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Hippotherapy : mechanics of human walking and horseback riding /
Abstract
Photocopy. Thesis (M.S.)--University of Delaware, 1992. Principal faculty adviser: David Barlow, College of Physical Education, Athletics and Recreation. Includes bibliographical references (leaves 63-71).
... De plus, le déplacement de l'animal au pas impose au bassin du cavalier un mouvement en forme de huit sur le plan sagittal, mouvement d'avant en arrière mais aussi de haut en bas (Fleck, 1992 ;Uchiyama, Ohtani, & Ohta, 2011). De nombreuses études ont montré que les mouvements du cheval induisaient, sur le corps du cavalier, des patterns de mouvement répétitifs et cycliques, qui sont similaires aux patterns de marche retrouvés chez l'Homme (Fleck, 1992 ;Garner & Rigby, 2015). ...
... De plus, le déplacement de l'animal au pas impose au bassin du cavalier un mouvement en forme de huit sur le plan sagittal, mouvement d'avant en arrière mais aussi de haut en bas (Fleck, 1992 ;Uchiyama, Ohtani, & Ohta, 2011). De nombreuses études ont montré que les mouvements du cheval induisaient, sur le corps du cavalier, des patterns de mouvement répétitifs et cycliques, qui sont similaires aux patterns de marche retrouvés chez l'Homme (Fleck, 1992 ;Garner & Rigby, 2015). La plupart de ces travaux a analysé les bienfaits de la pratique de l'équitation sur la marche de personnes atteints d'un handicap (Beinotti, Correia, Christofoletti, & Borges, 2010 ;Bertoti, 1988 ;Fleck, 1992 ;Hammer et al., 2005 ; McGibbon (Holt et al., 2010). ...
... De nombreuses études ont montré que les mouvements du cheval induisaient, sur le corps du cavalier, des patterns de mouvement répétitifs et cycliques, qui sont similaires aux patterns de marche retrouvés chez l'Homme (Fleck, 1992 ;Garner & Rigby, 2015). La plupart de ces travaux a analysé les bienfaits de la pratique de l'équitation sur la marche de personnes atteints d'un handicap (Beinotti, Correia, Christofoletti, & Borges, 2010 ;Bertoti, 1988 ;Fleck, 1992 ;Hammer et al., 2005 ; McGibbon (Holt et al., 2010). En d'autres termes, il est nécessaire de tenir compte de ces déséquilibres entre les ressources de l'organisme, les exigences de la tâche et les influences environnementales, dans l'optique d'une meilleure rééducation. ...
La thèse présentée a pour objectif d’analyser dans le cadre de l’approche dynamique du contrôle moteur la coordination motrice de participants sains et cérébrolésés évoluant sur un nouvel outil de rééducation, le cheval mécanique. L’analyse de ces coordinations spontanément adoptées par les individus sur ce cheval, ou modifiées suite à l’apprentissage d’une nouvelle coordination grâce à l’ajout d’un biofeedback visuel en temps réel, conduit à participer à (i) déterminer l’utilité du biofeedback dans ce type de tâche et (ii) à évaluer l’intérêt d’un protocole de 24 séances prescrites par nos soins et réalisées sur cet outil. L’objectif final est alors de participer à l’élaboration d’un protocole de rééducation posturale pour une population de patients cérébrolésés. La première étude a permis de mettre en avant le rôle joué par l’expertise dans l’évolution des coordinations posturales des individus sur le cheval mécanique amenant les cavalières expertes vers une coordination posturale plus adaptée (i.e. maintien des patterns en phase et en antiphase), en comparaison aux novices. Par ces analyses, la coordination tronc/cheval mesurée en antiphase, a été mise en lumière, correspondant ainsi à la coordination retrouvée dans l’activité équestre réelle. Par ailleurs, la mise en place d’une méthode d’apprentissage (étude 2) a permis de modifier le comportement postural des individus après seulement 3 séances, selon les conditions d’apprentissage prescrites. La fréquence d’oscillation du cheval avait un impact important sur la coordination des participants, qui adoptaient une coordination en antiphase (fort attracteur) lorsque la contrainte environnementale était élevée. Toutefois, ces observations n’ont pas permis de démontrer le réel intérêt de l’ajout d’un biofeedback visuel dans l’apprentissage d’une nouvelle coordination posturale chez des sujets sains. Enfin, la troisième étude réalisée chez des patients cérébrolésés a montré l’intérêt de cette nouvelle méthode de rééducation sur la coordination posturale de ces patients. Après 24 séances, leur coordination était différente de celle du groupe témoin, permettant de mettre en avant leur capacité à s’adapter aux contraintes et à développer des modes de coordinations posturales spécifiques (tronc/cheval en antiphase) à l’activité afin d’optimiser au mieux leur posture.
... The horse's gait is similar to that of humans, thus, a person who is riding a horse achieves a similar movement in their hips as if he or she were really walking (Fleck, 1992). As the neural mechanics of the horse's movement are similar to that of a human, normal neural locomotive reactions can be induced in a rider who is unable to walk, simply through the act of riding. ...
... Movement and locomotion are as vitally important in the disabled as they are in able-bodied persons, and as equilibrium is intrinsic to any movement, it can be considered the most important factor to physical movement. Horseback riding allows for physical simulation of normal locomotive hip movement in the rider, as well as stimulation of equilibrium and posture control (Fleck, 1992). Thus, this study aimed to measure changes in equilibrium ability in disabled children before and after engagement in a therapeutic horseback riding program. ...
... After 5 months of horseback riding training (twice per week; 30 minutes per session), the participants of each group, cerebral palsy (CP) (P < 0.05), intellectual disability (ID) (P < 0.001), and (AT) (P < 0.05), showed a notable increase in equilibrium ability. These results are attributed to the unique interaction between the rider and horse during exercise, including communication and signaling between the rider and horse, and the indirect gravitational effect and stimulus of the horse's movements (Fleck, 1992). ...
This study was performed on 26 disabled adolescent participants (16 male, 10 female) with the objective of testing changes in equilibrium after engagement in horseback riding. Participants of total 26 persons were divided into three groups as follows: 6 children with Cerebral Palsy (CP), 14 children with Intellectual Disability (ID) and 6 children with Autism (AT). Participants engaged in therapeutic horseback riding (TR) two times per week for 30 minutes per session. The 26 participants demonstrated a considerable increase in equilibrium ability, with an average increase in equilibrium time of 44.22?50.70 sec after TR. Equilibrium also increased according to disability group: CP (P
... The rider, then, reproduces movement patterns that are similar to those of natural human activities, such as walking. 2 More specifically, the pelvic girdle and torso undergo a similar range of motion in both activities. [51][52][53][54] Improvements in these factors are thought to be critical for enhancing gait. Walking is crucial for maintaining activities of daily living (ADLs) and quality of life and gait appears to be enhanced following EAAT in adults and children being treated for neuromuscular disorders. ...
... The improvements observed in gait of those who regularly engage in EAAT are thought to be related to the similarities between the motion of the rider's pelvis while sitting on a walking horse, the motion of the rider's pelvis while ambulating along a level surface, and the motion of the horse's pelvis while walking. 51,52,77 While most studies have focused on the noticeable, physical benefits of EAAT, the literature lacks evidence as to why the benefits occur. Very little evidence exists regarding the physiologic responses to EAAT, which need to be investigated concurrently with functional testing. ...
Objective:
To summarize the physical benefits of therapeutic horseback riding and hippotherapy and suggest directions for future research.
Methods:
Review of databases for peer-reviewed articles related to equine-assisted activities and therapies. Databases included MEDLINE via EBSCO, Web of Science, PubMed, Google Scholar, and Academic Search Complete. Articles were limited to those with full-text access published in English since 1987.
