Hippotherapy on Gross Motor Function in a Child with Hypotonic Quadriplegic Cerebral Palsy: A 1-year Follow-up

Abstract

Hippotherapy is used to improve gross motor function in children with cerebral palsy (CP). However, the therapeutic effects of hippotherapy using specific position and its longitudinal improvements in children of hypotonic CP have not been thoroughly examined. A 6-year-old girl with hypotonic quadriplegic CP was noted to have generalized hypotonia and global delay in development before intervention. There was sustained improvement in gross motor function after 12-month hippotherapy. She received a 15-minute intervention twice a week for one year with two treatment positions being used, sitting backwards for the first 3 months and prone propped position for the next 9 months. Gross motor function was measured using Gross Motor Function Measure (GMFM-88), Gross Motor Function Classification System (GMFCS), and selected GMFM-88 items assessed on horseback (GMFM-h). The improvement was limited after initial 3-month hippotherapy with sitting backward; however, marked improvement was noted after replacing the sitting backwards program by prone propped position in the following courses. GMFM scores increased from 31.37% to 82.35% and from 0 to 25% in dimension A and B, respectively. GMFCS improved from Level V to Level IV and GMFM-h total scores also increased from 29.17% to 81.25% after the prone propped treatment. We suggested that hippotherapy might enhance gross motor performance and functional ability in hypotonic CP with appropriate treatment position.