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, as compared to 10 minutes of barrel sitting, on symmetry of adductor muscle activity during walking in children with cerebral palsy (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: Randomized controlled trial plus clinical follow-up Setting: Out-patient hippotherapy 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 = .0001, (d=1.32). Effects of barrel sitting were not significant (p=.768, d=.10). Phase II: After 12 weeks of hippotherapy, testing in several functional domains showed improvements over baseline which were sustained for 12 weeks post treatment. Conclusions: Hippotherapy can improve adductor muscle symmetry during walking and functional motor skills.