Gross Motor Function Measure Dimensions Research Articles

Robotic gait training in patients with cerebral palsy: a retrospective analysis

Objective: The present study sought to retrospectively evaluate the efficacy of robotic gait training in children with cerebral palsy (CP) gross motor function classification system (GMFCS) levels II, III and IV. Method: The medical records from 69 patients with CP, who participated in the Lokomat® protocol, were analyzed using a retrospective approach. The results from the Gross Motor Function Measure (GMFM), 6-minute walk test (6MinWT), 10-meter walk test (10MWT) and Timed Up and Go (TUG) test were analyzed before and after the protocol was administered. Results: An improvement in GMFM was observed for all GMFCS levels. GMFCS level III patients showed a significant improvement in the 6MinWT (p= 0.01), and GMFCS level IV patients displayed a significant improvement in GMFM dimension B (p= 0.03). All tests showed a significant improvement when compared to their performance before the application of the protocol. Conclusion: The study suggests that all patients diagnosed with CP benefit from gait training, using the Lokomat® system, within their expected motor frame.

The Effect of a Horse-Riding Simulator with Virtual Reality on Gross Motor Function and Body Composition of Children with Cerebral Palsy: Preliminary Study.

This study aimed to evaluate the effect of a horse-riding simulator (HRS) with virtual reality (VR) on gross motor function, balance control, and body composition in children with spastic cerebral palsy (CP). Seventeen preschool and school-aged children with spastic CP were included; 10 children in the intervention group (HRS group) received 30 min of HRS with VR training twice a week for a total of 16 sessions in addition to conventional physiotherapy. Seven children in the control group were instructed to perform home-based aerobic exercises twice a week for 8 weeks in addition to conventional physiotherapy. Gross motor function measure (GMFM) and body composition were evaluated before the first session and after the last session. Before and after the 2-month intervention, Pediatric Balance Scale and Timed Up and Go test were evaluated for the HRS group. GMFM scores and body composition changed significantly in the HRS group (p < 0.05). However, no significant differences were observed in the control group. Changes in the GMFM total scores, GMFM dimension D scores, and skeletal muscle mass significantly differed between the HRS and control groups (p < 0.05). HRS with VR may be an effective adjunctive therapeutic approach for the rehabilitation of children with CP.

Baseline Gross Motor Function Affects the Outcome of Robot-Assisted Therapy in Ambulatory Individuals with Spastic Cerebral Palsy.

Robotic-assisted therapy (RAT) is a task-specific approach for treating gait disorders in individuals with neurological impairments. However, the effectiveness of RAT is not clear for different severities of involvement, pathologies, and ages. This study aimed to assess the functional and clinical status outcomes after RAT in individuals with cerebral palsy (CP). Twenty-eight individuals with bilateral spastic CP were enrolled (female = 10; male = 18; age = 15.2 ± 2.0 years). The RAT program consisted of 30 sessions: five sessions weekly for six weeks. Gross Motor Function Measure (GMFM) and clinical physical examinations were evaluated before and after RAT. Our results suggested that the RAT program with the described protocol can improve the general gross motor functions of individuals with CP in Gross Motor Function Classification System (GMFCS) levels I and II, and primarily improves performance on less complex GMFM items for those in GMFCS levels III and IV. The lower baseline functional level was related to a greater functional improvement. Older individuals were noticed to improve more in GMFM dimension D. Regarding impairments evaluated by clinical examinations, no change was found after RAT intervention. It is worth mentioning that the strength of knee muscles was not affected either.

To what extent are body structure and gait parameters related with gross motor function in children with Cerebral Palsy?

