Different horse’s paces during hippotherapy on spatio-temporal parameters of gait in children with bilateral spastic cerebral palsy: A feasibility study.
Abstract: Hippotherapy is often carried out for the rehabilitation of children with Cerebral Palsy (CP), with the horse riding at a walking pace. This study aimed to explore the immediate effects of a hippotherapy protocol using a walk-trot pace on spatio-temporal gait parameters and muscle tone in children with Bilateral Spastic CP (BS-CP). Ten children diagnosed with BS-CP and 10 healthy aged-matched children (reference group) took part in this study. The children with BS-CP underwent two sessions of hippotherapy for one week of washout between them. Two protocols (lasting 30min) were applied on separate days: Protocol 1: the horse's pace was a walking pace; and Protocol 2: the horse's pace was a walk-trot pace. Children from the reference group were not subjected to treatment. A wireless inertial measurement unit measured gait spatio-temporal parameters before and after each session. The Modified Ashworth Scale was applied for muscle tone measurement of hip adductors. The participants underwent the gait assessment on a path with surface irregularities (ecological context). The comparisons between BS-CP and the reference group found differences in all spatio-temporal parameters, except for gait velocity. Within-group analysis of children with BS-CP showed that the swing phase did not change after the walk pace and after the walk-trot pace. The percentage of rolling phase and double support improved after the walk-trot. The spasticity of the hip adductors was significantly reduced as an immediate result of both protocols, but this decrease was more evident after the walk-trot. The walk-trot protocol is feasible and is able to induce an immediate effect that improves the gait spatio-temporal parameters and the hip adductors spasticity.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Publication Date: 2016-08-09 PubMed ID: 27518920DOI: 10.1016/j.ridd.2016.07.015Google Scholar: Lookup
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- Journal Article
Summary
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This research focuses on investigating the immediate benefits of implementing a rapid pace (walk-trot) during hippotherapy sessions for children diagnosed with Bilateral Spastic Cerebral Palsy (BS-CP), in comparison to the traditional slower pace (walk pace). The key findings suggest that the faster pace enhances the children’s gait and reduces muscle spasticity.
Study Design and Participants
- The research included two subject groups: ten children diagnosed with Bilateral Spastic CP (BS-CP) and a control group composed of ten healthy children of a similar age. The latter group was not subjected to any therapy sessions.
- The children with BS-CP were scheduled for two sessions of hippotherapy, with a one-week interval between sessions. The ordained treatment protocols involved horses moving at two distinct paces: a walking pace (Protocol 1) utilized on one day, and a walk-to-trot pace (Protocol 2) on another day, each session lasting 30 minutes.
Methods of Measurement
- To analyze gait spatio-temporal parameters (features of movement and time related to walking), measurements were conducted before and after each hippotherapy session using a wireless inertial measurement unit.
- A gait assessment was performed on an irregular surface path, an environment that mirrors natural stumbling blocks. This was geared towards establishing the treatment’s effect in real-world applications.
- Muscle tone, especially in the hip adductors, was assessed using the Modified Ashworth Scale.
Results
- Comparisons highlighted differences in all spatio-temporal parameters except gait velocity between children with BS-CP and the reference group.
- Within-group analysis for children with BS-CP indicated that the swinging phase of their gait didn’t change after either of the two paces. However, the percentage of the rolling phase and double support improved after the trotting pace.
- Both protocols significantly reduced hip adductor spasticity, with the decrease being notably sizable after the trotting pace.
Conclusion
- The results suggest that incorporating a trotting pace in hippotherapy sessions for children with BS-CP could offer immediate benefits like gait improvement and significant reduction of muscle spasticity.
- The study affirms that trotting-pace protocol is practical and produces an immediate positive impact on the spatio-temporal parameters related to gait and hip adductor spasticity.
Cite This Article
APA
Antunes FN, Pinho ASD, Kleiner AFR, Salazar AP, Eltz GD, de Oliveira Junior AA, Cechetti F, Galli M, Pagnussat AS.
(2016).
Different horse’s paces during hippotherapy on spatio-temporal parameters of gait in children with bilateral spastic cerebral palsy: A feasibility study.
Res Dev Disabil, 59, 65-72.
https://doi.org/10.1016/j.ridd.2016.07.015 Publication
Researcher Affiliations
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
- Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
- Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Schoolarship fellow of Technical and Industrial, Development of Fundação de Amparo à Pesquisa do Rio Grande do Sul (Fapergs)-Foundation for Research Support of Rio Grande do Sul, Brazil.
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil.
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy; Motion analysis Lab, IRCCS San Raffaele Pisana, Rome, Italy.
- Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil. Electronic address: alinespagnussat@gmail.com.
MeSH Terms
- Accelerometry
- Adolescent
- Animals
- Biomechanical Phenomena
- Case-Control Studies
- Cerebral Palsy / rehabilitation
- Child
- Child, Preschool
- Cross-Over Studies
- Equine-Assisted Therapy / methods
- Feasibility Studies
- Female
- Gait
- Gait Disorders, Neurologic / rehabilitation
- Horses
- Humans
- Male
- Muscle Spasticity
- Muscle Tonus
- Walking Speed
Citations
This article has been cited 6 times.- Stergiou AN, Mattila-Rautiainen S, Varvarousis DN, Tzoufi M, Plyta P, Beris A, Ploumis A. The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy. Front Vet Sci 2023;10:1203481.
- Hyun C, Kim K, Lee S, Ko N, Lee IS, Koh SE. The Short-term Effects of Hippotherapy and Therapeutic Horseback Riding on Spasticity in Children With Cerebral Palsy: A Meta-analysis. Pediatr Phys Ther 2022 Apr 1;34(2):172-178.
- Yan Y, Fu X, Xie X, Ji S, Luo H, Yang F, Zhang X, Yang S, Xie P. Hip Adductor Intramuscular Nerve Distribution Pattern of Children: A Guide for BTX-A Treatment to Muscle Spasticity in Cerebral Palsy. Front Neurol 2019;10:616.
- Li HH, Shan L, Wang B, Jia FY. [Application of movement recognition technology in assessing spontaneous general movements in preterm infants]. Zhongguo Dang Dai Er Ke Za Zhi 2017 Dec;19(12):1306-1310.
- Günay Yazıcı C, Özden F, Çoban O, Tarakçı D, Aydoğdu O, Sarı Z. The Effect of Hippotherapy Simulator-Assisted Therapy on Motor and Functional Outcomes in Children with Cerebral Palsy. Medicina (Kaunas) 2025 Oct 9;61(10).
- Yan S, Park SH, Dee W, Keefer R, Rojas AM, Rymer WZ, Wu M. Trunk postural reactions to the force perturbation intensity and frequency during sitting astride in children with cerebral palsy. Exp Brain Res 2024 Jan;242(1):275-293.
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