Analyze Diet
Developmental medicine and child neurology2007; 49(1); 68-73; doi: 10.1017/s0012162207000175.x

Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy?

Abstract: Quantitative (not qualitative) studies were sought investigating whether horseback riding used as therapy improves gross motor function in children with cerebral palsy (CP). Eleven published studies on instructor-directed, recreational horseback riding therapy (HBRT) and licensed-therapist-directed hippotherapy were identified, reviewed, and summarized for research design, methodological quality, therapy regimen, internal/external validity, results, and authors'conclusions. Methodological quality was moderate to good for all studies; some studies were limited by small sample size or lack of non-riding controls. HBRT improved gross motor function in five of six studies (one study was inconclusive); hippotherapy improved gross motor function in all five studies. The studies found that during HBRT and hippotherapy: (1) the three-dimensional, reciprocal movement of the walking horse produced normalized pelvic movement in the rider, closely resembling pelvic movement during ambulation in individuals without disability; (2) the sensation of smooth, rhythmical movements made by the horse improved co-contraction, joint stability, and weight shift, as well as postural and equilibrium responses; and (3) that HBRT and hippotherapy improved dynamic postural stabilization, recovery from perturbations, and anticipatory and feedback postural control. The evidence suggests that HBRT and hippotherapy are individually efficacious, and are both medically indicated as therapy for gross motor rehabilitation in children with CP. Recommendations for future research are discussed.
Publication Date: 2007-01-11 PubMed ID: 17209981DOI: 10.1017/s0012162207000175.xGoogle Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article
  • Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research is about the effectiveness of horseback riding therapy and hippotherapy in helping children with cerebral palsy improve their gross motor function.

Study Selection and Analysis

The research involved studying quantitative data from previous studies regarding horseback riding therapy, specifically instructor-directed recreational horseback riding therapy (HBRT) and licensed-therapist-directed hippotherapy. The researchers found such 11 studies and analyzed their design, methodology, therapy regimen, validity, results, and conclusions.

  • HBRT involves recreational horseback riding directed by an instructor for therapeutic purposes.
  • Hippotherapy is a physiotherapy treatment method that harnesses the movements of a horse to achieve specific rehabilitative goals.

Evaluation of the Methodological Quality

The researchers evaluated the methodological quality considering the size of the sample and the presence or absence of non-riding control groups. The quality ranged from moderate to good across the studies, but there were some limitations related to small sample size and lack of control groups in some studies.

Results and Findings

  • The studies revealed that HBRT improved the gross motor function in five out of six studies. One study was inconclusive.
  • All five studies that examined hippotherapy concluded that it improved gross motor function.
  • The studies suggested that riding a horse offers a three-dimensional, reciprocal movement that can normalize the movement of the rider’s pelvis, similar to that in individuals without a disability when walking.
  • The sensation of the horse’s rhythmic smooth movement improved co-contraction, joint stability, and weight shift, as well as postural and equilibrium responses.
  • Both HBRT and hippotherapy were concluded to enhance dynamic postural stabilization, recovery from perturbations, and the anticipatory and feedback aspects of postural control.

Recommendations

The researchers conclude from the study evidence that both HBRT and hippotherapy have individual efficacy for gross motor rehabilitation in children with cerebral palsy. They further discuss recommendations for future research to advance the field.

Cite This Article

APA
Sterba JA. (2007). Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Dev Med Child Neurol, 49(1), 68-73. https://doi.org/10.1017/s0012162207000175.x

Publication

ISSN: 0012-1622
NlmUniqueID: 0006761
Country: England
Language: English
Volume: 49
Issue: 1
Pages: 68-73

Researcher Affiliations

Sterba, John A
  • Research Assistant Professor of Pediatrics, Department of Pediatrics, Division of Developmental Pediatrics and Rehabilitation, Robert Warner Rehabilitation Center, Women and Children's Hospital of Buffalo, NY, USA.