To systematically review the effectiveness of neuromuscular electrical stimulation (NMES) as an adjuvant therapy to improve gross motor function in children with spastic cerebral palsy.MEDLINE, EMBASE, Cochrane CENTRAL, PEDro and Scopus were searched. We included randomized controlled trials examining the effects of NMES combined with other therapies on gross motor function as assessed by the Gross Motor Function Measure (GMFM) and its functional dimensions. Two reviewers independently screened, extracted data, assessed the risk of bias (PEDro) and quality of the evidence (GRADE).Six randomized controlled trials (pooled n = 174) were included in the meta-analysis. NMES combined with other therapies presented medium effect size to improve gross motor function in children with cerebral palsy in comparison with conventional physical therapy or neurodevelopmental therapy. Our sensitivity analysis showed that NMES combined with other therapies was effective to improve GMFM-sitting and standing dimensions but not GMFM-walking dimension.Low-quality evidence suggests that NMES may be used as adjuvant therapy to improve sitting and standing dimensions of GMFM in children with spastic cerebral palsy.

Effects of virtual reality in body oscillation and motor performance of children with cerebral palsy: A preliminary randomized controlled clinical trial

Background and purposeVirtual reality is an adjuvant technique to rehabilitation of children with cerebral palsy (CP). It has been gaining prominence in this field because of its accessibility and great levels of motivation it promotes in treatment. However, there is a lack of studies addressing the effects of virtual reality-based therapy on activity levels regarding postural stability, especially considering the level of evidence presented by studies addressing this issue. Therefore, we aim to evaluate the effects of intervention in body sway and gross motor function of children with CP using an active video game. Materials and methodsIn this blind randomized controlled trial, fifteen children with CP, Gross Motor Function Classification System (GMFCS) I-II, regularly attending conventional physical therapy programs, were randomly assigned to an intervention (IG:n = 7) or to a control group (CG:n = 8). In both groups, children remained attending conventional therapy. In addition, IG underwent intervention using an active video game twice a week for 45 min and eight weeks. Standing body sway was assessed using a force plate, and Gross Motor Function Measure (GMFM) dimensions D (Standing) and E (Walking, Running and Jumping) were tested. ResultsFollowing the virtual reality-based intervention, the IG only showed significant improvements in the GMFM dimensions D (p = 0.021) and E (p = 0.008). Improvements were clinically significant (D = 10.8%; E = 14.0%). For the CG, no variable analyzed showed differences after eight weeks. ConclusionsIntervention using an active video game is a promising tool that can improve the gross motor function of children with CP, GMFCS I-II.

Effects of Hippotherapy on Functional Ability for The Children with Cerebral Palsy

The purpose of this study was to effects of hippotherapy on functional ability of children with cerebral palsy (CP). Fifty-seven children with CP participated were randomly divided into two groups. All of the groups received thirty minutes of conventional physical therapy program for three times a week per twelve weeks, however experimental group received additional fifteen minutes of the hippotherapy. Gross Motor Function Measure(GMFM) was used to compare the effects of hippotherapy. The results were as followings: GMFM score in dimensions A and B significantly increased in the control group after intervention. All dimensions of GMFM was significantly increased in experimental group after intervention. All dimensions of GMFM were significantly different between experimental group and control group. These results suggest that hippotherapy can be considered as a therapeutic method for physical therapy for the children with CP to improve the functional movements.

Comparative analysis of curative effect of bone marrow mesenchymal stem cell and bone marrow mononuclear cell transplantation for spastic cerebral palsy

BackgroundBone marrow mesenchymal stem cells (BMMSCs) and bone marrow mononuclear cells (BMMNCs) are both used to treat spastic cerebral palsy. However, the differences in therapeutic effect remain unknown.MethodsA total of 105 patients with spastic cerebral palsy were enrolled and randomly assigned to three groups: the BMMSC group, the BMMNC group and the control group. Patients in both transplantation groups received four intrathecal cell injections. Patients in the control group received Bobath therapy. The gross motor function measure (GMFM) and the fine motor function measure (FMFM) were used to evaluate the therapeutic efficacy before transplantation and 3, 6, and 12 months after transplantation.ResultsThree months after cell transplantation, scores in the A dimension of GMFM and the A and C dimensions of FMFM scores in the BMMSC group are all higher than those of the BMMNC and the control groups (P < 0.05). Six months after cell transplantation, scores in the A, B dimensions of GMFM and the A, B, C, D, and E dimensions of FMFM scores in the BMMSC group are higher than those of the BMMNC and the control groups (P < 0.05). Twelve months after cell transplantation, scores in the A, B, and C dimensions of GMFM and the A, B, C, D, and E dimensions of FMFM scores in the BMMSC group are all higher than those of the BMMNC and the control groups (P < 0.05). No obvious adverse effects were investigated during follow-up.ConclusionsBMMSC transplantation for the treatment of cerebral palsy is safe and feasible, and can improve gross motor and fine motor function significantly. In addition, compared with BMMNC, the motor function of children improved significantly in terms of gross motor and fine motor functions.

Clinical observation on scalp acupuncture for diffusion tensor imaging in cerebral palsy children with periventricular leukomalacia

To observe the effect of Governor Vessel-unblocking and mind-refreshing needling technique on diffusion tensor imaging (DTI) in cerebral palsy (CP) children with periventricular leukomalacia (PVL) and investigate the underlying mechanism. A total of 18 CP children with PVL received modern rehabilitation training and scalp acupuncture. The before-after study was conducted to compare the fractional anisotropy (FA) of the white matter fiber tracts, gross motor function measure (GMFM) score, Gesell developmental scale and changes in muscle tone. For the comparison before and after the first course of treatment, there were no statistical differences in DTI findings and FA values (both P>0.05); there were statistical differences in GMFM dimensions A and B (both P 0.05); and there were statistical differences in six items of Gesell development test (P 0.05); and there were statistical differences in six items of Gesell developmental test between before, after 30 and 60 treatments and between 30 and 60 treatments (P<0.05 or P<0.01). The Governor Vessel-unblocking and mind-refreshing scalp acupuncture has no significant efficacy on the repair and regeneration of white matter fibers in children with PVL and CP in a short period of time; however, it gradually works along with the prolonged treatment time. In addition, it can improve the motor function and mental development and the efficacy is closely associated with the time of treatment.

English

Objective: To examine sit-to-stand and loaded sit-to-stand exercises effect in standing, walking, and running dimensions of gross motor function measure (GMFM) in spastic diplegia cerebral palsy (SDCP) patients. Methods: This study was conducted in the period of May to October 2014 and included 24 children with SDCP as the subjects. The methods used in the study were interventional study with randomized controlled trial, and investigation of CP before and after the exercise intervention. The subjects were divided into two groups, sit-to-stand exercise group and loaded sit-to-stand exercise group. Results: The results showed that the increase of standing, walking, and running dimension scores of GMFM in the loaded group were higher (standing dimension score 12.00 vs 11.08 and walking and running dimensions 13.58 vs 13.42) compared to the unloaded group. Conclusions: Both sit-to-stand and loaded sit-to-stand exercise groups do not show significant differences in improving motor skills in standing, walking, and running dimensions of GMFM. Children with SDCP may receive the exercise to improve their motor skills in mobility aspects, such as standing, walking, and running. Keywords: Cerebral palsy, gross motor function measure, rehabilitation, sit-to-stand exercise DOI: 10.15850/ijihs.v4n1.680

Infra-low Frequency Transcranial Magnetic Stimulation Effectively Improves the Motor Function in Children with Spastic Cerebral Palsy

