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.
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.
Reprint requests to Helga E. Lechner, MSc, PT, Swiss Paraplegic Centre, Guido A. Zaech Str. 1, CH-6207 Nottwil, Switzerland
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.