RU2771878C2 - Method for joint canis and equine therapy of children with a central nervous system pathology - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to rehabilitation and neurology, and can be used for abilitation and rehabilitation of children with a neurological pathology. For this purpose, joint equine and canis therapy sessions are conducted, including the adaptation, main and final stages. At the adaptation stage, sessions 1 to 2, children are acquainted with the instructor, with a horse, practice mounting the horse and dismounting. Additionally, the adaptation stage includes acquaintance with a dog. At the main stage, exercises are consecutively performed while sitting on a walking horse: changing the support area, oculomotor gymnastics, exercises of a knocking nature, riding with eyes closed, exercises with a constantly changing path of movement, a combination of exercises with breathing gymnastics, exercises with objects. Additionally, exercises are used: when the horse walks in a straight line and in a circle, the child is offered to throw a ball to the dog, while sitting on a moving horse, the child is asked to look for the dog accompanying the horse, while the horse is moving, the child repeating the sounds made by the dog. The child is also offered to give the dog their own voice commands: "Speak", "Heel", "Go out", while sitting on a moving horse, and commands "Sit", "Down", while sitting on a standing horse, riding at a walk while holding a glass of water. At the final stage, relaxation exercises are performed: while lying on the neck of the horse, hugging the animal, riding at a walk in a prone position along and across the body of the horse, riding at a walk with eyes closed. At the end of the session, in order to reinforce the achieved effect, the child is offered to feed the horse and the dog - straightening the arm while opening the hand, and walk focusing the attention on the correct positioning of the feet, straight position of the body and legs. The course of joint equine and canis therapy therein consists of 20 sessions at a frequency of 2 per week, lasting from 30 to 60 minutes.

EFFECT: method ensures effective restorative treatment of children with a central nervous system pathology due to the development of the emotional-volitional sphere, postural control, manual functions, speech, improvement in the quality of life of children with a central nervous system pathology.

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Description

SUBSTANCE: invention relates to medicine, namely to rehabilitation treatment and neurology, and can be used for habilitation and rehabilitation of children with neurological pathology.

The increase in the number of children with pathology of the central nervous system (CNS) makes it urgent to search for new methods of restorative treatment. Moreover, often the pathology of motor development is combined with speech and emotional-volitional disorders, which makes it difficult to form communication skills and socialize the child [Prevention of disorders of psychomotor and speech development in children with perinatal CNS damage / A.I. Chubarova, M.A. Khan, T.E. Tulenkova, N.A. Mikitchenko, M.V. Rumyantseva // Bulletin of restorative medicine. 2019. No. 6 (94). S. 33-38].

Hippotherapy - therapeutic riding has a versatile effect on the body of the practitioner and is used in the complex rehabilitation treatment of children with CNS pathology [Hippotherapy for cerebral palsy: guidelines / L.M. Arkusha, N.V. Chebanenko, T.T. Batysheva, K.A. Zaitsev. - Moscow, 2012.-24 s], but is not able to include in the work all the possibilities of the child's body. Therefore, in combination with hippotherapy, other methods are often used.

There is a method of hippotherapy for patients with cerebral palsy in the conditions of the Black Sea coast, proposed by V.I. Komlatsky and N.V. Nikitina [RF Patent No. 2651902 on application No. 2017114707 dated 04/26/2017, published: 04/24/2018 Bull. No. 12.]. The method includes hippotherapy combined with warm sea bathing.

The disadvantage of this method is that it provides for a course of 14 procedures, which is not enough to obtain a lasting positive effect. Another drawback is that classes are combined with warm sea bathing, which is not available for most of the year on the Black Sea coast and is completely inaccessible in most of the country.

There is a method of hippotherapy for patients with cerebral palsy, proposed by D.A. Evmenov, I.I. Diamant, E.M. Khronenko and A.F. Shevtsov [RF Patent No. 2469694 on application No. 2011142558 dated 10/20/2011, published: 12/20/2012 Bull. No. 35.]. The peculiarity of the method lies in the fact that the child is engaged in hippotherapy in a neuro-orthopedic pneumosuit, first on a stationary horse, then - while the horse is slowly moving in a circle.

