Inter-Day Reliability and Changes of Surface Electromyography on Two Postural Muscles Throughout 12 Weeks of Hippotherapy on Patients with Cerebral Palsy: A Pilot Study

Hélène Viruega, Inès Gaillard, Laura Briatte, Manuel Gaviria, Hélène Viruega, Inès Gaillard, Laura Briatte, Manuel Gaviria

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.

Keywords: EMG; cerebral palsy; hippotherapy; neurorehabilitation; postural balance; postural muscles.

Conflict of interest statement

All authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Scatter dot plot of the mean values of the AM mRMS at the beginning and the end of each session (Ini/End) regardless of treatment time. Tukey multiple-comparison test: * (p < 0.05).
Figure 2
Figure 2
Scatter dot plot of the mean mRMS values of the RA muscle during the first three minutes of the session (Ini) in relation to the treatment time (T0: first session; 6 w: week 6; 12 w: week 12). Tukey multiple-comparison test: * (p < 0.05).
Figure 3
Figure 3
Scatter dot plot around the mean mRMS value of the AM muscle at the first 3 min of the session (Ini) in relation to the treatment time (T0: first session, 6 w: week 6, 12 w: week 12). Tukey multiple-comparison test: * (p < 0.05).
Figure 4
Figure 4
On the left, scatter dot plot of the mean values of RA MNF at the beginning and end of each session (Ini/End) regardless of the treatment time; on the right, scatter dot plot around the mean value of the RA MDF at the beginning and the end of each session (Ini/End) regardless of the treatment time. (T0: first session; 6w: week 6; 12w: week 12). Tukey multiple-comparison test: * (p < 0.05).
Figure 5
Figure 5
Scatter dot plot of the mean values of MNF (left graph) and MDF (right graph) of the AM muscle with respect to time of treatment (T0: first session; 6w: week 6; 12w: week 12). Data were compared at the end of the session (End). A gradually decrease trend, which was statistically confirmed, emerged at the end of the session in relation to the evolution of the treatment. *: p < 0.05 in the Tukey multiple-comparison test.

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