Abstract
PURPOSE: The purpose of this research study is to investigate whether hippotherapy influences gross motor functional outcomes in children between three and thirteen years of age, with a medical diagnosis of cerebral palsy, and a GMFCS level of III or IV. METHODS: A pre-post quantitative, quasi-experimental design was utilized to evaluate seven eligible participants using the Gross Motor Function Measure (GMFM), a Child Information Sheet, and a Parent/Guardian Reported Outcome Survey over a ten-week intervention period. Participants for the study were recruited through the Bit-By-Bit Medical Therapeutic Riding Center hippotherapy program on a voluntary basis. DATA ANALYSIS: Descriptive statistics were generated for the group of participants. In order to determine differences in motor function, change scores were generated for each dimension in the GMFM and for the resulting total score of the GMFM. A paired-t-test was used to compare the mean pre- and post-intervention GMFM scores from each dimension as well as total scores with a p≤ 0.05 level of significance. Correlation coefficients were calculated to determine if a relationship existed between the results of the GMFM and the parent/guardian outcome surveys. Finally, a between-groups analysis was conducted to investigate whether participant age, gender, prior use of Botox, or GMFCS level had any relationship to the results of the study. RESULTS: For gross motor function, there was typically an increase in the change scores for each dimension and for the total scores, as initially hypothesized by the researchers. A statistically significant (p≤0.05) positive change was found to have occurred in dimension B (sitting) and the total change score over a duration of ten weeks. The parent/guardian reported outcomes were largely positive regardless of the size of the changes identified by the GMFM. Additionally, the parents/guardians of six out of seven of the participants reported that hippotherapy had an overall positive impact on their child’s quality of life. CONCLUSIONS: Results of this study provide preliminary and limited quantitative evidence that hippotherapy improves gross motor function in children with CP. The Parent/Gaurdian Reported Outcome Survey supports the benefits of participation in hippotherapy as it indicates parents/guardians of children with CP percieve benefits both in motor function and quality of life as a result of the intervention.