zeigte ein unverändertes Rekrutierungsmuster.
Zusammenfassend lässt sich feststellen, dass die verminderte Belastung einer
Hintergliedmaße zu einer kompensatorischen Umverteilung der Kräfte auf die
übrigen Gliedmaßen führt, um die Entlastung der eingeschränkten Gliedmaße zu
erlauben. Dies kann jedoch beim chronisch lahmenden Hund zu Folgeschäden in
den Gelenken der vermehrt belasteten Extremitäten führen, was bei der
orthopädischen Untersuchung immer berücksichtigt werden muss. Die damit
79

Zusammenfassung
einhergehende veränderte Aktivierung der involvierten Muskulatur muss bei
Therapie- und Rehabilitationsmaßnahmen berücksichtigt werden, um z. B. mittels
gezielten Muskeltrainings große Asymmetrien in der Belastung zu vermeiden.
80

Summary
7. Summary
Stefanie Fischer
Electromyographical and computerized gait analyses in dogs with reversible
induced hind limb lameness
To cope with the loss of a limb`s function, dogs possess compensatory strategies.
The resulting lameness is marked by deviations of the animal`s gait from the
physiological pattern. Which changes occur in ground reaction forces (GRF) as well
as the muscle activity has not been studied in detail yet. Therefore, this project was
designed to determine the changes in selected kinetic, kinematic and
electromyographic parameters associated with a moderate hindlimb lameness. The
presented results may foster new ideas for the treatment and rehabilitation of
hindlimb lame patients in future.
In order to evaluate the changes in load distribution and muscle activity patterns in
adaption to lameness, we trained dogs to walk and trot on a treadmill and recorded
the vertical ground reaction forces and the activity of two leg and one back muscle
bilaterally before and after a transient load-bearing hindlimb lameness was induced.
To allow for the comparison of these data without introducing variability due to
differences in breed, age or weight, the examined dogs were all Beagles of
comparable size and age. After lameness was induced, the vertical force was
decreased in the ipsilateral and increased in the contralateral hindlimb at both gaits.
While peak force increased, no changes were observed for mean force and impulse
in the ipsilateral forelimb when the dogs walked or trotted. In the contralateral
forelimb, peak force was not changed, but mean force increased during walking and
trotting and vertical impulse increased during walking. Relative stance duration
increased in the affected hindlimb when the dogs trotted. In the contralateral foreand
hindlimbs, relative stance duration increased during walking and trotting, but
decreased in the ipsilateral forelimb during walking. Consistent with the unchanged
vertical forces as well as temporal parameters, neither the timing nor the excitement
81

Summary
changed significantly in the m. triceps brachii. In the ipsilateral m. vastus lateralis,
peak activity and integrated SEMG area were decreased, while they were increased
in the contralateral limb. In both sides, the duration of the muscle activity was
significantly longer due to delayed offset. These observations were in accordance
with previously described kinetic and kinematic changes. Changes in the activation
pattern of the m. longissimus dorsi concerned primarily the unilateral activity and was
discussed regarding known alterations in truncal and limb motions.
The current study provides new insights into the compensatory mechanisms of
hindlimb lame dogs and its findings are informative when designing new treatment
options and rehabilitative exercises such as targeted muscle training to prevent
chronic asymmetries in the stresses of the musculo-skeletal system.
82

Literaturverzeichnis
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83

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Danksagung
9. Danksagung
Bei Herrn Prof. Dr. Nolte möchte ich mich herzlich für die Betreuung und die
Bereitstellung dieses spannenden Themas und die Möglichkeit, diese Arbeit im
exzellent ausgestatteten Ganganalyselabor der Klinik für Kleintiere Stiftung
Tierärztliche Hochschule Hannover durchführen zu können, bedanken.
Frau PD Dr. Schilling danke ich recht herzlich für ihre hervorragende Betreuung, ihre
enorme Hilfsbereitschaft und ihre außerordentliche Unterstützung bei der Erstellung
meiner Arbeit. Durch ihre herausragende Fachkompetenz sowie ihre unbändige
Leidenschaft für die Bewegungsanalyse hat sie mich bei dieser Arbeit auf besondere
Weise inspiriert.
Ein herzliches Dankeschön an die Beaglepfleger/innen für die tolle Zusammenarbeit
und natürlich an die geduldigen und liebenswerten Probanden (Alex, Alfred, Elvis,
Erwin, Lou, Malte, Nico, Peggy und Simon), ohne die die Datenaufzeichnung und der
daraus resultierende Erkenntnisgewinn nicht möglich gewesen wäre.
Ganz besonders möchte ich mich bei meinen Leuten aus der Ganganalyse für Ihre
Unterstützung jeglicher Art bedanken, insbesondere bei meiner herzlichen
Mitstreiterin Daniela Helmsmüller für die vielen fachlichen Diskussionen, ihre Hilfe
beim „Exceln“ und ihre durchweg aufmunternde Art, meinem kolumbianischen
Freund Vladimir Galindo-Zamora für den täglichen Wissensaustausch, das
Heranführen an die Datenauswertung und für die vielen sehr spaßigen Momente,
meiner liebenswerten Büronachbarin Aniela Fuchs mit Alex, für die fachlich
geprägten Konversationen, für das viele Lachen und die unvergesslich netten
Stunden auch außerhalb des Büros, bei der durchweg engagierten Alexandra Anders
für ihre Geduld, ihren unentwegten Optimismus und ihre Sorgfalt bei der
Datenaufzeichnung, bei Jalal Abdelhadi für die vielen themenbasierten Diskussionen
sowie bei Sonja Möller und Birte Goldner mit Nike, ihr alle seid großartig und ich
werde euch sehr vermissen! Nicht zu vergessen die lieben Mädels aus dem
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Danksagung
Doktorandenzimmer, besonders Lisa Harder und Anne Sieslack mit Nelly, für die
netten Gespräche, die süßen Leckereien und einfach fürs da sein!
Meinem Marco möchte ich einen herzlichen Dank für seine große Geduld mit mir,
seine motivierenden Worte, sein besonderes Verständnis und die zahlreichen sehr
lieben Aufmunterungen aussprechen. Danke, dass du immer für mich da gewesen
bist und mir so diese Zeit um ein Vielfaches verschönert und erleichtert hast.
Mein größter Dank gilt meiner Familie, besonders meinen Eltern die mich jederzeit
bedingungslos unterstützt haben und ohne die mein Traumstudium mit dieser
anschließenden lehrreichen Doktorarbeit nicht möglich gewesen wäre und meinen
Geschwistern, meinem Bienchen, Nanni, sowie Szamba und Miro für den
allerschönsten Ausgleich im Leben, Ihr seid die Besten, danke dass es euch gibt!
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