This diploma thesis focuses on possible application ways of the selected therapies (canistherapy, hippotherapy and music therapy) in particular institutions for disabled people. The therapies mentioned above have been seen as the methods of a compact rehabilitation process which use a positive influence of animals and music on one´s health. The thesis contains the theoretical part which introduces the summary of development and current terminology on the field of zootherapy, canistherapy, hippotherapy and music therapy. The selected topic has been dissected here in full details. It also introduces the problem regarding physical disabilities in general. The practical part of the thesis is a data survey which have been gained in the form of a qualitative research, being presented in two significant chapters. In the first one, the survey regarding the characteristics of the involved institutions can be found. The second chapter is an analysis and comparison of gained information. The aim of the survey is to introduce and sum up the possible ways of using and application of these special therapies in the selected institutions for physically disabled people within the south Bohemian region. The methods of qualitative research have been used. To reach the goal, data collection in a form of observation, semi-standartized interview and photodocumentation have been applied. The complete conclusion of the gained information can be found in the final part of the thesis. The supplements contain some photos regarding these particular therapies and the structure of semi-standartized interview. The thesis can be used as a source of information for both experts and amateurs.

1 Abstract The subject of this thesis is hippotherapy as a supportive treatment method in children with Joubert syndrome and other hypotonic syndromes. In theoretical part is described Joubert syndrome in connection with education of students with special needs including legislation. In response to education of a child with disability there is further described therapy and basic therapeutic approaches that are often used concurrently with hippotherapy. Next part of thesis is focused on Joubert syndrome in terms of origin, causes, symptoms and diagnosis of the disease. With regards to research investigation in empiric part of the thesis there are further described specific educational approaches of individual with Joubert syndrome and other hypotonic syndromes. Theoretical part also comprises closer characteristics of hippotherapy as a possible supportive treatment method in terms of legislation, healthcare and social aspects. In empiric part there were used several methods of data collection within the qualitative research, these were analysis of studied literature, involved observation, case study, document analysis, narrative dialog with parent, discussion with hippotherapist and questionnaire submitted to parents of children attending hippotherapy. Key words: hippotherapy, Joubert syndrome, hypotonia,...

Title Positioning of patiens in hippotherapy Goals The goal of my thesis was maping and analysing positions and rules which are mostly used in hippotherapy, in which is used healthfull efekt of three dimentional motion of horses back. The target group are centers of rehabilitation, which are using hippotherapy under The Czech Hippotherapy Company, actively. Method Thesis is consisted of two sections. The first is consisted of data collection from czech and abroads literature, and in the second section is consisted of quastionnaire filled by hippotherapy centers. Results The thesis deals with descripton of hipporehabilitation and evaluation of questionnaire. The hippotherapy is a subsection of hipporehabilitation, which is using three dimentional motion of herses back. The main part of using hippotherapy is professional team and a horse. Every patient, who entres this therapy is individual, and by this is cared for him. It is necessary to choose the right positions and use another positions ofr patient. The results of questionnaire shows how important the graded therapeutist is. On the therapeutist depends the process of threatment and complection of the therapy due to another diseases of patients. Keywords Position, patient, hippotherapy, horse, tree-diensional movement, therapeutic riding

Title: Influence of race of horse and speed of it's walk on timing of muscles in hippotherapy Purposes: The goal of study is to find out if race of horse and speed of it's walk approaches muscles timing in the reverse sitting position. We also pretend quadrupedal locomotion activation. That would substantiate hippotherapy with sitting-unable children. : Methods: Surface Electromyography, physiotherapeutic screening Results: Muscles timing was different with selected races as well as with different speed of walk. Quadrupedal locomotion was certified. Keywords: hiporehabilitation, hippotherpy, reverse sitting, quadrupedal locomotion, race of a horse, surface electromyography

Abstract title: Postural deviations and their compensations of blind cyclist Thesis objective: The objective of this thesis is to create a compensatory motional program for a visually impaired client. Compensatory motional program deals with the positive influence of defective body posture and pain alleviation of relevant muscular areas, particularly in the areas of cervical, thoracic and lumbar spine. Method: The research method is qualitative examinations by usage of pretest and posttest designs. The thesis is conceived as the case report of a 31-year-old patient with acquired handicap. Exercise in fitness center was selected as part of compensatory motional program with the application of stretching, relaxing and work-out exercise. Additionally, hippotherapy was practiced to improve the stability of individual body areas, as well as to generally enhance the body posture. The testing methods for defective body postures by Jaroš and Lomíček, Matthiase; as well as testing method by Janda, were applied for the verification of program effect. The HHT motor test was applied for the verification of hippotherapy. Results: Compensatory motional program positively influenced the body posture of the clients already after three months of exercise. The integral part of hippotherapy was also the influence of...