Disadvantages of the method: during classes, the child learns only the postures of lying and sitting, control of the position of the head. At the same time, he does not make movements with his limbs, is not emotionally involved in the process. The child learns postures in a neuro-orthopedic pneumosuit, which provides him with support and facilitates the task, he does not learn to control his body without external fixation.

Today, canistherapy is gaining popularity - classes with specially trained dogs aimed at correction, rehabilitation and social adaptation of persons with developmental disorders of various origins [Kogalovskaya A.S. Features of the rehabilitation of disabled children using canistherapy // Bulletin of the Ivanovo State University. Ser.: Natural, social sciences. 2013. No. 1. pp. 41-46; Karomatov I.D., Baimurodov R.S. Canistherapy (literature review) // Biology and Integrative Medicine. 2017. No. 4. P. 236-254] It is believed that communication and games with a dog have a positive effect on children with disabilities, they can awaken the internal reserves of their body, stimulate positive changes in the emotional and volitional sphere, but data on the combination of hippotherapy with canister therapy for the rehabilitation of children with pathology We did not meet the CNS.

Closest to the proposed invention is a method of hippotherapy for children with CNS pathology [Therapeutic physical culture for infants with CNS pathology. Textbook for SPO / O.A. Zagorodnikova, S.V. Kirillova, S.A. Kovaleva, N. G. Konovalova, V.V. Fedorov; under total ed. N.G. Konovalova. - 2nd ed., revised. and additional - M.: Yurait Publishing House, 2019. - S. 169-180]. The method includes a course of 16 lessons with a frequency of 2 per week, lasting from 30 to 60 minutes, depending on the state of health and psychomotor development of the child. The rehabilitation process includes 2 stages - adaptation and main.

At the adaptation stage, the children get to know the instructor and the horse, practice getting on the horse, dismounting, form balance, and perform breathing exercises.

At the main stage, children perform the following exercises while sitting on a horse moving at a pace: changing the area of \u200b\u200bthe support; oculomotor gymnastics; disruptive exercises; driving with eyes closed exercises with a constantly changing route of movement; combination of exercises with breathing exercises; object exercises. To develop the manipulative activity of the hands, children are offered to throw balls into baskets.

In the final part - relaxation exercises: lying on the horse's neck, hug the animal; riding step in the prone position along and across the body of the horse; riding with closed eyes.

At the end of the lesson, the child is offered to feed the horse and walk, focusing on the correct setting of the feet, the straight position of the body and legs.

Disadvantages of this method: the method is limited to interaction with only one animal, without providing for additional exercises that could be implemented using another animal - a dog, to improve the emotional state of the child, to perform complex and additional exercises. In addition, if the contact of the child with the horse is not established, then this will create difficulties in including the child in the therapeutic process.

The objective of the invention is the development of the emotional-volitional sphere, postural regulation, manual functions, speech, improving the quality of life of children with pathology of the central nervous system.

The technical result of the proposed method is to increase the efficiency of restorative treatment of children with pathology of the central nervous system through joint canis and hippotherapy.

The task is achieved by the following sequence of actions. The course of joint canis and hippotherapy consists of 20 sessions, 2 per week, lasting from 30 to 60 minutes, depending on the state of health and psychomotor development of the child. The course includes 2 stages: adaptation and main.

At the adaptation stage (1-2 lessons), children get acquainted with the instructor, the horse, the dog, practice getting on the horse and dismounting. During this period, children develop balance, landing, and learn breathing exercises. At the main stage, the actual rehabilitation measures are carried out.

The horse is led on the reins, the child is put on an unsaddled horse with or without a herd. They help the child to get on the horse and get off the horse, while riding they insure from both sides.

Mounting a horse is the beginning of rehabilitation activities and is closely related to the formation of balance and the further transition to active movements. The initial approach to the formation of equilibrium is built as follows:

1. Change in the area of support: a) increase in the area of support; b) reduction of the area of support; c) additional support - a floating arm.

2. Oculomotor gymnastics. Starting position (IP) - sitting on a horse facing forward. At a step in a straight line: look up, right, left, down (without turning your head); fixing the gaze on a stable and moving object. On a step in a circle - the same.

3. Exercises of a confusing nature: a) a change in the speed of the horse's movement that is unexpected for the child; b) influence from the instructor.

4. Exercises with closed eyes: a) stepping along a variable route; b) movement with change of gaits.

5. Exercises with a constantly changing route of movement: a) movement in a straight line; b) movement along the serpentine step; c) working out the volt (movement in a circle).

6. The combination of all exercises with breathing exercises. When forming a respiratory stereotype, the correct position of the child on the horse is carefully monitored: the back is straight, the shoulders are lowered, since breathing and posture are closely related, and posture, in turn, affects the type of breathing. Training in normal breathing is combined with training in the correct position of all parts of the body in a variety of IPs: arms to the sides - inhale, lowered hands - exhale. Turning the head and eyes to the side - exhale, return to a straight position - inhale; lifting the eyes up - inhale, return to a straight position - exhale. During the entire session, the child is asked to keep his mouth closed and breathe through his nose.

7. Exercises with the use of objects while riding at a pace (balls of different diameters, sticks, dumbbells weighing from 300 g to 1000 g, soft toys).

8. At a step in a straight line, they offer the child to throw the ball to the dog. Repeat the exercises in circles.

9. Sitting on a moving horse, the child is asked to look for the dog that accompanies the horse: turning the eyes, head, torso to the left, to the right.

10. Repetition by the child of the sounds made by the dog. The instructor gives the dog a command: “Voice”, the dog barks. The instructor asks the child to repeat how the dog “talks”, “talk to the dog”. Exercises are performed on a moving horse.

11. The child is offered to give the dog voice commands himself: “Voice”, “Next”, “Forward”, sitting on a moving horse and the commands “Sit”, “Lie down”, sitting on a standing horse.

12. Walking with a glass of water in hand.

In the final part of the lesson, exercises are used:

13. "Hug of a horse" (IP - lying on the horse's neck, hands on the animal's neck).

14. From PI sitting on a horse backwards, transition to PI lying on his stomach, riding in this position.

15. "A bag of flour." Riding step. IP lying across the horse's back.

16. "Blind cow". Riding at a walk with eyes closed, facing in the direction of the horse and backwards.

Immediately after completing the exercises, the child is offered to feed the horse and the dog - straightening the arm with the opening of the palm.

The child is asked to say “Goodbye” to the animals and walk, focusing on the correct setting of the feet, the direct position of the torso and legs to consolidate the achieved effect.

Children with CNS pathology, in addition to the primary motor defect, have disorders in the autonomic regulation of the work of internal organs with a delay in the formation of sphincter discipline, impaired intestinal tone, heart and breathing rhythms, and form secondary defects in speech, emotional development, and communication. Such children often do not form play activities, they hardly adapt to society. G.N. Lavrova, on the basis of the results of a psychological and pedagogical study of children with cerebral palsy, identifies the following features of their social and personal development: a consistently low level of social and communicative competence; unfavorable adaptation upon admission to a preschool institution that persists with constant attendance at a kindergarten. Limitation of mastery of communicative means, difficulties in the development of speech [Lavrova G.N. Social and personal development of senior preschool children with cerebral palsy in the context of the introduction of standards for preschool education // Bulletin of the South Ural State University. Ser.: Psychology, 2013. - V. 6. No. 1. - S. 52-61.]. In children with autism spectrum disorders (ASD), these manifestations are much more pronounced than in children with cerebral palsy [Soldatenkova E.N. Assessment of the level of formation of self-image in children with autism spectrum disorders (ASD) // Siberian Bulletin of Special Education. 2014. - No. 1 (13). - S. 71-80]. A communication defect hinders all aspects of a child's development.

Communication with a dog gives a child, including a child with cerebral palsy, ASD, great pleasure and encourages physical activity. In this case, the motivation is so strong that even a non-speaking child tries to imitate the "talk" of the dog and give commands [Vorozhbitova A.L., Tyutina E.A. Recreational potential of canistherapy in a rehabilitation center for children and adolescents // Bulletin of the North Caucasian Federal University. 2015. No. 4 (49). S. 162-167].

In canistherapy, emphasis is placed on the following points: the dog’s skills, in our case: the ability to give voice, paw, bring the ball, run around the horse from different sides, run up the ramp at the instructor’s command, follow the commands given by the child with a voice, and the instructor with a gesture; cooperation between a child and a dog, in our case, the search for a dog by a child, the child repeating sounds after the dog, giving commands to the dog with his voice, throwing a ball to the dog, feeding the dog; the safety of the interaction between the child and the dog, in our case - the dog takes a treat from the child's hands in a friendly manner, gives him a paw, and allows himself to be stroked. In this case, the dog is assigned the role of an assistant therapist. The ability of the dog to psychologically favorably influence the child, mobilize his internal reserves, awaken the desire to speak, throw the ball, look around, stretch out his hand with an open palm, and stimulate other positive changes is used.

The method is carried out as follows.

The course of joint hippo- and canistherapy consists of 20 lessons, twice a week, lasting from 30 to 60 minutes, depending on the state of health and psychomotor development of the child. The course includes 2 stages: adaptation and main.

At the adaptation stage, children get acquainted with the instructor, the horse, the dog, practice getting on the horse and dismounting. During this period, children develop balance, landing, and learn breathing exercises. At the main stage, the actual rehabilitation measures are carried out.

The horse is led on the reins, the child is put on an unsaddled horse with or without a herd. They help the child to get on the horse and get off the horse, while riding they insure from both sides.

Mounting a horse is the beginning of rehabilitation activities and is closely related to the formation of balance and the further transition to active movements. The initial approach to the formation of equilibrium is built as follows:

1. Change in the area of support: a) increase in the area of support; b) reduction of the area of support; c) additional support - a floating arm. These exercises are important for normalizing the tone of the axial muscles, correcting the sitting posture, and expanding motor capabilities in the sitting posture on a standing and moving horse.

2. Oculomotor gymnastics. Starting position (IP) - sitting on a horse facing forward. At a step in a straight line: look up, right, left, down (without turning your head); fixing the gaze on a stable and moving object. On a step in a circle - the same. These exercises are important for emotional release, correction of the vestibular-oculomotor interaction, and improvement of postural regulation.

3. Exercises of a confusing nature: a) a change in the speed of the horse's movement that is unexpected for the child; b) influence from the instructor. These exercises are important for teaching a child to work out disturbing influences in a sitting position on a standing and moving horse - an important step in the formation of postural regulation.

4. Exercises with closed eyes: a) stepping along a variable route; b) movement with change of gaits. These exercises are important for improving the functioning of the proprioceptive and vestibular sensory systems, postural regulation, and emotional release.

5. Exercises with a constantly changing route of movement: a) movement in a straight line; b) movement along the serpentine step; c) working out the volt (movement in a circle). These exercises are important for improving the functioning of the proprioceptive and vestibular sensory systems, postural regulation, and emotional release.

6. The combination of all exercises with breathing exercises. When forming a respiratory stereotype, the correct position of the child on the horse is carefully monitored: the back is straight, the shoulders are lowered, since breathing and posture are closely related, and posture, in turn, affects the type of breathing. Training in normal breathing is combined with training in the correct position of all parts of the body in a variety of IPs: arms to the sides - inhale, lowered hands - exhale. Turning the head and eyes to the side - exhale, return to a straight position - inhale; lifting the eyes up - inhale, return to a straight position - exhale. During the entire session, the child is asked to keep his mouth closed and breathe through his nose.

