Analysis of strength and electromyographic activity of lower limbs of individuals with down syndrome assisted in physiotherapy and hippotherapy.

INTRODUCTION: one of the characteristics of Down Syndrome (DS) is muscle hypotonia. Different therapeutic approaches have a positive influence, between them Physiotherapy applications with different therapeutic approaches such as Hippotherapy have a positive effect on the physical health and quality of live of individuals with DS. OBJECTIVE: to evaluate the effects of both treatments on the strength and electromyographic activity of the lower limbs of children and adolescents with DS. METHODS: fourteen individuals, aged between 10 and 18 years, participated in two groups: Physiotherapy group (n = 5) and Hippotherapy group (n = 9). Thirty interventions were performed for each type of therapy, once a week, lasting 30 min. Pre and post-interventions, the 30-Second Chair Stand Test (30s-CST) was used to assess the strength of the lower limbs and the surface electromyography equipment (EMG 800RF) to assess the lower limb myoelectric activity. RESULTS: there was a reduction in the post-intervention electromyographic values for both treatments (p˂0.001), with significantly less myoelectric activity in Hippotherapy compared to Physiotherapy for all evaluated muscles (p˂0.001) and a significant increase in muscle strength for the Hippotherapy, post-intervention group (p = 0.0007). CONCLUSION: Physiotherapy and Hippotherapy are interventions that promote positive changes in the myoelectric activities of individuals with DS. However, only hippotherapy promoted an increase in strength of the lower limbs.

Analysis of Trunk Neuromuscular Activation During Equine-Assisted Therapy in Older Adults.

The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.

Electromyographic analysis of muscle activation of the trunk and lower limbs during human gait and hippotherapy using different ride mount materials.

OBJECTIVE: Activation of the trunk and lower limb muscles, namely the multifidus, rectus abdominis, rectus femoris, and tibialis anterior, was analyzed using surface electromyographyin 40 young, healthy, and sedentary individuals. METHODS: Data were collected from sneaker-clad subjects with independent gait and during hippotherapy using saddles and blankets, with the feet in and out of the stirrups. RESULTS: Surface electromyography results demonstrated a statistically significantly greater activation of the rectus femoris comparison to tibialis anterior muscle during hippotherapy. No statistically significant differences were observed when comparing variables related to the mount materials used in hippotherapy and human gait. CONCLUSION: In this study, similarities were observed between activation of the trunk and lower limb muscles during hippotherapy and human gait. In addition, the mount materials and practices used in hippotherapy did not influence muscle activity.

Impact of equine assisted therapy on the cardiovascular parameters of the elderly / Impacto da terapia assistida por equinos nos parâmetros cardiovasculares de idosos

INTRODUCTION: Physical activity programs in the elderly aim to prevent and/or reduce the functional decline resulting from the senescence process. Several studies provide evidence that Equine Assisted Therapy (EAT) is an effective means of improving health. However, studies addressing the effects of EATon the cardiovascular system are scarce. OBJECTIVE: To evaluate the effect of Equine Assisted Therapyon the cardiovascular responses of participants divided into two groups: normotensive and hypertensive. METHODS: Twenty individuals participated, aged between 60 and 79 years, divided into three groups: Normotensive Group (n=14), Hypertensive Group (n=6) and all participants, Total Group (n=20). The Omron® HEM 742 blood pressure monitor was used to measure blood pressure and the Gerathem® portable finger oximeter to measure heart rate and blood oxygen saturation. Ten visits were made once a week, lasting 30 minutes. RESULTS: Between the first and tenth interventions, there was a reduction in blood pressure and heart rate, with statistical significance of systolic blood pressure for the Hypertensive Group (p=0.0478), the Total Group (p=0.0201) and diastolic pressure for the Total Group (p=0.0421). There was also a statistically significant difference in systolic blood pressure and heart rate during some visits. Blood oxygen saturation increased after the intervention, but without statistical significance. CONCLUSION: Equine Assisted Therapy can promote a reduction in blood pressure in the elderly, especially hypertensive individuals.

