Hipoterapia versus simuladores de hipoterapia como opción de tratamiento en niños con parálisis cerebral: revisión sistemática / Hippotherapy versus hippotherapy simulators as a treatment option in children with cerebral palsy: A systematic review

Introducción y objetivo: La hipoterapia (HPOT) y los simuladores de hipoterapia (SHPOT) se utilizan en niños con parálisis cerebral para lograr su máxima funcionalidad e independencia. El objetivo es conocer si la HPOT y los SHPOT producen los mismos efectos beneficiosos sobre el equilibrio, la función motora gruesa y el control postural en menores de 18 años con parálisis cerebral. Materiales y métodos: Se utilizaron como palabras clave: hippotherapy, equine-assisted therapy y cerebral palsy. Las bases de datos utilizadas fueron: PeDro, Scopus, LILACS, ScienceDirect, Cochrane Library, Web of Science y CINAHL Complete (Ebsco). Fueron incluidos ensayos clínicos aleatorizados que estudiaran el efecto de la HPOT y/o los SHPOT sobre las variables mencionadas. Resultados: Cuatro estudios evaluaron el equilibrio, 4 la función motora gruesa y 2 el control postural. La HPOT y los SHPOT produjeron beneficios en todos ellos. Conclusiones: Ambas intervenciones producen mejoras sobre las variables estudiadas, aunque aumentan con la HPOT posiblemente debido a una mayor estimulación sensorial.(AU)

Introduction and objective: Hippotherapy (HPOT) and hippotherapy simulators (SHPOT) are used in children with cerebral palsy to achieve their maximum functionality and independence. The aim is to find out if HPOT and SHPOT produce the same effects on balance, gross motor function, and postural control in children under 18 years old with cerebral palsy. Materials and methods: The keywords used were: hippotherapy, equine-assisted therapy and cerebral palsy. The databases used were PeDro, Scopus, LILACS, ScienceDirect, Cochrane Library, Web of Science and CINAHL Complete (Ebsco). Studies were included if they were randomized clinical trials that studied the effect of HPOT and/or SHPOT on the variables mentioned in these patients. Results: Four studies assessed balance, 4 studied gross motor function, and 2 investigated postural control. Both HPOT and SHPOT produced benefits in all of them. Conclusions: According to the studied variables both interventions produce similar improvements. Although, they increase with HPOT possibly due to greater sensory stimulation.(AU)

[Hippotherapy versus hippotherapy simulators as a treatment option in children with cerebral palsy: A systematic review]. / Hipoterapia versus simuladores de hipoterapia como opción de tratamiento en niños con parálisis cerebral: revisión sistemática.

INTRODUCTION AND OBJECTIVE: Hippotherapy (HPOT) and hippotherapy simulators (SHPOT) are used in children with cerebral palsy to achieve their maximum functionality and independence. The aim is to find out if HPOT and SHPOT produce the same effects on balance, gross motor function, and postural control in children under 18 years old with cerebral palsy. MATERIALS AND METHODS: The keywords used were: hippotherapy, equine-assisted therapy and cerebral palsy. The databases used were PeDro, Scopus, LILACS, ScienceDirect, Cochrane Library, Web of Science and CINAHL Complete (Ebsco). Studies were included if they were randomized clinical trials that studied the effect of HPOT and/or SHPOT on the variables mentioned in these patients. RESULTS: Four studies assessed balance, 4 studied gross motor function, and 2 investigated postural control. Both HPOT and SHPOT produced benefits in all of them. CONCLUSIONS: According to the studied variables both interventions produce similar improvements. Although, they increase with HPOT possibly due to greater sensory stimulation.

Beneficios de la hipoterapia en pacientes con esclerosis múltiple. Revisión narrativa / Benefits of hippotherapy in patients with multiple sclerosis. Narrative review