Background: Cerebral palsy (CP) is one of the major diseases that lead to severe disability and seriously impacts the quality of life of children. Infra-low frequency transcranial magnetic stimulation (ILF-TMS) is a new technique of noninvasive brain stimulation that exactly regulates the power of specific neurotransmitters through a special magnetic field. Our study was in order to investigate the efficacy of ILF-TMS treatment in children with spastic cerebral palsy. Methods: 113 spastic cerebral palsic children were randomly divided into two groups: conventional rehabilitation group and ILF-TMS treatment group, Healthy control group was established at the same time. In conventional rehabilitaion group, children were treated with conventional rehabilitation treatment; In ILF-TMS treatment group were treated with ILF-TMS in addition to conventional rehabilitation treatment. Neurotransmitter in the brain was recorded with encephalofluctuograph (EFG) before and after ILF-TMS treatment. Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM) and Gesell development scale (GDS) were used to comprehensively evaluate the motor function in children with spastic cerebral palsy. Results: The results showed that the relative power of γ-aminobutyric acid (GABA) in spastic cerebral palsy was lower than that in healthy controls and was increased significantly after ILF-TMS treatment for 3 months. The relative power of glutamate (Glu) in spastic cerebral palsy was higher than that in healthy controls and was reduced significantly after ILF-TMS treatment for 3 months. After 3 months training period there was significant improvements on the GMFM (dimension B, dimension C and dimension D), FMFM (dimension A and dimension B) and GDS (gross motor DA and gross motor DQ) in the ILF-TMS treatment group when compared to conventional rehabilitation group. Conclusions: These findings indicate that GMFM is a sensitive indicator to assess the treatment efficacy in children with spastic cerebral palsy and ILF-TMS treatment can improve the motor function through regulating neurotransmitters in brain.

A pragmatic community exercise programme for young people with cerebral palsy: A pilot study

Introduction andaim: Peoplewith cerebral palsy (CP) are often discharged from paediatric services at the age of 16–21 years. However, as they reach adolescence and body weight and height increases, the energy required to ambulate also increases [1]. In addition, people with CP often show reduced levels of muscle strength [2]. These factors may explain why 75% of people with CP who lose the ability to walk do so at around 25 years. Therefore the aim of this pilot study was to investigate the feasibility of a community based exercise programme and its effects on improving physical fitness and function in adolescents and young adults with CP. Patients/materials and methods: Eight participants with diplegic and hemiplegic CP (GMFCS I-III) (mean age 20 years) took part in an exercise programme which included a mix of strength and aerobic exercises at their local leisure centre under the supervision of a fitness instructor. Instruction was delivered by a physiotherapist on 2–3 occasions. The programme prescribed three sessions per week for weeks 1– followed by two prescribed sessions during weeks 7-12. The participants underwent gait analysis at baseline (BL) and after approximately six (T2) and 12 weeks (T3) of the exercise programme. The assessment also includedmeasures of knee extensor, hip extensor and hip abductor strength (using an MIE Myometer), Gross Motor Function Measure (GMFM) dimensions D and E, a CP-specific 10m shuttle run/walk (SRT), the Rosenberg scale for Self Esteem and step count. Results: Two participants dropped out the exercise programme and did not return for the T3 assessment. The other six participants showed good compliance with the exercise programme (91% and 75% attendance of prescribed sessions for the 1st and 2nd block of sixweeks respectively)with no adverse events. Outcomemeasures at BL, T2 and T3 are shown in Table 1. Statistically significant effects of the exercise programme between BL and T3 for hip extensor strength and the Rosenberg Scale for Self-Esteem between BL and T3 for GMFM dimensions D&E were found. A trend (Cohen’s d=0.90) toward improvement was also found for hip abductor strength. Discussion and conclusions: This pilot study showed that for the majority of the participants with varying levels of function, exercising at a local leisure centre is feasible and safe. Preliminary results also indicate that this pragmatic community exercise programmecanbe efficacious in improvinghip extensor strength, gross motor function and increasing self-esteem.

Measurement properties of gait-related outcomes in youth with neuromuscular diagnoses: a systematic review.

Sound measurement properties of outcome tools are essential when evaluating outcomes of an intervention, in clinical practice and in research. The purpose of this study was to review the evidence on reliability, measurement error, and responsiveness of measures of gait function in children with neuromuscular diagnoses. The MEDLINE, CINAHL, EMBASE, and PsycINFO databases were searched up to June 15, 2012. Studies evaluating reliability, measurement error, or responsiveness of measures of gait function in 1- to 18-year-old children and youth with neuromuscular diagnoses were included. Quality of the studies was independently rated by 2 raters using a modified COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. Studies with a fair quality rating or better were considered for best evidence synthesis. Regarding the methodological quality, 32 out of 35 reliability studies, all of the 13 measurement error studies, and 5 out of 10 responsiveness studies were of fair or good quality. Best evidence synthesis revealed moderate to strong evidence for reliability for several measures in children and youth with cerebral palsy (CP) but was limited or unknown in other diagnoses. The Functional Mobility Scale (FMS) and the Gross Motor Function Measure (GMFM) dimension E showed limited positive evidence for responsiveness in children with CP, but it was unknown or controversial in other diagnoses. No information was reported on the minimal important change; thus, evidence on measurement error remained undetermined. As studies on validity were not included in the review, a comprehensive appraisal of the best available gait-related outcome measure per diagnosis is not possible. There is moderate to strong evidence on reliability for several measures of gait function in children and youth with CP, whereas evidence on responsiveness exists only for the FMS and the GMFM dimension E.

Effects of Therapeutic Riding in Children with Spastic Cerebral Palsy

This study examined the effect of therapeutic horseback riding in children with spastic cerebral palsy. Participants were placed in a therapeutic riding (TR) group (n=7) or physical therapy (PT) group (n=7). This study was then conducted for 30 minutes, twice a week, for 8 weeks. The gross motor function measure (GMFM), range of motion (ROM), and spasticity test (ST) were analyzed pre-test (TR0 and PT0), mid-test (TR1 and PT1), and post-test (TR2 and PT2). We used the SPSS 12.0 statistical software for data analysis. We observed significant changes in GMFM Dimension C (crawling and kneeling), D (standing), and E (walking, running, and jumping) between TR2 and TR0 (P < 0.05). In the control group, GMFM Dimension B (sitting) and E showed significant changes between PT2 compared to PT0 (P < 0.05). In future studies we will consider using a therapeutic riding program for the treatment of children with disorders.

Intrathecal baclofen and motor function in cerebral palsy

The aim of this retrospective analysis was to determine the impact of intrathecal baclofen (ITB) therapy on motor function in patients with cerebral palsy (CP). We studied 37 patients (18 males, 19 females) with CP treated with ITB (mean age at implant 13 y 7 mo, SD 7 y). Eighteen patients were affected by spastic diplegia, 12 by spastic quadriplegia, six by dystonic quadriplegia, and one by hemidystonia. Nine participants were in Gross Motor Function Classification System (GMFCS) level II, 13 in level III, seven in level IV, and eight in level V. Motor function was assessed by the Gross Motor Function Measure (GMFM) before the treatment and 12 months after the implant. The collected data showed an increase in the total median GMFM score in the overall population (p<0.001) and in every GMFM dimension (p<0.05) except for dimension D (standing). The analysis by degree of impairment revealed that patients with severe impairment and those with mild to moderate impairment improved the total median GMFM score (p<0.001 and p<0.05 respectively). Analysis by age showed that the best improvements in GMFM scores were reached by patients younger than 18 years old (p<0.05). Spasticity and dystonia, assessed by means of the Ashworth and Barry-Albright Dystonia scales, significantly decreased 12 months after the implant (p<0.001 and p<0.05 respectively). Finally, a subjective questionnaire administered to patients/caregivers revealed an overall improvement in participants' functional abilities. The results suggest that ITB therapy is an effective treatment for managing spasticity and dystonia, and for improving motor function in children with CP.

