Horse Riding as Therapy Shows Promise in Improving Postural Balance in Kids with Cerebral Palsy

Hippotherapy, based on the use of horse riding as a therapeutic or rehabilitative treatment, can improve postural balance in the sitting position, dynamic balance, and functionality in children with cerebral palsy,  according to a study by researchers in Brazil.

The study, “The effects of hippotherapy on postural balance and functional ability in children with cerebral palsy,” was published in the Journal of Physical Therapy Science.

Children with cerebral palsy have certain muscles excessively active in the body’s attempt to compensate for the instability caused by muscle weakness associated with the disease. However, this compensation mechanism may lead to muscle imbalance, increased hypertonia (an abnormal increase in muscle tension), and abnormalities that interfere with postural balance, which is important in developing complex motor skills. Postural imbalance can impact functional activities and limit the child’s participation in several activities.

The study’s aim was to investigate whether hippotherapy would have a beneficial effect on parameters such as the seated postural balance, dynamic balance, and functional performance in children with cerebral palsy.

It included 15 children with cerebral palsy, ages 5 to 10. Hippotherapy was performed for 30 minutes, twice a week, and researchers evaluated the evolution of the patients after 12 and 24 sessions of the treatment.

The postural balance in a sitting position was assessed using an AMTI AccuSway Plus force platform, both one week before and 12 and 24 sessions after the beginning of the treatment. The Berg Balance Scale (BBS) and Pediatric Evaluation of Disability Inventory (PEDI) were also used before and after the sessions.

“Significant differences were observed for center of pressure (COP) variables, including medio-lateral (COPml), anteroposterior displacement (COPap), and velocity of displacement (VelCOP), particularly after 24 sessions,” the authors wrote in their report.

“Our study observed improvement in all areas, including self-care, mobility, and social function, thus allowing the children to efficiently perform daily living activities related to actions such as object handling, eating, hygiene, locomotion, and social interaction.”

According to the authors, the rhythmic and repetitive movements of the horse promotes straightening-up reactions and postural balance by requiring continuous adjustment from the rider’s body in a changing environment. The exercise also increases the awareness of the weight of the body, body alignment, and center of gravity in the children.

The small number of patients and the absence of a control group limited the study, but the team believes their results support the use of hippotherapy to improve postural balance in children with cerebral palsy.