Introducción: La esclerosis múltiple es una enfermedad autoinmune desmielinizante y neurodegenerativa. Actualmente hay 2.800.000 personas con esclerosis múltiple, suponiendo la enfermedad discapacitante no traumática más común que afecta a los adultos jóvenes. En los últimos años se ha propuesto el uso de la hipoterapia en estos pacientes. La hipoterapia utiliza el movimiento del caballo para proporcionar retroalimentación sensorial. El objetivo de este trabajo es realizar una revisión de la literatura sobre la eficacia de la hipoterapia en pacientes con esclerosis múltiple. Método: Se realizó una revisión siguiendo la normativa PRISMA. Se consultaron las bases de datos de PubMed, Cinahl, PsycINFO, SPORTDiscus, Academic Search Complete, Lilacs, IBECS, CENTRAL, SciELO, y WOS. Se utilizó la herramienta Cochrane para valorar el riesgo de sesgo y la calidad de la evidencia se evaluó GRADE Resultados: La hipoterapia es eficaz en pacientes con esclerosis múltiple. La muestra fue de 179 pacientes de un total de seis estudios. El número total de sesiones osciló entre 10 y 36, con una frecuencia de una o dos veces por semana, 30 minutos sesión y una duración total de la terapia entre 8 y 24 semanas Conclusiones: La hipoterapia mejora el equilibrio, las actividades de la vida diaria, la movilidad, la fatiga, la espasticidad, la fuerza muscular y la calidad de vida en pacientes con esclerosis múltiple. (AU)

Efectos terapéuticos de la hipoterapia para personas mayores: revisión de la literatura / Therapeutic effects of hippotherapy in elderly people: scoping review

El presente trabajo tiene por objetivo realizar una revisión bibliográfica y estructurada basada en los resultados encontradosen torno a los términos Hipoterapia y Personas mayores. Para la búsqueda de referencias, se utilizó como descriptores lassiguientes palabras clave en inglés, Hippotherapy y Elderly, siendo estas palabras clave siempre introducidas en las bases dedatos del mismo idioma. Se utilizaron las bases de datos informatizadas SCOPUS, WOS, SPORTDiscus. PubMed y Cochrane. Paralimitar la búsqueda de documentos, se introdujeron cuatro criterios de inclusión: i) Mencionar al menos alguna de las carac-terísticas de la Hipoterapia para personas mayores (mínimo 20 palabras que mencionen la temática), ii) Seleccionar solamentedocumentos científicos (Artículos de revistas), pudiendo tener estos manuscritos un diseño experimental o ser estudio derevisión, iii) Ser accesible y estar disponible a texto completo o con acceso al resumen, y iiii) Estar escrito en el idioma español,inglés o portugués. Los resultados muestran que los documentos sobre Hipoterapia en personas mayores abordan tópicosde investigación diferentes, y muestran que las terapias ecuestres tienen efectos terapéuticos beneficiosos en la poblaciónde edad avanzada. Las intervenciones con Hipoterapia mejoran el equilibrio estático y el equilibrio dinámico, el equilibriopostural, la movilidad funcional, la flexibilidad, la fuerza muscular, el modo de andar y la cadencia de pasos. Disminuyen laespasticidad, provocando una disminución del riesgo de caída y una mejora de la calidad de vida de las personas de edadavanzada. Además, provocan beneficios a nivel psicológico, reduciendo los niveles de estrés y depresión, lo que produce unamejora en la calidad del sueño e influye positivamente en el estado de ánimo.(AU)

The present work aims to carry out a structured and bibliographic review based on the results found regarding the termsHippotherapy and Elderly people. For the reference search, the following keywords in English, Hippotherapy and Elderly, wereused as descriptors, these keywords being always entered in databases of the same language. The computerized databasesSCOPUS, WOS, SPORTDiscus were used. PubMed and Cochrane. To limit the search for documents, four inclusion criteria wereintroduced: i) Mention at least some of the characteristics of Hippotherapy for the elderly (minimum 20 words that mentionthe subject), ii) Select only scientific documents (journal articles) These articles may have an experimental design or be reviewarticles, iii) Be accessible and be available in full text or with access to the abstract, and iiii) Be written in Spanish, English orPortuguese. The results show that the papers on Hippotherapy in the elderly address different research topics and show thatequestrian therapies have beneficial therapeutic effects in the elderly population. Hippotherapy interventions improve staticbalance and dynamic balance, postural balance, functional mobility, flexibility, muscular strength, gait and cadence of steps.They reduce spasticity, causing a decrease in the risk of falls and an improvement in the quality of life of the elderly. In addition,they cause benefits on a psychological level, reducing levels of stress and depression, which produces an improvement in thequality of sleep and positively influences mood.(AU)