7. Exercises with the use of objects while riding at a pace (balls of different diameters, sticks, dumbbells weighing from 300 g to 1000 g, soft toys). These exercises develop the manipulative activity of the hands, postural regulation in difficult conditions.

8. At a step in a straight line, they offer the child to throw the ball to the dog. Repeat the exercises in circles. These exercises achieve: the development of manipulative activity of the hands, the formation of visual-motor interaction, the development of interaction between the child and the dog, and play activities.

9. Sitting on a moving horse, the child is asked to look for the dog that accompanies the horse: turning the eyes, head, torso to the left, to the right. Exercises are aimed at maintaining balance in conditions of eye and head movement, visual-vestibular interaction, suppression of neck-tonic and vestibulo-tonic reflexes, game activity.

10. Repetition by the child of the sounds made by the dog. The instructor gives the dog a command: “Voice”, the dog barks. The instructor asks the child to repeat how the dog “talks”, “talk to the dog”. Exercises are performed on a moving horse. Exercises are aimed at the development of speech, the development of interaction between the child and the dog, playing activities.

11. The child is offered to give the dog voice commands himself: “Voice”, “Next”, “Forward”, sitting on a moving horse and the commands “Sit”, “Lie down”, sitting on a standing horse. Exercises are aimed at the development of speech, the development of interaction between the child and the dog, playing activities.

12. Walking with a glass of water in hand. The exercise is aimed at controlling the distribution of muscle tone, balance. In the final part of the classes, exercises are used: 17. "Hug the horse" (IP - lying on the neck of the horse, hands on the neck of the animal). Through this exercise, trust is built in the horse as a great friend, partner, contact with the horse is formed, relaxation of the axial muscles.

18. From PI sitting on a horse back to front, transition to PI lying on his stomach, riding in this position. In this exercise, the oscillatory impulses of the horse's back are directly transmitted to all parts of the child's body, micromassage, warming up and relaxation of the whole body are achieved.

19. "A bag of flour." Riding step. IP lying across the horse's back. The exercise helps to find balance in the prone position, provides relaxation, micro-massage and warming up the whole body.

20. "Blind cow". Riding at a walk with eyes closed, facing in the direction of the horse and backwards. This exercise stimulates the proprioceptive perception of the whole body, develops balance, and leads to deep relaxation.

Immediately after completing the exercises, the child is offered to feed the horse and dog - straightening the arm with the palm open. The exercise builds trust in animals, interaction with direct contact "face to face".

The child is asked to say “Goodbye” to the animals and walk, focusing on the correct setting of the feet, the direct position of the torso and legs to consolidate the achieved effect.

Example 1. Maria is 5 years old. Diagnosis: cerebral palsy, spastic diplegia.

Prior to the start of classes, Maria had a state of anxiety, emotional stress: the girl was afraid to contact people other than family members, to be in unfamiliar places: she cried, turned away to her mother, hid her face. She sat with additional support with her back, hands on the back and armrests of the chair; could stand without crossing her legs, with armpit support; when walking with the support of two hands, the legs were bent at the knee and hip joints and crossed at the level of the hips. When standing and walking, the child relied only on his fingers. In the hip joints - flexion-adductor contractures, in the knee - flexion, equinus stop. Intelligence is preserved, development corresponds to age.

Maria was engaged in the described method for 10 weeks (20 lessons). In the first three sessions, Maria had a fear when riding a horse and shudders when a dog barked. From session to session, these symptoms became less pronounced, then completely disappeared.

The girl learned to hold a posture while sitting on a horse with a straight back without support while playing ball with a dog. Contractures in the hip and knee joints have decreased. Decreased equinus stop. When standing (feeding the dog and horse) and walking, he leans on the feet, the coordination of movements has improved, the decussation of the legs has “gone away”. Maria's anxiety and emotional stress have decreased: she travels calmly in public transport, does not hide her face when in contact with strangers, smiles, and offers her hand.

