Effects of Hippotherapy on Recovery of Gait and Balance Ability in Patients
with Stroke

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Abstract

[Purpose] The aim of this study was to examine the the effects of hippotherapy on gait and balance ability in patients with stroke. [Subjects and Methods] Thirty stroke patients were randomly divided into a hippotherapy group and a treadmill group and they conducted exercise for eight weeks. [Results] Berg Balance Scale score, gait velocity, and step length asymmetry ratio were significantly improved in the group receiving hippotherapy training. However, in the group receiving treadmill training, only step length asymmetry ratio was significantly improved. In the comparison between the hippotherapy group and treadmill group, there was no significant difference in Berg Balance Scale score, but a significant difference was found in gait velocity and step length asymmetry ratio. [Conclusion] The results of this study indicated that hippotherapy is a helpful treatment for stroke patients.

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Most cited references 16

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Falls in individuals with stroke.

Paul van Helden, Vivian Weerdesteyn, Alexander C. H. Geurts … (2007)

Stroke survivors are at high risk for falls in all poststroke stages. Falls may have severe consequences, both physically and psychosocially. Individuals with stroke have an increased risk for hip fractures, and after such a fracture, they less often regain independent mobility. In addition, fear of falling is a common consequence of falls, which may lead to decreased physical activity, social deprivation and, eventually, loss of independence. Important risk factors for falls are balance and gait deficits. Stroke-related balance deficits comprise reduced postural stability during quiet standing and delayed and less coordinated responses to both self-induced and external balance perturbations. Gait deficits include reduced propulsion at push-off, decreased hip and knee flexion during the swing phase, and reduced stability during the stance phase. Interventions addressing these deficits can be expected to prevent falls more successfully. Preliminary evidence shows that task-specific exercise programs targeting balance and gait deficits can indeed reduce the number of falls in individuals with stroke. Technological advances in assistive devices are another promising area. More research is needed, however, to provide conclusive evidence of the efficacy of these interventions regarding the prevention of falls in individuals with stroke.

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Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis.

Chitralakshmi Balasubramanian, Mark Bowden, Richard Neptune … (2007)

To understand the relationship between step length asymmetry and hemiparetic walking performance. Descriptive. Gait analysis laboratory. Convenience sample of 49 subjects with chronic hemiparesis. Not applicable. Subjects walked at their self-selected walking speed over both an instrumented mat and forceplates to collect spatiotemporal parameters and ground reaction forces, respectively. Step length asymmetry was quantified by using a step length ratio (SLR) defined as paretic step length divided by nonparetic step length. Paretic leg propulsion, self-selected walking speed, hemiparetic severity (assessed by Brunnstrom stages of motor recovery), and some spatiotemporal walking parameters quantified the hemiparetic walking performance. Paretic leg propulsion was quantified by the paretic propulsion (P(P)) ratio, calculated as the percentage contribution of paretic leg to the total propulsive impulse. Significant negative correlation (r=-.78) was revealed between SLR and P(P), indicating that subjects generating less propulsive force with the paretic leg walked asymmetrically with longer paretic steps than nonparetic steps. SLR and self-selected walking speed revealed a weaker correlation (r=-.35), whereas hemiparetic severity correlated strongly with SLR (rho=-.53). Step length asymmetry is related to propulsive force generation during hemiparetic walking. Subjects generating least paretic propulsion walk with relatively longer paretic steps. This suggests that one of the mechanisms for the longer paretic step may be the relatively greater compensatory nonparetic leg propulsion. Further, those with more severe hemiparesis (those dependent on abnormal flexor and extensor synergies) walk with the longest paretic steps relative to nonparetic. Finally, our results indicated that asymmetrical step lengths may not necessarily limit the self-selected walking speed, likely due to other compensatory mechanisms.

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Gait and balance disorders in older adults.

Brooke Salzman (2010)

Gait and balance disorders are common in older adults and are a major cause of falls in this population. They are associated with increased morbidity and mortality, as well as reduced level of function. Common causes include arthritis and orthostatic hypotension; however, most gait and balance disorders involve multiple contributing factors. Most changes in gait are related to underlying medical conditions and should not be considered an inevitable consequence of aging. Physicians caring for older patients should ask at least annually about falls, and should ask about or examine for difficulties with gait and balance at least once. For older adults who report a fall, physicians should ask about difficulties with gait and balance, and should observe for any gait or balance dysfunctions. The Timed Up and Go test is a fast and reliable diagnostic tool. Persons who have difficulty or demonstrate unsteadiness performing the Timed Up and Go test require further assessment, usually with a physical therapist, to help elucidate gait impairments and related functional limitations. The most effective strategy for falls prevention involves a multifactorial evaluation followed by targeted interventions for identified contributing factors. Evidence on the effectiveness of interventions for gait and balance disorders is limited because of the lack of standardized outcome measures determining gait and balance abilities. However, effective options for patients with gait and balance disorders include exercise and physical therapy.

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Author and article information

Journal

Journal ID (nlm-ta): J Phys Ther Sci

Journal ID (iso-abbrev): J Phys Ther Sci

Journal ID (publisher-id): JPTS

Title: Journal of Physical Therapy Science

Publisher: The Society of Physical Therapy Science

ISSN (Print): 0915-5287

ISSN (Electronic): 2187-5626

Publication date (Electronic): 28 February 2014

Publication date (Print): February 2014

Volume: 26

Issue: 2

Pages: 309-311

Affiliations

[1) ] Department of Hippotherapy, Sungduk College, Republic of Korea

[2) ] Department of Rehabilitation Science, Graduate School, Daegu University, Republic of Korea

Author notes

[* ]Corresponding author. Min Sik Yong, Department of Rehabilitation Science, Graduate School, Daegu University: 15 Jillyang, Gyeongsan-si, Gyeongbuk 712-714, Republic of Korea. (E-mail: peast4ever@ 123456naver.com )

Article

Publisher ID: jpts-2013-384

DOI: 10.1589/jpts.26.309

PMC ID: 3944312

PubMed ID: 24648655

SO-VID: d1c84131-5ec4-445b-a644-a1214538e105

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This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

Effects of Hippotherapy on Recovery of Gait and Balance Ability in Patients with Stroke

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Abstract

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Stroke MRI

Most cited references 16

Falls in individuals with stroke.

Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis.

Gait and balance disorders in older adults.

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