Benda, McGibbon and Grant (2003) performed a study that took fifteen children with spastic cerebral palsy and tested muscle symmetry before and after either participating in eight minutes of hippotherapy or sitting astride a stationary barrel for eight minutes. Their study concluded that significant improvement in the most affected muscles groups was noted for the children who participated in the Hippotherapy but not for the children who simply stretched over a barrel.
Improvements in Muscle Symmetry in Children with Cerebral Palsy after Equine-Assisted Therapy (Hippotherapy). The Journal of Alternative and Complementary Medicine 9(6):817-825.

Bertoti (1988) performed a study in which eleven children with moderate to severe spastic cerebral palsy were evaluated for improvement in posture over a period of ten weeks of no riding. No significant improvements were found. The study then evaluated these same children after a period of ten weeks of therapeutic riding where they demonstrated significant improvement in posture. Subjective clinical improvements in quality of muscle tone, balance and weight bearing abilities were also noted.
Effect of Therapeutic Horseback Riding on Posture in Children with Cerebral Palsy. Physical Therapy 68(10):1505-1512.

Casady, R.L. & Nichols-Larsen, D.S, (2004). The Effect of Hippotherapy on Ten Children with Cerebral Palsy. Pediatric Physical Therapy, 16, 165-172. This study evaluated the effect of hippotherapy on the general functional development of children with cerebral palsy. Subjects were evaluated prior to therapy and then after ten consecutive weeks of therapy. Subjects demonstrated statistically significant improvements between pre and post testing. The report states that “Hippotherapy appears to be a viable treatment strategy for therapists with experience and training in this form of treatment and a means of improving functional outcomes in children with cerebral palsy…”

Cherng, Liao, Leung and Hwang (2004) in their study concluded that children with spastic cerebral palsy who participated in a sixteen-week session of therapeutic riding while also receiving traditional therapy treatment demonstrated significant improvements in gross motor function over those children who only received traditional therapy treatment over the same period of time. In addition, the children who participated in therapeutic riding also sustained the improvements for a minimum of sixteen weeks.
The Effectiveness of Therapeutic Horseback Riding in Children with Spastic Cerebral Palsy. Adapted Physical Activity Quarterly 21:103-121.

Engsberg, J.R., Shurtleff, T.L., & Standeven, J.W., (2009). Changes in Dynamic Trunk/Head Stability and Functional Reach After Hippotherapy. Archives of Physical Medicine and Rehabilitation, 90, 1185-1195. This study objectively evaluated the efficacy of hippotherapy in improving head/trunk stability and functional reaching in children with spastic diplegia cerebral palsy. Subjects were evaluated prior to therapy, after twelve consecutive weeks of therapy and then again after twelve weeks of no therapy. Subjects demonstrated statistically significant improvements in head/trunk stability and functional reach and these improvements persisted for at least three months after therapy ceased.

In a study by McGibbon, Andrade, Widener, and Cintas (1998), they found that children with spastic cerebral palsy who participated in eight weeks of hippotherapy demonstrated a significant decrease in energy expenditure during ambulation and a significant increase in gross motor function.
Effect of an Equine Movement Therapy Program on Gait, Energy Expenditure, and Motor Function in Children with Spastic Cerebral Palsy: A Pilot Study. Developmental Medicine and Child Neurology,40:754-762.

Keren, Reznik and Groswasser (2001) completed a case study on a twenty-two year old male who suffered a severe traumatic brain injury resulting in impairments of motor control, communication, cognition and social behavior. His comprehensive treatment included use of orthoses, biofeedback, aquatic therapy, hippotherapy, medication and nerve blocking. After three years he can stand up and walk unaided, drink soup, play a few notes on the piano and cognitive improvements were noted.
Combined Motor Disturbances following Severe Traumatic Brain Injury: An Integrative Long-Term Treatment Approach. Brain Injury 15(7):633-638.