Results:
Acute and residual improvements in physical benefits, such as gross motor function (e.g., walking, running, jumping), spasticity, muscle symmetry, posture, balance, and gait occur in adults and children with varying disabilities. The benefits appear to be greatest following multiweek interventions with one or more sessions per week. Modest acute cardiovascular responses are observed during equine-assisted activities and therapies with little or no evidence for training improvements in heart rate or blood pressure at rest or during riding.
Conclusion:
The present body of literature provides evidence that equine-assisted activities and therapies are an effective means of improving many measures of physical health. However, more controlled trials are urgently needed to strengthen the current knowledge base, establish dose-response characteristics of equine-assisted activities and therapies, and explore the physiologic basis for the promising results suggested from the literature.
... Με τον τρόπο αυτό προωθούν την προβολή των εμπειριών ενός παιδιού ή και τον εντοπισμό ενός παιδικού προβλήματος υγείας (Iannuzzi & Rowan, 1991). Η κίνηση της λεκάνης του αλόγου κατά την διάρκεια της ιππασίας παρέχει κινητήρια και αισθητηριακή είσοδο στο ανθρώπινο σώμα, παράγοντας ιδιαίτερη κίνηση στην λεκάνη του αναβάτη που μοιάζει αρκετά με την ανθρώπινη κίνηση (Bertoti, 1988;Fleck, 1992;Potter, Evans, & Nolt, 1994). ...
Therapeutic horseback-riding is aiming to improve the social, sensory, psychological,communication, and education skills as well as their quality of life and health status of individuals with disabilities. The purpose of this study was to examine the effect of a therapeutic horsebackriding program on the socialand communication skills of children with autistic spectrum disorder(ASD). The importance of this study is related to the lack of relative research evidence in Greece and its effect on the above-mentioned skills. Ten children with ASD (4-12 years old) participated in this study. Instrument used was the Social Communication Questionnaire (SCQ), a parent-reportquestionnaire that assesses socialization and communication skills. Parents of children with ASD completed the SCQ twice- prior and after application of the equine program, with the cooperation of the primary researcher. Statistical analysis yielded significant differences in communication and
socialization abilities between pre and post measures, in favor of post measurements. Overall, this study indicated that horse-back riding had a positive effect on children with ASD, since their social and communication skills were significantly improved following the completion of the program.
... The movement of the horse's pelvis may provide motor and sensory inputs to the human body. The reciprocal movements of a walking horse produce a pelvic movement in the rider's body that closely resembles human ambulation (14)(15)(16). ...
Background
There are many obvious health benefits to riding, including developing a strong core and legs, but there are also many less obvious benefits, such as increased confidence and introspection. Few studies have addressed the effects of horseback riding on children and the mechanisms underlying how riding affects humans. We examined the effects of horseback riding on the ability to distinguish Go/No-go tasks and solve arithmetic problems in children.
Methods
The subjects were 34 boys and 72 girls, aged 10–12 years old, which were divided into three groups (horse riding, walking, and resting). They were healthy typical children, who performed the Go/No-go tasks and solved the arithmetic problems. The heart rate and heart rate variability of the children, and the three-dimensional acceleration of the children while walking horses, were examined.
Results
Riding on a half-breed horse or a pony improved the ability to perform Go/No-go tasks and solve arithmetic problems, possibly through sympathetic activity. Some horses, like the Kiso, might provide a healing effect to children through parasympathetic activity. Statistically significant differences in the three-dimensional acceleration and the autonomic activities were observed among the three horses. The acceleration in the Kiso horse group during walking in hand was significantly different from those involving the other two horses, indicating that the vibrations produced by these horses might modify the autonomic activities.
Conclusion
The most important beneficial factor of horseback riding for children and for human health appears to be associated with the horse’s vibrations, which may differ among horses. Riding some horses may improve the ability of children to respond with an appropriate action depending on the situation (Go reaction) or use self-control appropriately (No-go reaction), possibly through the activation of the sympathetic nervous system.
