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Home / Equine Research Bank / J Neuroeng Rehabil / Physical therapy treatments incorporating equine movement: a...
Journal of neuroengineering and rehabilitation2021; 18(1); 132; doi: 10.1186/s12984-021-00929-w

Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse.

Abstract: Physical therapy treatments incorporating equine movement are recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, to better understand the effectiveness of this type of treatment, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized. Four children with CP participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up Go or the 10 m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation. Correlation between vertical accelerations of children and horses were analyzed. In addition, peak frequencies of vertical accelerations of children and horses were compared. Functional tests modestly improved over time. The children's movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse's walk, demonstrated by reduced frequency errors and increased correlation. The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse's movement. Since the horse's gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern. The horse's movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning. The increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work. Trial registrationTexas A&M University Institutional Review Board. IRB2018-0064. Registered 8 March 2018. Link: https://rcb.tamu.edu/humans/irb and https://github.com/pilwonhur/HPOT.
© 2021. The Author(s).
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Publication Date: 2021-09-06 PubMed ID: 34488800PubMed Central: PMC8422664DOI: 10.1186/s12984-021-00929-wGoogle Scholar: Lookup
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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.

This study explores the effectiveness of physical therapy incorporating horse movement, or hippotherapy, on improving mobility and balance in children with cerebral palsy (CP). It provides insight into the correlation of movements between the child and horse during therapy and suggests that this therapy could facilitate neuromuscular learning of normal gait patterns in children with CP.

About the Study

  • This pilot study aimed to evaluate the interactions between children with cerebral palsy and horses during physical therapy sessions where equine movement, also known as hippotherapy, was used as a treatment intervention. The researchers hypothesized that the therapy could enhance the children’s functional mobility and balance.
  • The study involved four children with CP who all participated in eight physical therapy sessions incorporating horse movement.
  • Functional mobility of the children was assessed using the Timed Up Go or the 10m Walk Test.
  • Technology was utilized to measure and track the movements of the children and horses. Inertial measurement unit sensors were attached to both the children and horses, recording movements, acceleration, angular velocity, and body orientation.

Findings of the Study

  • The results showed modest improvement in the functional tests over the course of the sessions.
  • The children’s movements increasingly aligned with the vertical movement of the horse’s walk. This was shown through a decrease in frequency errors and a greater correlation between the vertical accelerations of children and horses.
  • The findings indicate that as the therapy sessions progressed, the participants appeared to become more attuned to the horse’s movement.
  • The horse’s gait mimics the normal human gait, thus providing children with CP, who generally have abnormal gait patterns, an opportunity for their neuromuscular system to experience a normal gait pattern.
  • The study underscored the potential for hippotherapy as a viable treatment tool to enhance functional mobility in children with cerebral palsy.

Implications of the Findings

  • The findings of this pilot study may serve as a useful base for future work in this area. This could lead to more expansive studies on the benefits of therapy involving interaction with horses for children with cerebral palsy.
  • It showcases the potential of combining traditional physical therapy techniques with innovative approaches, such as equine-assisted therapy, to improve treatment outcomes in children with cerebral palsy.
  • It could also lead to wider acceptance and incorporation of hippotherapy in <a href="/equine-rehabilitation-guide/" title="rehabilitation programs for children with CP.

Cite This Article

APA
Lightsey P, Lee Y, Krenek N, Hur P. (2021). Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. J Neuroeng Rehabil, 18(1), 132. https://doi.org/10.1186/s12984-021-00929-w

Publication

Journal of neuroengineering and rehabilitation
ISSN: 1743-0003
NlmUniqueID: 101232233
Country: England
Language: English
Volume: 18
Issue: 1
Pages: 132

Researcher Affiliations

Lightsey, Priscilla
  • Ride On Center for Kids (ROCK), Rockride Ln, Georgetown, TX, 78626, USA.
Lee, Yonghee
  • Department of Mechanical Engineering, Texas A&M University, TAMU, College Station, TX, 77843, USA.
Krenek, Nancy
  • Ride On Center for Kids (ROCK), Rockride Ln, Georgetown, TX, 78626, USA.
Hur, Pilwon
  • Department of Mechanical Engineering, Texas A&M University, TAMU, College Station, TX, 77843, USA. pilwonhur@gist.ac.kr.
  • School of Mechanical Engineering, Gwangju Institute of Science and Technology, Cheomdangwagi-ro, Gwangju, 61005, South Korea. pilwonhur@gist.ac.kr.