Desempenho funcional de crianças com paralisia cerebral participantes de tratamento multidisciplinar

A paralisia cerebral (PC) é um conjunto de desordens posturais e do movimento que causam limitações funcionais; é atribuída a distúrbios não-progressivos, porém mutáveis, decorrentes de lesão do cérebro imaturo. Os objetivos do estudo foram identificar as dimensões funcionais comprometidas e observar a evolução da função motora grossa de crianças com PC submetidas a tratamento multidisciplinar em um intervalo de quatro meses. A amostra foi composta por 27 crianças com PC (média de idade 7,6 anos) que freqüentavam a Associação Pestalozzi de Goiânia, GO. O nível de comprometimento das crianças foi atribuído segundo o sistema de classificação da função motora grossa GMFCS (Gross motor function classification system); a medida de função motora grossa GMFM (Gross motor function measure) foi aplicada no início do estudo e após quatro meses. Os resultados mostram que 55,6% das crianças estavam nos níveis IV e V do GMFCS; foi verificada evolução da função motora grossa em todas as dimensões avaliadas pela GMFM, exceto na postura sentada - sugerindo que as transferências de postura e a locomoção devem ser focalizadas no tratamento multidisciplinar dessas crianças com CP.

Relationships among functional outcome measures used for assessing children with ambulatory CP

In ambulatory children with cerebral palsy (CP), practitioners often examine outcomes using measures related to functions necessary for daily life. The Gross Motor Function Measure (GMFM) Dimensions D and E, Pediatric Outcomes Data Collection Instrument (PODCI) Parent and Child versions, Gillette Functional Assessment Questionnaire (FAQ) Walking subscale, Functional Independence Measure for Children (WeeFIM), Pediatric Quality of Life Inventory (PedsQL), temporal-spatial gait parameters, and O(2) cost during ambulation were selected for study. Cross-sectional data were collected in a prospective multicenter study of 562 participants with CP (339 males, 223 females), between 4 and 18 years of age (mean age 11y 1mo). There were 240 classified as Gross Motor Function Classification System Level I, 196 as Level II, and 126 as Level III. The tools that had the best interrelationships and underlying constructs predominately measured changes in physical function. These included portions of the FAQ, Parent PODCI, WeeFIM, and GMFM. GMFM Dimensions D and E exhibited a very strong relationship. Temporal-spatial gait parameters and O2 cost measures represented a different construct of physical function. The Child PODCI reports and both the Parent and Child PedsQL reports did not relate well to other measures, suggesting a pattern of answers not related to question content. The Parent PODCI, the FAQ Walking subscale, and GMFM Dimension E were found to be an appropriate minimum set of instruments for assessment of functional outcomes in patients with ambulatory CP.

Outcome assessments in children with cerebral palsy, Part I: descriptive characteristics of GMFCS Levels I to III

This prospective cross-sectional multicenter study assessed the relationships between Gross Motor Function Classification System (GMFCS) level and scores on outcome tools used in pediatric orthopedics. Five hundred and sixty-two participants with cerebral palsy (CP; 339 males, 223 females; age range 4-18y, mean age 11y 1mo [SD 3y 7mo]; 400 with diplegia, 162 with hemiplegia; GMFCS Levels I-III;) completed the study. The Functional Assessment Questionnaire (FAQ), Gross Motor Function Measure (GMFM) Dimensions D and E, Pediatric Quality of Life Inventory (PedsQL), the Pediatric Outcomes Data Collection Instrument (PODCI), Pediatric Functional Independence Measure (WeeFIM), temporal-spatial gait parameters, and O(2) cost were collected during one session. Descriptive characteristics are reported by GMFCS level clinicians can use for comparison with individual children. Tools with a direct relationship between outcome scores and GMFCS levels were the PODCI Parent and Child Global Function, Transfers & Basic Mobility, and Sports and Physical Function; PODCI Parent Upper Extremity Function; WeeFIM Self-care and Mobility; FAQ Question 1; GMFM Dimensions D and E; GMFM-66; O(2) cost; and temporal-spatial gait parameters. Child report scores differed significantly higher than Parent scores for six of eight PODCI subscales and three of four PedsQL dimensions. Children classified into different GMFCS levels function differently.

