Effectiveness of the Hippotherapy Simulator in Children and Adolescents With Cystic Fibrosis

Investigation of the Effectiveness of the Hippotherapy Simulator Added to Respiratory Physiotherapy in Children and Adolescents With Cystic Fibrosis

Cystic fibrosis (CF) is a genetic disease that affects many organs and systems, especially respiratory system problems due to lung damage. Patients often have difficulty in removing the sticky and viscous secretion that accumulates in the respiratory tract, and the risk of mortality increases with the development of respiratory failure. In patients with CF, exercise capacity, peripheral muscle strength, core endurance, flexibility, postural stability, physical activity level, and quality of life also decrease secondarily. Recently published guidelines recommend respiratory physiotherapy for coping with CF-related symptoms and recommend referral of patients to physical activity and exercise. Hippotherapy simulator is a mechanical exercise tool that imitates the walking movement of a real horse and is used to increase physical fitness parameters. This study aims to show the effects of exercises performed with a hippotherapy simulator in addition to respiratory physiotherapy on physical fitness, sputum production, physical activity and quality of life of children with CF.

cystic fibrosis, hippotherapy simulator, pulmonary functions, sputum expectoration, functional capacity, 6-Minute Walk Test, Postural stability, motor performance, respiratory physiotherapy

Home-based respiratory physiotherapy will be applied twice a day and every day of the week for 8 weeks

In addition to home-based respiratory physiotherapy, 30 min exercises with the hippotherapy simulator will be done.

30-minute (5 min warm-up+20 min exercise+5 min cool-down) center-based exercise with the hippotherapy simulator will be done 2 days a week for 8 weeks.

Respiratory physiotherapy includes breathing control (5x2), diaphragmatic breathing exercises (5x2), thoracic expansion exercises (5x2), incentive spirometer (5x2), opep device (5x2), postural drainage and percussion and cough improvement techniques (10 min). Home-based respiratory physiotherapy will be applied twice a day and every day of the week for 8 weeks.

Physical Activity Level. As a result of the 9-item questionnaire, 1 means lowest and 5 means highest physical activity level.

Quality of Life Assessment. In this questionnaire, which consists of 35 questions, the total score is 100, and a higher score indicates a better quality of life.

Subjective evaluation method questioning "sense of chest congestion" with visual analog scale (0-10 point). A higher score indicates greater sense of chest congestion.

Subjective assessment that evaluates "how hard the person has during sputum production" with a visual analog scale (0-10 point). A high score means that it is easy to sputum.

Inclusion Criteria: Be in the 8-14 age range To be diagnosed with cystic fibrosis according to the American Cystic Fibrosis Association consensus report criteria Having mild (FEV1 ≥ 70% predictive) lung disease according to the disease severity classification in the annual report of the American Cystic Fibrosis Society To be able to produce phlegm Exclusion Criteria: Contracture or deformity, History of diagnosed orthopedic problems affecting mobility or musculoskeletal surgery History of previous lung or liver transplant Have diagnosed vision, hearing, vestibular or neurological problems that may affect balance, History of hospitalization in the last 1 month Patients who have participated in any exercise training program in the last 6 months