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Updated: Nov 28, 2025

Measuring Cardiac Autonomic Nervous System ANS Activity in Children
Published on: April 29, 2013
Effect of Equine-Assisted Activities on Cardiac Autonomic Function in Children with Cerebral Palsy: A Pilot
In-Kyeong Park1, Ji Young Lee2, Min-Hwa Suk3
1Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea.
Insights
Equine-assisted activity improved cardiac autonomic function in children with cerebral palsy (CP). The 16-week program enhanced heart rate recovery (HRR) and reduced resting heart rate (RHR), suggesting benefits for cardiovascular health in CP patients.
Area of Science:
- Pediatric Cardiology
- Neurorehabilitation
- Exercise Physiology
Background:
- Children with cerebral palsy (CP) often exhibit impaired cardiac autonomic function, indicated by reduced heart rate recovery (HRR).
- Poor HRR is a prognostic marker linked to increased cardiovascular risks and mortality.
- Limited research exists on exercise interventions for improving cardiac autonomic function in pediatric CP populations.
Purpose of the Study:
- To investigate the impact of a 16-week equine-assisted activity (EAA) program on cardiac autonomic function in children with CP.
- To assess changes in heart rate recovery (HRR), resting heart rate (RHR), and peak oxygen uptake (VO2peak) following EAA.
Main Methods:
- A single-blinded, parallel, two-arm pilot randomized controlled trial involving 26 children with CP (GMFCS Levels I-II).
- Participants were randomized to either an EAA group or a control group.
- Intervention involved 40-minute EAA sessions twice weekly for 16 weeks, with assessments before and after.
Main Results:
- The EAA group showed significant improvements in HRR at 1, 3, and 5 minutes post-exercise (p < 0.009, p < 0.001, p < 0.004, respectively).
- Resting heart rate (RHR) significantly decreased in the EAA group (p < 0.013).
- No significant difference in peak oxygen uptake (VO2peak) was observed between the groups.
Conclusions:
- A 16-week equine-assisted activity program positively impacts cardiac autonomic function in children with CP.
- EAA can improve heart rate recovery and reduce resting heart rate in this population.
- Further research is warranted to explore the long-term cardiovascular benefits of EAA in children with CP.
Abstract:
Children with cerebral palsy (CP) have an impaired cardiac autonomic function. Attenuated heart rate recovery (HRR), which is a valuable prognostic parameter for autonomic nervous system, is known to be associated with an increased risk of cardiovascular events and all-cause mortality. However, only few studies have observed the effects of exercise on the cardiac autonomic function in children with CP. The purpose of this pilot study was to examine the effects of equine-assisted activity (EAA) program on cardiac autonomic function in children with CP. A single-blinded, parallel, two-arm pilot trial with 1:1 randomization to the EAA or control group. A tertiary university hospital and a local arena. Twenty-six children with CP (Gross Motor Function Classification System Levels I-II). Each lesson of the EAA program for the EAA group was conducted for 40 min twice a week, and the whole program duration was 16 weeks (a total of 32 sessions). A graded exercise test was performed to measure the resting heart rate (RHR), HRR, and peak oxygen uptake (VO2peak) on both groups before and after the 16-week period. The autonomic nervous function measured by the response of HRR improved at 1 min (p < 0.009), 3 min (p < 0.001), and 5 min (p < 0.004) only in the EAA group. RHR significantly improved in the EAA group (p < 0.013), whereas the VO2peak did not significantly differ between the two groups. The HRR and RHR of the children with CP improved after completing the 16-week EAA program. The results demonstrated that the program had a positive effect on the improvement of cardiac autonomic function in these patients. Clinical Trial Registration Number: NCT03870893.
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