Conclusion. As a result of a course of joint canine and hippotherapy, contractures in the child decreased, the girl learned to sit without additional support with her back or forearms, to perform movements with her hands from this position, turns of the body, head, eyes while sitting (playing ball with a dog). At the same time, Maria's muscle strength increased, postural regulation in sitting and standing positions improved, and walking became more stable. Decreased anxiety and emotional stress.

Example 2. Vladimir, 8 years old. Diagnosis: RAS.

Vladimir categorically refused to contact strangers, categorically refused to stay in unfamiliar places: it was impossible to go out with him for a walk, to the store, to travel by public transport. The child gave violent protest reactions that could not be corrected by educational measures. He agreed to move around the city only in his own car with his mother. There was no articulate speech. There was no gaming activity. Movements are constrained, angular, unfocused, uncoordinated. The gait is uneven, without cross-coordination. There is no discipline of the sphincters, the baby is in a diaper.

At the time of the beginning of classes, Vladimir had a field behavior: he did not pay attention to the horse and instructor standing next to him. All attention was on the dog, which walked around the horse. Vladimir categorically did not want to climb the ramp to get on the horse, but ran after the dog. The instructor gave the dog a command: “forward, onto the ramp” and Volodya ran onto the ramp after the dog, let him put himself on the horse, but always watched the dog while riding. Vladimir ignored the requests to throw the ball into the basket, but he fulfilled the requests to throw the ball to the dog, agreed to look for the dog, turn his head, torso for this, repeat “as the dog says”, give commands to the dog with his voice, trying to clearly pronounce the words.

Vladimir was engaged in the described method for 10 weeks. For the first 2 lessons, he climbed the ramp only for the dog, he performed commands that were only related to the dog. Then he gradually began to carry out other commands, giving commands to the dog, tried to repeat the words after the instructor, pronouncing them correctly, began to communicate with people: look into the face, into the eyes of the instructor, volunteers, answer their greetings, say goodbye.

At the end of the course, Vladimir learned to clearly pronounce the words, giving the dog the commands “Catch”, “Give a paw”, repeating after the instructor.

As a result of a course of joint canis- and hippotherapy, the child developed eye contact, inverted speech in the form of monosyllabic commands; the skills of greeting and parting with people appeared; there was play activity. The coordination of movements improved, which allowed the boy to expand his motor abilities, interhemispheric interaction develops, as evidenced by the appearance of cross-coordination when walking, two-handed manipulation of the ball during the game. The child developed the discipline of the sphincters, which made it possible to remove the diaper from him.

Conclusion. As a result of the course of joint canis and hippotherapy, the boy with ASD began to develop communication skills, verbal speech, play activity, improved coordination of movements, and formed the discipline of sphincters.

Example 3. Sofia is 16 years old. Diagnosis: cerebral palsy, double hemiplegia. Oligophrenia.

At the beginning of classes, she did not move independently, she did not hold her sitting position for long, with additional support on the back and armrests of the chair, fixing her head to the wheelchair. Hectation was noted, the mouth was constantly half-open, nasal breathing was difficult, fine motor skills were absent: she could not hold a spoon, a pen. Speech is difficult - sensorimotor alalia. Sleep is restless, intermittent. Appetite is bad. The chair is irregular.

Sophia was engaged in the described method for six months. During this time, she received 3 courses of joint canis and hippotherapy.

For the first lessons, the instructor sat on the horse together with Sophia and supported her by the shoulders, forming the correct fit (straight back), combining with breathing exercises. A soft Shants collar was worn for classes. Sophia spoke the name of the horse and the name of the dog. They offered to follow the dog and give commands, take and throw the ball. Sophia agreed to “play” with the dog: with pleasure she threw the ball to the dog alternately with her left and right hands, she refused to do other exercises (breathing exercises, exercises with objects). By the end of the second year, she, throwing the ball, clearly pronounced in her voice: "Catch Siona."

