The Short-term Effects of Hippotherapy and Therapeutic Horseback Riding on Spasticity in Children With Cerebral Palsy: A Meta-analysis

Cheolhwan Hyun, Kyungmin Kim, Soolim Lee, Nayeon Ko, In-Sik Lee, Seong-Eun Koh, Cheolhwan Hyun, Kyungmin Kim, Soolim Lee, Nayeon Ko, In-Sik Lee, Seong-Eun Koh

Abstract

Purpose: We systematically reviewed the short-term effects of hippotherapy and therapeutic horseback riding (THR) on lower-limb muscle spasticity in children with cerebral palsy (CP).

Methods: PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched for relevant quantitative studies. Treatment effects were coded using the Ashworth scale (AS) or modified Ashworth scale (MAS) in pre- and posttreatment evaluations. Of the 73 studies identified initially, 7 met the inclusion criteria.

Results: Treatment was associated with positive effects on lower-limb muscle spasticity, as supported by the AS or MAS scores. However, repeated trials did not show a statistically significant difference from a single trial (Q = 2.95, P = .086).

Conclusion: Hippotherapy and THR can be used to treat lower-limb muscle spasticity in children with CP. However, repeated sessions did not show a better effect in reducing spasticity.

What this adds to the evidence: This is the first meta-analysis to confirm that hippotherapy or THR can reduce lower-limb muscle spasticity in children with CP in the short term, but long-term effects on function still require further studies.

Conflict of interest statement

The authors declare no conflict of interest.

Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Wolters Kluwer Health, Inc. and the Academy of Pediatric Physical Therapy of APTA.

Figures

Fig. 1.
Fig. 1.
Flowchart of study selection. AS indicates Ashworth scale; MAS, modified Ashworth scale.
Fig. 2.
Fig. 2.
Forest plot of the effects of hippotherapy and therapeutic horseback riding on lower-limb muscle spasticity. TX indicates treatment; SD, standard deviation; SMD, standardized mean difference; CI, confidence interval.
Fig. 3.
Fig. 3.
Funnel plot of the pooled estimate of the random-effects model. Diagonal lines demarcate the area where 95% of points lie when a publication bias is absent.

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