Functional limits of agreement applied as a novel method comparison tool for accuracy and precision of inertial measurement unit derived displacement of the distal limb in horses

Over ground motion analysis in horses is limited by a small number of strides and restraints of the indoor gait laboratory. Inertial measurement units (IMUs) are transforming the knowledge of human motion and objective clinical assessment through the opportunity to obtain clinically relevant data under various conditions. When using IMUs on the limbs of horses to determine local position estimates, conditions with high dynamic range of both accelerations and rotational velocities prove particularly challenging. Here we apply traditional method agreement and suggest a novel method of functional data analysis to compare motion capture with IMUs placed over the fetlock joint in seven horses. We demonstrate acceptable accuracy and precision at less than or equal to 5% of the range of motion for detection of distal limb mounted cranio-caudal and vertical position. We do not recommend the use of the latero-medial position estimate of the distal metacarpus/metatarsus during walk where the average error is 10% and the maximum error 111% of the range. We also show that functional data analysis and functional limits of agreement are sensitive methods for comparison of cyclical data and could be applied to differentiate changes in gait for individuals across time and conditions.