walking is the most common form of human motion , and is composed of cyclically switching 
 single - support phases .
moreover , the trunks ability to balance load is a very important 
 element in this switching motion1 .
the 
 trunk needs to maintain the body s center of gravity within the base of support , and is an 
 important part of motor control required for individuals to perform various tasks in daily 
 life1 .
normal sensory feedback and an 
 ability for integrated higher center control are required to continuously maintain the 
 body s center of gravity within the base of support in the body .
maintenance of balance requires a complex process 
 requiring visual and vestibular organs and proper somatosensory response2 . among the sensory organs necessary for 
 maintaining balance
when 
 vision is blocked , there is an increased reliance on the vestibular , proprioceptive , and 
 tactile senses .
hence blindfolding can facilitate these senses and improve balance and gait 
 abilities2 . in recent years
, exercises such as the swiss ball exercise , proprioceptive neuromuscular 
 facilitation , virtual reality training , and horse riding simulation have been conducted to 
 improve balance and gait for stroke or polio patients .
horse riding simulation exercise is a 
 feedback exercise designed to correct postural changes following the movements of a 
 mechanical horse .
this differs from most other exercises performed for balance improvement 
 because it is a feed forward exercise that can predict movements3 .
the horse riding simulation is an exercise of the whole 
 body , which is performed using muscles and joints .
it can recover the ability to walk and 
 can improve joint range of movements , sense of balance , coordination , muscular strength , and 
 endurance for patients with reduced physical functions4 .
a number of studies have been conducted to examine the effects of horse riding simulation 
 exercise on trunk muscle activity .
however , studies on the effect of this treatment on 
 balance and gait are limited .
therefore , this study was conducted to identify the effects of 
 horse riding simulation with blindfolding on the balance and gait of healthy 
 individuals .
thirty subjects who participated in our experiment were randomly divided into an 
 experimental group ( n=15 ) and a control group ( n=15 ) .
those subjects were included who had 
 not undergone orthopedic surgery in the lower limbs , not taken medicine due to neurological 
 problems , and did not have any musculoskeletal back injury .
their average ages , heights , and 
 weights were 21.32  1.04 and 20.13  1.57  years , 169.32  10.01 and 171.24  9.64  cm , and 
 67.45  12.31 and 66.61  16.32  kg in the experimental and control groups , respectively . 

information on the study was provided to all of the subjects prior to their participation 
 and written informed consent was obtained according to the ethical standards of the 
 declaration of helsinki .
the subjects in the experimental group covered their eyes using a blindfold , climbed onto a 
 horse riding simulator , and performed the horse riding simulation exercise .
the subjects in 
 the control group performed the horse riding simulator exercise in the same manner without 
 wearing a blindfold .
all of the subjects performed the 20 minutes long exercise once a day , 
 five times a week , over a four - week period .
the horse riding exercise machine ( joba , eu7805 , 
 panasonic , japan ) creates a figure - eight movement using five axes , and creates 
 three - dimensional movements ( front and back , left and right , up and down ) similar to the 
 movements of a live horse3 . the machine is 
 designed to enable the rider to experience various movements similar to the movements of a 
 real horse based on a built - in program in the joba simulator .
the subjects were instructed 
 to maintain a correct sitting posture after seating themselves , and to hold on to the handle 
 to prevent a fall3 .
they were also 
 continuously instructed by the therapist to make postural corrections while sitting for the 
 correct alignment of the trunk .
the speed of the horse riding exercise machine was gradually 
 increased up to phase 3 , according to the adaptability of each subject3 , 4 . a balance measuring device ( good balance , metitur , finland ) was used for the quantitative 
 measurement of the ability to balance after the horse riding simulation exercise treatment . 
 in order to measure balance ,
the subjects were instructed to step onto a triangular platform 
 and maintain a symmetrical standing posture by placing their legs apart at shoulder width . 

