Use of hippotherapy in gait training for hemiparetic post-stroke

Abstract

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. Key words: stroke, hemiplegy, hippotherapy, gait and horseback riding therapy.Utilização da hipoterapia no treino de marcha em indivíduos hemiparéticos pós-acidente vascular cerebral RESUMO 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. Palavras-chave: acidente vascular cerebral, hemiplegia, hipoterapia, marcha e equoterapia.

The Effects of Horseback Riding Simulator Exercise on Postural Balance of Chronic Stroke Patients

“…This finding is consistent with the results reported by Hammer et al16 ) who conducted horseback riding simulator exercise for 11 multiple sclerosis patients and observed improvements in their BBS. Similarly, Beinotti et al17 ) conducted horseback riding exercise for 20 stroke patients and observed enhancement of their gait and balance abilities. Cho et al14 ) reported that horseback riding simulator exercises were effective at improving postural balance ability and proprioceptive sense, while Nashner and Peter18 ) reported that proprioceptive sense–improving exercises elicited a larger improvement in postural sway when the eyes were closed.…”

Equine Assisted Activities and Therapies: A Case Study of an Older Adult

“…EAAT also includes Adaptive Riding (AR), (AKA therapeutic riding) in which a riding instructor who is trained and certified to teach horseback riding to people with disabilities adapts riding lessons to the needs of the individual. EAAT uses the movement of the horse as a kinesio-therapeutic tool to improve the participant's muscle strength, body awareness, balance, and coordination (AHA, 2007;Beinotti, Correia, Christofoletti & Borges, 2010). During EAAT sessions, the horse provides a dynamic base of support and challenges these sensorimotor components.…”

Hipoterapia como técnica de habilitación y rehabilitación

“…En un estudio con 20 pacientes post enfermedad cerebro vascular, se observó que la hipoterapia asociada a la fisioterapia convencional aumentaba la independencia en la deambulación, la cadencia y la velocidad de la marcha. 46 En un estudio realizado por Lee CW et al, donde se medían los efectos de la hipoterapia en la recuperación de la marcha y el balance en pacientes post ictus con una muestra de 15 pacientes en el grupo experimental y el grupo control, se encontró una significancia estadística en la velocidad de la marcha, longitud del paso y balance medido con la escala de Berg con un valor p <0,05, concluyendo que la hipoterapia puede ser un método de tratamiento que puede ayudar en la rehabilitación de la marcha de estos pacientes. 47 En niños con parálisis cerebral se ha encontrado un aumento en la velocidad de la marcha, simetría en músculos aductores, aumento en la movilidad escapulo -pélvica, mayor basculación pélvica y aumento en la longitud del paso y altura luego de la intervención con hipoterapia.…”