Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy?
- Journal Article
- Review
Summary
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
Publication
Researcher Affiliations
- 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.- 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.
- 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.
- 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).
- 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.
- 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).
- 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.
- 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.
- 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).
- 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).
- 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).
- 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).
- 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.
- 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).
- 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.
- 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.
- Koca TT, Ataseven H. What is hippotherapy? The indications and effectiveness of hippotherapy. North Clin Istanb 2015;2(3):247-252.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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).
- 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).