Evaluation of the functional mobility and balance of adolescents with Down’s Syndrome treated in Hippotherapy and Physiotherapy

Introdução: A hipotonia muscular, característica da Síndrome de Down compromete a mobilidade funcional, o desempenho muscular e consequentemente interfere nas atividades da vida diária.Objetivos: Avaliar os efeitos da Equoterapia e da Fisioterapia sobre a mobilidade funcional  e equilíbrio de adolescentes com síndrome de Down.Materiais e Métodos: O estudo incluiu 14 sujeitos com síndrome de Down divididos em dois grupos: nove (seis masculinos e três femininos) no grupo Equoterapia e cinco (três masculinos e dois femininos) no grupo Fisioterapia, idade média 13,2 ±2,2 e 14,2 ±3,1 anos, respectivamente. Foram realizados 30 atendimentos, com duração de 30 minutos cada, uma vez por semana, de acordo com os tipos de intervenções para cada grupo, Equoterapia e Fisioterapia. A mobilidade funcional  e equilíbrio foi avaliada no pré e pós intervenções por meio do teste TimedUpand Go.Resultados: Analisando o teste TimedUpand Go, foi possível observar diferenças estatisticamente significantes (p=0,006) no grupo Equoterapia, comparando-se o pré e pós intervenção (1º e 30º atendimentos).Conclusão: A Equoterapia foi capaz de proporcionar melhora na mobilidade funcional e no equilíbrio dinâmico quando comparada à Fisioterapia. No entanto, ambas as intervenções são práticas seguras para a reabilitação de indivíduos com síndrome de Down.Introduction: A muscle hypotonia, the Down Syndrome compromises functional mobility, muscle performance and consequently interferes with activities of daily living.Objectives: Analyze the effects of hippotherapy and physiotherapy on functional mobility and balance in adolescents with Down syndrome.Materials and Methods: The study includes 14 individuals with Down syndrome divided into two groups: nine (six male and three female) in the Horse-assisted therapy group and five (three male and two female) in the Physiotherapy group, mean age 13.2 ± 2, 2 and 14.2 ± 3.1 years, respectively. Thirty projects were carried out, lasting 30 minutes each, once a week, according to the types of application for each group, Horse-assisted therapy and Physiotherapy. Functional mobility and balance was assessed in pre and post-alteration using the TimedUpand Go test.Results: By analyzing or testing the TimedUpand Go, it was possible to observe statistically significant differences (p = 0.006) in the Horse-assisted therapy group, comparing it or pretest (1st and 30th ventures).Conclusion: Riding Therapy was able to improve functional mobility and dynamic balance when compared to Horseassisted therapy. However, some are safe practical practices for Down syndrome rehabilitation

Effects of equine-assisted services on the immune, stomatognathic and functional capacity of older adults: longitudinal study

O envelhecimento é um processo dinâmico e progressivo, no qual as alterações morfológicas, funcionais e bioquímicas modificam progressivamente o organismo, tornando-o mais suscetível às agressões intrínsecas e extrínsecas. O sedentarismo constitui um problema de saúde pública em todo o mundo, principalmente entre os longevos, recomenda-se que esses se mantenham da maneira mais ativa que sua condição permitir. Os serviços assistidos por equinos (SAE) utilizam a interação com o animal para promover ganhos biopsicossociais. O presente estudo avaliou o sistema imunológico e estomatognático, bem como a capacidade funcional de adultos mais velhos submetidos a um Programa de SAE, com duração de três meses, com dois atendimentos semanais, em dias não consecutivos. Participaram 16 indivíduos, média de idade 69,4 (±5,6). Pré e pós-Programa foi aplicado o questionário Geriatric Oral Health Assessment Index (GOHAI) para a medir da autopercepção da saúde oral; foram coletadas amostras de saliva para avaliar a taxa de secreção salivar e a concentração de imunoglobulina A secretora (IgA-s); foi utilizado Trigno EMG para avaliar o desempenho eletromiográfico dos músculos masseteres e temporais; gnatodinamômetro digital Kratos para mensurar a força de mordida molar; Sistema T-Scan® III Occlusal Analysis para analisar os contatos de forças oclusais; Iowa Oral Pressure Instrument (IOPI) para mensurar a pressão lingual e labial. A capacidade funcional foi avaliada por instrumentos, amplamente utilizados em pesquisas científicas: Escala de Equilíbrio de Berg (EEB); Teste de Alcance Funcional (TAF); Timed Up and Go (TUG); Teste de Sentar e Alcançar (TSA); Teste de Sentar e Levantar (TSL), Teste Rosca Bíceps (TRB), Teste de Caminhada de Seis Minutos (TC6M). Os dados foram tabulados e analisados com alfa de 5%. Houve aumento da concentração de IgA-s (p=0,0412) imediatamente após e do fluxo salivar (p=0,0069) 72 horas após o Programa; redução da atividade mioelétrica na condição clínica de lateralidade direita para o músculo temporal esquerdo (p=0,0479), apertamento dental para o músculo masseter direito (p=0,0330), mastigação de alimento macio para o músculo temporal esquerdo (p=0.0108); redução do contato das forças oclusais para o dente 16 versus 26 (p=0,0430); aumento da pressão da língua (p=0,0087); melhor desempenho para o TAF (p=0,0431), TUG (p=0,0011), TSL (p=0,0302), TRB (p=0,0100), TC6M (p<0,0001). Os resultados evidenciam que os SAE são um recurso terapêutico viável para a população geriátrica.Aging is a dynamic and progressive process, in which morphological, functional and biochemical changes progressively modify the organism, making it more susceptible to intrinsic and extrinsic aggressions. A sedentary lifestyle is a public health problem all over the world, especially among the long-lived, it is recommended that they remain as active as their condition allows. Equine-assisted services (EAS) use the interaction with the animal to promote biopsychosocial gains. The present study evaluated the immune and stomatognathic systems, as well as the functional capacity of older adults submitted to a EAS Program, lasting three months, with two weekly appointments, on non-consecutive days. 16 individuals participated, mean age 69.4 (±5.6). Before and after the Program, the Geriatric Oral Health Assessment Index (GOHAI) questionnaire was applied to measure self-perception of oral health; saliva samples were collected to assess the rate of salivary secretion and the concentration of secretory immunoglobulin A (IgA-s); Trigno EMG was used to assess the electromyographic performance of the masseter and temporal muscles; Kratos digital gnathodynamometer to measure molar bite force; T-Scan® III Occlusal Analysis System to analyze occlusal force contacts; Iowa Oral Pressure Instrument (IOPI) to measure lingual and lip pressure. Functional capacity was assessed by instruments, widely used in scientific research: Berg Balance Scale (BSE); Functional Range Test (FRT); Timed Up and Go (TUG); Sit and Reach Test (SRT); 30 second chair stand test (30CST), Biceps Curl Test (BCT), Six Minute Walk Test (6MWT). Data were tabulated and analyzed with an alpha of 5%. There were an increase in the concentration of IgA-s (p=0.0412) immediately after and in the salivary flow (p=0.0069) 72 hours after the Program; reduction of myoelectric activity in the clinical condition of right laterality for the left temporal muscle (p=0.0479), dental clenching for the right masseter muscle (p=0.0330), chewing of soft food for the left temporal muscle (p= 0.0108); reduced contact of occlusal forces for tooth 16 versus 26 (p=0.0430); increased tongue pressure (p=0.0087); better performance for FRT (p=0.0431), TUG (p=0.0011), SST (p=0.0302), BCT (p=0.0100), 6MWT (p<0.0001). The results show that EAS are a viable therapeutic resource for the geriatric population

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