Blog 4 – Evidence and Research

There is a significant quantity of research evidence to support that the positive relationship between hippotherapy and well-being and that it is intertwined. The strength of the effect of hippotherapy on ones’ health is dependent on the relationship between the person, environment and occupation. There are numerous articles on the journal databases supporting the use of hippotherapy with children with cerebral palsy. I chose to look at 5 specific articles which supported using hippotherapy for children with cerebral palsy.  The results are quite similar between these chosen articles and all recommend hippotherapy as a tool to helping improve these children’s quality of life.

A conceptual reviews conclusion is that “Hippotherapy, by affecting multiple systems such as the sensory, muscular, skeletal, limbic, vestibular, and ocular systems simultaneously, leads to psychological, social, and educational benefits that will be evidenced in behavioural patterns used in other environments” ” (Grandos & Ferna’andez Agi, 2011, pg. 191).. Not only does hippotherapy target movement it also benefits the children psychologically and socially and this then helps the children education as they are more likely to be able to participate like the other children.

“Hippotherapy also helps children with cerebral palsy reduce their anterior and posterior head rotation and translation. This suggests that hippotherapy helps increase the child’s stability of the head and trunk in response to perturbations at the pelvis”( Shurtleff & Engsberg, 2010, Pg. 150). These findings show that using hippotherapy will benefit these children as they will have better head and trunk stability and will be able to have a better posture and stronger muscles then if they hadn’t had hippotherapy intervention.

 There is little evidence from the users’ perspective however I found the first qualitative study that looks at the benefits from the users’ perspective, it is important to look at the person experience and their opinions. “The main effects of hippotherapy, as identified by users and parents, are normalisation of muscle tone, improved trunk control, improved walking ability, carry over effects of hippotherapy to activities of daily living, and increased self-efficacy, confidence, and self-esteem. This study provided unique and new insights into the context in which hippotherapy happens, as well as its effects on impairment, activity, participation, and quality of life in people with cerebral palsy” (Debuse, Gibb & Chandler, 2009. Pg. 174).

 “Hippotherapy is proven to significantly improve symmetry of muscle activity compared to cerebral palsy children that were not subjected to hippotherapy. Postural control and balance were also improved during hippotherapy” (Zadnikkar & Kastrin, 2011, pg. 684). As occupational therapists we know that having a child with cerebral palsy, they struggle with postural control and balance. If we can help these children by them participating in hippotherapy it will help them in the long run and influence functioning in activities of daily life and improve quality of life in children with cerebral palsy.

Overall I believe there are a lot of benefits of hippotherapy for children with cerebral palsy. I believe that hippotherapy is an important step in helping children with cerebral palsy. As an occupational therapy student I believe that hippotherapy would be great to be used in occupational therapy, it would be something that a lot of children love and at the same time the child is improving in a range of ways. Horses are amazing animals and can make the world of difference for people by incorporating them into our interventions.

Benefits

· Physical abilities: Muscle tone, balance, coordination, muscle strength, flexibility, fitness, posture, gait (ability to walk), respiration, circulation, metabolism, sensory perception and integration, independence: self-care and mobility.

· Psychological abilities: Concentration, problem solving and decision making, insight, motivation, self-esteem, confidence, learning/practicing concepts e.g. letters, numbers, colours, distances, shapes etc.

· Social abilities: Communication and social skills, learning appropriate behaviour and manners, interaction with peers: individuals and groups, human/animal contact and bonding, building relationships, consideration for others and taking on responsibility.

· Recreational/sport/vocational abilities: Equestrian skills and horse management, develop interests, broaden experiences, challenge and success in competition with self and others, stimulation and/or relaxation, integration and community participation, work experience.

YouTube clip about benefits using real patients

 

References

Debuse, D., Gibb, C., & Chandler, C. (2009). Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Physiotherapy Theory and Practice. 25(3):174–192. doi: 10.1080/09593980902776662

Granados, A. C., & Ferna’andez Agi, I. (2011). Why Children With Special Needs Feel Better with Hippotherapy Sessions: A Conceptual Review. The Journal of Alternative and Complementary Medicine. 17 (3), 191-197. Doi: 10.1089/acm.2009.0229

Love to know autism. (2013). Hippotherapy. Retrieved from http://autism.lovetoknow.com/Hippotherapy
Shurtleff, T. L., & Engsberg, J. R. (2010). Changes in Trunk and Head Stability in Children with Cerebral Palsy after Hippotherapy:A Pilot Study. Physical & Occupational Therapy in Paediatrics. 30(2). doi: 10.3109/01942630903517223

Zadnikkar, M., & Kastrin, A. (2011).Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: a meta-analysis.. Developmental Medicine & Child Neurology. Pg. 683-691.doi: 10.1111/j.1469-8749.2011.03951.x