MeSH Terms

  • Animals
  • Cerebral Palsy / rehabilitation
  • Child
  • Exercise Therapy / methods
  • Horses
  • Humans
  • Professional-Patient Relations
  • Psychomotor Performance
  • Recreation
  • Teaching
  • Treatment Outcome

Citations

This article has been cited 34 times.
  1. 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.
    doi: 10.3389/fvets.2023.1203481pubmed: 37649564google scholar: lookup
  2. Kaya Y, Saka S, Tuncer D. Effect of hippotherapy on balance, functional mobility, and functional independence in children with Down syndrome: randomized controlled trial. Eur J Pediatr 2023 Jul;182(7):3147-3155.
    doi: 10.1007/s00431-023-04959-5pubmed: 37186034google scholar: lookup
  3. Bonanno M, Militi A, La Fauci Belponer F, De Luca R, Leonetti D, Quartarone A, Ciancarelli I, Morone G, Calabrò RS. Rehabilitation of Gait and Balance in Cerebral Palsy: A Scoping Review on the Use of Robotics with Biomechanical Implications. J Clin Med 2023 May 4;12(9).
    doi: 10.3390/jcm12093278pubmed: 37176718google scholar: lookup
  4. Ali MS, Awad AS. Comparison of the efficacy of two interventions in ameliorating abdominal thickness and sitting function in children with diplegia. J Taibah Univ Med Sci 2022 Aug;17(4):548-555.
    doi: 10.1016/j.jtumed.2022.01.011pubmed: 35983459google scholar: lookup
  5. Viruega H, Imbernon C, Chausson N, Altarcha T, Aghasaryan M, Soumah D, Lescieux E, Flamand-Roze C, Simon O, Bedin A, Smadja D, Gaviria M. Neurorehabilitation through Hippotherapy on Neurofunctional Sequels of Stroke: Effect on Patients' Functional Independence, Sensorimotor/Cognitive Capacities and Quality of Life, and the Quality of Life of Their Caregivers-A Study Protocol. Brain Sci 2022 May 9;12(5).
    doi: 10.3390/brainsci12050619pubmed: 35625006google scholar: lookup
  6. 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.
    doi: 10.1097/PEP.0000000000000880pubmed: 35184078google scholar: lookup
  7. Lightsey P, Lee Y, Krenek N, Hur P. Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. J Neuroeng Rehabil 2021 Sep 6;18(1):132.
    doi: 10.1186/s12984-021-00929-wpubmed: 34488800google scholar: lookup
  8. Panzera M, Alberghina D, Statelli A. Ethological and Physiological Parameters Assessment in Donkeys Used in Animal Assisted Interventions. Animals (Basel) 2020 Oct 13;10(10).
    doi: 10.3390/ani10101867pubmed: 33066258google scholar: lookup
  9. Dominguez-Romero JG, Molina-Aroca A, Moral-Munoz JA, Luque-Moreno C, Lucena-Anton D. Effectiveness of Mechanical Horse-Riding Simulators on Postural Balance in Neurological Rehabilitation: Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2019 Dec 25;17(1).
    doi: 10.3390/ijerph17010165pubmed: 31881693google scholar: lookup
  10. Scopa C, Contalbrigo L, Greco A, Lanatà A, Scilingo EP, Baragli P. Emotional Transfer in Human-Horse Interaction: New Perspectives on Equine Assisted Interventions. Animals (Basel) 2019 Nov 26;9(12).
    doi: 10.3390/ani9121030pubmed: 31779120google scholar: lookup
  11. Viruega H, Gaillard I, Carr J, Greenwood B, Gaviria M. Short- and Mid-Term Improvement of Postural Balance after a Neurorehabilitation Program via Hippotherapy in Patients with Sensorimotor Impairment after Cerebral Palsy: A Preliminary Kinetic Approach. Brain Sci 2019 Sep 29;9(10).