MeSH Terms

  • Animals
  • Cerebral Palsy
  • Child
  • Equine-Assisted Therapy
  • Gait
  • Horses
  • Humans
  • Movement
  • Physical Therapy Modalities
  • Pilot Projects

Conflict of Interest Statement

The authors declare that they have no competing interests.

References

This article includes 43 references
  1. Steffen T, Seney M. Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified parkinson disease rating scale in people with parkinsonism.. Phys Ther 2008;88(6):733–746.
    doi: 10.2522/ptj.20070214pubmed: 18356292google scholar: lookup
  2. Graham K, Harvey A, Rodda J, Nattrass G, Pirpiris M. The functional mobility scale.. J Pediatric Orthopaedics 2004;24(5):514–520.
    doi: 10.1097/01241398-200409000-00011pubmed: 15308901google scholar: lookup
  3. Graham K, Selber P. Musculoskeletal aspects of cerebral palsy.. J Bone Joint Surg 2003;85(2):157–166.
    doi: 10.1302/0301-620X.85B2.14066pubmed: 12678344google scholar: lookup
  4. Kirby RS, Wingate MS, Braun KVN, Doernberg NS, Arneson CL, Benedict RE, Mulvihill B, Durkin MS, Fitzgerald RT, Maenner MJ, Patz JA, Yeargin-Allsopp M. Prevalence and functioning of children with cerebral palsy in four areas of the united states in 2006: a report from the autism and developmental disabilities monitoring network.. Res Dev Disabil 2011;32(2):462–469.
    doi: 10.1016/j.ridd.2010.12.042pubmed: 21273041google scholar: lookup
  5. Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K. Effectiveness of rehabilitation to improve gait speed in children with cerebral palsy: a systemic review and meta-analysis.. Phys Ther 2016;96(12):1938–1954.
    doi: 10.2522/ptj.20150401pmc: PMC5131187pubmed: 27313240google scholar: lookup
  6. Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy relation between standing balance and walking function in children with spastic cerebral palsy.. Dev Med Children Neurol 2013;45(9):591–602.
    doi: 10.1111/j.1469-8749.2003.tb00963.xpubmed: 12948326google scholar: lookup
  7. Woollacott M, Shumway-Cook A. Postural dysfunction during standing and walking in children with cerebral palsy: what are the underlying problems and what new therapies might improve balance?. Neural Plast 2005;12(2–3):211–219.
    doi: 10.1155/NP.2005.211pmc: PMC2565447pubmed: 16097489google scholar: lookup
  8. Heneidy W, Eltalawy H, Kassem H, Naglaa Z. Impact of task-oriented training on balance in spastic hemiplegic cerebral palsied children.. Physiother Q 2020;28(2):52–56.
    doi: 10.5114/pq.2020.89808google scholar: lookup
  9. Matusiak-Wieczorek E, Dziankowska-Zaborszczyk E, Synder M, Borowski A. The influence of hippotherapy on the body posture in sitting position among children with cerebral palsy.. Int J Environ Res Public Health 2020;17(18):6846.
    doi: 10.3390/ijerph17186846pmc: PMC7558765pubmed: 32961681google scholar: lookup
  10. Benda W, McGibbon NH, Grant KL. Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). J Altern Complement Med 2003;9(6):817–825.
    doi: 10.1089/107555303771952163pubmed: 14736353google scholar: lookup
  11. Bertoti D. Effect of therapeutic horseback riding on posture in children with cerebral palsy.. Phys Ther 1989;68(10):1505–1512.
    pubmed: 3174832
  12. Casady R, Nichols-Larsen D. The effect of hippotherapy on ten children with cerebral palsy.. Pediatr Phys Ther 2004;16(3):165–172.
    doi: 10.1097/01.PEP.0000136003.15233.0Cpubmed: 17057544google scholar: lookup
  13. MacPhail A, Edwards J, Golding J, Miller K, Mosier C, Zwiers T. Trunk postural reactions in children with and without cerebral palsy during therapeutic horseback riding.. Pediatr Phys Ther 1988;10(4):143–147.
