Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy)

Objective: To evaluate the effect of hippotherapy (physical therapy utilizing the movement of a horse) on muscle activity in children with spastic cerebral palsy. Design: Pretest/post-test control group. Setting/location: Therapeutic Riding of Tucson (TROT), Tucson, AZ. Subjects: Fifteen (15) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy. Interventions: Children meeting inclusion criteria were randomized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel. Outcome measures: Remote surface electromyography (EMG) was used to measure muscle activity of the trunk and upper legs during sitting, standing, and walking tasks before and after each intervention. Results: After hippotherapy, significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy. No significant change was noted after sitting astride a barrel. Conclusions: Eight minutes of hippotherapy, but not stationary sitting astride a barrel, resulted in improved symmetry in muscle activity in children with spastic cerebral palsy. These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements.