Immediate and Long-Term Effects of Hippotherapy on Symmetry of Adductor Muscle Activity and Functional Ability in Children With Spastic Cerebral Palsy

Presented to the American Hippotherapy Association, April, 20–22, 2007, Atlanta, GA.

Abstract

McGibbon NH, Benda W, Duncan BR, Silkwood-Sherer D. Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy.

Objectives

To investigate the immediate effects of 10 minutes of hippotherapy, compared with 10 minutes of barrel-sitting, on symmetry of adductor muscle activity during walking in children with cerebral palsy (CP) (phase I). To investigate the long-term effects of 12 weeks of hippotherapy on adductor activity, gross motor function, and self-concept (phase II).

Design

Pretest/posttest randomized controlled trial plus clinical follow-up.

Setting

Outpatient therapy center.

Participants

Children with spastic CP (phase I: n=47; phase II: n=6).

Interventions

Phase I: 10 minutes of hippotherapy or 10 minutes of barrel-sitting; phase II: 12 weekly hippotherapy sessions.

Main Outcome Measures

Phases I and II: adductor muscle activity measured by surface electromyography. Phase II: gross motor function and self-perception profiles.

Results

Phase I: hippotherapy significantly improved adductor muscle asymmetry (P<.001; d=1.32). Effects of barrel-sitting were not significant (P>.05; d=.10). Phase II: after 12 weeks of hippotherapy, testing in several functional domains showed improvements over baseline that were sustained for 12 weeks posttreatment.

Conclusions

Hippotherapy can improve adductor muscle symmetry during walking and can also improve other functional motor skills.

Key Words: Cerebral palsy, Electromyography, Horses, Movement, Muscle spasticity, Rehabilitation

List of Abbreviations: APA, anticipatory postural adjustments, CP, cerebral palsy, EMG, electromyography, GMFCS, Gross Motor Function Classification System, GMFM-88, Gross Motor Function Measure-88, ICF, International Classification of Functioning, Disability, and Health, mV, microvolts, sEMG, surface electromyography, SPPC, Self-Perception Profile for Children

a Therapeutic Riding of Tucson Therapy Services, Tucson, AZ

b Institute for Children, Youth, and Families, Tucson, AZ

c Department of Pediatrics, Arizona Health Sciences Center, Tucson, AZ

d Central Michigan University, Mt Pleasant, MI

Reprint requests to Nancy H. McGibbon, MS, PT, HPCS, PO Box 647, Green Valley, AZ 85622

Supported by the National Institutes of Health/Department of Health and Human Services (project no. AT00008-05).

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(09)00204-4

doi:10.1016/j.apmr.2009.01.011

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