Can hippotherapy make a difference in the quality of life of children with cerebral palsy? A pragmatic study.

Objective: To determine if the addition of 12 weekly therapy sessions, incorporating hippotherapy as the primary intervention to each child's usual therapy program, will improve balance, participation, and quality of life.Methods: Pragmatic, multi-center, randomized, controlled trial of 13 children with cerebral palsy (CP), ages 3 to 6 years. A treatment group received 12 weeks of weekly hippotherapy intervention in addition to their usual therapy. A control group continued with their usual therapy only. Assessments were completed for the treatment group pre-intervention (P0), post intervention (P1), and 12 weeks post no intervention (P2). Control group assessments occurred in the same timeframe: baseline, 12 weeks and 24 weeks.Results: The only significant difference between the groups, post intervention, was on the Pediatric Balance Scale (PBS). Within group analysis showed no significant changes for the control group between any pretest/posttest measures. The treatment group demonstrated significant improvement on the PBS (P0-P1, p = .02; P0-P2, p = .02) and Activities Scale for Kids (P0-P1, p = .02; P0-P2, p = .02) with delayed improvement on the 1 Minute Walk Test (P1-P2, p = .02) and Pediatric Quality of Life - CP Module (P0-P2, p = .03).Conclusions: Improvements in balance in children with CP may promote increased participation and quality of life when hippotherapy is added to their treatment plan.

Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy.

OBJECTIVES: To investigate the immediate effects of 10 minutes of hippotherapy, compared with 10 minutes of barrel-sitting, on symmetry of adductor muscle activity during walking in children with cerebral palsy (CP) (phase I). To investigate the long-term effects of 12 weeks of hippotherapy on adductor activity, gross motor function, and self-concept (phase II). DESIGN: Pretest/posttest randomized controlled trial plus clinical follow-up. SETTING: Outpatient therapy center. PARTICIPANTS: Children with spastic CP (phase I: n=47; phase II: n=6). INTERVENTIONS: Phase I: 10 minutes of hippotherapy or 10 minutes of barrel-sitting; phase II: 12 weekly hippotherapy sessions. MAIN OUTCOME MEASURES: Phases I and II: adductor muscle activity measured by surface electromyography. Phase II: gross motor function and self-perception profiles. RESULTS: Phase I: hippotherapy significantly improved adductor muscle asymmetry (P<.001; d=1.32). Effects of barrel-sitting were not significant (P>.05; d=.10). Phase II: after 12 weeks of hippotherapy, testing in several functional domains showed improvements over baseline that were sustained for 12 weeks posttreatment. CONCLUSIONS: Hippotherapy can improve adductor muscle symmetry during walking and can also improve other functional motor skills.

Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy).

OBJECTIVE: To evaluate the effect of hippotherapy (physical therapy utilizing the movement of a horse) on muscle activity in children with spastic cerebral palsy. DESIGN: Pretest/post-test control group. SETTING/LOCATION: Therapeutic Riding of Tucson (TROT), Tucson, AZ. SUBJECTS: Fifteen (15) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy. INTERVENTIONS: Children meeting inclusion criteria were randomized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel. OUTCOME MEASURES: Remote surface electromyography (EMG) was used to measure muscle activity of the trunk and upper legs during sitting, standing, and walking tasks before and after each intervention. RESULTS: After hippotherapy, significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy. No significant change was noted after sitting astride a barrel. CONCLUSIONS: Eight minutes of hippotherapy, but not stationary sitting astride a barrel, resulted in improved symmetry in muscle activity in children with spastic cerebral palsy. These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements.