Horseback Riding as Therapy for Children with Cerebral Palsy

A systematic review of the literature on horseback riding therapy as an intervention for children with cerebral palsy (CP) was carried out. The terms horse, riding, hippotherapy, horseback riding therapy, equine movement therapy, and cerebral palsy were searched in electronic databases and hand searched. Retrieved articles were rated for methodological quality using PEDro scoring to assess the internal validity of randomized trials and the Newcastle Ottawa Quality Assessment Scale to assess cohort studies. PICO questioning (Population, Intervention, Comparison, and Outcomes) was used to identify questions of interest to clinicians for outcomes within the context of the International Classification of Functioning, Disability and Health. Levels of evidence were then accorded each PICO question. There is Level 2a evidence that hippotherapy is effective for treating muscle symmetry in the trunk and hip and that therapeutic horseback riding is effective for improved gross motor function when compared with regular therapy or time on a waiting list. No studies addressed participation outcomes.

[1]  D. Sackett.  Evidence-based medicine: how to practice and teach EBM: 2nd ed , 2000 .

[2]  D. Bertoti,et al.  Effect of therapeutic horseback riding on posture in children with cerebral palsy. , 1988, Physical therapy.

[3]  D. Nichols-Larsen,et al.  The Effect of Hippotherapy on Ten Children with Cerebral Palsy , 2004, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[4]  R. Busse,et al.  What is 'best practice' in health care? State of the art and perspectives in improving the effectiveness and efficiency of the European health care systems. , 2001, Health policy.

[5]  Katherine Pakieser-Reed,et al.  Closing the Gap Between Research and Clinical Practice , 2004, Topics in stroke rehabilitation.

[6]  K. Miller,et al.  Trunk Postural Reactions in Children with and Without Cerebral Palsy During Therapeutic Horseback Riding , 1998 .

[7]  Gordon H. Guyatt,et al.  Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice; Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice , 2003, BMJ : British Medical Journal.

[8]  E. Tauffkirchen.  [Hippotherapy--a supplementary treatment for motion disturbance caused by cerebral palsy (author's transl)]. , 1978, Pädiatrie & Pädologie.

[9]  Rebecca S. Graves,et al.  Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. , 2002 .

[10]  J. Mackinnon,et al.  Therapeutic horseback riding:. , 1995, Physical & occupational therapy in pediatrics.

[11]  B. Rogers,et al.  Horseback riding in children with cerebral palsy: effect on gross motor function. , 2002, Developmental medicine and child neurology.

[12]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[13]  R. Teasell,et al.  Stroke Rehabilitation Evidence-Based Review: Methodology , 2003, Topics in stroke rehabilitation.

[14]  Robert D. Herbert,et al.  Physiotherapy Evidence Database , 2000 .

[15]  M. Toomey,et al.  Powered Saddle and Pelvic Mobility , 1998 .

[16]  M. Msall,et al.  The Functional Independence Measure for Children (WeeFIM) , 1994, Clinical pediatrics.

[17]  M. Bigby.  Challenges to the hierarchy of evidence: does the emperor have no clothes? , 2001, Archives of dermatology.

[18]  A. MacPhail,et al.  A study of therapeutic effects of horseback riding for children with cerebral palsy. , 1995, Physical & occupational therapy in pediatrics.

[19]  V. Haehl,et al.  Influence of Hippotherapy on the Kinematics and Functional Performance of Two Children with Cerebral Palsy , 1999 .

[20]  G. Widener,et al.  Effect of an equine‐movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy: a pilot study , 1998, Developmental medicine and child neurology.

[21]  M. Law,et al.  The Environment: A Focus for Occupational Therapy , 1991 .

[22]  K. Słonka,et al.  Influence of artificial saddle riding on postural stability in children with cerebral palsy. , 1999, Gait & posture.

[23]  M. Law,et al.  Organizational Characteristics and Issues Affecting the Longevity of Self-Help Groups for Parents of Children with Special Needs , 2000, Qualitative health research.

[24]  M. Bax.  TERMINOLOGY AND CLASSIFICATION OF CEREBRAL PALSY , 1964, Developmental medicine and child neurology.

[25]  J. Kramer,et al.  Infant Motor Development and Aspects of the Home Environment , 2000 .

[26]  J. Grossman,et al.  The Randomized Controlled Trial: gold standard, or merely standard? , 2005, Perspectives in biology and medicine.

[27]  W. Coster,et al.  Pediatric Functional Outcome Measures , 1991 .

[28]  C. Edelbrock,et al.  Manual for the Child: Behavior Checklist and Revised Child Behavior Profile , 1983 .

[29]  P. Raina,et al.  Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. , 2000, Physical therapy.

[30]  M. Orlin,et al.  Recent advances in physical and occupational therapy for children with cerebral palsy. , 2004, Seminars in pediatric neurology.

[31]  M. Law,et al.  PARENT COMPLIANCE WITH THERAPEUTIC INTERVENTIONS FOR CHILDREN WITH CEREBRAL PALSY , 1993, Developmental medicine and child neurology.

[32]  D. Bartlett,et al.  The Relationship Between the Home Environment and Early Motor Development , 1999 .

[33]  B. Hanft,et al.  Therapy in Natural Environments: The Means or End Goal for Early Intervention?. , 2000 .

[34]  Esther Thelen,et al.  Postural Control During Reaching in Young Infants: A Dynamic Systems Approach , 1998, Neuroscience & Biobehavioral Reviews.

[35]  P. Grimaud.  [Cerebral palsy]. , 1972, Pediatrie.

[36]  Hua-Fang Liao,et al.  The Effectiveness of Therapeutic Horseback Riding in Children With Spastic Cerebral Palsy , 2004 .

[37]  D. Egnor.  Individuals with Disabilities Education Act Amendments of 1996 , 1996 .

[38]  F. Sutton,et al.  Best practice: what it is and what it is not. , 1999, International journal of nursing practice.

[39]  H. Vet,et al.  The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. , 1998, Journal of clinical epidemiology.

[40]  M. Law,et al.  Factors affecting family-centred service delivery for children with disabilities. , 2003, Child: care, health and development.

[41]  S. Campbell.  Therapy Programs for Children That Last a Lifetime , 1997 .

[42]  William Benda,et al.  Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). , 2003, Journal of alternative and complementary medicine.

[43]  M. Schmeler,et al.  Identifying best practice in the occupational therapy assistive technology evaluation: an analysis of three focus groups. , 1997, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.