Učinek hipoterapije na ravnotežje in utrujenost pri pacientih z multiplo sklerozo - pregled literature : diplomsko delo

Rihter, Klara (avtor), Kovačič, Tine (mentor), Hlebš, Sonja (recenzent)

Uvod: multipla skleroza (MS) je kronična avtoimunska vnetna bolezen, ki povzroča demielinizacijo bele snovi osrednjega živčevja – možganov in hrbtenjače. Težave z ravnotežjem in utrujenostjo spadajo med najbolj ovirajoče simptome MS. Omenjene težave nastopijo kmalu po nastopu bolezni, tudi ko ostali simptomi še niso tako izraziti in vplivajo na omejitve dejavnosti in sodelovanja pri osebah z MS. Med dopolnilne intervencije, ki učinkovito pomagajo pri simptomih MS, spada tudi hipoterapija. Namen: namen diplomske naloge je bil pregledati izsledke raziskav o učinkovitosti hipoterapije na izboljšanje ravnotežja in stopnjo simptomov utrujenosti pri pacientih z multiplo sklerozo. Metode dela: pregledane so bile podatkovne zbirke PEDro, PubMed in CINAHL za obdobje od leta 2013 do leta 2024. Za iskanje smo uporabili različne kombinacije ključnih besed: ''hippotherapy'' OR ''equine-assisted therapy'', ''multiple sclerosis''AND ''balance'' AND/OR ''fatigue''. Rezultati: v pregled literature smo vključili 6 raziskav, od tega 4, ki so randomizirane nadzorovane raziskave, eno nerandomizirano klinično raziskavo, ena pa je bila študija kliničnih primerov. Dve RCT sta po PEDro lestvici ocenjeni s 6 od 10, ena pa 8 od 10. Eno RCT smo po PEDro kriterijih ocenili sami z 7 od 10. V vse raziskave je bilo skupaj vključenih 182 pacientov. V petih raziskavah so izvajali hipoterapijo s konjem, v eni pa so uporabili simulator. Terapevtski programi so trajali od 6 do 16 tednov. Rezultati funkcijskih testov so v vseh raziskavah pokazali, da ima hipoterapija pozitiven učinek na omenjena simptoma. Statistično pomembna razlika je bila opažena predvsem med skupinami, kjer so pacienti v eksperimentalnih skupinah prejemali hipoterapijo, pacienti v kontrolnih skupinah pa so bili brez dodatnih terapij. Razprava in zaključek: glede na rezultate raziskav lahko zaključimo, da hipoterapija pozitivno učinkuje na izboljšanje funkcije ravnotežja in utrujenost pri pacientih z MS, kar se vidi iz boljših rezultatov funkcijskih testov za ravnotežje in boljših rezultatov pri vprašalnikih za stopnjo utrujenosti po intervenciji s hipoterapijo. Do statistično pomembnega izboljšanja pride predvsem v primerjavi s kontrolnimi skupinami brez dodatnih terapij, medtem ko je učinek hipoterapije primerljiv z učinkom drugih dodatnih intervencij. V prihodnje so potrebne dodatne randomizirane nadzorovane raziskave, kjer bi bila zagotovljena dvojna zaslepljenost in bi se primerjalo učinek hipoterapije pri pacientih z MS glede na stopnjo prizadetosti pacientov.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, fizioterapija, multipla skleroza, hipoterapija, ravnotežje, utrujenost
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [K. Rihter]
• Leto izida: 2025
• Št. strani: 36 str., [1] str. pril.
• PID: 20.500.12556/RUL-167677
• UDK: 615.8
• COBISS.SI-ID: 228144643
• Datum objave v RUL: 06.03.2025

RIHTER, Klara, 2025, Učinek hipoterapije na ravnotežje in utrujenost pri pacientih z multiplo sklerozo - pregled literature : diplomsko delo [na spletu]. Diplomsko delo. Ljubljana : K. Rihter. [Dostopano 5 maj 2025]. Pridobljeno s: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=slv&id=167677

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: The effect of hippotherapy on balance and fatigue in patients with multiple sclerosis - literature review : diploma work

Izvleček

Introduction: multiple sclerosis (MS) is a chronic autoimmune inflammatory disease that leads to demyelination of the white matter in the central nervous system, including the brain and spinal cord. Among the most debilitating symptoms of MS are balance problems and fatigue. These symptoms often emerge early in the disease, even before other symptoms become pronounced, and significantly affect the patient’s ability to engage in daily activities and social participation. Hippotherapy is one of the complementary interventions that has shown potential in alleviating MS symptoms. Objective: the aim of this literature review was to evaluate research findings on the effectiveness of hippotherapy in improving balance and reducing fatigue in patients with multiple sclerosis. Methods: a review of studies published between 2013 and 2024 was conducted using the PEDro, PubMed, and CINAHL databases. A combination of the following keywords was used in the search: "hippotherapy" OR "equine-assisted therapy," "multiple sclerosis" AND "balance" AND/OR "fatigue. Results: total of six studies were included in the review, comprising four randomized controlled trials (RCTs), one non-randomized clinical trial, and one case study. Two RCTs were rated 6 out of 10 on the PEDro scale, one was rated 8 out of 10, and one was self-rated at 7 out of 10. In total, 182 patients participated in the studies. Five studies utilized hippotherapy with horses, while one employed a simulator. The duration of the therapeutic programs ranged from 6 to 16 weeks. Functional test results from all studies consistently showed that hippotherapy had a positive effect on balance and fatigue. Statistically significant differences were found primarily between the experimental groups, which received hippotherapy, and the control groups, which did not receive any additional therapy. Discussion and conclusion: the findings of the reviewed studies suggest that hippotherapy has a beneficial impact on improving balance and reducing fatigue in individuals with MS. This is supported by better results in functional balance tests and improved scores on fatigue questionnaires following hippotherapy interventions. Statistically significant improvements were mainly observed in comparison to control groups that received no additional therapy. The effects of hippotherapy appear to be comparable to those of other complementary interventions. Future research should focus on additional randomized controlled trials with double-blind designs and explore the impact of hippotherapy in MS patients with varying degrees of disability.

• Ključne besede: diploma theses, physiotherapy, multiple sclerosis, hippotherapy, balance, fatigue