Efficacy Hippotherapy on Postural Asymmetries and Balance in Adolescents With Idiopathic Scoliosis

Idiopathic Scoliosis Clinical Trial

Official title:

Effects of Hippotherapy on Postural Asymmetries and Balance in Adolescents With Idiopathic Scoliosis: a Randomized Controlled Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04885023
• Other study ID #: Batterjee Medical College
• Secondary ID: (TURSP-2020/82)
• Status: Completed
• Phase: N/A
• Start date: February 20, 2020
• Est. completion date: March 7, 2021

Study information

• Verified date: May 2021
• Source: Batterjee Medical College
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study showed that the addition of hippotherapy to Schroth exercises is more effective in improving postural asymmetry and balance ability in adolescents with idiopathic scoliosis compared to Schroth exercises alone. Therefore, this combination should be considered during designing a rehabilitation program for AIS

Description:

The hippotherapy program started with a physical therapy assessment to develop specific corrective movements to be practiced while riding the horse based on the direction of the spinal curvature. Interventions were performed by a licensed physical therapist experienced with hippotherapy at two local therapeutic riding centers. The participants received 15 sessions split into two phases over 10 weeks. In the first phase, during the first 5 weeks, they performed 30 minutes of walking and sitting trot training without a stirrup iron once a week. The frequency was then raised to twice a week for the rest of the treatment program. Before the start of the intervention, two familiarization sessions were given to clarify safety guidelines, riding mistakes, and create a riding rapport with the horse. The individuals wore protective helmets during each hippotherapy session and mounted on a moving horse on walk and/or trot performing different positions, namely forward astride, side sitting, backward astride, sometimes with transitions between positions and often while the horse was moving. To restore normal alignment of the spine, participants were also asked to ride without holding on with their hands to perform self-correction movements. Examples of these movements include raising both arms high to decrease the degree of thoracic kyphosis, bending the upper trunk towards the convex side of the curve, raising the arm on the concave side with scapular adduction to level both shoulders. To correct pelvic obliquity, a small pad was put under the hip on the side of the lumbar convexity. Under the instructions of the physical therapist, a leader pulled the horse reins in front to control the horse gait, gait velocity, and orient the horse in different directions . All these movements activate the patient's neuromuscular and sensory reactions.

Both groups performed Schroth exercises that are patient-specific asymmetric exercises with rotational breathing methods used for three-dimensional correction. For the first 2 weeks, there were five 1-h long individual sessions during which the participants were trained in their home exercise program. This was followed by 1-h weekly visits and paired with their daily home exercises. These exercises aimed to provide and promote enhanced postural control by using asymmetrical standing postural exercises specifically designed to restore body balance and mobility. During ground exercises, aid pads were used to build pressure for costal protrusions and/or trunk asymmetry correction. Postural correction was facilitated by rotational breathing exercises focusing on the concave side of the thorax. During the therapy sessions, postural correction principles of the Schroth process, axial elongation, deflection, de-rotation, facilitation, stabilization, were used.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 52
• Est. completion date: March 7, 2021
• Est. primary completion date: December 18, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 10 Years to 18 Years

Eligibility

Inclusion Criteria:

• AIS,

• all curve types,

• curves with Cobb angle ranged between 10 and 25 degrees,

• a Risser grade 0 to 5, and

• the ability to attend weekly visits.

Exclusion Criteria:

• Children with any significant history of riding horses,

• with diagnosis other than AIS,

• having other treatment which might affect scoliosis,

• having chronic diseases requiring any drug usage,

• presence of other neurologic, muscular or rheumatic diseases, and

• having non-idiopathic scoliosis.

Related Conditions & MeSH terms

• Equine-assisted Therapy
• Idiopathic Scoliosis
• Scoliosis

Intervention

Other:
• Hippotherapy
The hippotherapy program for 10 weeks

Locations

Country	Name	City	State
Saudi Arabia	Batterjee Medical College	Jeddah	Makkah

Sponsors (2)

Lead Sponsor	Collaborator
Batterjee Medical College	Taif University

Country where clinical trial is conducted

Saudi Arabia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Scoliotic angle un degrees	Measured by formatric 4-D system	10 weeks
Primary	Kyphotic angle in degrees	Measured by formatric 4-D system	10 weeks
Primary	Pelvic obliquity in degrees	Measured by formatric 4-D system	10 weeks
Primary	Pelvic torsion in degrees	Measured by formatric 4-D system	10 weeks
Primary	Vertical spinal rotation in degrees	Measured by formatric 4-D system	10 weeks
Secondary	Overall balance index	Measured by Biodex Balance System	10 weeks
Secondary	Anteroposterior balance index	Measured by Biodex Balance System	10 weeks
Secondary	Mediolateral balance index	Measured by Biodex Balance System	10 weeks