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: Multiple Sclerosis (MS) is a chronic neuropathology characterized by infiltration of inflammatory cells in the central nervous system (CNS). Some studies have suggested that cumulative damage to DNA, induced accumulation of reactive oxygen species (ROS) may contribute to several mechanisms underlying the lesions of MS. As a result of dysfunctions observed in different CNS structures, changes in postural control are frequent observations in MS patients. Studies have shown that therapeutic interventions such as equine therapy has the potential to reduce many of the deficiencies observed in MS. Objectives: 1) assess the levels of DNA damage in MS patients, 2) investigate the relationship between rates of DNA damage and parameters of postural control in people with MS, and 3) Verify that hippotherapy is able to initiate changes postural control of patients with MS. Method: The study included 14 MS patients with a mean age of 40.7 ± 8.3 years and 28 healthy controls aged 35.10 ± 15.3 years. The DNA damage was evaluated using the alkaline version of the comet assay. The postural control was assessed by stabilometry for 30 seconds in quiet stance. Results: Patients with MS had higher rates of DNA damage (21.3 ± 4.8) than healthy controls (7.9 ± 6.1) with p = 0.0001. We found no association between rates of DNA damage and the parameters of postural control. After stimulation of hippotherapy, subjects with MS were able to reduce body oscillations Conclusion: MS patients showed more DNA damage than healthy controls. Hippotherapy can be recommended for rehabilitation of postural control in subjects with MS. / Introdução: A Esclerose Múltipla (EM) é uma neuropatologia crônica caracterizada pela infiltração de células inflamatórias no Sistema Nervoso Central (SNC). Alguns estudos tem sugerido que danos cumulativos ao DNA, induzidos pelo acúmulo de espécies reativas de oxigênio (EROs), possam contribuir para vários mecanismos subjacentes às lesões da EM. Em decorrência das disfunções observadas em diferentes estruturas do SNC, as alterações no controle postural são observações frequentes em portadores de EM. Neste sentido, estudos tem evidenciado que intervenções terapêuticas, como a equoterapia, tem potencial para reduzir muitas das deficiências observadas na EM. Objetivos: 1) Verificar os índices de dano ao DNA de portadores de EM, 2) Verificar a relação entre os índices de danos ao DNA e parâmetros do controle postural de portadores de EM, e 3) Verificar se a Equoterapia é capaz de desencadear alterações no controle postural de portadores de EM. Método: Foram incluídos no estudo 14 portadores de EM com idade média de 40,7±8,3 anos e 28 controles saudáveis com idade 35,10±15,3 anos. O dano ao DNA foi avaliado através da versão alcalina do ensaio cometa. O controle postural foi avaliado pela estabilometria, durante 30 segundos, em postura quieta. Resultados: Portadores de EM apresentaram maior índice de dano de DNA (21,3±4,8) do que controle saudáveis (7,9±6,1) com p=0,0001. Não foram encontradas associações entre os índices de dano ao DNA e os parâmetros do controle postural. Após a estimulação da equoterapia os sujeitos com EM foram capazes de reduzir as oscilações corporais. Conclusão: Portadores de EM apresentam maior dano ao DNA do que controles saudáveis. A estimulação proporcionada pela equoterapia foi capaz de desencadear alterações favoráveis no controle postural de portadores de EM, podendo ser indicada como uma prática terapêutica eficiente para esta população.

