The Effect Of A Five-Week Hippotherapy Programme On Gait In A Child With Angelman's Syndrome. A Case Study Using The Wee Glasgow Gait Index (Weeggi)

Abstract

Background/Aims Hippotherapy is a treatment modality performed by a qualified physical, occupational or speech therapist, using equine movement to gain therapeutic outcome; hippotherapy has been shown to improve gross motor development, tone, spasticity, balance, coordination, range of movement and muscle length. Angelman Syndrome is a rare genetic condition that causes ataxia, poor coordination and balance, reduced mobility, high tone and learning difficulties. Research into hippotherapy in Angelman Syndrome is sparse; therefore, this case study aimed to investigate the effect of a 5-week hippotherapy intervention on gait in a child with Angelman Syndrome, using the Wee Glasgow Gait Index (WeeGGI) Measure. Methods One participant was recruited to the case study using convenience sampling. The equine was selected based on their conformation, temperament and suitability for hippotherapy. A 5-week programme of hippotherapy was delivered using one equine, one therapist, a leader and two side walkers. Each session ranged between 30 and 40 minutes. A full physiotherapy assessment and the WeeGGI outcome measure were completed at pre and post-intervention. Results On the WeeGGI measure, a reduction of five points was achieved on the left leg and a reduction of two points was achieved for the right leg. Furthermore, an improvement in range of movement and muscle length was observed into left hip abduction, bilateral hamstrings and bilateral gastrocnemius and soleus. In addition to these results, the child was noted to have improved balance reactions, concentration, core strength and acceptance of base of support towards the end of the intervention period. Conclusions This 5-week hippotherapy programme demonstrated improvement in gait pattern, range of movement and muscle length in a child with Angelman Syndrome. Additionally, the child was noted to improve in non-gait specific domains, such as balance and independent adjustment of position while mounted. These findings add to the evidence base for the use of hippotherapy in rarer genetic conditions and suggest that hippotherapy is an effective and feasible treatment modality for this population. However, this was a small sample size and therefore it would be beneficial for further research to be carried out on a larger scale in order to generalise these findings to the wider population.