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

TLDR

To evaluate the effect of hippotherapy on muscle activity in children with spastic cerebral palsy. A pretest/post-test control group study with 15 children aged 4–12 in Tucson randomized to 8 minutes of hippotherapy or 8 minutes astride a stationary barrel, measuring trunk and upper leg EMG during sitting, standing, and walking before and after each intervention. Eight minutes of hippotherapy improved symmetry of muscle activity in the most asymmetrical groups, whereas stationary barrel sitting had no effect, indicating the horse’s movement drives the improvement.

Abstract

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.