Equine-Assisted Physiotherapy for Spinal Muscular Atrophy

Summary

This prospective interventional study evaluates the immediate and sustained effects of intensive equine-assisted physiotherapy in children with spinal muscular atrophy (SMA). The study compares an intensive equine-assisted physiotherapy program (NEUROEQUIP-SMA) with an individualized physiotherapy program based on SMA standard of care and neuroproprioceptive facilitation and inhibition principles (SMA-SOC-N). Both interventions are delivered as intensive 6-day rehabilitation programs. Outcomes include motor function, postural control, respiratory function, movement quality assessed by three-dimensional motion analysis, neuromuscular activity, quality of life, and selected molecular biomarkers. The study also evaluates the safety and tolerability of intensive rehabilitation in children with SMA.

Conditions

• Spinal Muscular Atrophy

Interventions

PROCEDURE

Individual physiotherapy (SMA-SOC-N)

Therapeutic procedures according to the international Standard of Care (SMA-SOC) recommendations, complemented by the principles of neuroproprioceptive facilitation and inhibition, will be used during therapy. Elements of breathing gymnastics, vibration techniques, stretching, eccentric and concentric exercise procedures will be combined. Individual physiotherapy will be conducted on the basis of set goals from the kinesiological examination, it will be adapted to the individuality of the child - his cooperation, fatigue and sleep time.

PROCEDURE

Equine-Assisted Physiotherapy Based on Neuroproprioceptive Facilitation and Inhibition

HT by CP is an accredited form of hippotherapy, whose methodology is based on the clinical picture of cerebral palsy. In this study, the accredited HT by CP methodology was applied to children with spinal muscular atrophy and complemented by principles of neuroproprioceptive facilitation and inhibition. Based on a special type of examination, this method precisely determines the "type / breed" of the horse according to the biomechanics of the movement of its back in the step, the position of the child and the neurophysiological function of the back - differentiation or sensorimotor skills. Furthermore, according to the course of therapy, the physiotherapist determines the pace of the horse's step, its length, selects special manual contacts according to the current situation and adjusts the duration of therapy to the client's fatigue. Therapy will be performed by therapists with professional competence to perform hippotherapy by children with CP.

PROCEDURE

Therapeutic grooming

In order to influence the psychomotor development in a comprehensive way, the psychosocial activity of therapeutic grooming will also be included in the study. Its goal is to support children's communication, their interaction with the environment, the ability to establish contact with the horse and the overall emotional support of children with SMA. The purpose of this activity is to clean the horse, its possible guide, stroking and contact with the horse, work from the ground.

Sponsors & Collaborators

• Charles University, Czech Republic

  lead OTHER

Principal Investigators

• Kamila Rasova, as.prof.Dr. · Clinic of rheumatology and rehabilitation, Third medical faculty CU and Faculty Thomayer Hospital

Study Design

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

1 Year

Max Age

10 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-04-22

Primary Completion

2024-09-25

Completion

2024-10-20

Countries

• Czechia

Study Locations