... A weakening of the quadriceps muscle, which may impair the stability of the knee joint at the end of the swing phase, is typical for L4 root syndrome as well as for a group of other conditions (Callaghan, Parkes, Hutchinson, & Felson, 2014). The similarity of pelvic movements while walking with the movements in hippotherapy has been observed (Fleck, 1997;Rigby, Garner, & Skurla, 2011). Several studies report that the pelvis position and improvements in the dynamic postural stability may also affect the movements in the joints of the lower limbs (Encheff, Armstrong, Masterson, Fox, & Gribble, 2012) and thus the walking performance (Quint & Toomey, 1998;Rigby, 2009). ...
Low back pain (LBP) is a painful disease which results in limitations on normal daily physical activities related to self-care, social contact and communication. Physiotherapy combined with spa treatments and hippotherapy could be a suitable treatment method recommended in patients with LBP. The purpose of the study was to determine the effect of standard physiotherapy with and without hippotherapy on gait kinematic parameters in patients with chronic LBP. A total of 23 patients suffering from LBP with a damage located between L4 and S1 segments were enrolled in the study. Thirteen of them (the experimental group) underwent in addition to standard physiotherapy also hippotherapy. Physiotherapy intervention and hippotherapy units were performed at the Darkov Spa, Czech Republic. The kinematic gait parameters were obtained by the Vicon MX system. The intensity of the pain was determined using the visual analogue pain scale (VAS). After the intervention, we found statistically significant increase in the range of motion the knee joint in the sagittal plane (P < 0.05) as well as the flexion in the hip joint (P<0.05) in the experimental group. Similar trends were observed in the control group. Only two significant differences (P<0.05) between lower extremities with and without pain propagation were detected for the experimental group while for the control group the number of differences increased after the intervention. VAS pain score decreased in both groups but significantly (P < 0.01) only in the experimental group. Particular physiotherapy protocol had an observable effect on the gait kinematics in the patients with chronic LBP. A significant effect of hippotherapy on the symmetry of gait and VAS pain score was found.
... 7 Also, horse riding exercise is similar to the effect obtained by gait training, because of the similarity in the pelvic motor gait when horse riding. 8 Moreover, horse riding strengthens the knee flexors and quadriceps muscles. 9 Furthermore, the effect of horse riding exercise has been validated by the correlation among muscular endurance, agility, coordination, flexibility, equilibrium, and aerobic capacity. ...
The purpose of this study was to investigate the effect of indoor horse riding exercise equipment on the young people in their twenties. We classified the effects into flexibility, muscle strengthening, and muscular reaction. Subjects performed horse riding exercise using SRider (Neipplus Co. & Chonbuk National Univ. Korea) that we developed Twenty male and twenty female subjects were included and they had no experience with horse riding as an exercise and no medical history of falling. Exercise was performed for 45 min a day and 3 days a week during 8 weeks in a constant temperature and humidity environment. Once a week, we conducted the body-effect measurements. We measured forward trunk flexion and backward trunk extension to verify the improvement of flexibility. We also measured lumbar joint torque using the BIODEX System3 to verify the improvement of muscle strength and reaction. Our results of flexibility showed that values of forward trunk flexion and backward trunk extension after the exercise were higher than those before the exercise. It also presented that the stimulated three-dimensional movement of the horse riding exercise activated joints and muscles not usually used Besides, the continuous movement of horse riding can reduce muscle tonus and relax stiff muscles. The muscle strengthening and muscular reaction results showed that peak lumbar joint torque after the exercise was higher than that before the exercise. We found that the horse riding exercise using indoor equipment improved flexibility, muscle strength, and muscular reaction. Moreover, we hope that this work will help us understand the exercise characteristic of this equipment.
... The concept of a real horseback riding places emphasis on treating patients through horse movement. In a real horseback riding, movement is transferred from the horse's back to the rider's pelvis and torso in a pattern resembling human gait (15,16). Movements are bilateral and symmetrical and continue as long as the horse is in motion (17,18). ...