Liberatore (2005) performed an exploratory analysis of adult hippotherapy clients and parents/guardians of pediatric hippotherapy clients in order to better understand the rationale behind this alternative therapy. She discovered that for some clients “undeniable, visible improvements in their medical conditions” were achieved. For other clients whose progress was slow even with more traditional therapy, she noted that clients did not view this type of therapy as therapy and believed it offered a motivation that rivaled more traditional therapy.
Rationale of Hippotherapy Use among Equine Facilitated Therapy Participants. Journal of Undergraduate Research 7(2):1-7.

Lynn Wingate (1981) completed a study on a pilot program she developed for seven children with various types of cerebral palsy. This program provided two hours per week of therapeutic riding for five weeks in addition to a parent support group. At the end of the program more than half of the family members reported observations of improvement in “posture, less falling when walking, improved sitting posture, (improved ADL’s), improved head control, some decrease in lower extremity hypertonus, and improved gait.”
Feasibility of Horseback Riding as a Therapeutic and Integrative Program for Handicapped Children. Physical Therapy 62(2):184-186.

Myra Haskin, M.D., Jennifer A. Bream, L.P.T. and William Erdman II, M.D. (1981) wrote a special report and completed a case study on a child with cerebral palsy who was receiving services at the Thorncroft Equestrian Complex located at The University of Pennsylvania Physical Medicine Department. This facility has provided hippotherapy services since 1971. Therapists incorporated the treatment principles of Rood, Bobath (NDT) and proprioceptive neuromuscular facilitation (PNF). The case study looked at a child with cerebral palsy who had been receiving hippotherapy weekly from age two to her current age of five. Hippotherapy was part of an integrated therapy program including aquatic therapy, speech therapy and traditional physical therapy. They found that “improvements as a result of this program have been back and neck strengthening; the patient is able to sit up longer, has better balance, and less spasticity in the lower extremities.” She also enjoyed her therapy sessions and went on to compete in horse shows.
The Pennsylvania Horseback Riding Program for Cerebral Palsy. American Journal of Physical Medicine 61(3); 141-144.

Quint and Toomey (1998) used a matched pair design research study in which they took thirteen children with cerebral palsy and subjected them to a total of 100 minutes of passive pelvic antero-posterior tilt and another thirteen children with cerebral palsy and sat them for the same time astride a static saddle. Results demonstrated a significant improvement in pelvic mobility for those children that were subjected to the movement of a horse at walk.
An Investigation in the Effects on Pelvic Mobility of Children with Cerebral Palsy of a Powered Saddle which Imitates the Movements of a Walking Horse. Physiotherapy 84(8):376-384.
Silkwood-Sherer D & Warmbier H. (2007). Effects of Hippotherapy on Postural Stability In Persons with Multiple Sclerosis. Journal of Neurologic Physical Therapy, 31(2): 77-84. PURPOSE: The purpose of this pilot study was to examine the effectiveness of hippotherapy as an intervention for the treatment of postural instability in individuals with multiple sclerosis (MS). SUBJECTS: A sample of convenience of 15 individuals with MS (24-72 years) were recruited from support groups and assessed for balance deficits. METHODS: This study was a nonequivalent pretest-posttest comparison group design. Nine individuals (4 males, 5 females) received weekly hippotherapy intervention for 14 weeks. The other 6 individuals (2 males, 4 females) served as a comparison group. All participants were assessed with the Berg Balance Scale (BBS) and Tinetti Performance Oriented Mobility Assessment (POMA) at 0, 7, and 14 weeks. RESULTS: The group receiving hippotherapy showed statistically significant improvement from pretest (0 week) to posttest (14 week) on the BBS (mean increase 9.15 points (x (2) = 8.82, p = 0.012)) and POMA scores (mean increase 5.13 (x (2) = 10.38, p = 0.006)). The comparison group had no significant changes on the BBS (mean increase 0.73 (x (2) = 0.40, p = 0.819)) or POMA (mean decrease 0.13 (x (2) = 1.41, p = 0.494)). A statistically significant difference was also found between the groups’ final BBS scores (treatment group median = 55.0, comparison group median 41.0), U = 7, r = -0.49. DISCUSSION: Hippotherapy shows promise for the treatment of balance disorders in persons with MS. Further research is needed to refine protocols and selection criteria.

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