Effectiveness of hippotherapy and therapeutic horseback riding on balance in hemiparetic patients after stroke / Efetividade da hipoterapia e da equoterapia terapêutica no equilíbrio de pacientes hemiparéticos pós-acidente vascular cerebral

Abstract Introduction: Stroke is one of the leading causes of disability and death worldwide. Individuals who suffered stroke present numerous functional limitations. Hippo-therapy (HPOT) is proposed as capable of promoting the recovery of postural balance in patients with neurological impairment. Objective: To analyze published articles, seeking the effects of HPOT on changes in postural balance, through the Berg Balance Scale (BBS), in individuals with stroke. Methods: We conducted a systematic review and meta-analysis of studies published on the electronic databases PubMed, VHL, SCIELO, Cochrane, SCOPUS, WoS, and Cinahl. Keywords: "hippotherapy", "horseback riding" and "stroke" linked by the OR and AND boolean operators. The research was restricted to clinical trials in an adult population with a history of stroke. Results: Four articles were included in this meta-analysis, which used HPOT as an intervention to improve postural balance. Three studies used a mechanical device (horseback riding), and the horse. The age ranged from 61 to 71 years, being more predominant the male sex. Sessions ranged from 6 to 12 weeks of 20 to 30 minutes per session. Quality analysis using the PEDro scale demonstrated scores ranging from 6 to 8 points in the selected studies. Overall, treatment with mechanical and conventional therapy resulted in an improvement in the total BBS score. As compared with conventional therapy just studies with horseback riding was superior to conventional therapy to improve postural balance in hemiparetic stroke patients. Conclusion: There are few studies of high quality; then, it is not possible to evaluate the effectiveness of HPOT using a horse or a mechanic simulator in patients with stroke when compared with conventional therapy. Future studies could clarify if HPOT has potential benefits as a complementary therapeutic strategy to conventional physiotherapy to promote the improvement of postural balance after stroke.

Resumo Introdução: O acidente vascular encefálico (AVE) é uma das principais causas de incapacidade e morte em todo o mundo. Existem diferentes prospostas terapêuticas para melhorar o equilíbrio postural de hemiparéticos após AVE, mas a efetividade de técnicas como a hipoterapia ainda está por ser esclarecida. Objetivo: Avaliar através da Escala de Equilíbrio de Berg (EEB) a efetividade da hipoterapia para melhorar o equilíbrio postural em pacientes hemiparéticos após acidente vascular encefálico em comparação à terapia convencional Métodos: Uma revisão sistemática foi conduzida com buscas nas bases de dados eletrônicas PubMed, BVS, SCIELO, Cochrane, SCOPUS, WoS e Cinahl. Palavras-chave: "hippotherapy", "horseback riding" e "stroke" ligadas pelos operadores booleanos OR e AND. A pesquisa foi restrita a ensaios clínicos numa população adulta com histórico de AVE. Resultados: Após a análise dos estudos, foram incluídos nessa metanálise quatro artigos que utilizaram a hipoterapia como intervenção para melhora do controle postural e equilíbrio postural. Três artigos utilizaram hipoterapia com simulador mecânico e um estudo realizou com cavalos. O grupo de comparação foi a fisioterapia convencional. A idade variou de 61 a 71 anos, sendo mais predominante o sexo masculino. As sessões, com duração de 20 a 30 minutos, variaram entre 6 e 12 semanas. A análise de viés dos estudos com a escala PEDro revelou pontuações de 6 a 8 pontos. O resultado de três dos quatro ensaios clínicos sugere que o simulador mecânico e convencional resultou em melhora estatisticamente significativa do escore total da EEB. Conclusão: Uma vez que há poucos estudos de alta qualidade, não é possível estabelecer a efetividade da hipoterapia utilizando cavalos ou simulador mecânico para promover a melhoria no equilíbrio postural em pacientes sobreviventes após AVE quando comparada ao tratamento convencional. Estudos futuros podem esclarecer se a hipoterapia pode ser considerada um tratamento complementar para melhoria do equilíbrio postural após AVE.

[Physiotherapy interventions through hippotherapy in the treatment of cerebral palsy. A literature review]. / Intervenciones fisioterápicas mediante hipoterapia en el tratamiento de la parálisis cerebral infantil. Revisión bibliográfica.

INTRODUCTION: Cerebral palsy is produced by nonprogressive injury to the developing brain. This lesion produces life-long motor impairments, disturbances in perception, speech, communication, cognition and competence. Physiotherapy is an important part of treatment, and may include hippotherapy, which uses the movement of the horse to stimulate the sensorial, neuromotor and cognitive systems to obtain functional results. METHODS: We performed a literature search using distinct databases and the following Keywords: "hippotherapy"; "cerebral palsy"; "children"; "treatment" and "physiotherapy". After application of the inclusion and exclusion criteria; elimination of duplicated tests; and critical appraisal of the retrieved texts; 22 articles were finally selected for the review. CONCLUSION: Hippotherapy is used by physiotherapy in the treatment of cerebral palsy. In this therapy, the horse's movement is purposefully manipulated to stimulate the patient's sensitive, neuromotor and cognitive systems and promote functional goals. Among the interventions used, the most recommend by the authors is the postural alignment, although there is no single standard of care, but the treatment is individually-tailored to the needs of each patient with cerebral palsy.

Effects of hippotherapy in multiple sclerosis: pilot study on quality of life, spasticity, gait, pelvic floor, depression and fatigue. / Efecto de la hipoterapia en esclerosis múltiple: estudio piloto en calidad de vida, espasticidad, marcha, suelo pélvico, depresión y fatiga.

INTRODUCTION AND OBJECTIVE: Hippotherapy is being used as a promising method in the physical treatment of multiple sclerosis (MS). MATERIAL AND METHOD: Comparative open clinical pre-post study into hippotherapy intervention during a 6-month period in patients with MS (n=6). Not randomised and with control group (n=4). The study was performed by MHG Foundation. RESULTS: A statistically significant improvement was observed in the therapy group in: spasticity pre-post measured by the modified Ashworth scale (P=.01). Statistically significant improvement in fatigue impact (P<.0001) measured with FIS; in general, perception of heath outcome in urinary quality of life scale KHQ (P=.033), and in subscales 2, 3 and 4 of MSQOL-54 (P=.011). Control group showed no improvement in any scale. CONCLUSIONS: This study reinforces current literature that supports hippotherapy as an adequate intervention for MS patients. Further studies with more participants, control groups and blinded research would be logical steps for future research in this field.

Efectos de la hipoterapia en niños con lesión del sistema nervioso central: estudio de casos / Effects of hippotherapy in children with central nervous system injury: study of cases

Introducción la hipoterapia está constituida como coadyuvante en los procesos de intervención fisioterapéutica, definida como un procedimiento alternativo de tratamiento utilizado por los especialistas dedicados a la atención al niño en condición de discapacidad. Objetivo: Determinar los efectos de la técnica de hipoterapia en los niños con lesión del sistema nervioso central. Pacientes y Métodos: Se realizó un estudio de casos de tipo descriptivo con cuatro niños con lesión del Sistema Nervioso Central. Se valoraron antes y después de la aplicación de la hipoterapia con el fin de establecer los efectos de la técnica. Resultados y conclusiones: se encontró una influencia positiva de la hipoterapia en la movilidad articular, flexibilidad, aptitud postural y reacciones de equilibrio de los participantes.

Introduction: Hippotherapy is constituted as an adjuvant in the processes of physiotherapeutic intervention, defined as an alternative treatment procedure used by specialists dedicated to the care of children with disabilities. Objective: To determine the effects of the hippotherapy technique in children with central nervous system injury. Patients and methods: A descriptive case study was conducted with four children with Central Nervous System injury. They were assessed before and after the application of hippotherapy in order to establish the effects of the technique. Results and conclusions: a positive influence of hippotherapy on joint mobility, flexibility, postural aptitude and equilibrium reactions was found.

Avaliação postural pré e pós-tratamento equoterapêutico em indivíduos com síndrome de Down / Evaluation postural pre and post-treatment in hippotherapy in individuals with Down syndrome

Introdução: Indivíduos com Síndrome de Down (SD) apresentam alterações motoras que contribuem para um desalinhamento de membros inferiores. Objetivo: Avaliar mudanças posturais de pacientes com SD submetidos a Equoterapia. Métodos: Participaram do estudo 5 indivíduos com SD, idade média de 12,60 anos (± 3,21). Avaliações foram feitas antes e após 20 sessões. A avaliação postural foi feita por fotogrametria utilizando o Software de Avaliação Postural (SAPO). Para análise estatística quantitativa realizou-se o teste "t" de Student, e análise qualitativa feita por meio de Cluster. Resultados: Nas vistas anterior, posterior e laterais após o tratamento equoterapêutico apresentaram diminuição da anteversão pélvica, da hiperextensão de MMII e melhor alinhamento do joelho com o quadril. A análise de Cluster demonstrou um agrupamento mais próximo das variáveis indicando que se comportaram de maneira mais semelhante entre elas. Conclusão: A Equoterapia promoveu mudanças posturais, com melhora do alinhamento de membros inferiores em indivíduos com SD.

Introduction: Individuals with Down syndrome (DS) have motor alterations that contribute to subsequent dealignment of the lower limbs. Objective: To evaluate the changes in the posture of the lower limbs of practitioners with DS who underwent hippotherapy. Methods: The study included 5 individuals with Down syndrome, mean age of 12.60 years-old (± 3.21). The evaluations were performed before and after 20 sessions of Hippotherapy. Postural assessment was made by photogrammetry using the Postural Assessment Software (SAPO), with marking distance to check for changes in the lower limbs. For quantitative analysis was done the statistical test "t" student (p <0.05), and qualitative analysis made by Cluster. Results: The increase of the distances analyzed in views anterior, posterior and lateral left and right after treatment with hippotherapy resulted in decreased pelvic anteversion, hyperextension of the lower limbs, lower anterior body and better alignment of the knee with the hip. Cluster analysis showed a grouping closest variable indicating that behaved more like therebetween. Conclusion: Hippotherapy promoted postural changes, providing an improved alignment of the lower limbs in individuals with Down syndrome.

Hipoterapia como técnica de habilitación y rehabilitación / Hippotherapy as a technique of habilitation and rehabilitation

La habilitación y rehabilitación son procesos a través de los cuales las personas con discapacidad tienen la oportunidad de contar y mantener óptimos niveles en los planos físico, sensorial, intelectual, psicológico y social; a pesar de la existencia de diferentes campos de habilitación y rehabilitación en la fisioterapia con todo un abanico de técnicas y procedimientos (Bobath, TFNP, Perfetti, rehabilitación basada en tareas y otras) para la intervención de estos pacientes, la hipoterapia (terapia con caballos) se perfila como una opción prometedora en el restablecimiento de las deficiencias de pacientes con afecciones neurológicas centrales y periféricas, donde el caballo juega un papel fundamental. El caballo es un animal por característica muy perceptivo, lo cual le permite graduar su comportamiento y conducta según la persona que lo monta, que en primera instancia lo muestra como una vía para su utilización con personas. Montar a caballo proporciona un trabajo físico, resistencia muscular, controles posturales y enderezamientos corporales para mantener equilibrio, balance, mantenimiento de posiciones y coordinación, también favorece la adquisición de habilidades cognitivas que permiten la interacción del jinete/amazona con su medio y por darse en espacios ambientales al aire libre facilitan el desarrollo de la persona en torno a todas sus esferas (personal, familiar y social). Es la hipoterapia una modalidad asistida con animales, que utiliza al caballo como medio facilitador en la rehabilitación o habilitación de deficiencias a nivel motor, senso-perceptivo, cognitivo, comunicativo y social, se aprovecha el paso, el carácter, la voluntad, la anatomía del animal y la planeación de ejercicios terapéuticos sobre este para que el fisioterapeuta los convierta en elementos fundamentales para el proceso de restablecimiento de la funcionalidad y funcionamiento del paciente (jinete/amazona).