Background
Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders, and thus effective treatments are required. Recently, a real horseback riding has been reported to be beneficial for the patients. However, it has some limitations, such as limited approaches and safety issues.Objective
The purpose of this study was to investigate the effect of horse simulator riding on back pain, body composition and trunk strength in the patients with CLBP.ParticipantsForty-seven men with CLBP (mean age 20.55 ± 1.38 years) were randomly divided into a control group (n = 23) and a horse simulator riding group (n = 24), and visual analogue scale (VAS), body composition and isokinetic trunk strength were measured after 8 weeks for which subjects in a horse simulator riding group had performed the horse simulator exercise (HSE).ResultsHorse simulator exercise significantly reduced pain scores of VAS and enhanced isokinetic torques of trunk at 30 and 90°/s. There were also significantly increased muscle mass and decreased fat mass in horse simulator riding group.Conclusion
It can be inferred that HSE may be helpful in relief of back pain and recovery of back function through developing trunk strength and balancing the ratio of trunk flexor/extensor muscles.
... The movement of the horse's pelvis during horseback riding provides motor and sensory inputs to the human body. The reciprocal movement of the walking horse produces pelvic movement in the rider's body that closely resembles human ambulation (Bertoti, 1988;Fleck, 1992;Potter et al., 1994). This implies that the horse's pelvic movement is similar to the human pelvic movement while walking. ...
... When horseback riding, movement is transferred from the horse's back to the rider's pelvis and torso in a pattern resembling human gait (Fleck, 1997). Movements are bilateral and symmetrical and continue as long as the horse is in motion (Heine, 1997;von Dietze, 2005). ...
A total of 24 patients, considerably disabled in daily activities by back pain, participated in an Equine Assisted Therapy (EAT) programme. The patients also had several health problems in addition to their current pain. The programme emphasised the principles of body awareness. The study is aimed at investigating not only whether symptom reduction would be achieved, but also at identifying qualities of EAT that were particularly beneficial for the patients' well being. The study was performed according to action research principles. The treatment reduced the pain and lessened other symptoms. The EAT also had an influence on the patients' self-image and a positive chain of effects was observed. The consequences were described according to four dimensions; the dimension of body awareness, competence, emotion and environment. The dimensions were interrelated having the simultaneous influence of a transition process and symptom reduction towards health.
Aims:
The objective of this case series was to document gross motor function, gait parameter, and bladder control outcomes following physical therapy incorporating hippotherapy in children with Down syndrome (DS).
Methods:
Four children between three and five years of age received eight-weekly physical therapy sessions incorporating hippotherapy. Outcome measures included the Gross Motor Function Measure-88 (GMFM-88), parental perception of function during every day activities, spatiotemporal parameters of gait and bladder control.
Results:
Total change scores on the GMFM-88 exceeded the standardized response mean in all four children, while scores on Dimension E improved in two children. From the mothers' perspectives, all children showed at least some improvement in walking, running, and jumping; sitting, kneeling, and standing; symmetry and comfort; balance; coordination and social interactions and there were inconsistent changes in bladder control. Only one child demonstrated changes greater than 20% in any of the gait parameters.
Conclusions:
Physical therapy incorporating hippotherapy may be a potential treatment to assist in improving gross motor function in children with DS, but eight sessions may not be long enough to show major improvements in gait parameters or bladder control. Further research in the form of larger controlled trials is warranted to provide more support for the intervention in those with DS.
Purpose:
The purpose of this study was to characterize pelvic displacement and cardiorespiratory responses to simulated horseback riding and walking in youth with cerebral palsy and to compare responses to youth without cerebral palsy before and after 8 weeks of hippotherapy.
