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Does Hippotherapy Improve the Functions in Children with Cerebral Palsy? Systematic Review Based on the International
Eric Pantera1,2, Priscilla Froment3, Didier Vernay4
1Department of Physical Medicine and Rehabilitation, University Rehabilitation Hospital Nimes University Hospital, Le Grau-du-Roi, France.
Insights
Hippotherapy, a form of equine-movement therapy, offers moderate evidence (Grade B) for improving motor function in children with cerebral palsy. This therapy is recommended based on scientific literature review.
Area of Science:
- Neurology
- Physical Therapy
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture.
- Hippotherapy utilizes equine movement for therapeutic interventions.
- Evidence-based practice necessitates systematic reviews for therapeutic modalities.
Purpose of the Study:
- To systematically review the scientific evidence for hippotherapy in children with cerebral palsy.
- To grade the evidence according to French Haute Autorité de Santé (HAS) recommendations.
- To align findings with the International Classification of Functioning (ICF).
Main Methods:
- Systematic literature search of MEDLINE and Cochrane Library databases.
- Keywords included "Equestrian therapy," "Hippotherapy," and "Equine-movement therapy."
- Methodological quality assessed using levels of proof and guideline grades (A-C).
Main Results:
- Seven randomized controlled studies and one systematic review provided Grade B evidence (moderate proof).
- Improvements observed in motor function, muscle contraction symmetry, spasticity, posture, and walking.
- Fifty non-randomized studies (Grade C) supported benefits in balance, coordination, and functional development.
Conclusions:
- Hippotherapy is recommended for children with cerebral palsy.
- The overall level of evidence supporting hippotherapy in this population is moderate (Grade B).
- Further research may strengthen evidence for specific functional outcomes.
Abstract:
Objective: To perform a systematic review of the literature regarding scientific reality of hippotherapy in children with cerebral palsy graded according to France HAS (Haute Autorité de Santé) recommendations and applied to the International Classification of Functioning. Methods: The research in MEDLINE and Cochrane Library databases was performed using the keywords: "Equestrian therapy," "Riding for the disabled," "Hippotherapy," "Equine-movement therapy," and "Therapeutic horse (back) riding." The methodological quality of the articles was assessed using four levels of proof and three guideline grades (A: strong; B: moderate; C: poor). Results: Seven prospective, randomized controlled studies and one systematic review confirm the level of proof of hippotherapy in children with cerebral palsy with grade B. Hippotherapy in children with cerebral palsy contributes to improve motor function, symmetry of muscle contraction, spasticity, posture, and walking. Fifty prospective no randomized studies confirm the level with grade C for balance, motor coordination, lumbopelvic mobility, walking speed, functional development, and social behavior. Conclusions: Hippotherapy in children with cerebral palsy can be recommended. Regarding the literature data, the level of proof of hippotherapy in children with cerebral palsy is moderate (grade B).
