Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1241-1248, October 2007

The Effect of Hippotherapy on Spasticity and on Mental Well-Being of Persons With Spinal Cord Injury

Presented in part to the 18th Jahrestagung der Deutschsprachigen Medizinischen Gesellschaft für Paraplegie, April 2005, Alpbach, Austria.

  • Helga E. Lechner, MSc, PT

      Affiliations

    • Swiss Paraplegic Centre, Nottwil, Switzerland
    • Corresponding Author InformationReprint requests to Helga E. Lechner, MSc, PT, Swiss Paraplegic Centre, Guido A. Zaech Str. 1, CH-6207 Nottwil, Switzerland
  • ,
  • Tanja H. Kakebeeke, PhD, PT

      Affiliations

    • Swiss Paraplegic Research, Nottwil, Switzerland.
  • ,
  • Dörte Hegemann, PT

      Affiliations

    • Swiss Paraplegic Centre, Nottwil, Switzerland
  • ,
  • Michael Baumberger, MD

      Affiliations

    • Swiss Paraplegic Centre, Nottwil, Switzerland

Abstract 

Lechner HE, Kakebeeke TH, Hegemann D, Baumberger M. The effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury.

Objectives

To determine the effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury (SCI), and to compare it with the effects of other interventions.

Design

Crossover trial with 4 conditions.

Setting

Swiss paraplegic center.

Participants

A volunteer sample of 12 people with spastic SCI (American Spinal Injury Association grade A or B).

Interventions

Hippotherapy, sitting astride a Bobath roll, and sitting on a stool with rocking seat. Each session lasted 25 minutes and was conducted twice weekly for 4 weeks; the control condition was spasticity measurement without intervention.

Main Outcome Measures

Clinical rating by a blinded examiner of movement-provoked muscle resistance, using the Ashworth Scale; self-rating of spasticity by subjects on a visual analog scale (VAS); and mental well-being evaluated with the self-rated well-being scale Befindlichkeits-Skala of von Zerssen. Assessments were performed immediately after intervention sessions (short-term effect); data from the assessments were analyzed 3 to 4 days after the sessions to calculate the long-term effect.

Results

By analyzing the clinically rated spasticity, only the effect of hippotherapy reached significance compared with the control condition (without intervention); median differences in the Ashworth scores’ sum before and after hippotherapy sessions ranged between −8.0 and +0.5. There was a significant difference between the spasticity-reducing effect of hippotherapy and the other 2 interventions in self-rated spasticity by VAS; median differences of the VAS before and after hippotherapy sessions ranged between −4.6 and +0.05cm. There were no long-term effects on spasticity. Immediate improvements in the subjects’ mental well-being were detected only after hippotherapy (P=.048).

Conclusions

Hippotherapy is more efficient than sitting astride a Bobath roll or on a rocking seat in reducing spasticity temporarily. Hippotherapy had a positive short-term effect on subjects’ mental well-being.

Key Words: Muscle spasticity, Physical therapy modalities, Physiotherapy, Rehabilitation, Spinal cord injuries

 

 Supported by the Swiss Paraplegic Foundation.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01284-1

doi:10.1016/j.apmr.2007.07.015

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1241-1248, October 2007