  14. McGibbon N, Andrade C, Widener G, Cintas HL. Effect of an equine-movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy.. Dev Med Child Neurol 1998;40(11):754–762.
    doi: 10.1111/j.1469-8749.1998.tb12344.xpubmed: 9881805google scholar: lookup
  15. Shurtleff T, Engsberg J. Changes in trunk and head stability in children with cerebral palsy after hippotherapy: a pilot study.. Phys Occup Ther Pediatr 2010;30(2):150–163.
    doi: 10.3109/01942630903517223pubmed: 20367519google scholar: lookup
  16. Sterba JA. Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy?. Dev Med Child Neurol 2007;49(1):68–73.
    doi: 10.1017/S0012162207000175.xpubmed: 17209981google scholar: lookup
  17. Silkwood-Sherer D, Killian C, Long T, Martin K. Hippotherapy—an intervention to habilitate balance deficits in children with movement disorders: a clinical trial.. Phys Ther 2012;92(5):707–717.
    doi: 10.2522/ptj.20110081pubmed: 22247403google scholar: lookup
  18. Encheff J, Armstrong C, Masterson M, Fox C, Gribble P. Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments.. Pediatr Phys Ther 2012;24(3):242–250.
    doi: 10.1097/PEP.0b013e31825c1dc3pubmed: 22735473google scholar: lookup
  19. Haehl V, Giuliani C, Lewis C. Influence of hippotherapy on the kinematics of functional performance on two children with cerebral palsy.. Pediatr Phys Ther 1999;11(2):89–101.
    doi: 10.1097/00001577-199901120-00006google scholar: lookup
  20. Garner BA, Rigby BR. Human pelvis motions when walking and when riding a therapeutic horse.. Hum Mov Sci 2015;39:121–137.
    doi: 10.1016/j.humov.2014.06.011pubmed: 25436916google scholar: lookup
  21. Horak F. Clinical measurement of postural control in adults.. Phys Ther 1987;67(12):1881–1885.
    doi: 10.1093/ptj/67.12.1881pubmed: 3685116google scholar: lookup
  22. Zadnikar M, Kastrin A. Effects of hippotherapy and therapeutic riding on postural control or balance in children with cerebral palsy: a meta-analysis.. Dev Med Child Neurol 2011;53(2):684–691.
    doi: 10.1111/j.1469-8749.2011.03951.xpubmed: 21729249google scholar: lookup
  23. Kwon J, Chang H, Lee J, Ha Y, Lee P, Kim Y. Effects of hippotherapy on gait parameters in children with bilateral spastic cerebral palsy.. Arch Phys Med Rehabil 2011;92:774–779.
    doi: 10.1016/j.apmr.2010.11.031pubmed: 21530725google scholar: lookup
  24. Uchiyama H, Ohtani N, Ohta M. Three-dimensional analysis of horse and human gaits in therapeutic riding.. Appl Anim Behav Sci 2011;135(4):271–276.
    doi: 10.1016/j.applanim.2011.10.024google scholar: lookup
  25. Paulson A, Vargus-Adams J. Overview of four functional classification systems commonly used in cerebral palsy.. Children 2017;4(4):30.
    doi: 10.3390/children4040030pmc: PMC5406689pubmed: 28441773google scholar: lookup
  26. Fritz S, Lusardi M. Walking speed: the sixth vital sign.. J Geriatric Phys Ther 2009;32(2):2–5.
    doi: 10.1519/00139143-200932020-00002pubmed: 20039582google scholar: lookup
  27. Bahrami F, Dehkordi SN, Dadgoo M. Inter and intra rater reliability of the 10 meter walk test in community dweller adults with spastic cerebral palsy.. Iran J Child Neurol 2011;11(1):57–64.
    pmc: PMC5329761pubmed: 28277557
  28. Verbecque E, Schepens K, Theré J, Schepens B, Klingels K, Hallemans A. The timed-up and go test in children: does protocol choice matter? A systemic review.. Pediatr Phys Ther 2019;31(1):22–32.
    doi: 10.1097/PEP.0000000000000558pubmed: 30557276google scholar: lookup
  29. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs test: preliminary reliability and validity of a new measure of functional mobility.. Pediatr Phys Ther 2004;16(2):90–98.
    doi: 10.1097/01.PEP.0000127564.08922.6Apubmed: 17057533google scholar: lookup
