Hippotherapy helped mobility of children with cerebral palsy in pilot study

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"The horse’s movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning."
“The horse’s movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning,” researchers say. File image by Fort George G. Meade

Physical therapy that incorporates equine movement can improve functional mobility in children with cerebral palsy, possibly because the walk of a horse mimics the human gait, the findings of fresh research suggest.

Priscilla Lightsey and her fellow researchers, reporting in the Journal of NeuroEngineering and Rehabilitation, set out in their pilot study to examine the kinematic outputs of horses and children when mounted, in a bid to better understand the effectiveness of this type of treatment.

Four children with cerebral palsy participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention.

Each 20-minute session consisted of 10 minutes of continuous riding and 10 minutes of riding with multiple go-stops. Inertial measurement unit sensors attached to the children and horses recorded movements and tracked acceleration, angular velocity and body orientation.

The study team looked for correlations between the vertical accelerations of children and horses. In addition, the peak frequencies of vertical accelerations of the children and horses were compared.

Two recognised tests were used to assess the children, with a particular focus on gait speed, as it is a key indicator of performance in people with neurological disorders.

The Timed Up and Go Test measures the time it takes a child to stand up from a chair, walk three meters, turn around, walk back to the chair, and sit down. It was employed because it is a commonly used measure to test dynamic and functional balance.

The study team looked for correlations between the vertical accelerations of children and horses.
The study team looked for correlations between the vertical accelerations of children and horses. File photo by Talisman Therapeutic Riding

The 10 Meter Walk Test measures the time it takes a person to walk at a comfortable speed from markers at 2 meters and 8 meters within a designated 10 meter pathway.

The children performed the tests before and after hippotherapy sessions on days 1, 4 and 8, for a total of six tests per participant.

The researchers found that the children’s results in the functional tests modestly improved over time. Further, they found that the children’s movements increasingly synchronized over time to the vertical movement of the horse’s walk.

“The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse’s movement,” they said.

“Since the horse’s gait at a walk mimics the human gait this type of treatment may provide individuals with cerebral palsy, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern.

“The horse’s movement at the walk is 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.”

Discussing their findings, the researchers said children with cerebral palsy often have impairments in sensory processing.

“During hippotherapy, the participant is experiencing multiple impulses per minute and reacting to such movements. This offers cognitive, limbic, and physical stimulation, as well as visual, vestibular, and the somatosensory system. Combined, these concentrated stimuli to the participant may facilitate development of new movement strategies in a way not offered in a more traditional physical therapy session.”

They said the cyclical and repetitive movements of the horse provide numerous opportunities for practice of postural adjustments.

“Maintaining postural control while simultaneously moving through space and adjusting perceptual skills, facilitates the refinement and exploration of new movement patterns, which in turn, enhances functional mobility.”

Their research, they said, may provide a useful baseline for future work.

The study team comprised Lightsey and Nancy Krenek, with the Ride On Center for Kids (ROCK) in Georgetown, Texas; and Yonghee Lee and Pilwon Hur, with Texas A&M University at College Station.

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

The study, published under a Creative Commons License, can be read here.

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