The habilitation and rehabilitation are processes through which people with disabilities go through to maintain optimal results at physical, sensory, intellectual, psychological and social levels. Despite the existence of different fields of habilitation and rehabilitation in physical therapy, with a wide range of techniques and procedures (Bobath, TFNP, Perfetti, rehabilitation based on assignments and others) for the intervention of these patients, the hippotherapy (therapy with horses) is emerging as a promising option in the restoration of the deficiencies of patients suffering from central and peripheral neurological disorders, where the horse plays a fundamental role. Horses are very perceptive animals which allow them to graduate their behavior and conduct according to the person who rides them, which first shows them as a means to use with people. Horse riding provides physical work, muscle endurance, postural control and straightening body to maintain balance, positions and coordination. It also favors the acquisition of cognitive skills that allow the interaction of the rider/Amazon with its environment as well as the development of the person around all his or her areas (personal, family and social) as it is practiced outdoors. Hippotherapy is a modality assisted with animals, which uses horses as a means of facilitating the rehabilitation or habilitation of people's deficiencies in their motor, senso- perceptual, cognitive, communicative and social levels by using step, character, the will, the anatomy of the animal and the planning of therapeutic exercises while riding, so that the physical therapist makes them become fundamental elements for the process of restoring the functionality and operation of the patient (rider/Amazon).

Effectiveness of equine therapy in children with psychomotor impairment.

INTRODUCTION: Equine therapy, an intervention method that has been practiced for decades around the world, is used to treat patients susceptible to psychomotor delays. OBJECTIVES: We examine development of gross motor function compared to other psychomotor skills in patients undergoing this therapy, and analyse how this improvement affects general health status and quality of life. MATERIAL AND METHODS: The study includes 11 children with delayed psychomotor development (aged 8.82 ± 3.89; 6 boys, 5 girls). The main study variables were gross motor function (GMFM-88) and perceived quality of life (Pediatric Quality of Life Inventory, PedsQL). Three measurements were performed: before and after a period of inactivity, and once again 2 months after the second measurement, following completion of a sustained period of therapy. RESULTS: We observed significant differences in overall results on the GMFM-88 between the initial and final tests and between the intermediate and final tests. Regarding the PedsQL quality of life scale, no statistically significant results were recorded. CONCLUSIONS: Noticeable changes in motor control were recorded throughout the course of the intervention, which suggests that equine therapy may be appropriate treatment in cases of delayed psychomotor development.

Efeito da equoterapia na estabilidade postural de portadores de esclerose múltipla: estudo preliminar / Effect of hippotherapy on the postural stability of patients with multiple sclerosis: a preliminary study / Efecto de la hipoterapia en la estabilidad postural de portadores de esclerosis múltiple: estudio preliminar

OBJETIVO: Este estudo se propôs a verificar se a estimulação por meio da equoterapia é capaz de desencadear alterações no controle postural de portadores de esclerose múltipla (EM). MÉTODO: Fizeram parte deste estudo 11 portadores de EM divididos em Grupo Intervenção (GI) e Grupo Controle (GC). O GI foi inserido num programa de hipoterapia durante 4 meses, sendo conduzidas 2 sessões semanais com duração de 50 minutos cada. A estabilidade postural foi avaliada utilizando uma plataforma de força (para calcular o deslocamento do centro de pressão (COP), durante 30 segundos, em postura ereta quasi-estática, com olhos abertos e fechados, antes e após o treinamento com equoterapia. O tratamento estatístico foi feito através do ANOVA e Post hoc de Tukey com p<0,05. RESULTADOS: A amplitude de oscilação anteroposterior reduziu significativamente no GI após a estimulação, enquanto o GC manteve um comportamento inalterado entre as avaliações. Em ambos os grupos, a estabilidade postural foi reduzida com a supressão da informação visual. CONCLUSÕES: A adaptação funcional proporcionada pela equoterapia foi capaz de melhorar a estabilidade postural dos portadores de EM. Os resultados corroboram a literatura que suporta o uso da equoterapia como uma intervenção em potencial nas desordens de controle postural em portadores de EM.

OBJECTIVE: This study intended to identify the effects of hippotherapy on the postural control of multiple sclerosis (MS) patients. METHODS: Eleven MS patients were separated into two groups: Intervention Group (IG) and Control Group (CG). Hippotherapy consisted of two 50-minute sessions each week for four months. Postural stability was evaluated before and after hippotherapy using a force plate to calculate the center of pressure (COP), when subjects stood still for 30 seconds, with eyes open and closed. Statistical analysis was performed by ANOVA and post hoc Tukey tests, p<0.05. RESULTS: Hippotherapy significantly reduced the amplitude of oscillation in the anteroposterior direction in IG while CG remained unaltered. In both groups postural stability was reduced after the suppression of visual information. CONCLUSIONS: Hippotherapy induced functional adaptations that resulted in better postural stability of subjects with MS. This study corroborates literature supporting the use of hippotherapy as a possible intervention for balance disorders in patients with MS.

