Effects of Simulated Equestrian Therapy on Motor Proficiency and Gait Parameters Among Down Syndrome Children
Condition: Down Syndrome
MeSH terms: Down Syndrome; Syndrome
Study type: Interventional

Summary: 
      According to the World Health Organization (WHO) and United Nations Children's Fund (UNICEF),
      one billion people suffer from physical and mental disabilities, with 240 million children.
      Whereas 26.4 million belong to Asia, and approximately 5 million are from Pakistan. The
      Centre for Disease Control and Prevention (CDC) reports developmental disorders as one of the
      leading causes of these disabilities. Several conditions are classified under this domain,
      including Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, Down syndrome,
      and Cerebral Palsy. Down syndrome (DS) has recently emerged as a prevailing condition in
      low-and middle-income countries, with an incidence of 1 in every 300 babies. DS is a genetic
      disorder due to the triplication of all or some parts of the 21st chromosome. Various
      problems characterize this disability, including; compromised motor skills proficiency and
      altered gait parameters. These deficits have been addressed using numerous effective
      techniques, one of which is 'Simulated Equestrian Therapy'. Despite advances in
      rehabilitating DS patients, a scarcity of literature still surfaces regarding using these
      simulators and their effects. To our knowledge, no study in Pakistan has been conducted to
      evaluate motor proficiency and gait parameters in the DS population using this intervention.
      Therefore, the present study is aimed to assess the effects of simulated equestrian therapy
      on motor proficiency and gait parameters in DS children.
    

Detailed description: 
      A total of 58 participants will be recruited for this study after obtaining informed
      voluntary assent from the guardians. Simple random sampling using the envelop method will be
      used for the group allocation, to which the participants will be blind. Each participant will
      be allocated randomly to the treatment group (n=29) that will receive Simulated Equestrian
      Therapy and the control group (n=29) to receive Neuromotor Therapy. Each participant will be
      assessed at baseline, after 6 and 12 weeks of intervention using Bruinink's test of motor
      proficiency (BOT-2) and 10 meter walk test (10MWT). Each participant's blood pressure and
      heart rate will also be recorded before each session to ensure safety. The participants will
      be wearing protective gear (belt, helmet, knee and elbow pads) and portable telemetry during
      the entire session. The session duration in both groups will comprise 30-45 minutes on
      average, varying with the progression each week. Each session will be provided three times/a
      week for 3 months.
    

Intervention name(s): Simulated Equestrian Therapy; Neuro-Motor Therapy
Intervention type(s): Device; Other
Intervention description(s): The treatment group will receive Simulated Equestrian Therapy for 12 weeks thrice per week using 2 horse simulators (wooden and mechanical) in two phases.
Phase I The child will be instructed to ride the mechanical simulator in a pre-defined area measuring 10 yards and complete a total of 4 rounds of this area. Rest periods in between and after will be provided to the child when required. Major muscles of the body will be targeted here to strengthen the core.
Phase II The child will be instructed to ride the wooden simulator and a combination of goal directed activates will be performed.; This group will perform overall stability and body balancing exercises to strengthen the core and develop the coordination and balance required for task performance. Each activity will be performed in a set of 2-3, considering the activity level of the child, with 8-12 repetitions attaining the available ROM and flexibility of the child. The participants will undergo warm-up before the exercise and cool-down afterwards.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment