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Home / Equine Research Bank / J Clin Med / Effects of Hippotherapy and Horse-Riding Simulators on Gross...
Journal of clinical medicine2025; 14(1); 283; doi: 10.3390/jcm14010283

Effects of Hippotherapy and Horse-Riding Simulators on Gross Motor Function in Children with Cerebral Palsy: A Systematic Review.

Abstract: : Cerebral palsy (CP) can have a negative impact on gross motor function. Conventional hippotherapy and horse-riding simulators (HRS) have shown promising results on gross motor function in populations with neurological disorders. This review aims to update the knowledge on the effectiveness of hippotherapy on gross motor function in children with CP. : A search was conducted in Academic Search Ultimate, CINAHL, Medline complete, and PEDro covering publications between 2012 and 2022. Two authors identified studies that met the inclusion criteria; a third author resolved discrepancies. Studies were included if they analyzed the effects of hippotherapy on the gross motor function of children with CP. The quality of the methodology was assessed according to the PEDro scale. : Of the 150 studies initially identified, 9 were included in this review. The studies showed fair (N = 3) and good (N = 6) methodological quality on the PEDro scale. The majority used conventional hippotherapy (N = 7), while a minority used HRS (N = 2). The most commonly used protocol for conventional hippotherapy was 1-2 sessions of 30-45 min per week for 8 weeks (N = 4), whereas for HRS, these protocols were varied. Seven studies on conventional hippotherapy and one study on HRS showed improvements in gross motor function. However, the hippotherapy protocols were not very standardized and the samples were neither homogeneous nor representative. : Conventional hippotherapy and HRS appear to have evidence to support their benefits on gross motor function in children with CP. However, more clinical trials with standardized protocols and more representative samples are needed to confirm these effects.
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Publication Date: 2025-01-06 PubMed ID: 39797365PubMed Central: PMC11720817DOI: 10.3390/jcm14010283Google Scholar: Lookup
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Summary

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Overview

  • This systematic review examines the impact of hippotherapy and horse-riding simulators (HRS) on improving gross motor function in children with cerebral palsy (CP).
  • It summarizes findings from multiple studies conducted between 2012 and 2022 to evaluate existing evidence and identify gaps for future research.

Background

  • Cerebral palsy is a neurological disorder that primarily affects movement and motor function, often leading to impaired gross motor skills in children.
  • Hippotherapy involves therapeutic horse riding, which provides movement input that can promote improvements in posture, balance, and motor control.
  • Horse-riding simulators (HRS) are mechanical devices designed to mimic horse movements, offering a controlled alternative to conventional hippotherapy.
  • Both interventions have shown potential benefits in other neurological conditions but require evaluation specifically for children with CP.

Methods

  • A systematic search was performed across 4 databases: Academic Search Ultimate, CINAHL, Medline Complete, and PEDro.
  • Search timeframe covered publications from 2012 to 2022 to include recent studies.
  • Inclusion criteria: Studies analyzing hippotherapy’s effects on gross motor function for children with CP.
  • Two reviewers independently screened studies, with a third resolving any disagreements to ensure selection accuracy.
  • Methodological quality of included studies was assessed using the PEDro scale, which rates study design rigor and bias risk.

Results

  • From 150 initially identified studies, 9 met all criteria and were included in the review.
  • Quality assessment indicated 3 studies had fair quality, while 6 demonstrated good methodological rigor.
  • Most studies (7/9) employed conventional hippotherapy; 2 studied horse-riding simulators.
  • Typical hippotherapy protocols involved 1-2 sessions per week, each lasting 30-45 minutes, generally continued for around 8 weeks.
  • HRS intervention protocols varied more widely without a standardized approach.
  • Seven of the conventional hippotherapy studies and one HRS study reported improvements in gross motor function in children with CP.
  • However, protocols and sample characteristics varied significantly, limiting the ability to generalize findings.

