Changes in Dynamic Trunk/Head Stability and Functional Reach After Hippotherapy

Abstract Shurtleff TL, Standeven JW, Engsberg JR. Changes in dynamic trunk/head stability and functional reach after hippotherapy. Objectives To determine if hippotherapy (therapy using a horse) improves head/trunk stability and upper extremity (UE) reaching/targeting in children with spastic diplegia cerebral palsy (SDCP). Design Pre-postoperative follow-up with a 12-week intervention and 12-week washout period after intervention. Setting A human performance laboratory with 6 camera video motion capture systems for testing. Participants Eleven children (age 5–13y, average 8y) with SDCP, 8 children (age 5–13y, average 8y) without disabilities. Intervention Hippotherapy intervention performed at 3 therapeutic horseback riding centers. Main Outcome Measures Video motion capture using surface markers collecting data at 60Hz, a mechanical barrel to challenge trunk and head stability, and functional reach/targeting test on static surface. Results Significant changes with large effect sizes in head/trunk stability and reaching/targeting, elapsed time, and efficiency (reach/path ratio) after 12 weeks of hippotherapy intervention. Changes were retained after a 12-week washout period. Conclusions Hippotherapy improves trunk/head stability and UE reaching/targeting. These skills form the foundation for many functional tasks. Changes are maintained after the intervention ceases providing a skill foundation for functional tasks that may also enhance occupational performance and participation.