Beyond the straight line when assessing quality of movement in horses.
- abphysio
- Jul 23
- 4 min read
A practical solution for vets, physios and equine therapists who want to track the movements that matter.
As equine clinicians, we’ve all faced the same frustrations:
How do you know if your treatment truly made a difference?
How can you reliably track changes in a horse’s movement over time?
How do you pick up subtle dysfunctions that only appear under certain conditions?
Without reliable tools for field-based assessment, too many of us have been left relying on subjective visual impressions and client feedback. This makes it harder to monitor progress and leaves room for ineffective interventions to continue, which can waste time and money. Worse still, continued poor-quality movement can contribute to chronic pain and compromised welfare for the horse.
Human athletes benefit from structured outcome measures to guide rehabilitation and performance management. But equine athletes haven’t had access to the same evidence-based approach due to a lack of suitable outcome measures.
To start the process of developing a new outcome measure for horses, we asked the question: Is there a core set of in-hand movements that can reliably screen for quality of movement in horses—without requiring expensive technology?
To answer this, we conducted an online survey of equine sports medicine veterinarians, physiotherapists, and equine allied health professionals, distributed through professional associations.
81 valid responses were received.
58% of respondents were physiotherapists, 28% veterinarians, and 14% had mixed backgrounds.
These clinicians were highly experienced and saw horses daily or weekly for performance management or rehabilitation.
The average clinical experience was 13.9 years, with all participants holding undergraduate and postgraduate qualifications, plus a fifth holding multiple professional certifications.
The main limitation of this study was the sample size. So, the results should be considered descriptive and not generalised too broadly. The full journal article is available here: Visually Assessing Equine Quality of Movement: A Survey to Identify Key Movements and Patient-Specific Measures.
What the survey revealed about how clinicians are currently assessing movement
Instrumented gait analysis (kinematics, IMUs or other devices) was rarely used, with most people ticking never. Veterinarians were slightly more likely than physiotherapists to use IMUs, but overall, the use of technology in day-to-day practice is not common, and it is not necessarily suitable for all cases.
Many relied on subjective visual assessment, either live or using slow-motion video.
Nearly 50% used simple smartphone videos often or always during assessments.
Which movements matter most?
The survey confirmed what many of us already suspected: assessing only trot in a straight line is not enough to truly evaluate soundness or movement quality. By looking if a movement received a mode of always, often, sometimes or never, we were able to identify a core group of in-hand movements clinicians frequently used:
Walk and trot in a straight line on both firm and soft surfaces (viewed from front, behind, and side).
Small circles (5–10 m) at walk and trot on firm and soft surfaces.
Stepping back on firm and soft surfaces.
Hind leg cross-over on a firm surface.
Lunging on a soft surface at walk, trot, and canter (15–20 m circle).
Upward and downward transitions.
Movements that were only sometimes or never used—such as ridden work, lateral movements, or neurological reflex tests—were excluded from the proposed new assessment tool.
Clinicians reported they chose movements based on the individual case presentation. And the reasons offered for not using particular movements were predictable. Such as clinician preference or time limitations. Common barriers were not being able to access suitable facilities such as a smooth level surface, inclines or poles.
Assessment also depended on the training level of the horse and handler, which encompasses discipline specific expectations. Consider the differences between assessing a young racehorse compared to an older dressage horse.
We also asked how clinicians currently monitor the progress of more complex movements.
64% used goal setting, but most goals were informal and subjective rather than measurable.
74% relied on owner-reported outcomes, yet when asked to specify, only 7 provided measures in the form of grading: same, better, worse or different. The majority were qualitative descriptions of observed changes in behaviour or movement.
Subjective visual assessment, of live or videoed horses (including slow-motion), was the most commonly reported method to track progress of complex movements.
The Patient-Specific Functional Scale (PSFS) was familiar to many physiotherapists but less so to veterinarians.
82% agreed that a modified PSFS would be useful for complex functional movements in horses, especially when combined with clinician-scored movement tasks.
Most clinicians acknowledged the lack of objective measures for equine movement and expressed a strong desire for a structured, field-friendly tool.
This research laid the foundation for the development of the Equine Quality of Movement Score (EQoMS)—a structured, field-friendly outcome measure for assessing how horses move. The EQoMS combines:
A standardised battery of 30 core in-hand movement tests
Clear directives for what good quality looks like for each movement (similar to a dressage test)
A unique scoring system sensitive to subtle dysfunctions that may only appear in specific conditions
The EQoMS fits into routine clinical assessment—no expensive tech, no extra hassle. It helps you: Monitor progress pre- and post-treatment
Reduce subjective bias
Track rehabilitation milestones safely
Communicate movement changes clearly with owners, riders, and other team members
Strengthen your evidence-based practice.
By adopting the EQoMS, you’ll be able to document the difference your treatments make, improve communication with your clients, monitor performance and advocate for better welfare for the horses you care for.
Ready to sharpen your clinical eye?
An online training program is now available to help equine clinicians understand the terminology, practice scoring, and confidently integrate the EQoMS into their daily practice.
👉 Sign up for the EQoMS training program today: https://www.abphysio4horseandrider.com/eqoms
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