The fourth participant ambulated with a rolling walker, had a decreased cadence, and found sit-to-stand transitions challenging, making the TUG impractical and necessitating a different assessment tool. The 10 Meter Walk Test ( 10 mWT) was chosen, which measures the time it takes a person to walk at a comfortable speed from markers at 2–8 m within the designated 10 m pathway. It is cost effective, easy-to-use, safe, and has been shown to have excellent inter-rater and intra-rater reliability [ 27]. Sensors Notably, the TUG results were more variable after the HPOT sessions (s.d.: 4.17) than before (s.d.: 3.56) (Fig. 5 top left vs. bottom left).Specifically, variability drastically reduced during sessions 4 and 8 for Pre-HPOT whereas variability remained relatively constant throughout the sessions for Post-HPOT. Encheff J, Armstrong C, Masterson M, Fox C, Gribble P. Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments. Pediatr Phys Ther. 2012;24(3):242–50. Postural control is affected by sensory information [ 41]. Children with CP often have impairments in sensory processing [ 41]. During HPOT the participant is experiencing multiple impulses per minute and reacting to such movements [ 17]. This offers cognitive, limbic, and physical stimulation [ 10, 42], as well as visual, vestibular, and the somatosensory system [ 17]. Combined, these concentrated stimuli to the participant may facilitate development of new movement strategies in a way not offered in a more traditional PT session [ 10]. McGibbon N, Andrade C, Widener G, Cintas HL. Effect of an equine-movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy. Dev Med Child Neurol. 1998;40(11):754–62.

Lariviere O, Provot T, Valdes-Tamayo L, Bourgain M, Chadefaux D. Force pattern and acceleration waveform repeatability of amateur runners. Proceedings 2020;49(136).

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Shurtleff T, Engsberg J. Changes in trunk and head stability in children with cerebral palsy after hippotherapy: a pilot study. Phys Occup Ther Pediatr. 2010;30(2):150–63. Functional tests modestly improved over time. The children’s movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse’s walk, demonstrated by reduced frequency errors and increased correlation. Conclusions

Pavao SL, dos Santos Silva FP, Savelsbergh GJ, Rocha NC. Use of sensory information during postural control in children with cerebral palsy: systemic review. J Mot Behav. 2015;47(4):291–9. Haehl V, Giuliani C, Lewis C. Influence of hippotherapy on the kinematics of functional performance on two children with cerebral palsy. Pediatr Phys Ther. 1999;11(2):89–101. Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy relation between standing balance and walking function in children with spastic cerebral palsy. Dev Med Children Neurol. 2013;45(9):591–602. Gordon AM, Magill RA. Motor learning: application of principles to pediatric rehabilitation. In: Campbell S, Palisano R, Orlin M, editors. Physical Therapy for Children. St. Louis: Elevier & Saunders; 2012. p. 151–74. Garner BA, Rigby BR. Human pelvis motions when walking and when riding a therapeutic horse. Hum Mov Sci. 2015;39:121–37.The principles of HPOT derive from the movements a horse provides to the individual astride the equine. Studies have been done to look at the kinematic movement patterns of the horse and rider. MacPhail et al. [ 13] used kinematic analysis to look at the pelvic movement of the horse and lateral trunk movements of riders; six with CP and seven with no disabilities. Kinematic analysis revealed that the horse’s pelvis appeared to move in a dual frequency sinusoidal curve pattern, as opposed to a simple sinusoidal curve, leading researchers to note that this more complicated movement pattern increased the need for postural adjustments of riders. The increased demand on the rider to respond to the movement imparted by the horse appeared to have facilitated typical equilibrium reactions in the two participants with CP. The researchers reported that normal equilibrium responses (using the children who were typically developing as the reference) were elicited in 65–75% of the responses for riders who had diplegic CP and 10–35% of the responses for riders with quadriplegic CP. The researchers concluded that for children with diplegic CP, it might be an effective way to elicit and practice sitting equilibrium reactions [ 13]. Benda W, McGibbon NH, Grant KL. Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). J Altern Complement Med. 2003;9(6):817–25. One of the things you will notice when it comes to getting light fixtures is to ensure you know what you need. Garden spotlights are a great way to give an instantaneous modern feel to your garden area. This type of lighting is extremely versatile and gives you directional control over the focus of the beam. You can use this control to express yourself creatively with the lighting in your garden. Use them to highlight your favourite areas, and when you get bored you can change the lighting to produce a totally different affect. Due to limited number of participants, statistical analyses could not be performed. Instead, mean and standard deviation (s.d.) were reported in the result section. In sum, with continued HPOT sessions, children with CP showed improved functional mobility (Fig. 5). For children with CP, functional deficits are often a result of poor postural control [ 6]. Yet motor skills improve when postural control improves [ 38]. HPOT may facilitate equilibrium and righting reactions through the variations in the horse’s velocity, direction, and stride length [ 14]. In a study by MacPhail et al. [ 13], the researchers noted that involuntary postural reactions of the trunk and head—specifically, equilibrium and righting reaction—were a result of the passive displacement of the rider’s center of gravity. The movement imparted to the rider when the horse is walking plays a crucial role in HPOT treatments.

Outdoor Lamps. We made creative yet functional lamps for your pathways and your gardens. With these, you get to play around with the designs, size, and how bright or dim you want them. Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy. Children. 2017;4(4):30. Casady R, Nichols-Larsen D. The effect of hippotherapy on ten children with cerebral palsy. Pediatr Phys Ther. 2004;16(3):165–72. Wouda FJ, Giuberti M, Bellusci G, Maartens E, Reenalda J, van Beijnum B-JF, Veltink PH. Estimation of vertical ground reaction forces and sagittal knee kinematics during running using three inertial sensors. Front Physiol 2018;9(218).To analyze how the riders and horses interact, we examined the vertical acceleration, ACCz, from all sensors for the following reasons. First of all, acceleration can be considered as an interaction force between the horse and rider normalized by the rider’s body mass. Several studies also have reported that leg acceleration and ground reaction force are highly correlated while running [ 30, 31]. Therefore, even though acceleration is a kinematic variable, it conveys the information on the cause of the movement, not like other kinematic variables including position, velocity, and orientation. Even though Uchiyama et al. [ 24] also investigated acceleration, they simply compared acceleration of human walking and acceleration of horse walking to examine the similarity of their walking, but didn’t study how horse’s walking affects human’s movement. Second, we decided to focus on the vertical direction since the vertical up-and-down movement of the center of mass (1) is dominant and energy-efficient [ 32, 33] and (2) involves with significantly larger impulse due to the gravity as opposed to any other directions [ 34]. ACCz indicates changes in gravity that generate physical changes in movements of the body [ 35], and may represent the interaction force normalized by the mass of the body. In this study, we analyzed the data from the first 10 min of the sessions (Fig. 1), when the equine movement was continuous, to observe the uninterrupted repetitive and rhythmical patterns. Data from the second half of the sessions will be analyzed in the future study. Participants 1–3 performed the TUG whereas participant 4 found sit-to-stand transitions challenging, making the TUG impractical. Therefore, participants 1–3 performed TUG and participant 4 performed 10 mWT. On average, the times taken to finish the TUG decreased by 18.3% and 27.5% for session 4 and session 8 compared to session 1, respectively (Fig. 5). A few exceptions existed. For example, subjects 2 showed increased TUG after HPOT session 4 compared to session 1 whereas subject 3 showed increased TUG before HPOT session 4 compared to session 1. The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse’s movement. Since the horse’s gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern. The horse’s movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning. The increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work. Uchiyama H, Ohtani N, Ohta M. Three-dimensional analysis of horse and human gaits in therapeutic riding. Appl Anim Behav Sci. 2011;135(4):271–6. Physical therapy treatments incorporating equine movement are recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, to better understand the effectiveness of this type of treatment, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized. Methods

Graham K, Harvey A, Rodda J, Nattrass G, Pirpiris M. The functional mobility scale. J Pediatric Orthopaedics. 2004;24(5):514–20. The shade is made of polycarbonate and has an IP65 rating which means that the luminaire is protected against rain, but please note that the product should not be completely submerged in water. The primary goal of any physical therapy treatment is to improve a patient’s functional ability [ 1]. Functional mobility is defined as the way a person moves within their environment on a daily basis to interact with society and family [ 2]. Healthcare providers frequently treat individuals with cerebral palsy who have deficits in functional mobility as well as in other domains. The diagnosis of cerebral palsy (CP) refers to a non-progressive lesion in the developing brain which affects a person’s ability to move [ 3]. CP is the most common cause of motor disability in children [ 2, 4, 5] and Kirby et al. [ 4] reported that the prevalence of CP is 3.3 per 1000 births in the United States, with 75–81% of those diagnosed with spastic CP. It often causes poor balance and muscle weakness [ 3]. These deficits lead to decreased postural control, which is essential for all movements [ 6, 7]. Further, poor balance adversely affects functional mobility which in turn affects activities of daily living [ 8]. Physical therapists work with this population to facilitate improved motor function to enhance daily life [ 9]. Therapy often spans years for individuals with CP, making it challenging for therapists to find a variety of effective, evidenced-based treatments that are also motivating for the patient over a long period of time. This study is intended to contribute an evidence-based treatment option for physical therapists, one that may be considered novel, enjoyable, and appealing when compared to traditional therapy techniques.

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Hong W, Kumar NA, Hur P. A phase-shifting based human gait phase estimation for powered transfemoral prostheses. IEEE Robotics Automation Lett. 2021;6(3):5113–20. If you are the kind of person that enjoys changing the furniture around and can't stand the same old thing for too long then installing some spotlights will let you refresh your garden lighting whenever the mood takes you. What do you need from a garden spotlight? Something cost effective? A study by Uchiyama et al. [ 24] used acceleration data to evaluate the similarity between the movements of children and horse based on the hypothesis that the horse’s pelvic movement during therapeutic riding sessions are similar to the human pelvic movement while walking. Three-dimensional accelerometers collected acceleration of both horses and humans walking for a three-minute period and stride-phase data was generated from foot movements. The results showed that the frequency peaks of human walking corresponded with those of the horse walking, especially during the stride-phase. The authors concluded that riding a horse at a walk provides sensory and motor input to the rider comparable to the human activity of walking, thus offering a potential treatment option for individuals with gait abnormalities [ 24]. no botulinum toxin treatments, orthopedic, or neurosurgery in the six months preceding initiation of HPOT sessions Eight 20-min physical therapy sessions incorporating HPOT were conducted (Fig. 1). A series of figure-of-eight patterns were made, at a steady pace, across the arena for the initial 10 min. For the second 10-min period, the horse continued the pattern, walking at the same steady pace but with walk-halt-walk transitions at 1-min intervals. Three of the four children were given a ring-shaped toy to hold with both hands during the second 10-min period, to reduce the impulse for upper extremity protective extension with changes in perturbations. The fourth child was not given a toy as she needed her hands on a weight-bearing surface to maintain stability. The first half of the session allowed the riders to feel to the slow, rhythmical, multi-dimensional aspect of the horse’s gait at a walk. The second part of the session further challenged the rider’s balance, righting reactions, and trunk control.