Intrasession and Intersession Reliability of Handheld Dynamometry in Children with Cerebral Palsy

The primary purpose of this study was to determine the intrasession and intersession reliability of isometric force measurements using handheld dynamometry of the knee extensors and flexors and hip abductors in 15 children with cerebral palsy. A secondary purpose was to explore the relationships between muscle forces and standing and walking skills among these subjects. Fifteen children with spastic diplegic or quadriplegic cerebral palsy (mean age, 11.7 +/- 3.6 years) participated. Two test sessions were separated by four to 14 days. Isometric force production was measured for three muscle groups bilaterally using a handheld dynamometer. Reliability was measured using the intraclass correlation coefficient (ICC 3,1) and the standard error of measurement. The relationship between muscle force values and standing and walking skills [measured with the Gross Motor Function Measure (GMFM), Dimensions D and E] was examined using Pearson's correlation coefficient. Except for left knee flexion, the intrasession and intersession ICCs were 0.84 or greater. The standard errors of measurement ranged from 6.72 to 25.26 N. GMFM Dimensions D and E were positively related to normalized hip abductor force. GMFM Dimension E and the sum of Dimensions D + E were positively related to normalized knee flexor force. This group of children with cerebral palsy demonstrated primarily good to high reliability coefficients for isometric force measurements of three lower extremity muscle groups using handheld dynamometry. We suggest that physical therapists use the standard error of measurement for individual clients to help them distinguish measurement error from true changes in muscle force production.

The Effect of Hippotherapy on Ten Children with Cerebral Palsy

The purpose of this study was to determine whether hippotherapy has an effect on the general functional development of children with cerebral palsy. The study employed a repeated-measures design with two pre-tests and two post-tests conducted 10 weeks apart using the Pediatric Evaluation of Disability Inventory (PEDI) and the Gross Motor Function Measure (GMFM) as outcome measures. A convenience sample of 10 children with cerebral palsy participated whose ages were 2.3 to 6.8 years at baseline (mean +/- SD 4.1 +/- 1.7). Subjects received hippotherapy once weekly for 10 weeks between pre-test 2 and post-test 1. Test scores on the GMFM and PEDI were compared before and after hippotherapy. One-way analysis of variance of group mean scores with repeated measures was significant (p < 0.05) for all PEDI subscales and all GMFM dimensions except lying/rolling. Post hoc analyses with the Tukey test for honest significant differences on the PEDI and GMFM total measures as well as GMFM crawling/kneeling and PEDI social skills subtests were statistically significant between pre-test 2 and post-test 1. The results of this study suggest that hippotherapy has a positive effect on the functional motor performance of children with cerebral palsy. 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, although specific functional skills were not investigated.

Horseback riding in children with cerebral palsy: effect on gross motor function

The effects of recreational horseback riding therapy (HBRT) on gross motor function in children with cerebral palsy (CP: spastic diplegia, spastic quadriplegia, and spastic hemiplegia) were determined in a blinded study using the Gross Motor Function Measure (GMFM). Seventeen participants (nine females, eight males; mean age 9 years 10 months, SE 10 months) served as their own control. Their mean Gross Motor Function Classification System score was 2.7 (SD 0.4; range 1 to 5). HBRT was 1 hour per week for three riding sessions of 6 weeks per session (18 weeks). GMFM was determined every 6 weeks: pre‐riding control period, onset of HBRT, every 6 weeks during HBRT for 18 weeks, and 6 weeks following HBRT. GMFM did not change during pre‐riding control period. GMFM Total Score (Dimensions A‐E) increased 7.6% (p&lt;0.04) after 18 weeks, returning to control level 6 weeks following HBRT. GMFM Dimension E (Walking, Running, and Jumping) increased 8.7% after 12 weeks (p&lt;0.02), 8.5% after 18 weeks (p&lt;0.03), and remained elevated at 1.8% 6 weeks following HBRT (p&lt;0.03). This suggests that HBRT may improve gross motor function in children with CP, which may reduce the degree of motor disability. Larger studies are needed to investigate this further, especially in children, with more severe disabilities. Horseback riding should be considered for sports therapy in children with CP.