| Sažetak | Jedan od najčešćih i težih neuromotornih odstupanja u dječjoj dobi je cerebralna paraliza (CP).
To je skupina trajnih i promjenjivih poremećaja pokreta i/ili posture i motoričkih funkcija zbog
oštećenja mozga koji je još nezreo ili u razvoju (Katušić, 2011). Jedan od glavnih izazova u
svakodnevnici je kontrola držanja. Različiti pristupi i terapije postoje kako bi poboljšali držanje
i ravnotežu osobe, poput Vojta terapije, Temple Fay tretman, terapija senzorne integracije,
hipoterapija i drugi (Zadnikar, 2011). Zadnikar (2011) naglašava hipoterapiju i jahanje kao
jednu od terapija koji utječu na poboljšanje koordinacije, kontrole glave i trupa, poboljšanje
hoda. Hod konja omogućava ritmične i ponavljajuće obrasce kretanja u kojima uočavamo
sličnosti ako ga uspoređujemo s hodom čovjeka. Sličnosti se nalaze u trodimenzionalnim
kretnjama konja u hodu i kretanju zdjelice čovjeka u hodu (Zadnikar, 2011). Možemo reći da
korisnika pokreće konj i on reagira na pokrete konja (Debuse, 2008). Općenito za jahača, pa
tako i korisnika s cerebralnom paralizom, hipoterapija utječe fizički i psihički. S jedne strane
utječe se na ravnotežu, snagu, mišićni tonus, opseg pokreta, držanje, hod, a s druge strane na
samopouzdanje, samopoštovanje, koncentraciju i raspon pažnje. Hipoterapiju provodi posebno
educirani zdravstveni djelatnik (Zadnikar, 2011). Cilj ovog rada je prikazati studiju slučaja
odrasle osobe sa spastičnom cerebralnom paralizom koja redovito, jednom tjedno, odlazi na
hipoterapiju kroz 12 tjedana. Radom se nastoji prikazati kako hipoterapija može utjecati na
ravnotežu osobe. Ravnoteža se procjenjivala Bergovom skalom balansa koja je ujedno i
najpoznatija skala za procjenu ravnoteže. Sama procjena prikazala je pozitivne rezultate u
području održavanja ravnoteže korisnice. Prema navedenoj skali, korisnica je poboljšala
rezultate na ukupno tri aktivnosti te se broj bodova između inicijalne i finalne procjene povećao
za tri. Osim toga, ispitali smo i zadovoljstvo osobe nakon provedene terapije. Korisnica je u
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anketnom upitniku zaokružila svoj stupanj zadovoljstva s određenim stavkama u samom
procesu hipoterapije. U anketnom upitniku bilo je moguće zaokružiti stupanj zadovoljstva od 1
do 5. U svim stavkama, korisnica je dodijelila visoke ocjene (4 i 5) i time pokazala visoko
zadovoljstvo: u pristupu stručnog osoblja, u aktivnostima koje se provode u sklopu hipoterapije,
koliko je sigurna u rukama osoblja tijekom hipoterapije, odabranim konjem na kojem jaše i
svojim napretkom u cjelokupnoj hipoterapiji. |
| Sažetak (engleski) | One of the most common and severe neuromotor deviations in childhood is cerebral palsy (CP).
It is a group of permanent and variable disorders of movement and/or posture and motor
functions due to damage to the brain that is still immature or developing (Katušić, 2011). One
of the main challenges in everyday life is posture control. Various approaches and therapies
exist to improve a person's posture and balance, such as Vojta therapy, Temple Fay treatment,
sensory integration therapy, hippotherapy and others (Zadnikar, 2011). Zadnikar (2011)
emphasizes hippotherapy and horse riding as one of the therapies that influence the
improvement of coordination, control of the head and trunk, improvement of gait. The gait of
a horse enables rhythmic and repetitive patterns of movement in which we can see similarities
if we compare it with the gait of a human. Similarities are found in the three-dimensional
movements of a horse while walking and the movement of the pelvis of a person while walking
(Zadnikar, 2011). We can say that the user is moving by the horse and he reacts to the horse's
movements (Debuse, 2008). In general, for the rider, including the user with cerebral palsy,
hippotherapy has a physical and psychological effect. On the one hand, it affects balance,
strength, muscle tone, range of motion, posture, gait, and on the other hand, self-confidence,
self-esteem, concentration and attention span. Hippotherapy is performed by a specially trained
health worker (Zadnikar, 2011). The aim of this paper is to present a case study of an adult with
spastic cerebral palsy who regularly, once a week, goes to hippotherapy for 12 weeks. The work
tries to show how hippotherapy can affect a person's balance. Balance was assessed using the
Berg balance scale, which is also the most well-known balance assessment scale. The
assessment showed positive results in the area of maintaining the balance of the user. According
to the mentioned scale, the user improved results on three activities and the number of points
between the initial and final assessment increased by three points. In addition, we also examined
the person's satisfaction after the therapy. A person circled her level of satisfaction with certain
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items in the hippotherapy process in the questionnaire. In the questionnaire, it was possible to
circle the degree of satisfaction from 1 to 5. In all items, the user assigned high marks (4 and 5)
and on that way showed high satisfaction: in the approach of the professional staff, in the
activities carried out as part of hippotherapy, how safe she feels in the hands of the staff during
hippotherapy, the chosen horse on which she rides and her progress in overall hippotherapy. |