Conclusions

  • Evidence suggests both conventional hippotherapy and horse-riding simulators have beneficial effects on gross motor function in children with cerebral palsy.
  • Despite promising results, the lack of standardized treatment protocols and heterogeneous samples mean results should be interpreted cautiously.
  • Further well-designed clinical trials are needed, featuring consistent intervention methods and diverse representative populations.
  • This future research will help confirm the effectiveness and optimize the use of hippotherapy and HRS in CP rehabilitation.

Cite This Article

APA
Ortega-Cruz A, Sánchez-Silverio V, Riquelme-Aguado V, Alonso-Perez JL, Abuín-Porras V, Villafañe JH. (2025). Effects of Hippotherapy and Horse-Riding Simulators on Gross Motor Function in Children with Cerebral Palsy: A Systematic Review. J Clin Med, 14(1), 283. https://doi.org/10.3390/jcm14010283

Publication

Journal of clinical medicine
ISSN: 2077-0383
NlmUniqueID: 101606588
Country: Switzerland
Language: English
Volume: 14
Issue: 1
PII: 283

Researcher Affiliations

Ortega-Cruz, Antonio
  • Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
Sánchez-Silverio, Víctor
  • School of Applied Health Sciences, Pontificia Universidad Católica Madre y Maestra, Autopista Duarte Km 1 1/2, Santiago De Los Caballeros 51000, Dominican Republic.
Riquelme-Aguado, Víctor
  • Department of Basic Health Sciences, Rey Juan Carlos University, 28933 Madrid, Spain.
  • Grupo de Investigación Consolidado de Bases Anatómicas, Moleculares y del Desarrollo Humano de la Universidad Rey Juan Carlos (GAMDES), 28922 Alcorcón, Spain.
Alonso-Perez, Jose Luis
  • Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
  • Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
Abuín-Porras, Vanesa
  • Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
Villafañe, Jorge Hugo
  • Department of Physiotherapy, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.
  • Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain.

Conflict of Interest Statement

The authors declare no conflicts of interest.

