Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of hippotherapy on children with cerebral palsy: systematic review and meta-analysis

  • Kim, Kwon-Hoi (Team of Physical Therapy, Catholic University of Korea, Uijeongbu ST. Mary's Hospital) ;
  • Lee, Suk-Min (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2019.11.25
  • Accepted : 2020.03.11
  • Published : 2020.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The most important goal of hippotherapy is to improve function, gait, and balance. The purpose of this study was to investigate the effects of hippotherapy on function, gait, and balance of children with cerebral palsy (CP). Design: A systematic review and meta-analysis. Methods: We've searched the PubMed, EMBASE, and Cochrane Library CENTRAL databases for English experimental studies published up until September 2018. To analyze the effects of hippotherapy on the function, gait, and balance of children with cerebral palsy, the systematic review and meta-analysis were performed on Patient/Participants/Population Problem, Intervention, Comparison, Outcome with Timing, Setting Study Design. Papers retrieved from the database were removed from the literature management database. Methodological quality evaluation was evaluated using Cochrane's risk of bias. Data was analyzed using the Revman 5.3 program of the Cochrane library. Results: In this study, we found that the effect size of hippotherapy, denoted as d, was -3.82, and that hippotherapy had the most effect on gait, but no statistical significant difference was observed. We also found no significant difference in function and balance after hippotherapy. It was found from the funnel plot that there was no publication bias as the plot was symmetrically distributed around the dotted line. Conclusions: There are many unclear studies and a lack of randomized controlled trials (RCTs) in this research area. More RCTs on the effects of hippotherapy on children with CP should be conducted in the future.

Keywords

References

  1. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
  2. Stanley F, Blair E, Alberman E. Cerebral palsies: epidemiology and causal pathways. London: Cambridge University Press; 2000.
  3. Krejci E, Janura M, Svoboda Z. The benefit of hippotherapy for improvement of attention and memory in children with cerebral palsy: a pilot study. Acta Gymnica 2015;45:27-32. https://doi.org/10.5507/ag.2015.004
  4. Pavao SL, Nunes GS, Santos AN, Rocha NA. Relationship between static postural control and the level of functional abilities in children with cerebral palsy. Braz J Phys Ther 2014;18:300-7. https://doi.org/10.1590/bjpt-rbf.2014.0056
  5. Liptak GS. Complementary and alternative therapies for cerebral palsy. Ment Retard Dev Disabil Res Rev 2005;11:156-63. https://doi.org/10.1002/mrdd.20066
  6. Frank A, McCloskey S, Dole RL. Effect of hippotherapy on perceived self-competence and participation in a child with cerebral palsy. Pediatr Phys Ther 2011;23:301-8. https://doi.org/10.1097/PEP.0b013e318227caac
  7. Ketelaar M, Vermeer A, Hart H, van Petegem-van Beek E, Helders PJ. Effects of a functional therapy program on motor abilities of children with cerebral palsy. Phys Ther 2001;81:1534-45. https://doi.org/10.1093/ptj/81.9.1534
  8. Yeo SM, Lee JY, Shin HY, Seo YS, Kwon JY. Factors influencing motor outcome of hippotherapy in children with cerebral palsy. Neuropediatrics 2019;50:170-7. https://doi.org/10.1055/s-0039-1685526
  9. Stergiou A, Tzoufi M, Ntzani E, Varvarousis D, Beris A, Ploumis A. Therapeutic effects of horseback riding interventions: a systematic review and meta-analysis. Am J Phys Med Rehabil 2017;96:717-25. https://doi.org/10.1097/PHM.0000000000000726
  10. Hamill D, Washington KA, White OR. The effect of hippotherapy on postural control in sitting for children with cerebral palsy. Phys Occup Ther Pediatr 2007;27:23-42. https://doi.org/10.1080/J006v27n04_03
  11. Franjoine MR, Gunther JS, Taylor MJ. Pediatric balance scale: a modified version of the berg balance scale for the school-age child with mild to moderate motor impairment. Pediatr Phys Ther 2003;15:114-28. https://doi.org/10.1097/01.PEP.0000068117.48023.18
  12. 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. Hum Mov Sci 2009;28:387-93. https://doi.org/10.1016/j.humov.2009.04.001
  13. RDA-Samsung. Riding for the disabled. Gunpo: SAMSUNG Equestrian Team; 2002.
  14. Zadnikar M, Kastrin A. Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: a meta-analysis. Dev Med Child Neurol 2011;53:684-91. https://doi.org/10.1111/j.1469-8749.2011.03951.x
  15. Martin-Valero R, Vega-Ballon J, Perez-Cabezas V. Benefits of hippotherapy in children with cerebral palsy: a narrative review. Eur J Paediatr Neurol 2018;22:1150-60. https://doi.org/10.1016/j.ejpn.2018.07.002
  16. Shin WJ. An introduction of the systematic review and metaanalysis. Hanyang Med Rev 2015;35:9-17. https://doi.org/10.7599/hmr.2015.35.1.9
  17. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. Chichester: Wiley-Blackwell; 2008. p.266-78.
  18. Oh SS. Meta-analysis : theory and practice. Seoul: Konkuk University Press; 2002. p. 185-89.
  19. Ando T, Takagi H, Briasoulis A, Grines CL, Afonso L. Comparison of health related quality of life in transcatheter versus surgical aortic valve replacement: a meta-analysis. Heart Lung Circ 2019;28:1235-45. https://doi.org/10.1016/j.hlc.2018.07.013
  20. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315:629-34. https://doi.org/10.1136/bmj.315.7109.629
  21. Park WJ, Park SJ, Hwang SD. Effects of Cognitive Behavioral Therapy on attention deficit hyperactivity disorder among schoolaged children in Korea: a meta-analysis. J Korean Acad Nurs 2015;45:169-82. https://doi.org/10.4040/jkan.2015.45.2.169
  22. Champagne D, Corriveau H, Dugas C. Effect of hippotherapy on motor proficiency and function in children with cerebral palsy who walk. Phys Occup Ther Pediatr 2017;37:51-63. https://doi.org/10.3109/01942638.2015.1129386
  23. McGibbon NH, Benda W, Duncan BR, Silkwood-Sherer D. Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy. Arch Phys Med Rehabil 2009;90:966-74. https://doi.org/10.1016/j.apmr.2009.01.011
  24. Silkwood-Sherer DJ, Killian CB, Long TM, Martin KS. Hippotherapy--an intervention to habilitate balance deficits in children with movement disorders: a clinical trial. Phys Ther 2012;92:707-17. https://doi.org/10.2522/ptj.20110081
  25. Mutoh T, Mutoh T, Tsubone H, Takada M, Doumura M, Ihara M, et al. Impact of serial gait analyses on long-term outcome of hippotherapy in children and adolescents with cerebral palsy. Complement Ther Clin Pract 2018;30:19-23. https://doi.org/10.1016/j.ctcp.2017.11.003
  26. Casady RL, Nichols-Larsen DS. The effect of hippotherapy on ten children with cerebral palsy. Pediatr Phys Ther 2004;16:165-72. https://doi.org/10.1097/01.PEP.0000136003.15233.0C
  27. Davis E, Davies B, Wolfe R, Raadsveld R, Heine B, Thomason P, et al. A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsy. Dev Med Child Neurol 2009;51:111-9. https://doi.org/10.1111/j.1469-8749.2008.03245.x
  28. McGee MC, Reese NB. Immediate effects of a hippotherapy session on gait parameters in children with spastic cerebral palsy. Pediatr Phys Ther 2009;21:212-8. https://doi.org/10.1097/PEP.0b013e3181a39532
  29. McGibbon NH, Andrade CK, Widener G, Cintas HL. Effect of an equine-movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy: a pilot study. Dev Med Child Neurol 1998;40:754-62. https://doi.org/10.1111/j.1469-8749.1998.tb12344.x
  30. Kwon JY, Chang HJ, Yi SH, Lee JY, Shin HY, Kim YH. Effect of hippotherapy on gross motor function in children with cerebral palsy: a randomized controlled trial. J Altern Complement Med 2015;21:15-21. https://doi.org/10.1089/acm.2014.0021
  31. Cherng RJ, Liao HF, Leung HWC, Hwang AW. The effectiveness of therapeutic horseback riding in children with spastic cerebral palsy. Adapt Phys Activ Q 2004;21:103-21. https://doi.org/10.1123/apaq.21.2.103
  32. Kang H, Jung J, Yu J. Effects of hippotherapy on the sitting balance of children with cerebral palsy: a randomized control trial. J Phys Ther Sci 2012;24:833-6. https://doi.org/10.1589/jpts.24.833
  33. Herrero P, Gomez-Trullen EM, Asensio A, Garcia E, Casas R, Monserrat E, et al. Study of the therapeutic effects of a hippotherapy simulator in children with cerebral palsy: a stratified single-blind randomized controlled trial. Clin Rehabil 2012;26:1105-13. https://doi.org/10.1177/0269215512444633
  34. Berman NG, Parker RA. Meta-analysis: neither quick nor easy. BMC Med Res Methodol 2002;2:10. https://doi.org/10.1186/1471-2288-2-10
  35. Lucena-Anton D, Rosety-Rodriguez I, Moral-Munoz JA. Effects of a hippotherapy intervention on muscle spasticity in children with cerebral palsy: a randomized controlled trial. Complement Ther Clin Pract 2018;31:188-92. https://doi.org/10.1016/j.ctcp.2018.02.013
  36. El-Meniawy GH, Thabet NS. Modulation of back geometry in children with spasticdiplegic cerebral palsy via hippotherapy training. Egypt J Med Hum Genet 2012;13:63-71. https://doi.org/10.1016/j.ejmhg.2011.10.004
  37. Kwon JY, Chang HJ, Lee JY, Ha Y, Lee PK, Kim YH. Effects of hippotherapy on gait parameters in children with bilateral spastic cerebral palsy. Arch Phys Med Rehabil 2011;92:774-9. https://doi.org/10.1016/j.apmr.2010.11.031
  38. Park ES, Rha DW, Shin JS, Kim S, Jung S. Effects of hippotherapy on gross motor function and functional performance of children with cerebral palsy. Yonsei Med J 2014;55:1736-42. https://doi.org/10.3349/ymj.2014.55.6.1736
  39. 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;9:817-25. https://doi.org/10.1089/107555303771952163
  40. Deutz U, Heussen N, Weigt-Usinger K, Leiz S, Raabe C, Polster T, et al. Impact of hippotherapy on gross motor function and quality of life in children with bilateral cerebral palsy: a randomized open-label crossover study. Neuropediatrics 2018;49:185-92. https://doi.org/10.1055/s-0038-1635121

Cited by

  1. Equine‐assisted activities and therapies in children with attention‐deficit/hyperactivity disorder: A systematic review vol.28, pp.6, 2020, https://doi.org/10.1111/jpm.12710