Effects of hippotherapy on gait parameters in children with bilateral spastic cerebral palsy

Objectives: To evaluate the effects of hippotherapy on temporospatial parameters and pelvic and hip kinematics of gait in children with bilateral spastic cerebral palsy. Design: Nonrandomized prospective controlled trial. Setting: Outpatient therapy center. Participants: Children (N=32) with bilateral spastic cerebral palsy, Gross Motor Function Classification System level 1 or 2. Intervention: Hippotherapy (30min twice weekly for 8 consecutive weeks). Main Outcome Measures: Temporospatial parameters and pelvic and hip kinematic parameters in 3-dimensional motion analysis, Gross Motor Function Measure (GMFM)-88, and score for dimensions D (standing) and E (walking, running, jumping) of the GMFM, GMFM-66, and Pediatric Balance Scale (PBS). Results: Hippotherapy significantly improved walking speed, stride length, and pelvic kinematics (average pelvic anterior tilt, pelvic anterior tilt at initial contact, pelvic anterior tilt at terminal stance). Scores for dimension E of the GMFM, GMFM-66 and PBS also increased. Conclusions: Hippotherapy provided by licensed health professionals using the multidimensional movement of the horse may be used in conjunction with standard physical therapy for improvement of gait and balance in children with bilateral spastic cerebral palsy.