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Improvements in Muscle Symmetry in Children with Cerebral Palsy After Equine-Assisted Therapy (Hippotherapy)

This study aims to evaluate the effect of hippotherapy (physical therapy utilizing the movement of a horse) on muscle activity in children with spastic cerebral palsy. Research designed with Pretest/post-test control group and applied in Therapeutic Riding of Tucson (TROT), Tucson, AZ.  It is sampled with fifteen (15) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy.

Children meeting inclusion criteria were randomized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel. 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. 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.

 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.

This study provides some preliminary objective data on the effects of the movement of the horse on muscle activity in children with cerebral palsy. It has several limitations. Despite randomization, the group assigned to the barrel appeared to show less asymmetry of muscle activity prior to testing, although this was not statistically significant and may be due to one outlier. Statistical power was limited by the small number (n) of this study, and findings need to be replicated with a larger cohort. In addition, the results may suggest but in no way confirm lasting effect of the therapy, and do not address possible extinction of effect after a series of sessions is completed. We do believe this pilot study deserves follow-up investigation, and await a randomized control trial of a full 12-week hippotherapy program.

Link: https://www.liebertpub.com/doi/abs/10.1089/107555303771952163

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