OBJETIVO: El objetivo de éste estudio fue identificar los efectos de la hipoterapia sobre el control postural en pacientes con esclerosis múltiple (EM). MÉTODO: Hicieron parte de este estudio 11 portadores de EM divididos en Grupo Intervención (GI) y Grupo Control (GC). El GI fue insertado en un programa de hipoterapia durante cuatro meses, siendo realizadas dos sesiones semanales con duración de 50 minutos cada una. La estabilidad postural fue evaluada utilizando una plataforma de fuerza (para calcular el desplazamiento del centro de presión (COP), durante 30 segundos en postura erecta casi-estática, con ojos abiertos y cerrados, antes y después del entrenamiento con hipoterapia. El tratamiento estadístico fue realizado a través de ANOVA y Post hoc de Tukey con p<0,05. RESULTADOS: la amplitud de oscilación antero-posterior se redujo significativamente en el GI después de la estimulación, mientras que el GC mantuvo un comportamiento sin cambios entre las evaluaciones. En ambos grupos la estabilidad postural fue reducida con la supresión de la información visual. CONCLUSIONES: la adaptación funcional proporcionada por la hipoterapia fue capaz de mejorar la estabilidad postural de los portadores de EM. Los resultados corroboran la literatura que soporta el uso de la hipoterapia como una potencial intervención en los desordenes del control postural en portadores de EM.

Use of hippotherapy in gait training for hemiparetic post-stroke / Utilização da hipoterapia no treino de marcha em indivíduos hemiparéticos pós-acidente vascular cerebral

OBJECTIVE: To evaluate the hippotherapy influence on gait training in post-stroke hemiparetic individuals. METHOD: The study was constituted of 20 individuals divided into two groups. Group A performed the conventional treatment while group B the conventional treatment along with hippotherapy during 16 weeks. The patients were evaluated by using the Functional Ambulation Category Scale, Fugl-Meyer Scale, only the lower limbs and balance sub items, Berg Balance Scale, and functional assessment of gait (cadence) in the beginning and end of the treatment. RESULTS: Significant improvements were observed in the experimental group including motor impairment in lower limbs (p=0.004), balance, over time (p=0.007) but a significant trend between groups (p=0.056). The gait independence, cadence and speed were not significantly in both groups (p=0.93, 0.69 and 0.44). CONCLUSION: Hippotherapy associated with conventional physical therapy demonstrates a positive influence in gait training, besides bringing the patients' gait standard closer to normality than the control group.

OBJETIVO: Avaliar a influência da hipoterapia no treino de marcha em indivíduos hemiparético pós-AVC. MÉTODO: O estudo constou de 20 indivíduos divididos em dois grupos (A e B); o grupo A realizou tratamento convencional e o grupo B, tratamento convencional e hipoterapia, durante 16 semanas. Os pacientes foram avaliados pela Escala de Fugl-Meyer, Escala de Equilíbrio de Berg, Escala de Deambulação Funcional e a Cadência, no início e no final do tratamento. RESULTADOS: Melhoras significativas foram observadas no grupo experimental incluindo comprometimento motor em membros inferiores (p-valor=0,004), o equilíbrio, em relação ao tempo (p-valor=0,007) porém uma tendência significância entre os grupos (p=0,056). A independência na marcha, cadência e a velocidade não apresentaram relevância estatística em ambos os grupos (p-valor=0,93, 0,69 e 0,44). CONCLUSÃO: A Hipoterapia associada ao tratamento convencional mostra ter influência no treino de marcha, além de tornar o padrão de marcha dos pacientes mais próximo da normalidade em relação ao grupo controle.

Efeitos da hippoterapia no desenvolvimento funcional de duas crianças com síndrome de down / Effects of hippotherapy on the functional development of two children with down syndrome

As incapacidades motoras apresentadas por portadoras da síndrome de Down podem se manifestar funcionalmente, interferindo na capacidade de realizar de forma independente diversas atividades de vida diária. O objetivo desse estudo foi avaliar os efeitos de intervenção fisioterapêutica pela Hippoterapia no desenvolvimento funcional de crianças com síndrome de Down. Foram selecionadas para essa pesquisa duas crianças portadoras da síndrome e com idade de dois anos. Ambas foram avaliadas funcionalmente pelo teste PEDI (Pediatric Evaluation of Disability Inventory) e por avaliação baseada no modelo NDTA (Neuro Development Treatment Assessment), antes e após a intervenção. As sessões foram realizadas duas vezes por semana com duração de trinta minutos cada, totalizando dez sessões. Nos primeiros quinze minutos a criança montava juntamente com uma Fisioterapeuta treinada, que realizou manuseios baseados na teoria neuroevolutiva. Nos quinze minutos restantes, a criança montava sozinha e a terapeuta provia segurança posicionando-se ao lado do cavalo. As duas crianças obtiveram melhora nas três áreas de desempenho de habilidades funcionais e de assistência do cuidador do PEDI. Na avaliação do NDTA observou-se melhora das reações de equilíbrio e de retificação de tronco. Os resultados obtidos sugerem que a Hippoterapia pode ser benéfica quando usada como complemento ao tratamento convencional nas crianças tom síndrome de Down.(AU)

This study aimed at evaluating the effects of physical therapy intervention by means of the hippotherapy in children with Down syndrome. Two two-year-old children were selected for this research and they were both evaluated by PEDI (Pediatric Evaluation of Disability Inventory) and NDTA (Neuro Development Treatment Assessment) before and after the intervention. Thirty-minute sessions were carried out twice a week in a total of ten sessions. For the first fifteen minutes the child rode together with a physical therapist, who handled it based on the neuro development theory. For the other fifteen minutes the child was left to ride on its own and the physical therapist stayed right beside the horse to make the child feel safe. Both children improved their condition significantly on the PEDI, in the three areas of performance and facilitator assistance. The NDTA results showed improvement of balance reactions and trunk postural control. The results suggested the usefull effects of hippotherapy used together with conventional treatment for children with Down syndrome.(AU)

Efeitos da hippoterapia no desenvolvimento funcional de duas crianças com síndrome de down / Effects of hippotherapy on the functional development of two children with down syndrome

As incapacidades motoras apresentadas por portadoras da síndrome de Down podem se manifestar funcionalmente, interferindo na capacidade de realizar de forma independente diversas atividades de vida diária. O objetivo desse estudo foi avaliar os efeitos de intervenção fisioterapêutica pela Hippoterapia no desenvolvimento funcional de crianças com síndrome de Down. Foram selecionadas para essa pesquisa duas crianças portadoras da síndrome e com idade de dois anos. Ambas foram avaliadas funcionalmente pelo teste PEDI (Pediatric Evaluation of Disability Inventory) e por avaliação baseada no modelo NDTA (Neuro Development Treatment Assessment), antes e após a intervenção. As sessões foram realizadas duas vezes por semana com duração de trinta minutos cada, totalizando dez sessões. Nos primeiros quinze minutos a criança montava juntamente com uma Fisioterapeuta treinada, que realizou manuseios baseados na teoria neuroevolutiva. Nos quinze minutos restantes, a criança montava sozinha e a terapeuta provia segurança posicionando-se ao lado do cavalo. As duas crianças obtiveram melhora nas três áreas de desempenho de habilidades funcionais e de assistência do cuidador do PEDI. Na avaliação do NDTA observou-se melhora das reações de equilíbrio e de retificação de tronco. Os resultados obtidos sugerem que a Hippoterapia pode ser benéfica quando usada como complemento ao tratamento convencional nas crianças tom síndrome de Down.

This study aimed at evaluating the effects of physical therapy intervention by means of the hippotherapy in children with Down syndrome. Two two-year-old children were selected for this research and they were both evaluated by PEDI (Pediatric Evaluation of Disability Inventory) and NDTA (Neuro Development Treatment Assessment) before and after the intervention. Thirty-minute sessions were carried out twice a week in a total of ten sessions. For the first fifteen minutes the child rode together with a physical therapist, who handled it based on the neuro development theory. For the other fifteen minutes the child was left to ride on its own and the physical therapist stayed right beside the horse to make the child feel safe. Both children improved their condition significantly on the PEDI, in the three areas of performance and facilitator assistance. The NDTA results showed improvement of balance reactions and trunk postural control. The results suggested the usefull effects of hippotherapy used together with conventional treatment for children with Down syndrome.