the participants head movements were minimized by guiding them to gaze at a fixed forward 
 point .
the center of pressure ( cop ) was measured for 30 seconds while each subject was 
 standing , eyes open , with each arm placed comfortably by the hip joint .
after three repeated 
 measurements , their average was calculated . a gait measuring analyzer ( gait rite , technologies ltd .
it can measure the velocity , step length , 
 stride length , single support , double support , cadence , functional ambulation profile ( fap ) , 
 step time , and cycle time .
each subject was verbally instructed to walk as usual , while 
 starting from a point 2  m away from an ambulatory mat to help measure the natural gait .
the 
 subjects were instructed to lift their heads and look straight forward , and then walk 
 barefoot while naturally moving their upper limbs .
each subject performed this task three 
 times , and the corresponding data were collected .
the rater reliability was r=0.90 , and the interclass correlation 
 coefficient for all of the gait measurements at comfortable gait speeds was substantially 
 high at r=0.965 .
data analysis was 
 performed using the spss software package version 18.0 ( spss inc . ,
, differences in the 
 general characteristics of the experimental and control groups were compared using 
 independent t - tests and  tests .
comparisons of variables before and after 
 training within each group were made using paired sample t - tests .
comparisons of pre- and 
 post - test differences in variables between the experimental and control groups were 
 performed using the independent t - test .
an effect size < 0.2 reflects a negligible mean difference ; 
 0.20.5 , a small difference ; 0.50.8 , a moderate mean difference ; and > 0.8 , a large 
 difference .
statistical analysis was performed at a 95% confidence level , and p 
 values<0.05 were considered statistically significant6 .
thirty subjects completed this experiment . balance and gait were measured for the 
 experimental and control groups before and after intervention ( table 1table 1.comparison of change in characteristics of the experimental group and control 
 group with values presented as mean ( standard deviation)eg ( n=15)cg ( n=15)pre - testpost - testpre - testpost - testbalancestatic balance ( score)78.3 ( 6.2)84.4 ( 7.2)*77.1 ( 9.7)81.3 ( 8.6)*dynamic balance ( score)76.1 ( 8.7)81.6 ( 6.3)*73.6 ( 9.5)76.6 ( 7.5)*gaitvelocity ( m / s)87.3 ( 6.7)92.4 ( 5.8)*82.4 ( 5.4)86.3 ( 6.9)single support ( % ) 40.3 ( 7.9)44.8 ( 8.50)41.6 ( 7.5)43.8 ( 9.1)*cadence ( steps / min)96.7 ( 13.6)103.7 ( 14.86)*91.7 ( 14.8)96.5 ( 15.2)*eg : experimental group ; cg : control group .
the experimental group showed significant improvement in static balance , 
 dynamic balance , velocity , and cadence compared to the pre - intervention results ( p<0.05 ) . 

in addition , the control group showed significant improvement in static and dynamic balance , 
 single support , and cadence compared to the pre - intervention results ( p<0.05 ) . 

significant differences in the post - training gains in static and dynamic balance and cadence 
 were observed between experimental and control groups ( p<0.05 ) .
both the experimental and 
 control groups showed a big gain in static balance ( effect size=0.87 ) and cadence ( effect 
 size=1.31 ) .
this study was undertaken to determine the effects of horse riding simulation exercise with 
 blindfolding on balance and gait of healthy individuals .
the experimental group , which was 
 additionally blindfolded , showed statistically significant improvements in balance and 
 cadence compared to the control group .
a previous study reported that horse riding simulator treatment improved symmetrical 
 weight - bearing in a standing posture , and improved balance through the maintenance of 
 correct posture7 . a horse riding 
 simulation exercise generates 50 to 100 three - dimensional physical movements ( front and 
 back , left and right , up and down ) due to the movements of the horse riding exercise 
 machine .
this exercise can produce effects similar to walking , activate the trunk muscles to 
 continuously maintain balance , and help correct posture8 .
another study reported that the horse riding simulator normalized 
 the trunk muscle activity and developed equilibrium reactions , to help improve balance in 
 the trunk9 .
this concurs with the present 
 study , in which we found that the horse riding simulation exercise improved balance and 
 gait .
the present study showed improvements in both static and dynamic balance following horse 
 riding simulation exercise with blindfolding .
this may be because the subjects have an 
 increased reliance on the vestibular organs and somatosensory system .
this then improves the 
 subjects motor control , enabling proper maintenance of physical alignment and the 
 spontaneous control of movement3 . in 
 addition
, the improvement in gait found in the study may be from the improved stability and 
 coordination in the trunk .
this may have occurred through motor learning of the trunk 
 according to the changes in the base of support .
this result suggests that a horse riding 
 simulator can improve balance and gait . as the horse riding simulation exercise generates higher levels of self - motivation and 
 interest when compared to other exercises
, we recommend the clinical application of this 
 exercise for patients with impaired balance4 .
first , as healthy 
 individuals were used , additional studies should be conducted involving patients with 
 functional disorders .
second , the intervention period was short and no long term follow - up 
 was performed .
 [ purpose ] the study was conducted to determine the effect of horse riding simulation 
 combined with blindfolding on healthy individuals balance and gait . 
 [ subjects and 
 methods ] thirty subjects were randomly divided into an experimental group ( n=15 ) and a 
 control group ( n=15 ) . 
 the subjects in the experimental group covered their eyes using a 
 blindfold , climbed onto a horse riding simulator , and performed the horse riding 
 simulation exercise . 
 the control group took part in the horse riding exercises without a 
 blindfold . 
 all of the subjects performed the 20 minutes long exercise once a day , five 
 times a week , over a four - week period . 
 [ results ] the experimental group showed significant 
 improvement in static balance , dynamic balance , velocity , and cadence compared to 
 pre - intervention measurements . 
 in addition , the control group showed significant 
 improvement in static balance , dynamic balance , single support , and cadence compared to 
 pre - intervention measurements . 
 significant differences in post - training gains in static 
 balance , dynamic balance , and cadence were observed between the experimental group and the 
 control group . 
 [ conclusion ] subjects that performed horse riding simulation exercise after 
 blindfolding showed significant improvements in balance and cadence compared to the 
 control group . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION