Fernando Copetti

The effects of hippotherapy on postural balance and functional ability in children with cerebral palsy

[Purpose] This study evaluated the effects of hippotherapy on seated postural balance, dynamic balance, and functional performance in children with cerebral palsy and compared the effects of 12 and 24 sessions on seated postural balance. [Subjects and Methods] This study included 15 children with cerebral palsy aged between 5 and 10 years. Interventions: A hippotherapy protocol was performed for 30 minutes, twice a week, for 12 weeks. Postural balance in a sitting position was measured using an AMTI AccuSway Plus force platform 1 week before initiating the hippotherapy program and after 12 and 24 weeks. The Berg Balance Scale (BBS) and Pediatric Evaluation of Disability Inventory (PEDI) were used before and after 24 sessions. [Results] Significant differences were observed for center of pressure (COP) variables, including medio-lateral (COPml), anteroposterior displacement (COPap), and velocity of displacement (VelCOP), particularly after 24 sessions. There were also significant differences in BBS scores and PEDI score increases associated with functional skills (self-care, social function, and mobility), caregiver assistance (self-care), social function, and mobility. [Conclusion] Hippotherapy resulted in improvement in postural balance in the sitting position, dynamic balance, and functionality in children with cerebral palsy, an effect particularly significant after 24 hippotherapy sessions.

Efeito da equoterapia na estabilidade postural de portadores de esclerose múltipla: estudo preliminar

OBJETIVO: El objetivo de este estudio fue identificar los efectos de la hipoterapia sobre el control postural en pacientes con esclerosis multiple (EM). METODO: Hicieron parte de este estudio 11 portadores de EM divididos en Grupo Intervencion (GI) y Grupo Control (GC). El GI fue insertado en un programa de hipoterapia durante cuatro meses, siendo realizadas dos sesiones semanales con duracion de 50 minutos cada una. La estabilidad postural fue evaluada utilizando una plataforma de fuerza (para calcular el desplazamiento del centro de presion (COP), durante 30 segundos en postura erecta casi-estatica, con ojos abiertos y cerrados, antes y despues del entrenamiento con hipoterapia. El tratamiento estadistico fue realizado a traves de ANOVA y Post hoc de Tukey con p<0,05. RESULTADOS: la amplitud de oscilacion antero-posterior se redujo significativamente en el GI despues de la estimulacion, mientras que el GC mantuvo un comportamiento sin cambios entre las evaluaciones. En ambos grupos la estabilidad postural fue reducida con la supresion de la informacion visual. CONCLUSIONES: la adaptacion 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 intervencion en los desordenes del control postural en 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.

Parameters of the center of pressure displacement on the saddle during hippotherapy on different surfaces

Background: Hippotherapy uses horseback riding movements for therapeutic purposes. In addition to the horses movement, the choice of equipment and types of floor are also useful in the intervention. The quantification of dynamic parameters that define the interaction of the surface of contact between horse and rider provides insight into how the type of floor surface variations act upon the subjects postural control. Objective: To test whether different types of surfaces promote changes in the amplitude (ACOP) and velocity (VCOP) of the center of pressure (COP) displacement during the riders contact with the saddle on the horses back. Method: Twenty two healthy adult male subjects with experience in riding were evaluated. The penetration resistances of asphalt, sand and grass surfaces were measured. The COP data were collected on the three surfaces using a pressure measurement mat. Results: ACOP values were higher in sand, followed by grass and asphalt, with significant differences between sand and asphalt (anteroposterior, p=0.042; mediolateral, p=0.019). The ACOP and VCOP values were higher in the anteroposterior than in the mediolateral direction on all surfaces (ACOP, p=0.001; VCOP, p=0.006). The VCOP did not differ between the surfaces. Conclusion: Postural control, measured by the COP displacement, undergoes variations in its amplitude as a result of the type of floor surface. Therefore, these results reinforce the importance of the choice of floor surface when defining the strategy to be used during hippotherapy intervention.

Características miofuncionais e eletromiográficas de crianças e adolescentes obesos

Purpose: to investigate the myofunctional and electromyographic characteristics of obese patients in relation to sex and age group. Method: a convenience sample of 28 obese children and adolescents of both sexes, participants in the group of the Obesity Clinic of Pediatrics, University Hospital of Santa Maria, in the period of January to July 2011. The myofunctional characteristics were performed by experienced speech pathologist through the Assessment Protocol Myofunctional with scores (AMIOFE). Electromyographic evaluation of masseter and temporal muscles was obtained using the Lynx Electromyograph and were held three collections for each of the situations (rest, chewing, swallowing and maximum intercuspation). The EMG data were normalized, expressed as a percentage, using the mean of maximal intercuspation of each muscle studied in the assessments. Results: most of the obese in this research presented myofunctional characteristics within the normal range, not being statistically significant difference when compared by sex and age. Although the average standard of the electrical activity of masseter and temporal muscles during rest, chewing and swallowing obese according to sex and age showed no statistically significant difference, there is an increased activation of the masseter muscles than the temporal. Conclusions: it can be concluded that obese children and adolescents of both sexes have myofunctional characteristics within normal limits and there is an increased activation of the masseter muscles for chewing and swallowing of the temporal muscles.

Effect of hippotherapy on the postural stability of patients with multiple sclerosis: a preliminary study

OBJETIVO: El objetivo de este estudio fue identificar los efectos de la hipoterapia sobre el control postural en pacientes con esclerosis multiple (EM). METODO: Hicieron parte de este estudio 11 portadores de EM divididos en Grupo Intervencion (GI) y Grupo Control (GC). El GI fue insertado en un programa de hipoterapia durante cuatro meses, siendo realizadas dos sesiones semanales con duracion de 50 minutos cada una. La estabilidad postural fue evaluada utilizando una plataforma de fuerza (para calcular el desplazamiento del centro de presion (COP), durante 30 segundos en postura erecta casi-estatica, con ojos abiertos y cerrados, antes y despues del entrenamiento con hipoterapia. El tratamiento estadistico fue realizado a traves de ANOVA y Post hoc de Tukey con p<0,05. RESULTADOS: la amplitud de oscilacion antero-posterior se redujo significativamente en el GI despues de la estimulacion, mientras que el GC mantuvo un comportamiento sin cambios entre las evaluaciones. En ambos grupos la estabilidad postural fue reducida con la supresion de la informacion visual. CONCLUSIONES: la adaptacion 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 intervencion en los desordenes del control postural en 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.

Análise do desenvolvimento motor e qualidade do ambiente domiciliar de crianças pré-escolares

Objective – The aim of this study was to analyze the motor development and quality of the household environment of children. Methods – This is a descriptive and quantitative study, conducted with 44 children between 18-42 months of private educational institutions for children in the Central Santa Maria, RS. Affordance in the Home Environment for Motor Development - Self Report and Peabody Developmental Motor Scales-2 were used to evaluate the household environment and motor development. Results – The main age was 31.6 months, 59.09% were female and 40.91% male, 50% live in apartment, 72.72% of households provide sufficient opportunities for motor development. The sub-tests that showed the best and worst motor performance were: fine manipulation and locomotion. Regarding the Total Motor Quotient, 63.64% are children with an average score. Conclusion – The motor development of most of the children lies within the normal range for chronological age, the residences allow reasonable opportunities for motor development.

Hippotherapy on postural balance in the sitting position of children with cerebral palsy – Longitudinal study

ABSTRACT Purpose: To verify the effects of 12, 24, 36 hippotherapy sessions over time on postural balance while sitting in children with cerebral palsy as well the effects of treatment after one interruption period of 45 days. Methods: Hippotherapy program with a twice-weekly treatment with a total of 13 children aged 5–10 years old. Measurements of postural balance during sitting were performed using the AMTI AccuSway Plus platform. Results: There was a statistically significant reduction in mediolateral and anteroposterior sway after the first 12 hippotherapy sessions, and further significant sway reduction occurred as the treatment progressed. Changes in the center of pressure displacement velocity variable began to occur after 24 sessions. Conclusion: Seated postural balance improved in children with cerebral palsy, as evidenced by lower COP displacement, particularly after a greater number of sessions. After the last evaluations, when completing 36 sessions of hippotherapy, it was verified that the improvements to the postural balance continued to occur. Therefore, further studies with a longer treatment period may help to clarify if, at some point, there is stabilization in the improvement of postural balance. Furthermore, it is important to analyze the impact of hippotherapy on functional activities over time.

Mother's perception of children's motor development in southern Brazil

Parents’ perceptions of children’s motor competence are important because they influence the way parents interact with their children to promote motor skills development. Thirty-six mothers of 16- to 66-month old children (61%, 22 boys and 39%, 14 girls, n = 36) estimated their child’s performance while the child was being evaluated, by another trained researcher, with the same scale (Peabody Developmental Motor Scale 2nd Ed.) in a different room. Underestimations, accurate estimations, overestimations, and parental accuracy were investigated. Mothers overestimated significantly their child’s stationary and locomotion skills and their GMQ and Total Motor Quotients (TMQ). Identical levels of motor performance were found in girls and boys, and estimation accuracy was similar for both genders. We discuss our results in the context of the parents’ routines (little time interacting with children actively) and the relevance of their perceptions of the children’s abilities as a further influence on the children’s development and engagement in physical activities.

A EQUOTERAPIA NO EQUILÍBRIO POSTURAL DE PESSOAS COM ESCLEROSE MÚLTIPLA

Multiple sclerosis (MS) is a chronic and progressive disease induced by autoimmune inflammatory responses that attack myelin of the nerve tissue, with changes in postural balance being common manifestations in MS. Objective: Verify if the hippotherapy, inserted as a complementary activity, influences the postural balance of MS patients. Method: A total of six cases were evaluated. The performance of postural balance was assessed by the Berg Balance Scale (BBS) before and after 30 sessions of hippotherapy, performed twice a week, over a period of four months. Results: After the intervention, there was an increase in scores on BBS in four individuals and two of them maintained their scores. Conclusions: The stimulation of hippotherapy as a complementary activity proved to be able to improve the results of performance in functional tasks that require static and dynamic balance, assessed by BBS.

Efecto de la hipoterapia en la estabilidad postural de portadores de esclerosis múltiple: estudio preliminar

OBJETIVO: El objetivo de este estudio fue identificar los efectos de la hipoterapia sobre el control postural en pacientes con esclerosis multiple (EM). METODO: Hicieron parte de este estudio 11 portadores de EM divididos en Grupo Intervencion (GI) y Grupo Control (GC). El GI fue insertado en un programa de hipoterapia durante cuatro meses, siendo realizadas dos sesiones semanales con duracion de 50 minutos cada una. La estabilidad postural fue evaluada utilizando una plataforma de fuerza (para calcular el desplazamiento del centro de presion (COP), durante 30 segundos en postura erecta casi-estatica, con ojos abiertos y cerrados, antes y despues del entrenamiento con hipoterapia. El tratamiento estadistico fue realizado a traves de ANOVA y Post hoc de Tukey con p<0,05. RESULTADOS: la amplitud de oscilacion antero-posterior se redujo significativamente en el GI despues de la estimulacion, mientras que el GC mantuvo un comportamiento sin cambios entre las evaluaciones. En ambos grupos la estabilidad postural fue reducida con la supresion de la informacion visual. CONCLUSIONES: la adaptacion 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 intervencion en los desordenes del control postural en 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.