The Effect of Exercise by Mechanical Hippotherapy Device on Postural Stability and Balance in Stroke
Condition: Stroke; Gait, Hemiplegic; Balance, Postural
MeSH terms: Stroke; Gait Disorders, Neurologic
Study type: Interventional

Summary: 
      Stroke,one of the leading cause of death, is caused by ischemia or hemorrhage. It results in
      neurological deficits such as hemiplegia. Hemiplegia show disability characterized loss of
      motor, sensory and cognitive function. Reduced postural control and balance stability results
      gait disturbances such as asymmetric weight bearing, risk of falling and imbalances. It also
      shows increased energy expenditure, decreased independence on quality of life and limited
      mobility. Physical therapy can be effective method for solving these problems. Hippotherapy,
      also known as horseback riding therapy, is a form of physical therapy strategy that uses
      equine movement. The concept of hippotherapy is to use a horse as a therapeutic tool, and it
      is based on similarities in gait between the human and horse. The horse's gait provides
      patients having motor disabilities with rhythmic and repetitive movements similar to human
      walking, thereby giving them training opportunities to improve posture, balance, and
      strength. Even though it has many effect on solving these problems, hippotherapy centers are
      not enough. Due to climate and environmental situations, hippotherapy devices were improved
      and had similar effects on patients with stroke. In literature, these device mostly used on
      cerebral palsy, but investigator wants to use hippotherapy device on patient with Hemiplegia.
      For these reasons, the effects of exercises by mechanical hippotherapy device on postural
      control and balance will be investigated.
    

Detailed description: 
      Investigator will randomly allocate 30 patients with hemiplegia to two groups; Control group
      (n=15), experimental group(n=15).The control group will receive conventional rehabilitation
      for 45 min/day, following by postural control exercises 15 min/day 5 times/week for 4 weeks,
      while the experimental group receive conventional rehabilitation for 45 min/day following by
      use of a hippotherapy device for 15 min/day, 5 times/week for 4 weeks. Assessment procedure
      will be held at the beginning and 4th week of study. Assessment procedure will be held at the
      beginning and 4th week of study. All subjects will be assessed by berg balance scale and
      BIODEX primarily while Timed up and go test, SF-36, Functional reach test, functional
      independence measurement(FIM), Trunk Impairment Scale (TIS), Trunk Control Test (TCT),
      motricity index, Fugl-meyer will be held secondarily.
    

Intervention name(s): exercise by hippotherapy device; conventional rehabilitation; postural control exercises
Intervention type(s): Other; Other; Other
Intervention description(s): Hippotherapy device mostly used on cerebral palsy, but we want to use hippotherapy device on patient with Hemiplegia.; Bobath exercises: Bobath is a type of physiotherapy treatment which aims to improve movement and mobility in patients with damage to their central nervous system (brain and spinal cord).; perturbation on four directions, weight bearing exercises on standing positions
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: randomized controlled trial
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: stroke, hippotherapy, balance, postural control, gait