INTRODUÇÃO: Programas de atividade física em idosos visam prevenir e/ou reduzir o declínio funcional decorrente do processo de senescência. Vários estudos fornecem evidências de que a Terapia Assistida por Equinos (TAE) é um meio eficaz de melhorar a saúde. No entanto, estudos que abordam os efeitos da TAE no sistema cardiovascular são escassos. OBJETIVO: Avaliar o efeito da Terapia Assistida por Eqüinos nas respostas cardiovasculares dos participantes dividos em dois grupos: normotensos e hipertensos. MÉTODOS: Participaram 20 indivíduos, com idade entre 60 a 79 anos, distribuídos em três Grupos: Grupo Normotenso (n=14), Grupo Hipertenso (n=6) e todos os participantes, Grupo Total (n=20). Foi utilizado o monitor de pressão arterial Omron® HEM 742 para aferir a pressão arterial e o oxímetro de dedo portátil Gerathem® para medir a freqüência cardíaca e a saturação de oxigênio no sangue. Foram realizados dez atendimentos uma vez por semana, com duração de 30 minutos. RESULTADOS: Entre a primeira e décima intervenção, houve redução da pressão arterial e da frequência cardíaca, com significância estatística da pressão arterial sistólica para o Grupo Hipertenso (p=0,0478), o Grupo Total (p=0,0201) e da pressão diastólica para o Grupo Total (p=0,0421). Também houve diferença estatisticamente significante da pressão arterial sistólica e da frequência cardíaca durante alguns atendimentos. A saturação de oxigênio no sangue aumentou após a intervenção, porém sem significância estatística. CONCLUSÃO: A Terapia Assistida por Eqüinos pode promover redução da pressão arterial em idosos, principlamente de hipertensos.

Electromyographic analysis of stomatognathic muscles in elderly after hippotherapy.

The aging process affects the entire human body, including the stomatognathic system, and can trigger not only occlusal but also postural imbalances involving other muscular chains. Hippotherapy has been used to promote cervical, postural, and balance control in individuals with diverse impairments. The present study used electromyography to evaluate the masseter and temporal muscles in an elderly population pre- and post-hippotherapy. Participants included 17 individuals, mean age 66,5±7 years. Electromyographic recording of the bilateral masseter and temporal muscles was performed during the postural resting condition and activities that involved the active participation of these muscles in different conditions. The practitioner performed no other type of activity or exercise during the intervention because the objective is to evaluate the effect of the three-dimensional movement provided by the horse. Raw electromyographic data were tabulated using commercially available software (IBM® SPSS® Statistics 234.0) and subjected to statistical analysis, in which p ≤ 0.05 was considered to be statistically significant. Post-hippotherapy, there was lower electromyographic activity for the masseter and temporalis muscles in all the static mandibular tasks, with significant effect for time for the right temporal muscle (p = 0.038), the left temporal muscle (p = 0.028) and in the all dynamic mandibular tasks for the left temporal muscle (p = 0.025) and the left masseter muscle (p = 0.027). Hippotherapy promotes a reduction in the myoelectric activity of the masticatory muscles of elderly individuals.

Impact of hippotherapy for balance improvement and flexibility in elderly people.

INTRODUCTION: The decrease in functional ability, strength, balance, flexibility, agility, and coordination owing to neurological and muscular changes is one of the characteristic features of the human aging process. Hippotherapy has been highlighted as a therapeutic approach with physical and psychological benefits for this section of the population. However, the effects of hippotherapy in elderly people need to be further studied by assessing their balance and flexibility. METHODS: Thirty elderly people were recruited and divided into two groups; 15 in the Hippotherapy Group (HG), and 15 in the control group (CG) (aged 66.07 ±â€¯5.80 and 68.47 ±â€¯5.85 years, respectively). The HG received ten 30-min sessions of hippotherapy once a week. Assessment included the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), the Functional Reach Test (FRT)and the Sit-and-Reach Test with the Well's box before the first and after the tenth session of hippotherapy; and the Sit-and-Reach Test before and after each session. RESULTS: The HG demonstrated a significant difference in the TUG test execution time and the FRT scores before and after the hippotherapy sessions (p = 0.036, p = 0.030, respectively), indicating an improvement in functional range. The examination of flexibility with the Wells's box also revealed a significant difference in the rates (cm) before and after 10 sessions of the hippotherapy for the HG (p = 0.033). CONCLUSIONS: The present findings showthat hippotherapy improved elderly people's functional mobility, dynamic balance, and flexibility. These results will guide professionals who treat this population.

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

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

Analysis of the electromiographic activity of lower limb and motor function in hippotherapy practitioners with cerebral palsy.

OBJECTIVE: Investigation of the effects of hippotherapy treatment on lower limb muscle activity and gross motor function in subjects with cerebral palsy (CP), comparing them to a group of subjects with adequate motor development. METHODS: Evaluation was made of seven individuals with spastic diparetic CP, average age 9.3 (±3.3) years (CP group), Gross Motor Function Classification System (GMFCS) levels I and II, and eight individuals with adequate motor development, average age 10.9 (±3.2) years (control group). The groups were submitted to 25 sessions of hippotherapy, each lasting 30 min, on a weekly basis, and the muscle activity of the lower limbs was evaluated using surface electromyography during the 1st, 10th, 20th, and 25th sessions. For the CP group, Gross Motor Function Measurement (GMFM-88) was performed before and after hippotherapy treatment. RESULTS: There was higher muscle activity in the 10th session, compared to the other sessions, with greater activity of the tibialis anterior muscles, for both groups studied. After treatment, the CP group showed significant improvement in the GMFM total score, and in the scores for dimensions D and E. CONCLUSION: Hippotherapy sessions improved the muscle responses in both groups, and improved the gross motor function of the subjects with CP.

Activation of lower limb muscles with different types of mount in hippotherapy.

OBJECTIVES: To analyze muscle activation of lower limbs (LL) of subjects in hippotherapy sessions. METHODS: The study included 10 healthy subjects, five male and five female, with an average age of 24.03 (±4.06) years. Subjects underwent four hippotherapy sessions of 30 min with interval of one week, and each session was performed with a different type of mount material in the following order: 1st performed with saddle and feet in the stirrups (S1), 2nd with saddle and feet off the stirrups (S2), 3rd with blanket and feet off the stirrup (S3) and 4th with blanket and feet in the stirrups (S4). Surface electromyographies were performed at 1, 10, 20 and 30 min of session, and the electrodes were placed on muscle bellies bilaterally on the muscles rectus femoris, vastus medialis, vastus lateralis and tibialis anterior. RESULTS: The analysis of muscle activity during these four sessions showed a significant difference in muscle recruitment in LL, and sessions with blanket and feet in the stirrups provided greater muscle activation of quadriceps and tibialis anterior with the horse at step gait (p = 0.0002). CONCLUSION: The results suggest that feet positioned in the stirrups is a relevant factor for greater muscle recruitment in LL to maintain postural balance while riding, especially using a blanket as mount material for ride a horse.

Electromyographic evaluation of the lower limbs of patients with Down syndrome in hippotherapy / Avaliação eletromiográfica dos membros inferiores de pacientes com síndrome de Down na equoterapia

Hippotherapy is a therapeutic method that uses the horse's movement to achieve functional results in practitioners with Down syndrome (DS), who present motor and neurophysiological changes that affect the musculoskeletal system. Evaluating the motor behavior related to the control and the improvement of muscle activation in practitioners with Down syndrome subjected to hippotherapy. 10 practitioners were divided into two groups: Down Group (DG) ­ practitioners with DS, and Healthy Group (HG) ­ practitioners with no physical impairment. The muscles gluteus medius, tensor fasciae latae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius were evaluated by electromyography using gross RMS values, which correspond to muscle activation; the evaluations were performed on the 1st and 10th hippotherapy sessions (frequency: once a week), and after 2 months interval without treatment, they were performed on the 1st and 10th hippotherapy sessions (frequency: twice a week). It was noted that activation of the studied muscles increased with the passing of sessions, regardless the weekly frequency of attendance; however, the period without treatment resulted in reduction of this effect. Practitioners with DS presented satisfactory changes in muscle activation pattern, in learning and in motor behavior during hippotherapy sessions.

Equoterapia é um método terapêutico que utiliza o movimento do cavalo para alcançar resultados funcionais, realizada em praticantes com síndrome de Down (SD), que apresentam alterações neurofisiológicas e motoras que afetam o sistema musculoesquelético. Avaliar o comportamento motor relacionado ao controle e melhora a ativação muscular em praticantes com SD submetidos ao tratamento equoterapêutico. Participaram dez praticantes divididos em dois grupos: grupo Down (GD) - praticantes com SD, e grupo Saudável (GS) - praticantes sem comprometimento físico. Os músculos glúteo médio, tensor da fáscia lata, reto femoral, vasto medial, vasto lateral, bíceps femoral, tibial anterior e gastrocnêmio foram avaliados por meio da eletromiografia, utilizando o valor de RMS bruto que corresponde à ativação muscular, e as avaliações foram realizadas na primeira e décima sessões de equoterapia (frequência: 01 vez por semana); e após intervalo de dois meses sem tratamento, foi realizada na primeira e décima sessões de equoterapia (frequência: 02 vezes por semana). Observou-se que a ativação muscular dos músculos estudados aumentou com o passar das sessões, independente da frequência semanal de atendimento; mas o período sem tratamento resultou em redução deste efeito. Os praticantes com SD apresentaram mudanças satisfatórias no padrão de ativação muscular, na aprendizagem e no comportamento motor no decorrer das sessões de equoterapia.

Effects of hippotherapy on posture in individuals with Down Syndrome / Efeitos da equoterapia na postura de indivíduos com Síndrome de Down

Abstract Introduction: Individuals with Down syndrome (DS) have alterations that affect the musculoskeletal system, causing abnormal patterns, and alter the morphological anatomical and mechanical axes that provide intrinsic stability to the skeleton, and can trigger misalignments and orthopedic disorders in adulthood. Objective: The objective of student to evaluate posture and postural alignment before and after the hippotherapyin individuals with DS. Methods: Posture of five individuals with DS was evaluated by the software SAPO before and after 27 sessions the hippotherapy. Data were subjected to qualitative descriptive analysis using cluster and statistical analysis with the aid of the software Sigma Stat 2.0, considering differences as statistically significant at p-value < 5%. Results: Improvements were achieved for the alignment of shoulder, head, hip, and lower limbs, in addition to decrease in kyphosis and head protrusion. Conclusion: Patients with DS demonstrated satisfactory changes in motor behavior reflected in improved static posture after treatment with hippotherapy.

Resumo Introdução: Indivíduos com síndrome de Down (SD) apresentam alterações que afetam o sistema musculoesquelético, provocando padrões anormais e alterando os eixos anatômicos morfológicos e mecânicos que proporcionam uma estabilidade intrínseca ao esqueleto, podendo desencadear desalinhamentos e alterações ortopédicas na vida adulta. Objetivo: O objetivo desse estudo foi avaliar a o alinhamento postural antes e após o tratamento equoterapêutico em indivíduos com SD. Métodos: Foram avaliados cinco indivíduos com SD por meio do aplicativo SAPO de avaliação postural, antes e após vinte e sete sessões. Realizou-se a análise qualitativa descritiva por meio do Cluster e análise estatística utilizando o programa Sigma Stat 2.0, considerando estatisticamente significativas as diferenças em que o valor p foi menor que 5%. Resultados: Foi possível verificar melhoras no alinhamento de ombro, de cabeça, de quadril e membros inferiores, bem como diminuição da cifose e da protrusão de cabeça. Conclusão: Os indivíduos com SD apresentaram mudanças satisfatórias no comportamento motor que refletiram em uma melhora da postura estática após o tratamento na equoterapia.

Avaliação da modulação autonômica em indivíduos com síndrome de Down na equoterapia / Autonomic modulation of assessment in individuals with Down syndrome in hippotherapy

Introdução: A equoterapia é uma modalidade terapêutica que atende em grande parte os indivíduos com síndrome de Down, por apresentarem alterações motoras, cognitivas e sócio-afetivas. Sabe-se que as alterações na frequência cardíaca são moduladas pelo Sistema Nervoso Autônomo, entretanto, na literatura não há descrições sobre a Variabilidade de Frequência Cardíaca nestes praticantes, sobretudo na atividade relacionada à equoterapia. Objetivos: Avaliar a Variabilidade da Frequência Cardíaca de pacientes com Síndrome de Down antes, durante e após sessões de equoterapia. Métodos: Foram recrutadas 6 crianças com Síndrome de Down, idade média 12 ± 1,6 anos. A Frequência Cardíaca foi avaliada com um cardiofrequencímetro - Polar (RS800CX), antes, durante e após 5 sessões semanais. Resultados: Houve tendência a diminuição da atividade parassimpática no repouso inicial entre primeira e quinta sessão; e diminuição significativa da atividade parassimpática observada pelo índice pNN50 ao comparar a Frequência Cardíaca durante a primeira e quinta sessões. Conclusão: O tratamento equoterapêutico apresentou uma tendência à diminuição da Variabilidade da Frequência Cardíaca nas crianças estudadas.

