Background: Dynamic postural instability is a common neuromuscular impairment in cerebral palsy (CP), which often includes balance dysfunction and an associated risk of serious falls. Robotic hippotherapy has recently become a widespread clinical application to facilitate postural core stabilization, strength, and endurance through repetitive vestibular and proprioceptive stimulation to the spine via the sensorimotor system pathways. However, the long-term effects of robotic hippotherapy on dynamic postural instability in CP remain unclear.Objective: To examine the long-term effects of robotic hippotherapy on dynamic postural stability in CP.Methods: An advanced three-dimensional biomechanical eight-camera video motion capture (VMC) system was used to compute the center of mass (COM) pathway, which represents intervention-related spinal core instability. The robotic hippotherapy system was used to improve dynamic postural stability and associated balance performance. Robotic hippotherapy exercise was provided for 45 minutes/session, 2-3 times a week over the 12-week period.Results: Abnormal mean COM pathway length, standard deviation, and range substantially decreased after 12 weeks of robotic hippotherapy. The initial x-axis COM was greater than that of the y-axis. However, the amount of abnormal anterior-posterior and medio-lateral postural sway substantially decreased after robotic hippotherapy.Conclusions: This study provides the first compelling evidence that the robotic hippotherapy is safe and effective for postural instability control and sitting balance dysfunction that mitigates the risk of falls in CP.

This qualitative study used focus groups to identify meaningful components of exercise and active recreation (E/AR) related to consistent participation for those with spinal cord injury (SCI). Transcripts from each focus group were analyzed with classical content analysis, grounded theory coding, and meaning condensation using the International Classification of Function, Disability and Health (ICF). Variables within each of the ICF domains (body structures and functions, activities/participation, and environment) were indicated as meaningful components leading to increased participation, independence, and reasons why people consistently participated in E/AR. Occupational therapists can utilize these components to implement therapeutic intervisions, which provide clients with a sense of purpose and being, thus improving outcomes in meaningful occupations.

While the novel robotic hippotherapy system has gradually gained clinical application for therapeutic intervention on postural and locomotor control in individuals with neurological or musculoskeletal impairments, the system's validity and reliability for the robotic hippotherapy system has not been well established. The objective of the current study was to investigate the validity and test-retest reliability of the robotic hippotherapy system by comparing with real horse movements. The 3-axis accelerometer sensors attached on the robotic and real horse saddles were used to collect 3-dimensional acceleration data at a preferred walking velocity. Linear regression analysis showed an excellent correlation in the time-to-peak acceleration (TPA) (R-2 = 0.997), but little correlation in X-axis acceleration between the real and robotic horses (R-2 = 0.177), thus confirming consistent time control and a certain degree of variability between the robotic and real horse movements. The mean resultant accelerations for a real horse and robotic horse were 3.22 m/s(2) and 0.67 m/s(2), respectively, accounting for almost five times greater acceleration in the real horse than the robotic horse.

OBJECTIVE:The purpose of this investigation was to determine whether hippotherapy increased function and participation in children with autism spectrum disorder (ASD). We hypothesized improvements in motor control, which might increase adaptive behaviors and participation in daily activities.METHOD:Six children with ASD ages 5-12 participated in 12 weekly 45-min hippotherapy sessions. Measures pre- and post-hippotherapy included the Vineland Adaptive Behavior Scales-II and the Child Activity Card Sort. Motor control was measured preintervention and postintervention using a video motion capture system and force plates.RESULTS:Postural sway significantly decreased postintervention. Significant increases were observed in overall adaptive behaviors (receptive communication and coping) and in participation in self-care, low-demand leisure, and social interactions.CONCLUSION:These results suggest that hippotherapy has a positive influence on children with ASD and can be a useful treatment tool for this population.

Falls are the leading cause of injuries and deaths in adults over the age of 65. The purpose of this case study is to explore the use of Equine Assisted Activities and Therapies (EAAT) to improve the mechanisms of balance, postural sway, fear of falling (FOF), and participation in older adults (OA). The participant (a 76-year-old woman), completed 10 Adaptive riding (AR) sessions over a six-week period, led by a Level II therapist (COTA/L and PATH certified riding instructor). Changes in function were assessed using the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), Activity Card Sort (ACS), and Video Motion Capture (VMC) system. Results indicated improved static standing balance, postural stability, and greater dynamic head and trunk control. Additionally, the participant expressed decreased FOF, decreased back pain, the ability to recover self after a fall, and an increase in activity participation as indicated in the ACS.

Introduction: This case study followed a 6-year-old child with cerebral palsy for an additional 24 weeks after a 12-week pilot study of hippotherapy (HPOT). Method: Pre-post measures were performed using a video motion capture system before and after 12 weeks, showing head/trunk control improvements. Results: The third measure after 24 more weekly treatments showed no further improvement on the original variables. However, an unanticipated improvement in postural sway was found at the end of 9 months. Conclusion: This suggests that additional investigations are needed with more children with cerebral palsy over longer periods to identify outcomes from extended interventions beyond the 6–12 weeks of most published HPOT studies. Such further work could support better treatment planning and inform discharge criteria considering diminishing returns. The information would provide better evidence-based criteria for referrals and funding. This may make HPOT more accessible for those with disabilities who can benefit in specific and predictable ways.

Hippotherapy (HPOT) is a therapy that uses horse movement. This pilot investigation objectively evaluated the efficacy of HPOT in improving head/trunk stability in children with cerebral palsy (CP). The participants were six children with spastic diplegia and six children without disability. Head and trunk stability was challenged by using a motorized barrel and measured by a video motion capture system before and after a 12-week intervention of 45 min of HPOT a week. The variables measured were anterior-posterior (AP) translation of the head, and spine at five points and average AP head angles. At pre-testing, children with CP demonstrated significant differences in AP translation and AP head rotation compared with children without disability. Following HPOT, children with CP demonstrated significant reductions in head rotation and AP translation at C7, eye, and vertex. At post-testing, translation at C7 did not differ significantly between children with CP and children without disability. After HPOT intervention, children with CP reduced their AP head rotation and translation, suggesting that they had increased stability of the head and trunk in response to perturbations at the pelvis. The findings suggest that HPOT might improve head and trunk stability in children with CP.

Changes in dynamic trunk/head stability and functional reach after hippotherapy.Objectives: To determine if hippotherapy (therapy using a horse) improves head/trunk stability and upper extremity (UE) reaching/targeting in children with spastic diplegia cerebral palsy (SDCP).Design: Pre-postoperative follow-up with a 12-week intervention and 12-week washout period after intervention.Setting: A human performance laboratory with 6 camera video motion capture systems for testing.Participants: Eleven children (age 5-13y, average 8y) with SDCP, 8 children (age 5-13y, average 8y) without disabilities.Intervention: Hippotherapy intervention performed at 3 therapeutic horseback riding centers.Main Outcome Measures: Video motion capture using surface markers collecting data at 60Hz, a triechanical barrel to challenge trunk and head stability, and functional reach/targeting test on static surface.Results: Significant changes with large effect sizes in head/trunk stability and reaching/targeting, elapsed time, and efficiency (reach/path ratio) after 12 weeks of hippotherapy intervention. Changes were retained after a 12-week washout period.Conclusions: Hippotherapy improves trunk/head stability and UE reaching/targeting. These skills form the foundation for many functional tasks. Changes are maintained after the intervention ceases providing a skill foundation for functional tasks that may also enhance occupational performance and participation.