    doi: 10.3390/brainsci9100261pubmed: 31569505google scholar: lookup
  12. Noh HJ, Kim CM, Park JW. A study on muscle activity based on the ankle posture for effective exercise with indoor horse riding machine. J Phys Ther Sci 2019 Feb;31(2):170-174.
    doi: 10.1589/jpts.31.170pubmed: 30858658google scholar: lookup
  13. De Santis M, Contalbrigo L, Borgi M, Cirulli F, Luzi F, Redaelli V, Stefani A, Toson M, Odore R, Vercelli C, Valle E, Farina L. Equine Assisted Interventions (EAIs): Methodological Considerations for Stress Assessment in Horses. Vet Sci 2017 Sep 8;4(3).
    doi: 10.3390/vetsci4030044pubmed: 29056702google scholar: lookup
  14. Malcolm R, Ecks S, Pickersgill M. 'It just opens up their world': autism, empathy, and the therapeutic effects of equine interactions. Anthropol Med 2018 Aug;25(2):220-234.
    doi: 10.1080/13648470.2017.1291115pubmed: 28513182google scholar: lookup
  15. Ohtani N, Kitagawa K, Mikami K, Kitawaki K, Akiyama J, Fuchikami M, Uchiyama H, Ohta M. Horseback Riding Improves the Ability to Cause the Appropriate Action (Go Reaction) and the Appropriate Self-control (No-Go Reaction) in Children. Front Public Health 2017;5:8.
    doi: 10.3389/fpubh.2017.00008pubmed: 28220146google scholar: lookup
  16. Koca TT, Ataseven H. What is hippotherapy? The indications and effectiveness of hippotherapy. North Clin Istanb 2015;2(3):247-252.
    doi: 10.14744/nci.2016.71601pubmed: 28058377google scholar: lookup
  17. Moraes AG, Copetti F, Angelo VR, Chiavoloni LL, David AC. The effects of hippotherapy on postural balance and functional ability in children with cerebral palsy. J Phys Ther Sci 2016 Aug;28(8):2220-6.
    doi: 10.1589/jpts.28.2220pubmed: 27630401google scholar: lookup
  18. Jang CH, Joo MC, Noh SE, Lee SY, Lee DB, Lee SH, Kim HK, Park HI. Effects of Hippotherapy on Psychosocial Aspects in Children With Cerebral Palsy and Their Caregivers: A Pilot Study. Ann Rehabil Med 2016 Apr;40(2):230-6.
    doi: 10.5535/arm.2016.40.2.230pubmed: 27152272google scholar: lookup
  19. Kim SR, Cho SH, Kim JW, Lee HC, Brienen M, Cho BJ. Effects of horseback riding exercise therapy on background electroencephalograms of elderly people. J Phys Ther Sci 2015 Jul;27(7):2373-6.
    doi: 10.1589/jpts.27.2373pubmed: 26311985google scholar: lookup
  20. Cho SH, Kim JW, Kim SR, Cho BJ. Effects of horseback riding exercise therapy on hormone levels in elderly persons. J Phys Ther Sci 2015 Jul;27(7):2271-3.
    doi: 10.1589/jpts.27.2271pubmed: 26311966google scholar: lookup
  21. Lee N, Park S, Kim J. Effects of hippotherapy on brain function, BDNF level, and physical fitness in children with ADHD. J Exerc Nutrition Biochem 2015 Jun;19(2):115-21.
    doi: 10.5717/jenb.2015.15061209pubmed: 26244130google scholar: lookup
  22. Temcharoensuk P, Lekskulchai R, Akamanon C, Ritruechai P, Sutcharitpongsa S. Effect of horseback riding versus a dynamic and static horse riding simulator on sitting ability of children with cerebral palsy: a randomized controlled trial. J Phys Ther Sci 2015 Jan;27(1):273-7.
    doi: 10.1589/jpts.27.273pubmed: 25642090google scholar: lookup
