Introduction: Down syndrome (DS) is a genetic disorder characterized by muscle hypotonia and poorly developed postural strategies. Continuous physical therapy is therefore essential for preventing falls and fostering functional independence in individuals with DS. Hippotherapy, which utilizes three-dimensional movements in combination with physiotherapy techniques, is emerging as a complementary technique that has a beneficial effect on the balance of children with developmental disorders. Purpose: The purpose of this master's thesis was to assess the immediate impact of a single 30-minute hippotherapy session on static balance parameters in individuals with DS. Methods: In a quantitative experimental study with a pre-post design without a control group, 17 people with DS who met the inclusion criteria were included in the study. We performed stabilometry before and after 30 minutes of hippotherapy, recording the movement of the center of pressure under four sensory conditions (hard or soft surface combined with open or closed eyes). Data were analyzed using parametric and nonparametric statistical tests, depending on their distribution. Results: The most consistent improvement after hippotherapy was detected in the parameter of average velocity and path length in the y direction, both of which were statistically significantly lower in all conditions. The stabilogram area, assessed using PCA, decreased in three conditions (except in the easiest measured condition: eyes open, hard surface). The path length in the x direction decreased statistically significantly after hippotherapy only in two demanding conditions (soft surface with open and closed eyes), while the stabilogram area calculated with FAO was statistically significantly smaller only in the most difficult condition (soft surface, closed eyes). The effect sizes were mostly moderate to large, with the most pronounced effects observed under the more challenging conditions. Discussion and conclusion: The results suggest that hippotherapy has an immediate effect on improving certain aspects of postural control in individuals with DS, particularly under more demanding sensory conditions, and it may be beneficial as part of a comprehensive physiotherapy treatment for enhancing balance in individuals with DS. The effects were not uniform across all stabilometric indicators, highlighting the need for further research with a larger sample, controlled design and longer observation period to better assess the durability of the effects and their clinical implications.
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