Does hippotherapy improve motor function in children with cerebral palsy? Systematic review

Abstract

To perform a systematic review of the literature regarding hippotherapy in children with cerebral palsy. The research in Medline and Cochrane Library databases was performed using the keywords “Equestrian therapy”, “Riding for the disabled”, “Hippotherapy”, “Equine-movement therapy”, “Therapeutic horse (back) riding”. The methodological quality of the articles was assessed using four levels of evidence and three guideline grades (A: strong B: moderate C: poor). Six prospective randomized controlled studies confirm the level of evidence of hippotherapy and/or instructor-directed recreational horseback riding therapy (HBRT) in children with cerebral palsy with grade B. Hippotherapy and/or HBRT in children with cerebral palsy contributes to improve motor function, symmetry of muscle contraction, spasticity, posture and walking. Ten prospective no randomized studies confirm the level with grade C for balance, motor coordination, lumbo-pelvic flexibility, walking speed, and social behavior. The level of evidence of hippotherapy in children with cerebral palsy is moderate (no grade A studies and six grade B studies).