Method:
Eight youth with cerebral palsy (Mage = 10 ± 4 years; Mheight = 137 ± 24 cm; Mweight = 32 ± 16 kg) and 8 youth without cerebral palsy (Mage = 11 ± 2 years; Mheight = 149 ± 14 cm; Mweight = 48 ± 15 kg) underwent a hippotherapy intervention. Participants completed simulated horseback riding at an intensity approximating a fast walk (0.65 Hz) and walked on a treadmill (1 mph, 0% grade) before and after hippotherapy. Pelvic displacement along the anterior-posterior, vertical, and medial-lateral axes, heart rate, oxygen consumption, ventilation, and blood pressure were measured at rest and during steady-state exercise in both exercise modes.
Results:
Kinematics and cardiorespiratory responses were similar between the 2 groups during simulated horseback riding (p > .05 for all) before the intervention. Significantly greater cardiorespiratory responses were observed in the youth with cerebral palsy compared with the group without cerebral palsy while walking before and after the intervention (p < .05, effect sizes 26% to 237% greater). Eight weeks of hippotherapy did not alter responses, but anecdotal improvements in gait, balance, posture, and range of motion were observed in those with cerebral palsy.
Conclusion:
These results contribute to our understanding regarding the efficacy of hippotherapy as an intervention to improve functional abilities in those with cerebral palsy.
Equine-assisted therapy (EAT), an umbrella term for various forms of therapy such as physical therapy, occupational therapy, speech-language therapy and psychotherapy where a horse is part of the treatment team, is an emerging field internationally. The Federation for Horses in Education and Therapy International has members in 49 countries (Federation of Horses in Education and Therapy International (HETI 2012)), and the number of educational programs offering training in this field is growing. In order for equine-assisted therapy to be established as a valid form of treatment and accepted as different from recreational activities involving horses, more research and information is needed. The purpose of this chapter is to provide an overview of equine-assisted therapy including the history of the field and of the human-horse relationship, the current state of research, considerations for a general theoretical framework, and a review of equine-assisted therapy as physical therapy and as psychotherapy.
[Purpose] This study was conducted to evaluate the effect of mechanical horseback riding
exercise on the balance ability of the elderly. [Subjects and Methods] Ten elderly
patients were assigned to an experimental group, and they performed 15 min of horseback
riding. Another 10 elderly patients were assigned to a control group, and they performed
15 min of one-leg standing exercise. Both exercises were repeated five times a week for a
total of six weeks. The participants’ balance ability was evaluated. [Results] The
horseback-riding group showed significant differences between the pre-and post-test
balance abilities as assessed by the Berg Balance Scale (BBS) and the Timed Up and Go
(TUG) test. [Conclusion] Horseback riding effectively improves the balance ability of the
elderly. Horseback riding should be considered as a therapeutic method for the physical
therapy of the elderly.
• Throughout the centuries, the horse and human relationship has evolved from one of sustenance to one of partnership. Historically, the idea of horses being partnered with humans in a therapeutic capacity is evident from writings of the ancient Greeks to documentation by European physicians and therapists from the 1500s through the 1800s. The impetus for the development of modern day equine-assisted activities and therapies (EAAT) is credited to a Danish dressage rider named Lis Hartel, who won an equestrian silver medal at the 1952 Olympic Games despite being partially paralyzed by polio. Her international accomplishments on the back of a horse demonstrated the potential healing power of riding
• In 1870, Chassaigne published the first known study testing the effects riding had on individuals with disabilities. He concluded positive benefits on balance, posture, and muscle control. Research on EAAT was limited until the Scandinavian polio outbreak in in the 1940s. Since that time, numerous publications on the benefits of EAAT have been documented, echoing outcomes of early investigators; however, many publications lack the rigor necessary for credibility in the US medical community. Small sample sizes, heterogeneity of study groups, lack of control groups or randomized treatment assignment, and lack of codified interventions, are all cited as criticisms for peer-reviewed studies.
