Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy.

This research examines how Equine Assisted Physiotherapy (EAPT) can aid in improving trunk control as well as other movement aspects in children with cerebral palsy by providing a new environment for movement experiences.

Research Objectives and Methods

• The goal of the study was to understand whether and how physiotherapy involving horse-riding sessions could enhance trunk control and other movement aspects in children diagnosed with cerebral palsy. The researchers also assessed whether these changes, if any, could be effectively measured.
• To achieve this, the study employed a multiple case approach integrated with a mixed methods design. The subjects of the study were two children with cerebral palsy, both classified under GMFCS grade 1.
• For a period of six months, the children were observed and recorded via video during their EAPT sessions. Alongside this, the children were tested using a modified Norwegian version of the Trunk Impairment Scale.
• Experienced physiotherapists performed a qualitative analysis of the video recordings, comparing any notable changes in movement with the results from the scale testing.

Research Findings

• The study discovered that riding bareback led to improvements in trunk control that could be both observed and measured. However, the same was not true when the participants were riding with a saddle, which instead resulted in diminished trunk control.
• Other observable alterations in movement included shifts from asymmetry to symmetry and an adaptation to rhythm. There was also the observation that participants were gaining mastery of riding skills and experienced reduced loss of postural control.
• Further, the study noted increased instances where the children altered their movements spontaneously in response to the horse, indicating a form of dialogue between the rider and the horse.
• This dialogue proved to be influenced both positively and negatively by the instructions and feedback provided by the therapist during the sessions.

Conclusions Drawn

• The study underlines how balance and symmetry can be stimulated during EAPT sessions even in a body characterized by imbalance and asymmetry, common in children with cerebral palsy. Through EAPT, the children were able to explore and experiment with new movement qualities.
• The research also highlights the impact of equipment and feedback on the movement qualities, with riding bareback providing better trunk control than riding with a saddle, and therapist feedback influencing the child-horse interaction.