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Title:Kratkoročna učinkovitost hipoterapije v kombinaciji z razvojno-nevrološko obravnavo na status grobe gibalne funkcije pri osebah z Rettovim in atipičnim Rettovim sindromom : doktorska disertacija študijskega programa tretje bolonjske stopnje Fizioterapija
Authors:ID Kapel, Alen (Author)
ID Velnar, Tomaž (Mentor) More about this mentor... New window
ID Kos, Nataša (Comentor)
Files:URL https:
 
.pdf Kapel_Alen_dr_2025.pdf (4,03 MB)
MD5: B0F4C882520E19BA6AF52387D464435A
 
Language:Slovenian
Work type:Doctoral dissertation
Typology:2.08 - Doctoral Dissertation
Organization:UAMEU - Alma Mater Europaea University
Abstract:RTT velja za gensko pogojeno razvojno-nevrološko motnjo s progresivno-regresivnim razvojem. Ker gre za kompleksno klinično stanje s številnimi patološkimi stanji, ki se razvijajo skozi štiri razvojne faze, sta spremljanje in vodenje sindroma zapletena, saj gre za številna heterogena stanja. V zdravstveno-medicinski stroki je sindrom deležen dolgoročnega vseživljenskega spremljanja, v sklopu nevrofizioterapije pa znanost izpostavlja večmodalen pristop k (re)habilitaciji. V sklopu naše raziskave smo raziskali učinkovitost hipoterapije v kombinaciji z razvojno nevrološko obravnavo (RNO) pri izboljševanju stanja grobe gibalne funkcije in nevro-vedenjskih stanj sindroma z uporabo lestvic Rett syndrome gross motor scale (RSGMS) in Rett syndrome behaviour questionner (RSBQ). Disertacija prek primerjalne analize učinkov izolirane RNO in kombinacije RNO s hipoterapijo naslavlja vrzel v obstoječi znanstveni literaturi in omogoča vpogled v kratkoročno učinkovitost hipoterapije na status grobe gibalne funkcije žensk z RTT. Z uporabo kvantitativne raziskovalne metodologije smo izvedli kvazieksperimentalno retrospektivno študijo s predtest–potest zasnovo ter kontrolno skupino in ugotovili, da ima kombiniran pristop – hipoterapija z RNO – ugodnejši vpliv na vsesplošno stanje. Vedenjski in nevrološki simptomi, ki so potrjeni z bistvenim znižanjem vrednosti ocen na lestvici RSBQ, nakazujejo, da tovrstna integrirana strategija prinaša celostnejši terapevtski učinek za osebe z RTT. Skupna ocena grobih gibalnih funkcij (merjenih z RSGMS) ni dosegla statistično značilne razlike v primerjavi s samostojnim pristopom RNO, so pa pozitivni trend ter izboljšave v posameznih poglavjih (hoja/stoja in izzivi) pokazatelj, da je kombinirana terapija učinkovita pri dinamičnih motoričnih sposobnostih in zahtevnejših funkcionalnih nalogah. Izsledki disertacije potrjujejo, da hipoterapija predstavlja pomembno dopolnitev k RNO oseb z RTT. Kombinirana intervencija prispeva k napredku na področju grobe gibalne funkcije in nevro-vedenjskega stanja, saj celostno naslavlja kompleksno fenotipsko sliko sindroma. Disertacija odpira prostor za nadaljnje longitudinalne raziskave z večjimi vzorci in v več centrih, ki bi omogočile ovrednotenje dolgoročnih učinkov, zlasti z vključitvijo genske analize za razumevanje specifičnih odzivov.
Keywords:groba gibalna funkcija, razvojna-nevrološka obravnava, hipoterapija, multimodalen pristop, nevro-vedenjsko stanje
Place of publishing:Maribor
Place of performance:Maribor
Publisher:A. Kapel
Year of publishing:2025
Year of performance:2025
Number of pages:202 str., [8] f. pril.
PID:20.500.12556/ReVIS-12904 New window
COBISS.SI-ID:264461315 New window
UDC:615.825:798.2(043.3)
Publication date in ReVIS:13.01.2026
Views:225
Downloads:5
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Secondary language

Language:English
Abstract:RTT is considered a genetically determined neurodevelopmental disorder with a progressive-regressive course. Due to its complex clinical presentation involving multiple pathological conditions that evolve through four developmental stages, monitoring and management of the syndrome are challenging and characterized by considerable heterogeneity. In the medical field, RTT is subject to lifelong monitoring, while within neurophysiotherapy, the scientific community emphasizes the importance of a multimodal (re)habilitation approach. Our study investigated the effectiveness of hippotherapy in combination with NDT in improving gross motor function and neurobehavioral symptoms of RTT, using the RSGMS and RSBQ scales. Through a comparative analysis of isolated NDT and the combined NDT–hippotherapy approach, the dissertation addresses a gap in the existing literature and provides insight into the short-term efficacy of hippotherapy on the gross motor function of females with RTT. Using a quantitative research design, a quasiexperimental retrospective study with a pretest–posttest structure and control group was conducted. Findings indicate that the combined approach—hippotherapy with NDT—has a more favorable impact on the overall clinical status. Behavioral and neurological symptoms showed statistically significant improvement as reflected in lower RSBQ scores, suggesting that this integrated therapeutic strategy provides a more comprehensive effect for individuals with RTT. Although the overall gross motor scores (as measured by RSGMS) did not reach statistical significance compared to DNT alone, positive trends and improvements in specific domains (walking/standing and challenges) suggest that the combined therapy is effective for enhancing dynamic motor skills and more demanding functional tasks. The findings of this dissertation confirm that hippotherapy is a valuable adjunct to NDT for individuals with RTT. The combined intervention contributes to improvements in gross motor function and neurobehavioral outcomes by addressing the complex phenotypic manifestations of the syndrome holistically. The dissertation highlights the need for further longitudinal studies with larger sample sizes and multi-center designs to evaluate long-term outcomes, especially with the inclusion of genetic analysis to better understand individual responses.
Keywords:gross motor function, neuro-developmental treatment, hippotherapy, multimodal approach, neurobehavioral symptoms


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