As a result of three courses of combined hippotherapy and hippotherapy, Sofia's range of motion increased, muscle strength increased, and coordination of movements improved. She began to hold the posture sitting with a straight back for 5 minutes on a moving horse, watching the dog. Sophia learned to hold her head, which made it possible to remove the Shants collar during classes and not fix her head to a wheelchair in everyday life. Her posture and breathing improved, the skill of nasal breathing was formed, which made it possible to improve phonation. Game activity appeared, attacks of hectation became less frequent. Improved sleep and appetite. The chair returned to normal.

Conclusion. As a result of a course of joint canine and hippotherapy, Sofia learned to hold her head and back while sitting on a walking horse. At the same time, her range of motion in the joints of the limbs increased, muscle strength increased, nasal breathing was formed, speech improved, game activity was formed, sleep and the functioning of internal organs normalized.

The proposed method is used in the Children and Youth Equestrian Center "Favorite", Novokuznetsk for six months. During this time, 40 children with cerebral palsy and 5 children with ASD underwent a course of joint canis and hippotherapy. All children improved their posture and gait, began to speak better, mastered the discipline of sphincters and were able to get rid of diapers, learned to breathe through their nose. Parents of children with ASD got the opportunity to carry them in public transport, take their children with them to the store. Thus, it can be seen that the implementation of the proposed method of joint therapy increases the effectiveness of restorative treatment of children with pathology of the central nervous system, improves the quality of life of such children.

Advantages of the method in comparison with analogues:

1. The method allows you to include in the habilitation work all the possibilities of the child's body.

2. The method provides for a course of 20 procedures for 10 weeks, which is enough to obtain a stable positive effect.

3. The method is based on the interaction of a child with a horse and a dog, which makes it available for use throughout the country throughout the year.

4. During classes, the child actively forms eye movements, visual-motor interaction.

5. The child makes purposeful movements with his hands.

6. The method forms a gaming activity.

7. The method generates speech.

8. The child is emotionally involved in the process, which increases the efficiency of restoring postures and movements, provides emotional stability, greater openness to the world, and facilitates socialization.

9. The problem of fear or lack of contact with one of the animals used in the method is leveled by switching the child's attention to another animal.

Claims (1)

A method for joint canis and hippotherapy for children with pathology of the central nervous system, including an adaptation stage, main and final, at the adaptation stage, children get acquainted with an instructor, a horse, practice mounting a horse and dismounting; at the main stage, exercises are sequentially performed while sitting on a horse moving at a step: changing the area of \u200b\u200bthe support; oculomotor gymnastics; disruptive exercises; driving with eyes closed exercises with a constantly changing route of movement; combination of exercises with breathing exercises; exercises with objects; at the final stage, relaxation exercises are performed: lying on the horse's neck, hug the animal; riding step in the prone position along and across the body of the horse; riding with closed eyes; at the end of the lesson, to consolidate the achieved effect, the child is offered to feed the horse and walk, focusing on the correct setting of the feet, the direct position of the trunk and legs, characterized in that the course of joint hippo and canis therapy consists of 20 lessons, a frequency of 2 per week, lasting from 30 to 60 minutes; the adaptation stage 1-2 of the lesson additionally includes an acquaintance with the dog, at the main stage they additionally use exercises: when the horse moves in a straight line and in a circle, they offer the child to throw the ball to the dog; sitting on a moving horse, the child is asked to look for the dog that accompanies the horse; while the horse is moving, the child repeats the sounds made by the dog; the child is offered to give the dog voice commands himself: “Voice”, “Next”, “Forward”, sitting on a moving horse, and the commands “Sit”, “Lie down”, sitting on a standing horse; riding a walk, holding a glass of water in your hand; at the final stage, the child is offered to feed the horse and the dog - straightening the arm with the palm open.