• The physical effects of EAAT on individuals with cerebral palsy remain the most documented area of research. Meta-analyses and systematic reviews of the literature incorporating well-designed research trials investigating the effects of mounted EAAT on individuals with cerebral palsy show conflicting results regarding improvements in gross motor function; however, significant improvements in balance and postural control were found. Randomized clinical trials determining the appropriate type, dose and frequency of EAAT, assignment of horse to participant, and sorting out the true effect of the horse is necessary for the EAAT industry to gain credibility.
• Demonstrated efficacy of EAAT is essential for parents, guardians, and participants to know whether EAAT is beneficial and what evidence exists to support this type of monetary and personal investment. In addition, quality research is important for granting agencies to support EAAT programs. Finally, increasing the number of randomized clinical trials testing the efficacy of EAAT will be essential for the field to earn legitimacy in the medical community, support insurance reimbursement, and be viewed as a viable therapeutic option for identified populations.
• Although limited, several funding opportunities exist specifically for research in the area of animal-assisted interventions. The Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Horses and Humans Research Foundation are two examples of agencies that support high quality research investigating horse and human interactions. Continued support is essential to provide funding opportunities for research that will further legitimize the EAAT field and move the industry forward.
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A prevailing rationale for equine assisted therapies is that the motion of a horse can provide sensory stimulus and movement patterns that mimic those of natural human activities such as walking. The purpose of this study was to quantitatively measure and compare human pelvis motions when walking to those when riding a horse. Six able-bodied children (inexperienced riders, 8-12years old) participated in over-ground trials of self-paced walking and leader-paced riding on four different horses. Five kinematic measures were extracted from three-dimensional pelvis motion data: anteroposterior, superoinferior, and mediolateral translations, list angle about the anteroposterior axis, and twist angle about the superoinferior axis. There was generally as much or more variability in motion range observed between riding on the different horses as between riding and walking. Pelvis trajectories exhibited many similar features between walking and riding, including distorted lemniscate patterns in the transverse and frontal planes. In the sagittal plane the pelvis trajectory during walking exhibited a somewhat circular pattern whereas during riding it exhibited a more diagonal pattern. This study shows that riding on a horse can generate movement patterns in the human pelvis that emulate many, but not all, characteristics of those during natural walking.
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This study was conducted to evaluate the effect of the exercise on elderly balance ability by using hippotherapy and therapeutic ball exercise. 10 patients were assigned to the hippotherapy group and they got with 30 minutes of hippotherapy. Another 10 elderly were assigned to the therapeutic ball group and they got with 30 minutes of therapeutic ball exercise. All procedures were repeated 5 times a week for the total of four weeks. To investigate the participants balancing abilities, the Time" Up & Go"(TUG) and One Leg Stand Test(OLST) were evaluated. The results of study were significant differences between pre-test and post-test of TUG and OLST(p.05). The conclusion showed that both the hippotherapy and the therapeutic ball exercises were effective on elderly balancing ability. Consequently, it would be better to practice therapeutic ball than hippotherapy for elderly exercise because the more economical and there is less restriction of space than the hippotherapy.
The purpose of this study was to investigate the effect of indoor horseback riding exercise equipment on the human body. Subjects performed horseback riding exercise using Slim-Rider. We used human body effect methods to analyze the exercise effect. We classified the effects into flexibility, muscle strengthening, and muscular reaction. Twenty male and 20 female subjects were included. They had no experience with horseback riding as an exercise and no medical history of falling. Subjects exercised 40 min/day 3 days per week for 4 weeks in a constant temperature and humidity environment. Once per week, we conducted the body-effect measurements. We measured forward trunk flexion and backward trunk extension to verify improvements in flexibility. We measured lumbar joint torque using the BIODEX System3 to verify improvements in muscle strength and reaction. The flexibility results showed that indices of forward trunk flexion and backward trunk extension were higher after exercise than those before exercise, suggesting that the stimulated three-dimensional movement of the horseback riding exercise activated joints and muscles not usually used. Besides, the continuous movement of horseback riding can reduce muscle tonus and relax stiff muscles. The muscle strengthening and muscular reaction results showed that peak lumbar joint torque was higher after exercise than that before exercise. Horseback riding exercise stimulates sensory and motor nerves, which improved muscle reaction. We found that horseback riding exercise using indoor equipment improved flexibility, muscle strength, and muscular reaction. We suggest that indoor horseback riding could provide exercise for patients undergoing rehabilitation or treatment.