References

This article includes 32 references
  1. Abuin-Porras V, Pedersini P, Berjano P, Villafañe JH. The efficacy of physical therapy on the improvement of the motor components of visual attention in children with cerebral palsy: A case series study.. J. Exerc. Rehabil. 2019;15:103.
    doi: 10.12965/jer.1836568.284pmc: PMC6416505pubmed: 30899744google scholar: lookup
  2. Longo E, Regalado ICR, Galvão ERVP, Ferreira HNC, Badia M, Baz BO. I Want to play: Children with cerebral palsy talk about their experiences on barriers and facilitators to participation in leisure activities.. Pediatr. Phys. Ther. 2020;32:190–200.
    doi: 10.1097/PEP.0000000000000719pubmed: 32604358google scholar: lookup
  3. Stavsky M, Mor O, Mastrolia SA, Greenbaum S, Than NG, Erez O. Cerebral palsy—Trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention.. Front. Pediatr. 2017;5:21.
    doi: 10.3389/fped.2017.00021pmc: PMC5304407pubmed: 28243583google scholar: lookup
  4. Korzeniewski SJ, Slaughter J, Lenski M, Haak P, Paneth N. The complex aetiology of cerebral palsy.. Nat. Rev. Neurol. 2018;14:528–543.
    doi: 10.1038/s41582-018-0043-6pubmed: 30104744google scholar: lookup
  5. Michael-Asalu A, Taylor G, Campbell H, Lelea LL, Kirby RS. Cerebral palsy: Diagnosis, epidemiology, genetics, and clinical update.. Adv. Pediatr. 2019;66:189–208.
    doi: 10.1016/j.yapd.2019.04.002pubmed: 31230694google scholar: lookup
  6. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, Cioni G, Damiano D, Darrah J, Eliasson AC. Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment.. JAMA Pediatr. 2017;171:897–907.
    doi: 10.1001/jamapediatrics.2017.1689pmc: PMC9641643pubmed: 28715518google scholar: lookup
  7. Escolano-Pérez E, Herrero-Nivela ML, Losada JL. Association between preschoolers’ specific fine (but not gross) motor skills and later academic competencies: Educational implications.. Front. Psychol. 2020;11:1044.
    doi: 10.3389/fpsyg.2020.01044pmc: PMC7289974pubmed: 32581931google scholar: lookup
  8. Pillastrini P, Ferrari S, Rattin S, Cupello A, Villafañe JH, Vanti C. Exercise and tropism of the multifidus muscle in low back pain: A short review.. J. Phys. Ther. Sci. 2015;27:943–945.
    doi: 10.1589/jpts.27.943pmc: PMC4395749pubmed: 25931765google scholar: lookup
  9. Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy.. Children. 2017;4:30.
    doi: 10.3390/children4040030pmc: PMC5406689pubmed: 28441773google scholar: lookup
  10. De Guindos-Sanchez L, Lucena-Anton D, Moral-Munoz JA, Salazar A, Carmona-Barrientos I. The effectiveness of hippotherapy to recover gross motor function in children with cerebral palsy: A systematic review and meta-analysis.. Children. 2020;7:106.
    doi: 10.3390/children7090106pmc: PMC7552760pubmed: 32825159google scholar: lookup
  11. 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;28:2220–2226.
    doi: 10.1589/jpts.28.2220pmc: PMC5011565pubmed: 27630401google scholar: lookup
  12. 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. 2020;17:165.
    doi: 10.3390/ijerph17010165pmc: PMC6981612pubmed: 31881693google scholar: lookup
  13. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Mc Namara M, Paton MC, Popat H. State of the evidence traffic lights 2019: Systematic review of interventions for preventing and treating children with cerebral palsy.. Curr. Neurol. Neurosci. Rep. 2020;20:3.
    doi: 10.1007/s11910-020-1022-zpmc: PMC7035308pubmed: 32086598google scholar: lookup
  14. Hariohm K, Prakash V, Saravankumar J. Quantity and quality of randomized controlled trials published by Indian physiotherapists.. Perspect. Clin. Res. 2015;6:91.
    doi: 10.4103/2229-3485.154007pmc: PMC4394587pubmed: 25878954google scholar: lookup
  15. Chinniah H, Natarajan M, Ramanathan R, Ambrose JWF. Effects of horse riding simulator on sitting motor function in children with spastic cerebral palsy.. Physiother. Res. Int. 2020;25:e1870.
    doi: 10.1002/pri.1870pubmed: 32808394google scholar: lookup
  16. Herrero P, Gómez-Trullén EM, Asensio Á, García E, Casas R, Monserrat E, Pandyan A. Study of the therapeutic effects of a hippotherapy simulator in children with cerebral palsy: A stratified single-blind randomized controlled trial.. Clin. Rehabil. 2012;26:1105–1113.
    doi: 10.1177/0269215512444633pubmed: 22610128google scholar: lookup
  17. Matusiak-Wieczorek E, Dziankowska-Zaborszczyk E, Synder M, Borowski A. The influence of hippotherapy on the body posture in a sitting position among children with cerebral palsy.. Int. J. Environ. Res. Public Health. 2020;17:6846.
