Abstract
Cerebral palsy (CP) is an umbrella term covering a group of permanent developmental disorders of movement and posture characterized by highly variable clinical features. The aim of this study was to assess the short-term and mid-term effects of neurorehabilitation via hippotherapy on the contractile properties of two key postural muscles during functional sitting in such patients. Thirty-minute hippotherapy sessions were conducted biweekly for 12 weeks in 18 patients (18.1 ± 5.7 years old). Surface electromyography (EMG) was implemented bilaterally in rectus abdominis and adductor magnus. We quantitatively analyzed the amplitude of EMG signals in the time domain and its spectral characteristics in the frequency domain. EMGs were recorded at the beginning and end of each session on day one and at week six and week twelve. Statistical analysis revealed a substantial inter-day reliability of the EMG signals for both muscles, validating the methodological approach. To a lesser extent, while beyond the scope of the current study, quantitative changes suggested a more selective recruitment/contractile properties’ shift of the examined muscles. Exploring postural control during functional activities would contribute to understanding the relationship between structural impairment, activity performance and patient capabilities, allowing the design of neurorehabilitation programs aimed at improving postural and functional skills according to each individual’s needs. The present study provides basic quantitative data supporting the body of scientific evidence making hippotherapy an approach of choice for CP neurorehabilitation.
Highlights
Cerebral palsy (CP) is a motor syndrome that results from a permanent, non-progressive injury in the developing brain
Since hippotherapy might support the regularization of sitting postural balance [10], we aimed to explore the role of the pelvic girdle in this regularization by choosing two key muscles above and below this main anatomical structure, namely, the rectus abdominis (RA) and the adductor magnus (AM)
Since one of the main neurophysiological alterations of the CP neuromotor system is the activation and fine-tuning of the postural muscles, we focused on the recording of the electrical activity of these muscles by means of surface electromyography (EMG)
Summary
Cerebral palsy (CP) is a motor syndrome that results from a permanent, non-progressive injury in the developing brain. The clinical picture is shaped according to the time of occurrence of the lesion, the location and severity of the neural alterations, life experience, and activity level of the subject. CP includes a broad number of movement and postural disorders. The severity, the type of motor impairment, and the associated deficiencies (e.g., communication, intellectual capacity, behavioral problems) are highly variable. Overall prevalence has remained stable over the past 40 years, despite progress in antenatal and perinatal care. In France, around 125,000 people are affected [1]
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