Hippotherapy, also known as equestrian rehabilitation, makes use of the physical interactions between the riding patient and the horse movements, by inducing the patient's trunk to became receptive and responsive to solicitations and consequently improving his postural control and his muscular tone. Evidences of therapy effectiveness have been assessed in gross motor function rehabilitation in children affected by cerebral palsy (CP) and in subjects affected by spinal lesions. However a quantitative and progressing assessment of such results is still lacking because of the intrinsic difficulty of collecting objective data 'on the riding camp'. Typically, the enhancements are evaluated by physicians in the lab, at the end of the rehabilitation cycles, by means of standard postural analysis protocols. This work proposes a multi-parametric method for the objective assessment of the effectiveness of equestrian rehabilitation. In particular a system to evaluate the level of "activity" of the rider with respect to the horse movements is illustrated. The time evolution of this parameter is assumed as an indicator of the enhancement in muscle tone and co-ordination of the patient, hence as an estimate of the therapy efficacy. Preliminary experiments conducted on the riding camp are presented. The results are encouraging, though a full validation of the method will require the involvement of a suitable sample of patients and an evaluation of the reliability and repeatability of the results, based on standard postural analysis protocols.
The purpose of this case report is to describe the impact of an 11-week hippotherapy program on the gross motor functions of two children (respectively 28 and 37 months old) diagnosed with Down syndrome. Hippotherapy is a strategy that uses the horse's motion to stimulate and enhance muscle contraction and postural control. The children were assessed by the Gross Motor Function Measure (GMFM) and accelerometry. The results indicate that both children improved on many dimensions of the GMFM. Power spectral analysis of the acceleration signals showed improvement in postural control of either the head or trunk, because the children adopted two different adaptative strategies to perturbation induced by the moving horse.
Quantitative (not qualitative) studies were sought investigating whether horseback riding used as therapy improves gross motor function in children with cerebral palsy (CP). Eleven published studies on instructor-directed, recreational horseback riding therapy (HBRT) and licensed-therapist-directed hippotherapy were identified, reviewed, and summarized for research design, methodological quality, therapy regimen, internal/external validity, results, and authors'conclusions. Methodological quality was moderate to good for all studies; some studies were limited by small sample size or lack of non-riding controls. HBRT improved gross motor function in five of six studies (one study was inconclusive); hippotherapy improved gross motor function in all five studies. The studies found that during HBRT and hippotherapy: (1) the three-dimensional, reciprocal movement of the walking horse produced normalized pelvic movement in the rider, closely resembling pelvic movement during ambulation in individuals without disability; (2) the sensation of smooth, rhythmical movements made by the horse improved co-contraction, joint stability, and weight shift, as well as postural and equilibrium responses; and (3) that HBRT and hippotherapy improved dynamic postural stabilization, recovery from perturbations, and anticipatory and feedback postural control. The evidence suggests that HBRT and hippotherapy are individually efficacious, and are both medically indicated as therapy for gross motor rehabilitation in children with CP. Recommendations for future research are discussed.
The purpose of this single subject research study was to examine the effects of a once weekly, 10-week hippotherapy program for three children, ages 27-54 months, with cerebral palsy. Participants were rated as Level V on the Gross Motor Function Classification System. The Sitting Dimension of the Gross Motor Function Measure was used to establish a baseline of sitting abilities, and was administered every 2 weeks during intervention. The Sitting Assessment Scale and the Gross Motor Function Measure were administered before, after, and 4 weeks postintervention. Parental perceptions of the hippotherapy intervention were assessed using questionnaires. None of the children made gains on any of the standardized outcome measures. Parental perceptions were very positive, with reported improvements in range of motion and head control.
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