La thérapie par le cheval améliore l’équilibre postural

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A clinical trial evaluating the effectiveness of hippotherapy on static and dynamic balance of the elderly.

A Korean randomized controlled trial of Kim and colleagues, published in the Journal of Physical Therapy Science in 2014, compared to eight weeks, the effectiveness of hippotherapy program compared to a training on a treadmill on postural and dynamic balance of elderly. The results show that the postural and dynamic balance is further improved in the group receiving hippotherapy compared to the group receiving the treadmill on program.

The Study Rationale

Aging is accompanied by a weakening of the muscles and increasing difficulty in performing activities of daily living. Muscle weakness and functional limitation deteriorate the balance control capabilities. The risk of falls is then increased. The vicious circle of deconditioning is at work: the elderly reduce their daily physical activity for fear of falling, causing a loss of functional capacity. fall risk is increased then altering the quality of life and well-being of these people.

Hippotherapy or therapy horse could be useful to improve postural control. Indeed, at a session of hippotherapy, the patient not only controls balance through its own movements but also in response to movements of the horse. The horse acts as a mediator. Hippotherapy could improve control of muscle tone, its movements, trunk balance, dynamic balance and sensory integration.

The Question

A hippotherapy program he improves postural and dynamic balance of older people?

The Protocol

The randomized controlled trial of Kim and colleagues, evaluates the effectiveness of hippotherapy on postural and dynamic balance of elderly. The study focuses on 30 people aged over 65. The clinical trial included older people who have not been falling in the year prior to the intervention and have no diseases that can skew the analysis. Seniors were randomly placed in either the group receiving hippotherapy either group benefiting from training in treadmill walking.

The main measures related postural balance evaluated by the amplitude of the swing and the dynamic balance measured by the magnitude and speed of the steps. Participants assessed early intervention and late intervention to 3 months.

The tested Non-Pharmacological Intervention (NPI)

In the 2 groups, INM included sessions of 20 minutes, 3 times a week for 3 months.

At each session of hippotherapy, the horse walking around a circle 30 meters in diameter, 20 times clockwise and 20 times to the left.

The training started on treadmill at a minimum speed of 0.1 km / h. Participants then progressed to their individual maximum speed they maintained for 20 minutes.

Main Results

The results show a similar increase in the amplitude and speed of the strides after 3 months of intervention in both groups. This increase is beneficial for postural and dynamic balance of the elderly.

What it means in general

Hippotherapy improves the ability to control its dynamic and postural balance and face the risk of falls in an imbalance. Hippotherapy is a good alternative to trainings on more tedious treadmill.

What it means for Healthcare Professionals

A hippotherapy program from three months to three sessions per week and improves dynamic postural balance of the elderly, which can probably reduce their risk of falling.

What it means for Researchers

Randomized controlled trials testing the effectiveness of hippotherapy on postural balance and dynamics of the elderly are still rare. Future studies will need to replicate this clinical trial on a larger number of participants. A long-term monitoring and comparing the number of fall would be useful.

What it means for Policymakers

In an aging society, it is essential to prevent falls among the elderly by improving their posture and dynamic balance. In fact, falls are a leading cause of disability and social isolation among the elderly. Hippotherapy proves relevant INM to improve balancing abilities of the elderly and prevent falls.

The reference

Kim SG, Lee C-W (2014). The effects of Hippotherapy on elderly persons’ static balance and gait. Journal of Physical Therapy Science, 26, 25-27.

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To reference this Blog en Sante © article.

Ninot G (2016). A disease management program reduces the risk of new diseases. Blog en Sante, A75.

© Copyright 2016 Grégory Ninot. All rights reserved.