Introduction: The hippotherapy is a therapeutic modality that serves largely individuals with Down syndrome, because they have motor, cognitive and socioemotional changes. It is known that changes in heart rate are modulated by the autonomic nervous system, however, in the literature there are no descriptions of the variability of heart rate in these practitioners, especially in the activity related to hippotherapy. Objectives: To evaluate Heart Rate Variability in practitioners of hippotherapy with Down Syndrome. Methods: Six children with Down Syndrome were recruited, age rate of 12 ± 1.6 years. The Heart Rate were evaluate using a cardiofrequencimetre ­ Polar (RS800CX), before, during and after 5 sessions of hippotherapy once weekly. Results: There were tendency of decrease in the parasympathetic activity during initial rest between first and fifth sessions, and significant decrease of the parasympathetic activity observed by the value of pNN50 compared to the Heart Rate during the first and fifth sessions. Conclusions: This study has shown that children treated with hippotherapy had tendency to have their Heart Rate Variability decreased.

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.

Material de montaria para equoterapia em indivíduos com síndrome de Down: estudo eletromiográfico / Riding equipment for hippotherapy in individuals with Down syndrome: an electromyographic study

Introdução: Os indivíduos com síndrome de Down apresentam características peculiares da anomalia, sendo a principal e mais frequente a hipotonia muscular. Objetivo: Verificar o melhor material de montaria e posicionamento dos pés para o recrutamento da musculatura de tronco de crianças com síndrome de Down que utilizam do tratamento da equoterapia. Métodos: Foram avaliados cinco praticantes com síndrome de Down por meio da eletromiografia, durante quatro sessões de equoterapia. Para análise estatística, foi utilizado o teste de Kruskal- Wallis para comparações múltiplas de dados não paramétricos. Resultados: O material de montaria de manta associado com os pés fora do estribo proporcionou maior recrutamento dos músculos estudados, sendo o músculo da região cervical o mais acionado. Conclusão: Por meio desse estudo piloto, infere-se que a manta com pés fora do estribo promoveu uma melhor otimização do tônus dos indivíduos analisados.

Introduction: Individuals with Down syndrome have peculiar characteristics of the anomaly, the main and most common is muscle hypotonia. Objective: To check the best material to mount and position the feet for the recruitment of the trunk muscles of children with Down syndrome using the treatment of hippotherapy. Methods: Five riders with DS were assessed using surface electromyography during four sessions of therapeutic riding. Statistic analysis: data were analyzed using the Kruskal-Wallis non parametric test. Results: The material riding blanket associated with the feet out of the stirrup elicited greater recruitment of the muscles being studied, the muscle of the cervical region being triggered the most. Conclusion: Through this pilot study we infer that the blanket with feet out of the stirrup promoted a better optimization of the tone of the individuals included in the study.

Avaliação da flexibilidade pelo método do Flexômetro de Wells em crianças com Paralisia Cerebral submetidas a tratamento hidroterapêutico: estudo de casos / Flexibility evaluation by the method of Wells? Flexometer in children with Cerebral Palsy submitted to hydrotherapy treatment: study of the cases

Avaliar a flexibilidade da cadeia muscular posterior, utilizando o método proposto por Wells e Dillon, antes e após cada sessão de hidroterapia. Foi verificada a flexibilidade de três crianças com Paralisia Cerebral (PC) diparéticas, com idades entre sete a dez anos. Os valores de flexibilidade foram aferidos, utilizando o Flexômetro de Wells. Houve aumento significativo da flexibilidade da cadeia muscular posterior dos pacientes após cada sessão de hidroterapia, tanto na avaliação em grupo quanto individual, assim como antes da primeira sessão de hidroterapia quando comparada com a última. O estudo sugere que a hidroterapia promove melhora da flexibilidade em relação à cadeia muscular posterior de crianças com PC diparéticas, pelo relaxamento global e consequente diminuição do tônus muscular, quando associada a exercícios de alongamentos passivos.

To evaluate the flexibility of the posterior muscle chain using the method proposed by Wells and Dillon, before and after each hydrotherapy session. The study verified the flexibility of three children with diplegic cerebral palsy (CP), aged 7 to 10. The values of flexibility were measured using the Wells? Flexometer. There was a significant increase in the flexibility of posterior muscle chain of the patients after each session of hydrotherapy, both in the individual evaluation and in the group, as well as before the first session of hydrotherapy compared to the last. The study suggests that hydrotherapy promotes the improvement of flexibility, by relaxation of muscle tone of children with diplegic CP, in relation to the posterior muscle chain, when combined with passive stretching exercises.