  23. Lee D, Lee S, Park J. Effects of indoor horseback riding and virtual reality exercises on the dynamic balance ability of normal healthy adults. J Phys Ther Sci 2014 Dec;26(12):1903-5.
    doi: 10.1589/jpts.26.1903pubmed: 25540494google scholar: lookup
  24. Park ES, Rha DW, Shin JS, Kim S, Jung S. Effects of hippotherapy on gross motor function and functional performance of children with cerebral palsy. Yonsei Med J 2014 Nov;55(6):1736-42.
    doi: 10.3349/ymj.2014.55.6.1736pubmed: 25323914google scholar: lookup
  25. Lee CW, Kim SG, Na SS. The effects of hippotherapy and a horse riding simulator on the balance of children with cerebral palsy. J Phys Ther Sci 2014 Mar;26(3):423-5.
    doi: 10.1589/jpts.26.423pubmed: 24707098google scholar: lookup
  26. Lemke D, Rothwell E, Newcomb TM, Swoboda KJ. Perceptions of equine-assisted activities and therapies by parents and children with spinal muscular atrophy. Pediatr Phys Ther 2014 Summer;26(2):237-44.
    doi: 10.1097/PEP.0000000000000027pubmed: 24675128google scholar: lookup
  27. Park J, Lee S, Lee J, Lee D. The effects of horseback riding simulator exercise on postural balance of chronic stroke patients. J Phys Ther Sci 2013 Sep;25(9):1169-72.
    doi: 10.1589/jpts.25.1169pubmed: 24259938google scholar: lookup
  28. Holm MB, Baird JM, Kim YJ, Rajora KB, D'Silva D, Podolinsky L, Mazefsky C, Minshew N. Therapeutic horseback riding outcomes of parent-identified goals for children with autism spectrum disorder: an ABA' multiple case design examining dosing and generalization to the home and community. J Autism Dev Disord 2014 Apr;44(4):937-47.
    doi: 10.1007/s10803-013-1949-xpubmed: 24091469google scholar: lookup
  29. Sunwoo H, Chang WH, Kwon JY, Kim TW, Lee JY, Kim YH. Hippotherapy in adult patients with chronic brain disorders: a pilot study. Ann Rehabil Med 2012 Dec;36(6):756-61.
    doi: 10.5535/arm.2012.36.6.756pubmed: 23342306google scholar: lookup
  30. Herrero P, Asensio A, García E, Marco A, Oliván B, Ibarz A, Gómez-Trullén EM, Casas R. Study of the therapeutic effects of an advanced hippotherapy simulator in children with cerebral palsy: a randomised controlled trial. BMC Musculoskelet Disord 2010 Apr 16;11:71.
    doi: 10.1186/1471-2474-11-71pubmed: 20398394google scholar: lookup
  31. Anttila H, Autti-Rämö I, Suoranta J, Mäkelä M, Malmivaara A. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr 2008 Apr 24;8:14.
    doi: 10.1186/1471-2431-8-14pubmed: 18435840google scholar: lookup
  32. Ye G, Gao L, Liu C, Huang J, Zheng X, Gao Y, Wang H, Wang H. The effectiveness of different exercise mode interventions in improving disease activity in patients with ankylosing spondylitis: a network and dose-dependent meta-analysis. Front Physiol 2025;16:1715944.
    doi: 10.3389/fphys.2025.1715944pubmed: 41640843google scholar: lookup
  33. Panzera M, Statelli A. Heart Rate Variability Spectral Analysis for Monitoring Autonomic Activation in a Donkey Involved in Animal-Assisted Therapy: A Single Subject Design During Animal-Assisted Therapy Sessions. Vet Sci 2025 Nov 28;12(12).
    doi: 10.3390/vetsci12121131pubmed: 41472111google scholar: lookup
  34. 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).
    doi: 10.3390/medicina61101811pubmed: 41155798google scholar: lookup