Effects of hippotherapy on gross motor function and functional performance of children with cerebral palsy

Eun Sook Park, Dong Wook Rha, Jung Soon Shin, Soohyeon Kim, Soojin Jung, Eun Sook Park, Dong Wook Rha, Jung Soon Shin, Soohyeon Kim, Soojin Jung

Abstract

Purpose: The purpose of our study was to investigate the effects of hippotherapy on gross motor function and functional performance in children with spastic cerebral palsy (CP).

Materials and methods: We recruited 34 children (M:F=15:19, age: 3-12 years) with spastic CP who underwent hippotherapy for 45 minutes twice a week for 8 weeks. Twenty-one children with spastic CP were recruited for control group. The distribution of gross motor function classification system level and mean age were not significantly different between the two groups. Outcome measures, including the Gross Motor Function Measure (GMFM)-66, GMFM-88 and the Pediatric Evaluation of Disability Inventory: Functional Skills Scale (PEDI-FSS), were assessed before therapy and after the 8-weeks intervention as outcome measures.

Results: There were no significant differences between intervention and control groups in mean baseline total scores of GMFM-66, GMFM-88 or PEDI-FSS. After the 8-weeks intervention, mean GMFM-66 and GMFM-88 scores were significantly improved in both groups. However, the hippotherapy group had significantly greater improvement in dimension E and GMFM-66 total score than the control group. The total PEDI-FSS score and the sub-scores of its 3 domains were significantly improved in the hippotherapy group, but not in the control group.

Conclusion: The results of our study demonstrate the beneficial effects of hippotherapy on gross motor function and functional performance in children with CP compared to control group. The significant improvement in PEDI-FSS scores suggests that hippotherapy may be useful to maximize the functional performance of children with CP.

Keywords: Cerebral palsy; disability evaluation; function; hippotherapy; physical activity; spastic.

Conflict of interest statement

The authors have no financial conflicts of interest.

References

    1. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8–14.
    1. Beckung E, Carlsson G, Carlsdotter S, Uvebrant P. The natural history of gross motor development in children with cerebral palsy aged 1 to 15 years. Dev Med Child Neurol. 2007;49:751–756.
    1. Wright FV, Rosenbaum PL, Goldsmith CH, Law M, Fehlings DL. How do changes in body functions and structures, activity, and participation relate in children with cerebral palsy? Dev Med Child Neurol. 2008;50:283–289.
    1. Debuse D, Gibb C, Chandler C. Effects of hippotherapy on people with cerebral palsy from the users' perspective: a qualitative study. Physiother Theory Pract. 2009;25:174–192.
    1. Whalen CN, Case-Smith J. Therapeutic effects of horseback riding therapy on gross motor function in children with cerebral palsy: a systematic review. Phys Occup Ther Pediatr. 2012;32:229–242.
    1. Meregillano G. Hippotherapy. Phys Med Rehabil Clin N Am. 2004;15:843–854.
    1. Snider L, Korner-Bitensky N, Kammann C, Warner S, Saleh M. Horseback riding as therapy for children with cerebral palsy: is there evidence of its effectiveness? Phys Occup Ther Pediatr. 2007;27:5–23.
    1. Sterba JA. Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Dev Med Child Neurol. 2007;49:68–73.
    1. Bertoti DB. Effect of therapeutic horseback riding on posture in children with cerebral palsy. Phys Ther. 1988;68:1505–1512.
    1. Mackinnon JR, Noh S, Lariviere J, Macphail A, Allan DE, Laliberte D. A study of therapeutic effects of horseback riding for children with cerebral palsy. Phys Occup Ther Pediatr. 1995;15:17–34.
    1. Casady RL, Nichols-Larsen DS. The effect of hippotherapy on ten children with cerebral palsy. Pediatr Phys Ther. 2004;16:165–172.
    1. Shurtleff TL, Standeven JW, Engsberg JR. Changes in dynamic trunk/head stability and functional reach after hippotherapy. Arch Phys Med Rehabil. 2009;90:1185–1195.
    1. Davis E, Davies B, Wolfe R, Raadsveld R, Heine B, Thomason P, et al. A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsy. Dev Med Child Neurol. 2009;51:111–119.
    1. Hamill D, Washington KA, White OR. The effect of hippotherapy on postural control in sitting for children with cerebral palsy. Phys Occup Ther Pediatr. 2007;27:23–42.
    1. McGee MC, Reese NB. Immediate effects of a hippotherapy session on gait parameters in children with spastic cerebral palsy. Pediatr Phys Ther. 2009;21:212–218.
    1. Tseng SH, Chen HC, Tam KW. Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy. Disabil Rehabil. 2013;35:89–99.
    1. Sterba JA, Rogers BT, France AP, Vokes DA. Horseback riding in children with cerebral palsy: effect on gross motor function. Dev Med Child Neurol. 2002;44:301–308.
    1. Steenbeek D, Gorter JW, Ketelaar M, Galama K, Lindeman E. Responsiveness of Goal Attainment Scaling in comparison to two standardized measures in outcome evaluation of children with cerebral palsy. Clin Rehabil. 2011;25:1128–1139.
    1. Ketelaar M, Vermeer A, Helders PJ. Functional motor abilities of children with cerebral palsy: a systematic literature review of assessment measures. Clin Rehabil. 1998;12:369–380.
    1. Smits DW, Gorter JW, Ketelaar M, Van Schie PE, Dallmeijer AJ, Lindeman E, et al. Relationship between gross motor capacity and daily-life mobility in children with cerebral palsy. Dev Med Child Neurol. 2010;52:e60–e66.
    1. Lundkvist Josenby A, Jarnlo GB, Gummesson C, Nordmark E. Longitudinal construct validity of the GMFM-88 total score and goal total score and the GMFM-66 score in a 5-year follow-up study. Phys Ther. 2009;89:342–350.
    1. Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ. Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther. 2000;80:873–885.
    1. Alotaibi M, Long T, Kennedy E, Bavishi S. The efficacy of GMFM-88 and GMFM-66 to detect changes in gross motor function in children with cerebral palsy (CP): a literature review. Disabil Rehabil. 2014;36:617–627.
    1. McGibbon NH, Andrade CK, Widener G, Cintas HL. Effect of an equine-movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy: a pilot study. Dev Med Child Neurol. 1998;40:754–762.
    1. Kwon JY, Chang HJ, Lee JY, Ha Y, Lee PK, Kim YH. Effects of hippotherapy on gait parameters in children with bilateral spastic cerebral palsy. Arch Phys Med Rehabil. 2011;92:774–779.
    1. James S, Ziviani J, Boyd R. A systematic review of activities of daily living measures for children and adolescents with cerebral palsy. Dev Med Child Neurol. 2014;56:233–244.
    1. Kwon TG, Yi SH, Kim TW, Chang HJ, Kwon JY. Relationship between gross motor function and daily functional skill in children with cerebral palsy. Ann Rehabil Med. 2013;37:41–49.
    1. Kuijper MA, van der Wilden GJ, Ketelaar M, Gorter JW. Manual ability classification system for children with cerebral palsy in a school setting and its relationship to home self-care activities. Am J Occup Ther. 2010;64:614–620.
    1. Holsbeeke L, Ketelaar M, Schoemaker MM, Gorter JW. Capacity, capability, and performance: different constructs or three of a kind? Arch Phys Med Rehabil. 2009;90:849–855.

Source: PubMed

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