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.

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.

Percepciones acerca de los beneficios de la equinoterapia para preservar la integridad psicofísica de adultos mayores / Perceptions about the potential benefits of equine therapy as a means to preserve the psycho-physical integrity of senior citizens

El siguiente trabajo incursiona en la aplicación de los fundamentos y práctica de la equinoterapia2 en adultos mayores (de 55 años de edad en adelante).Se procede a una revista de la literatura académica internacional en lo concerniente al bienestar de los adultos mayores para poder establecer el estado actual de la discusión y verificar si la equinoterapia podría resultar una respuesta aceptable y útil para resolver los problemas citados por los autores al respecto. A fin de poder contrastar las visiones globales de los letrados con la realidad local, se efectuó una pequeña encuesta complementaria a adultos mayores que practican actividad física regularmente, tendiente a verificar si los patrones predichos por la literatura se concretaban en las opiniones populares de las personas interesadas. Se concluye que la equinoterapia es una herramienta potencialmente benéfica para promover y asegurar el bienestar psicofísico de los adultos mayores, pero que lamentablemente no se encuentra lo suficientemente diseminada. Los adultos mayores no la conocen o no la relacionan como una de las disciplinas que podrían practicar y además por falta de recomendación médica frecuente, no existen grandes posibilidades para que las personas mayores que viven en zonas urbanas puedan trasladarse a entornos donde hay caballos ni acceder de manera económicamente plausible a la equinoterapia...

The following piece drowns into the application of the main ideas and practices of Equine Therapy in senior citizens (55 years old and over).We proceed by performing a literature review of the most updated papers in the field of elderly people's welfare to verify whether Equine Therapy could result in an acceptable and useful response to the most frequently quoted problems that persons approaching and having reached retirement age usually face. In order to be able o contrast global views on the matter with the local reality, we managed to undertake a small complementary survey to verify whether the predicted patterns by the literature coincide with the popular opinions of the individuals concerned. We have reached the conclusion that Equine Therapy is a potentially beneficial tool to promote and ensure the psycho-physical welfare of senior citizens. Nevertheless, it has not been sufficiently disseminated among this population yet and no initiatives have been undertaken to promote its popularity. One option to promote its use could be by making it easier for citizens from urban areas to gain access to fields where horses can be kept and the discipline can be practiced...

Equoterapia: qualidade de vida para o idoso sobre o cavalo / Hippotherapy: quality of life for the elderly on the horse

A Equoterapia é uma técnica de reabilitação e educação que utiliza a equitação e as atividades equestres para proporcionar ao praticante benefícios físicos, psicológicos, educacionais e sociais. Esta atividade exige a participação do corpo inteiro, trabalhando o praticante de forma global, sendo o cavalo utilizado como método terapêutico que contribuirá para o desenvolvimento do equilíbrio, tônus, força muscular, a conscientização do próprio corpo, o aperfeiçoamento de coordenação motora, atenção, autoconfiança, autoestima e a qualidade de vida. O idoso na Equoterapia irá utilizar o cavalo como um mediador terapêutico no tratamento de diversas patologias proporcionando bem-estar e consequente melhora da qualidade de vida, sendo um tratamento prazeroso, pois se foge de consultórios e ambientes fechados. Além disso, o movimento tridimensional, rítmico e balançante do cavalo irá estimular o sistema vestibular, a melhora da consciência espaço-temporal, a concentração, o equilíbrio e a consolidação da segurança gravitacional, deixando o idoso menos vulnerável a quedas e a incapacidades funcionais. Sendo assim, esse artigo de revisão de literatura teve como objetivo verificar os efeitos e mostrar a importância da prática da Equoterapia, a fim de obter melhor qualidade de vida e longevidade...

Hippotherapy is a technique of rehabilitation and education that uses horse riding and equestrian activities to provide physical benefits to the practitioner, psychological, educational and social. This activity requires the participation of the entire body, the practitioner working in a global horse being used as a therapeutic method that will help develop equilibrium, muscle tone, muscle strength, body awareness, improvement of motor coordination, attention, self-confidence, self-esteem and quality of life. Hippotherapy in the elderly will use the horse as a therapeutic agent in treating various pathologies providing welfare and thus improved quality of life, and a pleasurable treatment, because it runs away from offices and indoor environments. Moreover, threedimensional movement, rhythmic rocking horse and will stimulate the vestibular system, the improvement of consciousness space-time, concentration, equilibrium and consolidation of security gravitational leaving the elderly less vulnerable to falls and related disabilities. Therefore, this article literature review aimed to determine the effects and show the importance of the practice of hippotherapy in order to obtain better quality of life and longevity...

Use of hippotherapy in gait training for hemiparetic post-stroke / Utilização da hipoterapia no treino de marcha em indivíduos hemiparéticos pós-acidente vascular cerebral

OBJECTIVE: To evaluate the hippotherapy influence on gait training in post-stroke hemiparetic individuals. METHOD: The study was constituted of 20 individuals divided into two groups. Group A performed the conventional treatment while group B the conventional treatment along with hippotherapy during 16 weeks. The patients were evaluated by using the Functional Ambulation Category Scale, Fugl-Meyer Scale, only the lower limbs and balance sub items, Berg Balance Scale, and functional assessment of gait (cadence) in the beginning and end of the treatment. RESULTS: Significant improvements were observed in the experimental group including motor impairment in lower limbs (p=0.004), balance, over time (p=0.007) but a significant trend between groups (p=0.056). The gait independence, cadence and speed were not significantly in both groups (p=0.93, 0.69 and 0.44). CONCLUSION: Hippotherapy associated with conventional physical therapy demonstrates a positive influence in gait training, besides bringing the patients' gait standard closer to normality than the control group.

OBJETIVO: Avaliar a influência da hipoterapia no treino de marcha em indivíduos hemiparético pós-AVC. MÉTODO: O estudo constou de 20 indivíduos divididos em dois grupos (A e B); o grupo A realizou tratamento convencional e o grupo B, tratamento convencional e hipoterapia, durante 16 semanas. Os pacientes foram avaliados pela Escala de Fugl-Meyer, Escala de Equilíbrio de Berg, Escala de Deambulação Funcional e a Cadência, no início e no final do tratamento. RESULTADOS: Melhoras significativas foram observadas no grupo experimental incluindo comprometimento motor em membros inferiores (p-valor=0,004), o equilíbrio, em relação ao tempo (p-valor=0,007) porém uma tendência significância entre os grupos (p=0,056). A independência na marcha, cadência e a velocidade não apresentaram relevância estatística em ambos os grupos (p-valor=0,93, 0,69 e 0,44). CONCLUSÃO: A Hipoterapia associada ao tratamento convencional mostra ter influência no treino de marcha, além de tornar o padrão de marcha dos pacientes mais próximo da normalidade em relação ao grupo controle.