Effect of horse riding equipment in activity of trunk and lower limb muscles in equine-assisted therapy

Equine-assisted therapy uses the horse in rehabilitation and/or education of people, such as Down syndrome(SD), cerebral palsy(PC)and intellectual disability(DI). In context, the rehabilitation program and horse riding equipment should be usedaccording to the specific characteristics of each individual, becoming an ally in the quest for excellence in equine-assisted therapy programs. The aim was to evaluate the effect of riding equipment used in equine-assisted therapy on the muscular activityof trunk and lower limb of individuals with SD, PC and DI. The study included 15 individuals equally assigned to each group: SD, PC and DIwith a mean age of 16.2 (±1.10), 16 (±1.22)e 16 (±0) years,respectively. The analysis of muscle activity was performed through surface electromyography, using four variations of horse riding equipment: saddle with and without feet supported on the stirrups and blanket with and without feet supported on the stirrups. Sigma Stat 3.5®software was used for statistical analysis.The Shapiro Wilk's test was used for normality of the data, the Bartlett test for homogeneity of the variances and the Kruskal-Wallis test for repeated measures with no normal distribution.Statistically significant differences were observed forp<0.05.The SDgroup presented a greater muscular activity of trunk and lower limbs with blanket equipment without the feet supported in the stirrups (H = 15.078, p = 0.002), as in the DI group (H=8.302, p = 0.040), while inPCgroup was the saddle with feet supported in the stirrups (H=11.137,p = 0.011). The choice of riding equipment used in equine-assisted therapy interferes differently in the pattern of muscular activation of the trunk and the lower limbs, according to the pathological processes of the practitioners. It should be an important aspect to consider when planninga treatment.

Características clínicas y evolutivas del tortícolis muscular congénito / Clinical characteristics and outcome of congenital muscular torticollis

El Tortícolis Muscular Congénito (TMC), es un síndrome compartamental resultado de la afectación del músculoesternocleidomastoideo asociado a malposición intrauterina. Es la tercera anomalía músculo-esquelética más conocida en la edad pediátrica. Describir la distribución de frecuencia de las variables clínicas y evolutivas del TMC. Se realizó una investigación clínica per se, transversal, descriptiva a través de la revisión de historias clínicas de pacientes con TMC atendidos porNeuropediatría y Medicina Física / Rehabilitación del Instituto Hospital Universitario Los Andes durante el lapso 2001 - 2011. Se incluyeron 16 casos: 11 femeninos; 9 de los casos con edad al ingreso de 5 meses o más. Se observó asociación de TMC con presentación podálica en la mitad de los casos y en un tercio de los mismos con cesáreas complicadas. El motivo de consulta máscomún fue la posición lateral cervical, siendo derecha en 11 casos. Fueron constantes los hallazgos de pseudo tumoración cervical, espacio hombro-cuello y ángulos de rotación cervical disminuidos. Catorce pacientes presentaron plaquiocefalia y asimetría facial. Los pacientes menores de 3 meses de edad respondieron al tratamiento rehabilitador y los de 5 meses o más al tratamiento rehabilitadorcombinado con tratamiento quirúrgico. El diagnóstico precoz de TMC y la intervención temprana podrían favorecer el pronóstico funcional del paciente y evitar el apoyo quirúrgic.

The Congenital Muscular Torticollis (CMT) is a compartmental syndrome resulting from a disturbance of thesternocleidomastoid muscle associated with an intrauterine malposition. It is the third best known muscle-skeletal anomaly in the pediatric age. To describe the frequency distribution of the CMT clinical and evolving variables. A transversaldescriptive clinical research was conducted through the review of medical records of patients with CMT from the Neuropediatric andPhysical Medicine / Rehabilitation units of the Hospital Universitario Los Andes Institute during the period 2001-2011. 16 cases, 11 female, were reviewed, 9 of which were five or more months old at admission. Association of TMC with breech presentation in half of the cases and a third of them with complicated caesarean section was observed. The most common reason for seeking consultation was the lateral cervical position, this being at the right in 11 cases. The findings of cervical pseudo tumor were constant, shoulder-neck space and cervical rotation angles were decreased. Fourteen patients presented plaquiocefalia and facial asymmetry. Patients under 3 months of age had a positive response to rehabilitation treatment and those 5 or more months old to rehabilitation treatment combined with surgical treatment. An early diagnosis of CMT and an early intervention could promote a functional prognosis of the patient and avoid surgical support.

Transposition flap for correction of ectopic breast in Poland's syndrome using a pre-molded silicone prosthesis / Retalho de transposição para correção de mama ectópica em síndrome de Poland usando prótese de silicone pré-moldada

The authors report a variation of Poland's syndrome with ectopic right breast. Three surgeries were performed at different times: transposition flap to place the mammary gland in an anatomic position; reduction of the contralateral left breast; and implantation of a pre-molded silicone prosthesis to correct the malformation caused by the absence of the major and minor pectoral muscles. The surgeries were performed at six-month intervals, and the final outcome was new and acceptable positioning of the breasts.

Os autores apresentam uma variante da síndrome de Poland com mama direita ectópica. Foram realizados três tempos cirúrgicos: retalho de transposição para colocação da glândula mamária em posição anatômica; redução da mama contralateral esquerda; e implantação de prótese de silicone pré-moldada para correção do defeito causado pela agenesia dos músculos peitoral maior e peitoral menor. Com intervalo de seis meses entre as cirurgias, o resultado final apresenta novo posicionamento aceitável das mamas.

[ impact of exercise therapy on the musculoskeletal abnormalities of blind boy students of 12- 18 years old at Tehran Mohebbi blind school]

The purpose of this study was to examine the 13 musculoskeletal abnormalities [front head, lateral bending head, shoulder dropping, scoliosis, kyphosis, lumbar lordosis, flat back, pelvicobliguity, genu varum, x.leg, flat foot, pes cavus, and hallux valgus] after a period of exercise therapy on the blind boy students without secondary disability. In this semi-experimental research, 60 boy students were included from secondary and high school [12-18 years old] including 34 congenital blind and 26 semi blind. They were selected among 135 students at Tehran Mohebbi blind school. They were tested by measurement tools [symetrigraph, antropometer, and podioscope]. After examining the results by the New York test, the students who were diagnosed with one or more musculoskeletal abnormalities took part in four-month's exercises with 3 sessions at week. The results were registered after the end of the exercise program and administered secondary exam. The data before and after the exam were analyzed. 80 percent of the blind students at pre-exam had musculoskeletal abnormalities which are decreased to 45 percent after exercises. There were significant differences on the rate of recovery at 11 abnormalities [Exact - Sign = 0 < 0/05] and there were not significant differences at pelvicobliguity and x.leg abnormalities [Exact - Sign = 1 <0/05]. The research findings emphasized on the validation and important of exercise therapy on musculoskeletal abnormalities