Effect of Hippotherapy on Functional Reach in Children with Cerebral Palsy

Meredith Alvey & Lauren Speelman

Background on Cerebral Palsy

References

Evidence

Conclusion

Hippotherapy and Trunk Stability

• Non-progressive disorder that damages the central nervous system1,2

• Effects:• Spasticity• Ataxia• Involuntary movements• Decreased trunk stability• Lower extremity more effected than

upper• Trunk instability causes proximal instability in

the upper extremities2

• Proximal instability at the shoulder reduces distal control2

• Leads to difficulties with reaching and targeting their functional tasks2

• Physical therapists use to promote improved posture and balance1,2,3

• Involves various positioning on the horse and a variety of activities1,2,3

• Cognitive games• Reaching• Stretching• Exercises

• Forces the child to activate the core to stabilize themselves in an upright position

• The horse provide diverse practice conditions1,2,3

• Significant effect on head control and reduced anterior and posterior translation2

• Improved head control demonstrates improved trunk stability 2

• Results were seen post-intervention and maintained at 12 weeks post-intervention2

• Maintenance of the results allow independence without reliance on continued hippotherapy

• Results were moving more towards the results for the children without disabilities2

• Posture and balance are important to establish so the child can focus on more distal motor control2

• Proximal stability enables distal control2

• May facilitate better functional use of the hands in everyday activities2,3

• Results showed an improved efficiency with a functional reach2

1. Haehl V, Giuliani C, Lewis C. Influence of hippotherapy on the kinematics and functional performance of two children with cerebral palsy. Pediatric Physical Therapy [serial online]. June 1999;11(2):89-101. Available from: CINAHL, Ipswich, MA. Accessed November 14, 2013.

2. Shurtleff T, Standeven J, Engsberg J. Changes in dynamic trunk/head stability and functional reach after hippotherapy. Archives Of Physical Medicine And Rehabilitation [serial online]. July 2009;90(7):1185-1195. Available from: MEDLINE, Ipswich, MA. Accessed November 14, 2013.

3. Zadnikar M, Kastrin A. Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: a meta-analysis. Developmental Medicine & Child Neurology [serial online]. August 2011;53(8):684-691. Available from: CINAHL, Ipswich, MA. Accessed November 14, 2013.

• Improved posture and balance provide the building blocks for them to improve upon their functional reach capacity

• Proximal control and stabilization allows these children to focus on improving distal motor control and skills2

• Improved distal motor control allows more independence in activities of daily living2,3

• Brushing teeth• Dressing• Feeding

• Independence with ADLs allows development of confidence3

• More desire to engage in new activities3

• Opens up opportunities to interact with their peers and their environment, which allows further development of motor and cognitive skills

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