“…However, poor performance is highly multifactorial and comorbidities with other respiratory and nonrespiratory conditions in poorly performing horses must be considered 25, 26, 32, 33, 34. Poor performance is also difficult to define objectively, but may be assessed based on riders’ or trainers’ impression, using semiquantitative scores 12, 35, 36. Signs like delayed recovery of respiratory rate after exercise and exaggerated respiratory effort during work,37 warrant further consideration.…”