Bakgrund   En växande äldre befolkning innebär utmaningar gällande ensamhet, fallolyckor, demenssjukdom och att kunna tillgodose en god hälsa bland äldre personer. För att möta de utmaningarna krävs en bredd av åtgärder. Ett område som fått allt större genomslag är djurassisterad terapi. Tidigare studier har bland annat visat hur djurens närvaro bland människor bidrar med upplevelser av lugn. I Sverige finns numera rekommendationer från Socialstyrelsen om att djurassisterad terapi kan användas hos äldre med demenssjukdom. En central del av sjuksköterskans profession är att främja hälsa och förebygga sjukdom. De omvårdnadsåtgärder som görs för att uppnå detta ska vara evidensgrundande. Ett ökat intresse finns därmed för djurassisterad terapi utifrån den kontexten.   Syfte Syftet var att beskriva vilken betydelse djurassisterad terapi kan ha för äldres hälsa.  Metod En icke-systematisk litteraturöversikt gjordes med sökningar i tre olika databaser. Dessa var PubMed, CIHNAL och PsycINFO. Tydliga avgränsningar med inklusions- och exklusionskriterier arbetades fram. Totalt inkluderades 15 artiklar med både kvantitativ och kvalitativ design. Nogsam kvalitetsgranskning av artiklarna gjordes utifrån Sophiahemmets bedömningsunderlag. Vidare gjordes en integrerad dataanalys beskriven av Kristensson för att sammanställa resultatet. Först gjordes detta individuellt för att sedan diskuteras gemensamt. Detta för att säkerställa ett så tillförlitligt tillvägagångssätt som möjligt.  Resultat Tre områden där hälsan kan påverkas av djurassisterad terapi framkom, dessa var fysisk, psykisk och social hälsa. Bland annat ökade rörelseförmågan och den sociala interaktionen. Smärta och känslor av ensamhet minskades samtidigt som puls och blodtryck sänktes och det allmänna stämningsläget förbättrades. Slutligen påverkades även den kognitiva förmågan. Slutsats Djurassisterad terapi kan ha betydelse för äldre personers hälsa även om det finns ett behov av fortsatt forskning på området. Vidare finns behovet av riktlinjer på nationell nivå för implementering av djurassisterad terapi. I dagsläget bygger det nämligen på enskilda kommuners arbete för att ta fram riktlinjer kring användningen på särskilda boenden. / Background An increasing amount of elderly people creates challenges regarding loneliness, fall injuries, dementia as well as challenges to work towards a good health. One method which has gotten more attention recently is animal assisted therapy because it contributes to people’s experience of calmness among other things. In Sweden there are recommendations from the National Board of Health and Welfare that animal assisted therapy can be used in nursing homes for people with dementia. An important part of the profession of nurses is to promote health and to prevent diseases. This work should be based on evidence. Therefore, there is a growing interest for animal assisted therapy. Aim The aim was to describe the importance of animal assisted therapy for the health of elderly people.  Method  A non-systematic literature review was conducted by using terms in three databases: PubMed, CINAHL and PsycINFO. Delimitations with clear inclusion and exclusion criteria are presented in the literature review. In total 15 articles were included with quantitative and qualitative data. Their quality was analyzed by using an assessment tool from Sophiahemmet University. The result was compiled by using an integrative data analysis described by Kristensson. First made individually and then together to make sure it was made in a reliable manner.  Results Three main categories were identified where animal assisted therapy can influence the physical, mental, and social health. Among other things it improved the patients’ mood, mobility and social interaction while it decreased blood pressure, heart rate as well as the feeling of loneliness and pain. The cognitive functioning also got affected. Conclusions Animal assisted therapy can be important for the health of older people, but it needs further research. National guidelines to implement animal assisted therapy are also needed because today the municipalities themselves must create the guidelines in their nursing homes.

Bakgrund: Fysisk aktivitet är en viktig del för hälsan och det krävs flera olika fysiska och psykosociala förmågor för att vara fysiskt aktiv. Ridterapi kan påverka de olika förmågorna till fysisk aktivitet, både fysiskt och psykosocialt, dock är den vetenskapliga evidensen tvetydig. Ett sätt att stärka den evidensbaserade praktiken för ridterapi är att öka kunskapen om fysioterapeuters erfarenheter av hur ridterapi påverkar förmågan till fysisk aktivitet. Syfte: Att utforska fysioterapeuters erfarenheter av hur ridterapi kan påverka förmågan till fysisk aktivitet hos individer med permanent fysisk funktionsnedsättning i olika åldrar. Metod: En kvalitativ deskriptiv studie genomfördes med en induktiv ansats och en semistrukturerad intervjuguide användes. Ett ändamålsenligt bekvämlighetsurval användes, där sex fysioterapeuter från olika verksamheter rekryterades. Resultat: Analysen resulterade i sex underkategorier och tre kategorier. Kategoriernas namn var ”Påverkan på fysisk funktion”, ”Ger möjligheter till att vara aktiv på fritiden” och ”Förändrade tankar och känslor om rörelse”. Slutsats: Deltagarna erfar att ridterapi påverkar förmågor till fysisk aktivitet, utifrån ett bio-psyko-socialt perspektiv. Förmågor på individ- och omgivningsnivå var kroppskontroll, motivation, självförtroende, handikappanpassad anläggning och kuperad terräng. Resultatet bidrar till EBP genom att fylla kunskapsluckan gällande fysioterapeuternas erfarenheter inom området. / Background: Physical activity is an important part of health, and several different physical and psychosocial abilities are required to be physical active. Hippotherapy can affect the different abilities to physical activity, both physically and psychosocially, however, the scientific evidence is ambiguous. One way to strengthen the evidence-based practice for hippotherapy is to increase knowledge about physiotherapists' experiences of how hippotherapy affects the ability to do physical activity. Aim: To explore physiotherapists experience of how hippotherapy can affect the ability to be physical active in individuals with permanent physical disability at different ages. Method: A qualitative descriptive study was conducted with an inductive approach and a semi-structured interview guide. A purposeful convenience sample was used, where six physiotherapists from different practices were recruited.  Results: The analysis resulted in six subcategories and tree categories. The name of the categories was “effect on physical function”, “provides opportunities to be active in free time” and “changed thoughts and feelings about movement”.  Conclusion: The participants experienced that hippotherapy affects abilities for physical activity based on biopsychosocial perspective. Abilities at the individual and environment level were body control, motivation, self-confidence, disabled facilities and hilly terrain. The result contributes to EBP by filling the knowledge gap regarding physiotherapists' experiences in the field.

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