Cerebral palsy is a group of permanent disorders affecting movement and posture due to non-progressive disturbances in the developing brain. The aim of this study is to investigate the effects of hippotherapy on physical function, including balance, trunk control, posture, and handgrip strength, as well as bladder and bowel symptoms and family quality of life in children with cerebral palsy.
Cerebral palsy is a group of permanent disorders of movement and posture caused by non-progressive disturbances in the developing brain. Children with cerebral palsy may experience limitations in balance, trunk control, posture, mobility, and daily activities. During hippotherapy, the rhythmic and multidirectional movements of the horse provide continuous sensory and motor stimulation, requiring the child to make repeated postural adjustments. These characteristics may support balance, postural control, muscle activation, and functional performance. Although the effects of hippotherapy on motor function in children with cerebral palsy have been investigated, evidence regarding its combined effects on physical function, bladder and bowel symptoms, and family quality of life remains limited. Therefore, the present study aims to investigate the effects of hippotherapy on physical function-including balance, trunk control, posture, and handgrip strength-as well as bladder and bowel symptoms and family quality of life in children with cerebral palsy. The findings may contribute to the literature and provide guidance for rehabilitation practices.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Participants will receive 30-minute hippotherapy sessions once weekly for 8 weeks in addition to their ongoing special education program. The program will include exercises targeting balance, postural control, trunk stabilization, coordination, muscle strength, upper extremity function, and sensory processing.
Participants will continue their ongoing special education program throughout the 8-week study period. The program includes educational activities, speech and language therapy, occupational therapy, proprioceptive activities, and sensory-based interventions according to the individual needs of the child.
Ankara Yildirim Beyazit University
Ankara, Turkey (Türkiye)
Balance
Balance will be assessed using the Pediatric Balance Scale, a 14-item scale evaluating sitting balance, standing balance, transfers, reaching, turning, and stepping activities. The total score ranges from 0 to 56, with higher scores indicating better balance performance. The scale will be administered by a physiotherapist.
Time frame: Baseline and at the end of the 8-week intervention
Trunk Control
Trunk control will be assessed using the Trunk Control Measurement Scale. The total score ranges from 0 to 58, with higher scores indicating better trunk control. The assessment will be administered by a physiotherapist.
Time frame: Baseline and at the end of the 8-week intervention
Posture
Postural alignment will be assessed using the New York Posture Rating Chart. The total score ranges from 13 to 65, with higher scores indicating better postural alignment. The assessment will be performed by a physiotherapist.
Time frame: Baseline and at the end of the 8-week intervention
Handgrip Strength
Handgrip strength will be measured in kilograms using a hand dynamometer. Three measurements will be obtained for each hand, with a 1-minute rest period between measurements. The mean value of the three measurements will be used in the analysis. Higher values indicate greater handgrip strength.
Time frame: Baseline and at the end of the 8-week intervention
Bladder and Bowel Symptoms
Bladder and bowel symptoms will be assessed using the Bladder and Bowel Dysfunction Questionnaire. The total score ranges from 0 to 52, with higher scores indicating greater symptom severity. The questionnaire will be completed by the child with parental assistance.
Time frame: Baseline and at the end of the 8-week intervention
Familiy Quality of Life
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Family quality of life will be assessed using the Cerebral Palsy Quality of Life Questionnaire-Primary Caregiver Form (CP QOL-Child). Each domain is scored from 0 to 100, with higher scores indicating better quality of life. The questionnaire will be completed by the child's parent or primary caregiver.
Time frame: Baseline and at the end of the 8-week intervention