    doi: 10.3390/ijerph17186846pmc: PMC7558765pubmed: 32961681google scholar: lookup
  18. Mutoh T, Mutoh T, Tsubone H, Takada M, Doumura M, Ihara M, Shimomura H, Taki Y, Ihara M. Impact of long-term hippotherapy on the walking ability of children with cerebral palsy and quality of life of their caregivers.. Front. Neurol. 2019;10:834.
    doi: 10.3389/fneur.2019.00834pmc: PMC6701452pubmed: 31456733google scholar: lookup
  19. Vidal A, de Azevedo Fernandes JMG, da Rosa Gutierres IC, da Silva FC, Silva R, Gutierres Filho PJB. Effects of weekly hippotherapy frequency on gross motor function and functional performance of children with cerebral palsy: A randomized controlled trial.. Motricidade. 2021;17:79–86.
  20. Kwon JY, Chang HJ, Yi SH, Lee JY, Shin HY, Kim YH. Effect of hippotherapy on gross motor function in children with cerebral palsy: A randomized controlled trial.. J. Altern. Complement. Med. 2015;21:15–21.
    doi: 10.1089/acm.2014.0021pubmed: 25551626google scholar: lookup
  21. 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;55:1736–1742.
    doi: 10.3349/ymj.2014.55.6.1736pmc: PMC4205717pubmed: 25323914google scholar: lookup
  22. Chang HJ, Kwon JY, Lee JY, Kim YH. The effects of hippotherapy on the motor function of children with spastic bilateral cerebral palsy.. J. Phys. Ther. Sci. 2012;24:1277–1280.
    doi: 10.1589/jpts.24.1277google scholar: lookup
  23. Kang H, Jung J, Yu J. Effects of hippotherapy on the sitting balance of children with cerebral palsy: A randomized control trial.. J. Phys. Ther. Sci. 2012;24:833–836.
    doi: 10.1589/jpts.24.833google scholar: lookup
  24. Park EY. Gross motor function and activities of daily living in children and adolescents with cerebral palsy: A longitudinal study.. J. Dev. Phys. Disabil. 2018;30:189–203.
    doi: 10.1007/s10882-017-9579-4google scholar: lookup
  25. Menor-Rodríguez MJ, Sevilla Martín M, Sánchez-García JC, Montiel-Troya M, Cortés-Martín J, Rodríguez-Blanque R. Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature.. J. Clin. Med. 2021;10:2589.
    doi: 10.3390/jcm10122589pmc: PMC8230898pubmed: 34208206google scholar: lookup
  26. Wood WH, Fields BE. Hippotherapy: A systematic mapping review of peer-reviewed research, 1980 to 2018.. Disabil. Rehabil. 2021;43:1463–1487.
    doi: 10.1080/09638288.2019.1653997pubmed: 31491353google scholar: lookup
  27. Jonsson U, Eek MN, Sunnerhagen KS, Himmelmann K. Cerebral palsy prevalence, subtypes, and associated impairments: A population-based comparison study of adults and children.. Dev. Med. Child Neurol. 2019;61:1162–1167.
    doi: 10.1111/dmcn.14229pubmed: 30950519google scholar: lookup
  28. Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral palsy: Current opinions on definition, epidemiology, risk factors, classification and treatment options.. Neuropsychiatr. Dis. Treat. 2020;16:1505–1518.
    doi: 10.2147/NDT.S235165pmc: PMC7297454pubmed: 32606703google scholar: lookup
  29. Noble JJ, Gough M, Shortland AP. Selective motor control and gross motor function in bilateral spastic cerebral palsy.. Dev. Med. Child Neurol. 2019;61:57–61.
    doi: 10.1111/dmcn.14024pubmed: 30203469google scholar: lookup
  30. 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;34:172.
    doi: 10.1097/PEP.0000000000000880pmc: PMC8959353pubmed: 35184078google scholar: lookup
  31. Stergiou A, Tzoufi M, Ntzani E, Varvarousis D, Beris A, Ploumis A. Therapeutic effects of horseback riding interventions: A systematic review and meta-analysis.. Am. J. Phys. Med. Rehabil. 2017;96:717–725.
    doi: 10.1097/PHM.0000000000000726pubmed: 28252520google scholar: lookup
  32. Mi YS, Young LJ, Yeon SH, Sik SY, Yi KJ. Factors influencing motor outcome of hippotherapy in children with cerebral palsy.. Neuropediatrics. 2019;50:170–177.
    pubmed: 31009955

Citations

This article has been cited 2 times.
  1. 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
  2. Abd-Elzaher RE, Abd-El-Aal EM, Abd-Elrazek Mahmoud A, Abd-Elrahman BM. Effectiveness of video assisted teaching program for caregivers on gross motor outcome among children with cerebral palsy undergoing hyperbaric oxygen therapy: A quasi-experimental study.. Sci Rep 2025 Aug 5;15(1):28502.
    doi: 10.1038/s41598-025-14038-4pubmed: 40764644google scholar: lookup
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