Efectos de la hipoterapia en la rehabilitación de la marcha en personas con diagnóstico de parálisis cerebral una revisión rápida entre los años 2013 a 2023
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Fecha
2024
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Facultad/escuela
Idioma
es
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Universidad Andrès Bello
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Licencia CC
Licencia CC
Resumen
Antecedentes: La Parálisis Cerebral (PC) es una alteración motora originada por una lesión del Sistema Nervioso Central (SNC) inmaduro. En Chile, es un desafío lograr una atención de calidad y accesible a personas en situación de discapacidad (PsD). La hipoterapia (HPOT) parece una alternativa de rehabilitación que podría beneficiar a esta población, sin embargo, requiere evidencia. Métodos: Se efectuó una revisión rápida de estudios entre los años 2013 y 2023, incluyendo Meta análisis, Revisiones sistemáticas (RS), Estudios Aleatorios Controlados (ECA) y Ensayos clínicos realizados a personas con diagnóstico de PC que mediante Hipoterapia intervinieran sobre la marcha. Resultados: Se incluyeron 5 estudios, que reportaron mejoras significativas en la marcha. Esto se evidenció en las puntuaciones del GMFM-66 dimensión E, en la velocidad de marcha, longitud de paso, aceleración media, cadencia y aceleración promedio y desplazamiento horizontal/vertical; todos con valor estadístico significativo p< 0,05. En contraste, en un estudio la longitud de zancada no experimentó un aumento significativo, tampoco la distancia (p= 0,96). Discusión: Si bien a la fecha hay pocas revisiones con calidad metodológica, la bibliografía respalda los efectos de la HPOT sobre la marcha. Los resultados, muestran beneficios sobre la motricidad gruesa, así como en cadencia, velocidad, balance medio, altura del paso y cinemática. En contraste, existen limitaciones en las investigaciones, la heterogeneidad de las variables, el tamaño de la muestra y la falta de estandarización de los objetivos y protocolos usados, pudo influir. Conclusión: Los resultados obtenidos en el presente estudio demostraron que una intervención en base a hipoterapia generó efectos positivos en la marcha en personas con PC. La temporalidad de sesiones, se establece entre 1 a 2 sesiones por semana con una duración de 30 minutos, para tener efectos positivos. Se sugieren futuros estudios que aporten mayor evidencia respecto a esta estrategia de rehabilitación
Background: Cerebral Palsy (CP) is a motor disorder caused by an injury to the immature Central Nervous System (CNS). In Chile, to achieve quality and accessible healthcare for people with disabilities is challenging. (PsD). Hippotherapy (HPOT) appears to be a rehabilitation alternative that could benefit this group of people, however, it requires evidence. Methods: A rapid review of studies published between 2013 and 2023 was carried out , including Meta analysis, Systematic Reviews (SR), Randomized Controlled Studies (RCTs) and Clinical Trials carried out with people diagnosed with CP undergoing gait intervention using Hippotherapy. Results: 5 studies were included, which reported significant improvements in gait. This was evidenced in the scores of the GMFM-66 dimension E, in walking speed, step length, average acceleration, cadence and average acceleration and horizontal/vertical displacement; all with significant statistical value p< 0.05. In contrast, in one study stride length did not experience a significant increase, nor did distance (p= 0.96). Discussion: Although to the date there are few reviews with methodological quality, the literature supports the effects of HPOT on gait. The results show benefits on gross motor skills, as well as cadence, speed, average balance, step height and kinematics. In contrast, there are limitations in these researches, the heterogeneity of the variables, the sample size and the lack of standardization of the objectives and protocols used, could have had an influence. Conclusion: The results obtained in the present study demonstrated that an intervention based on hippotherapy generated positive effects on gait in people with CP. The timing of sessions is established between 1 to 2 sessions per week with a duration of 30 minutes each, in order to have positive effects. Future studies are suggested to provide sizeable evidence regarding this rehabilitation strategy
Background: Cerebral Palsy (CP) is a motor disorder caused by an injury to the immature Central Nervous System (CNS). In Chile, to achieve quality and accessible healthcare for people with disabilities is challenging. (PsD). Hippotherapy (HPOT) appears to be a rehabilitation alternative that could benefit this group of people, however, it requires evidence. Methods: A rapid review of studies published between 2013 and 2023 was carried out , including Meta analysis, Systematic Reviews (SR), Randomized Controlled Studies (RCTs) and Clinical Trials carried out with people diagnosed with CP undergoing gait intervention using Hippotherapy. Results: 5 studies were included, which reported significant improvements in gait. This was evidenced in the scores of the GMFM-66 dimension E, in walking speed, step length, average acceleration, cadence and average acceleration and horizontal/vertical displacement; all with significant statistical value p< 0.05. In contrast, in one study stride length did not experience a significant increase, nor did distance (p= 0.96). Discussion: Although to the date there are few reviews with methodological quality, the literature supports the effects of HPOT on gait. The results show benefits on gross motor skills, as well as cadence, speed, average balance, step height and kinematics. In contrast, there are limitations in these researches, the heterogeneity of the variables, the sample size and the lack of standardization of the objectives and protocols used, could have had an influence. Conclusion: The results obtained in the present study demonstrated that an intervention based on hippotherapy generated positive effects on gait in people with CP. The timing of sessions is established between 1 to 2 sessions per week with a duration of 30 minutes each, in order to have positive effects. Future studies are suggested to provide sizeable evidence regarding this rehabilitation strategy
Notas
Actividad Final de (Magíster en Neurorrehabilitación)
Palabras clave
Parálisis Cerebral, Equinoterapia, Revisión Sistemática