Hippotherapy to Improve the Balance of Children With Movement Disorders

Overview

The purpose of this study is to determine if adding hippotherapy treatment will improve balance for children ages 5-17 who have disabilities such as cerebral palsy and down syndrome. We also want to find out if by improving their balance the children increase their participation in age appropriate activities.

Full Title of Study: “Hippotherapy to Improve Balance Deficits in a Cohort of Children With Movement Disorders: A Pilot Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: December 2007

Detailed Description

The primary purpose of this study is to determine the effects of hippotherapy on the balance of children with developmental disorders that cause mild to moderate balance problems. The secondary purpose is to determine if the use of hippotherapy also improves perceived functional abilities and thus quality of life as measured by the pediatric balance scale and Activities Scale for Kids (respectively)

Interventions

  • Other: Hippotherapy
    • Children will receive treatment by a licensed physical therapist using hippotherapy as the treatment strategy. This includes sitting on a horse who’s movement is controlled by a horse leader, with the PT directing the movements required of the horse, as well as supplying supplemental cues to the participant. Alternative positions (such as sitting backward and sideways) may also be used during the treatment session.

Arms, Groups and Cohorts

  • Experimental: Treatment group
    • Children between 5-17 years who have balance deficits related to any movement disorder (preferably neuromuscular)

Clinical Trial Outcome Measures

Primary Measures

  • Pediatric Balance Scale
    • Time Frame: 8-9 weeks
    • The Pediatric Balance Scale (PBS) is a standardized 14 item test of various component activities related to balance. It is a modified child version of the adult Berg Balance Scale. The PBS has high total score test-retest reliability of ICC (3,1) =0.998, as well as good interrater reliability (ICC(3,1) = 0.997).1

Secondary Measures

  • Activities Scale for Kids
    • Time Frame: 8-9 weeks
    • Activities Scale for Kids – Participation (ASKp) is a self-administered 30 item questionaire that measures the impact of children’s disability to overall function and participation within relevant environments. It correlates well with parent reports on the Childhood Health Assessment Questionnaire (r=0.81, p<0.000) and clinician observations of children’s function (ICC=0.92, p<0.000).

Participating in This Clinical Trial

Inclusion Criteria

  • between the ages of 5 and 17 – have a neuromuscular diagnosis or confirmed difficulties with balance – be able to stand 4 seconds without an assistive device – be able to follow testing instructions – must be under 250 pounds – be able to attend a minimum 10/12 sessions. Exclusion Criteria:

  • any compounding orthopedic or medical condition not related to the primary developmental diagnosis. – previous hippotherapy intervention or therapeutic riding experience – allergies or aversion to horses. – refusal of parents to sign the therapeutic riding center's liability release form – any new treatments (includes therapies, drugs, or other complementary treatments) within one month of the start of the study or plans for new treatments during the intervention period – lack of a physician referral for physical therapy

Gender Eligibility: All

Minimum Age: 5 Years

Maximum Age: 17 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Central Michigan University
  • Provider of Information About this Clinical Study
    • Dr. Debbie Silkwood-Sherer, Central Michigan University
  • Overall Official(s)
    • Debbie J Silkwood-Sherer, PT, DHS, Principal Investigator, Central Michigan University

References

McGibbon NH, Benda W, Duncan BR, Silkwood-Sherer D. Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy. Arch Phys Med Rehabil. 2009 Jun;90(6):966-74. doi: 10.1016/j.apmr.2009.01.011.

Casady RL, Nichols-Larsen DS. The effect of hippotherapy on ten children with cerebral palsy. Pediatr Phys Ther. 2004 Fall;16(3):165-72. doi: 10.1097/01.PEP.0000136003.15233.0C.

Benda W, McGibbon NH, Grant KL. Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). J Altern Complement Med. 2003 Dec;9(6):817-25. doi: 10.1089/107555303771952163.

Silkwood-Sherer D, Warmbier H. Effects of hippotherapy on postural stability, in persons with multiple sclerosis: a pilot study. J Neurol Phys Ther. 2007 Jun;31(2):77-84. doi: 10.1097/NPT.0b013e31806769f7.

Citations Reporting on Results

Silkwood-Sherer D. Hippotherapy as an Intervention to Improve Postural Control of Children with Movement Disorders. Dev Med Child Neurol 51(S5):18-19, 2009 [abstract]

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