  30. Lariviere O, Provot T, Valdes-Tamayo L, Bourgain M, Chadefaux D. Force pattern and acceleration waveform repeatability of amateur runners.. Proceedings 2020;49(136).
  31. Wouda FJ, Giuberti M, Bellusci G, Maartens E, Reenalda J, van Beijnum B-JF, Veltink PH. Estimation of vertical ground reaction forces and sagittal knee kinematics during running using three inertial sensors.. Front Physiol 2018;9(218).
    pmc: PMC5874328pubmed: 29623042
  32. Ortega J, Farley C. Minimizing center of mass vertical movement increases metabolic cost in walking.. J Appl Physiol 2005;99(6):2099–2107.
    doi: 10.1152/japplphysiol.00103.2005pubmed: 16051716google scholar: lookup
  33. Wurdeman S, Raffalt P, Stergiou N. Reduced vertical displacement of the center of mass is not accompanied by reduced oxygen uptake during walking.. Sci Rep 2017;7(17182).
    pmc: PMC5719393pubmed: 29215063
  34. Nilsson J, Thorstensson A. Ground reaction forces at different speeds of human walking and running.. Acta Physiol Scand 1989;136:217–227.
    doi: 10.1111/j.1748-1716.1989.tb08655.xpubmed: 2782094google scholar: lookup
  35. van Hees VT, Gorzelniak L, León ECD, Eder M, Pias M, Taherian S, Ekelund U, Renström F, Franks PW, Horsch A, Brage S. Separating movement and gravity in an acceleration signal and implications for the assessment of human daily physical activity.. Iran J Child Neurol 2013;8(4):61691.
    pmc: PMC3634007pubmed: 23626718
  36. Kenney JF, Keeping ES. Root mean square.. Mathematics of Statistics vol. 1, 3rd edn. 1962;pp. 59–60.
  37. Hong W, Kumar NA, Hur P. A phase-shifting based human gait phase estimation for powered transfemoral prostheses.. IEEE Robotics Automation Lett 2021;6(3):5113–5120.
    doi: 10.1109/LRA.2021.3068907google scholar: lookup
  38. Liao H, Jeny S, Lai J, Cheng CK, Hu M. The relation between standing balance and walking function in children with spastic cerebral palsy.. Dev Med Child Neurol 1997;39(2):106–122.
    doi: 10.1111/j.1469-8749.1997.tb07392.xpubmed: 9062425google scholar: lookup
  39. Gordon AM, Magill RA. Motor learning: application of principles to pediatric rehabilitation.. Physical Therapy for Children 2012;pp. 151–174.
  40. Janura M, Peham C, Dvorakova T, Elfmark M. An assessment of the pressure distribution exerted by a rider on the back of a horse during hippotherapy.. Human Mov Sci 2009;28(3):387–393.
    doi: 10.1016/j.humov.2009.04.001pubmed: 19406498google scholar: lookup
  41. Pavao SL, dos Santos Silva FP, Savelsbergh GJ, Rocha NC. Use of sensory information during postural control in children with cerebral palsy: systemic review.. J Mot Behav 2015;47(4):291–299.
    doi: 10.1080/00222895.2014.981498pubmed: 25514677google scholar: lookup
  42. Fleck CA. Hippotherapy: Mechanics of Human Walking and Horseback Riding. Barbara Engel Therapy Services 1997;pp. 153–176.
  43. HPOT Repository. https://github.com/pilwonhur/HPOT.

Citations

This article has been cited 3 times.
  1. Visser EK, Jens AL, Nieuwe Weme LE, Spaapen AA, Maarleveld KN, Enzerink KH, Tromp PN, Haven-Pross SC. Assessing Equine Behavioural Responses in Equine-Assisted Services: A Field Study Analysis. Animals (Basel) 2025 Feb 25;15(5).
    doi: 10.3390/ani15050671pubmed: 40075954google scholar: lookup
  2. 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.
    doi: 10.1007/s00221-023-06744-0pubmed: 38015245google scholar: lookup
  3. Kocyigit BF, Adilbekov E, Zharmenov S, Akyol A, Yessirkepov M. Evaluating the efficacy of hippotherapy: a promising intervention in rheumatology, pain medicine, and geriatrics. Rheumatol Int 2023 Dec;43(12):2185-2191.
    doi: 10.1007/s00296-023-05451-xpubmed: 37700080google scholar: lookup
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