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.

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.

Motor development analysis of three-year-old children born preterm through the Motor Development Scale - Case Report

INTRODUCTION: Prematurity and low birth weight are conditions that may compromise the normal development of a child at different stages of development. Considering that these conditions may cause delay in the acquisition of motor skills, it is important to evaluate, detect and prevent possible changes in motor development. OBJECTIVE: To investigate the influence of prematurity and low birth weight on the motor development of children of three years old relating chronological age to general motor age. METHODS: This is an analysis of five cases of preterm children 32.1 (± 1.82) weeks and underweight 1704 (± 384.41) grams, mean chronological age of 43.2 (± 2.59) months, evaluated through the Motor Development Scale (MDS) in the Laboratory of Electromyography and Kinematics (LAELCIN) of the Federal University of Triângulo Mineiro (UFTM), considering general motor age (GMA) and chronological age (CA) as variables CASE: The five preterm and low birth weight children presented a difference between the mean general motor age (37.6 ± 7.40) months and the mean chronological age (43.2 ± 2.59) months, indicating delayed motor development. CONCLUSION: It was observed the absence of linearity of the variables, indicating delay in the motor development, thus justifying the necessity and importance of the longitudinal monitoring of this population for early detection and intervention.

INTRODUÇÃO: A prematuridade e o baixo peso ao nascimento são condições que podem comprometer o desenvolvimento normal da criança nas diferentes etapas evolutivas. Considerando que estas condições podem acarretar atraso na aquisição de habilidades motoras, é importante avaliar, detectar e prevenir as possíveis alterações no desenvolvimento motor. OBJETIVO: Analisar a influência da prematuridade e do baixo peso ao nascimento no desenvolvimento motor de crianças na faixa etária de três anos de idade, relacionando a idade cronológica com a idade motora geral. MÉTODO: Trata-se de uma análise com cinco casos de crianças nascidas pré-termo 32,1 (±1,82) semanas e com baixo peso 1704 (± 384,41) gramas, idade cronológica média de 43,2 (±2,59) meses, avaliadas por meio da Escala de Desenvolvimento Motor (EDM) no Laboratório de Eletromiografia e Cinemática (LAELCIN) da Universidade Federal do Triângulo Mineiro (UFTM), considerando as variáveis idade motora geral (IMG) e idade cronológica (IC). RELATO: As cinco crianças nascidas pré-termo e com baixo peso apresentaram diferença entre a idade motora geral média (37,6, ±7,40) meses e a idade cronológica média (43,2, ±2,59) meses, indicando atraso no desenvolvimento motor. CONCLUSÃO: Observou-se ausência de linearidade das variáveis, indicando atraso no desenvolvimento motor, justificando assim, a necessidade e importância do acompanhamento longitudinal dessa população para detecção e intervenção precoce.

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.

Avaliação da flexibilidade de crianças com paralisia cerebral espástica após intervenção fisioterapêutica / Assessment of the flexibility of children with spastic cerebral palsy after physiotherapeutic intervention

Introdução: A fisioterapia favorece a flexibilidade e diminue a espasticidade de crianças com paralisia cerebral (PC). Objetivos: avaliar os benefícios da fisioterapia convencional para a flexibilidade a curto e longo prazo de crianças com PC espástica. Métodos: participaram seis pacientes com PC espástica, idade de seis a 14 anos, ambos os gêneros. Foram realizadas 16 sessões de fisioterapia convencional com alongamentos passivos. Para avaliação da flexibilidade, aplicou-se o Teste de Sentar e Alcançar utilizando o Banco de Wells antes e após cada sessão. Para a análise estatística foi utilizado o Software Sigma-Stat® versão 3.5 com significância estatística (p<0,05). Resultados: houve aumento significativo da flexibilidade da cadeia muscular posterior comparando pré e pós individualmente (p<0,05) e da média pré e pós sessões (p<0,0001). Conclusão: fisioterapia convencial por meio de exercícios de alongamentos passivos melhora a flexibilidade da cadeia muscular posterior de crianças com PC espástica a curto ou a longo prazo.

Introduction: Physiotherapy favors flexibility and reduce the spasticity of children with spastic cerebral palsy. Objectives: To evaluate the benefits of conventional physiotherapy to improve the flexibility of the posterior muscle chain in the short and long term of children with spastic cerebral palsy. Methods: participated six patients with a diagnosis of Cerebral Palsy, age of six to 14 years, both genders. There were 16 sessions of conventional physiotherapy with passive stretching. For the assessment of flexibility, the sit and reach test was applied using the Wells's box before and after each session. For statistical analysis, Sigma-Stat® Software version 3.5 was used with statistical significance (p <0.05). Results: There was a significant increase in the flexibility of the posterior muscular chain of the children when comparing pre and post individually (p <0.05) and the mean before and after the sessions (P <0.0001). Conclusion: Conventional physiotherapy through passive stretching exercises improves the flexibility of the posterior muscular chain of children with spastic Cerebral Palsy in the short or long term.

Influência dos estímulos ambientais domiciliares na mobilidade de crianças com baixa visão: habilidade funcional e assistência do cuidador / Influence of the home environmental affordances in the mobility of children with low vision mobility: functional skills and caregiver assistance

RESUMO Objetivo: Analisar e correlacionar a influência dos estímulos presentes no ambiente domiciliar nas habilidades funcionais e no nível de assistência do cuidador na mobilidade de crianças com baixa visão e visão normal. Métodos: Participaram sete crianças com diagnóstico de baixa visão (32,29 ± 7,09 meses) e sete com visão normal (31,57 ± 6,90 meses). Os instrumentos utilizados foram Affordances in the Home Environment for Motor Development - Self Report (AHEMD-SR) e Inventário de Avaliação Pediátrica de Incapacidade (PEDI) referente à parte I (habilidades funcionais) e II (assistência do cuidador) da área de mobilidade. Resultados: De acordo com o PEDI, não houve diferença significativa entre crianças com baixa visão e visão normal nas habilidades funcionais (U=13,5; p=0,076) e na assistência do cuidador (U=13,0; p=0,083) na área de mobilidade, porém houve correlação moderada (r=+0,756; p=0,049) entre as partes I e II para crianças com baixa visão. No AHEMD-SR, crianças com baixa visão apresentaram diferenças significativas nas subescalas: motricidade fina (U=7,5; p=0,024), motricidade grossa (U=7,5; p=0,024) e AHEMD total (U=8,0; p=0,035). Porém ambas receberam a classificação "média" para as oportunidades de estimulação do ambiente domiciliar. Conclusão: O ambiente domiciliar das crianças com baixa visão apresentou razoáveis oportunidades de estímulos, no entanto seu desempenho estava dentro dos padrões de normalidade para as habilidades funcionais e assistência do cuidador em mobilidade.

ABSTRACT Objective: To analyse and correlate the influence of the present affordances in the home environment in the functional skills and the level of caregiver assistance for the mobility of children with low vision and normal vision. Methods: Participated seven children with low vision diagnosis (32.29 ± 7.09 months) and seven with normal vision (31.57 ± 6.90 months). The instruments used were Affordances in the Home Environment for Motor Development - Self Report (AHEMD-SR) and Pediatric Evaluation of Disability Inventory (PEDI) relative to the parties I (functional skills) and II (caregiver assistance) for the mobility area. Results: According to PEDI, there was no significant difference between children with low vision and normal vision in functional skills (U=13.5; p=0.076) and caregiver assistance (U=13.0; p=0.083) in the mobility area, however there was moderate correlation (r=+0.756; p=0.049) between the parties I and II for children with low vision. In AHEMD-SR, children with low vision showed significant differences in the subscales: fine-motor (U=7.5; p=0.024), gross-motor (U=7.5; p=0.024), and AHEMD total (U=8.0; p=0.035). However, both children received classification "average" for the affordances in the home environment. Conclusion: Children with low vision showed no differences in functional skills and caregiver assistance in the mobility. And the home environment offered reasonable affordances, which favored the functional skills and caregiver´s assistance in the mobility.