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Hippotherapy Acute Impact on Heart Rate Variability Non-Linear Dynamics in Neurological Disorders

Neurological disorders are associated with autonomic dysfunction. Hippotherapy (HT) is a therapy treatment strategy that utilizes a horse in an interdisciplinary approach for the physical and mental rehabilitation of people with physical, mental and/or psychological disabilities. However, no studies have been carried out which evaluated the effects of HT on the autonomic control in these patients. Therefore, the objective of the present study was to investigate the effects of a single HT session on cardiovascular autonomic control by time domain and non-linear analysis of heart rate variability (HRV). The HRV signal was recorded continuously in twelve children affected by neurological disorders during a HT session, consisting in a 10-minute sitting position rest (P1), a 15-minute preparatory phase sitting on the horse (P2), a 15-minute HT session (P3) and a final 10-minute sitting position recovery (P4). Time domain and nonlinear HRV indices, including Sample Entropy (SampEn), Lempel-Ziv Complexity (LZC) and Detrended Fluctuation Analysis (DFA), were calculated for each treatment phase. We observed that SampEn increased during P3 (SampEn = 0.56 ± 0.10) with respect to P1 (SampEn = 0.40 ± 0.14, p < 0.05), while DFA decreased during P3 (DFA = 1.10 ± 0.10) with respect to P1 (DFA = 1.26 ± 0.14, p < 0.05). A significant SDRR increase (p < 0.05) was observed during the recovery period P4 (SDRR = 50 ± 30 ms) with respect to the HT session period P3 (SDRR = 30 ± 10 ms). Our results suggest that HT might benefit children with disabilities attributable to neurological disorders by eliciting an acute autonomic response during the therapy and during the recovery period.

Children participating in the HT program offered by the Instituto Marcos Sahium, Uberlândia, MG, Brazil, were recruited through verbal invitation to their parents/guardians. Children between the ages of 4 and 12 years affected by neurological disorders were eligible. Participants were excluded if they presented with atlantoaxial instability, coxofemoral luxation, structural scoliosis greater than 35°, osteoporosis, spinal disc herniation or severe cardiomyopathy. A total of 12 children provided assent to participate in the study and their parents/guardians signed the written informed consent document.

results suggest that HT might benefit children with disabilities attributable to neurological disorders by eliciting an acute autonomic response during the therapy and during the recovery period. The authors consider this result to be of extreme interest, as our patients’ regulation mechanism positively responded to perturbation induced by HT, with manifestations during the therapy and during the recovery period. The results hereby presented are relevant and might serve as a valid starting point for the development of future studies aimed at a better understanding of how HT can benefit and provide an effective contribution for the rehabilitation of patients with disabilities attributable to neurological disorders.

Link: https://www.sciencedirect.com/science/article/abs/pii/S0031938416300981

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