1. Effect of Hippotherapy on Functional Reach in Children with Cerebral Palsy Meredith Alvey & Lauren Speelman Background on Cerebral Palsy References Evidence Conclusion Hippotherapy and Trunk Stability Non-progressive disorder that damages the central nervous system 1,2 Effects: Spasticity Ataxia Involuntary movements Decreased trunk stability Lower extremity more effected than upper Trunk instability causes proximal instability in the upper extremities 2 Proximal instability at the shoulder reduces distal control 2 Leads to difficulties with reaching and targeting their functional tasks 2 Physical therapists use to promote improved posture and balance 1,2,3 Involves various positioning on the horse and a variety of activities 1,2,3 Cognitive games Reaching Stretching Exercises Forces the child to activate the core to stabilize themselves in an upright position The horse provide diverse practice conditions 1,2,3 Significant effect on head control and reduced anterior and posterior translation 2 Improved head control demonstrates improved trunk stability 2 Results were seen post-intervention and maintained at 12 weeks post-intervention 2 Maintenance of the results allow independence without reliance on continued hippotherapy Results were moving more towards the results for the children without disabilities 2 Posture and balance are important to establish so the child can focus on more distal motor control 2 Proximal stability enables distal control 2 May facilitate better functional use of the hands in everyday activities 2,3 Results showed an improved efficiency with a functional reach 2 1.Haehl V, Giuliani C, Lewis C. Influence of hippotherapy on the kinematics and functional performance of two children with cerebral palsy. Pediatric Physical Therapy [serial online]. June 1999;11(2):89- 101. Available from: CINAHL, Ipswich, MA. Accessed November 14, 2013. 2.Shurtleff T, Standeven J, Engsberg J. Changes in dynamic trunk/head stability and functional reach after hippotherapy. Archives Of Physical Medicine And Rehabilitation [serial online]. July 2009;90(7):1185- 1195. Available from: MEDLINE, Ipswich, MA. Accessed November 14, 2013. 3.Zadnikar M, Kastrin A. Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: a meta-analysis. Developmental Medicine & Child Neurology [serial online]. August 2011;53(8):684-691. Available from: CINAHL, Ipswich, MA. Accessed November 14, 2013. Improved posture and balance provide the building blocks for them to improve upon their functional reach capacity Proximal control and stabilization allows these children to focus on improving distal motor control and skills 2 Improved distal motor control allows more independence in activities of daily living 2,3 Brushing teeth Dressing Feeding Independence with ADLs allows development of confidence 3 More desire to engage in new activities 3 Opens up opportunities to interact with their peers and their environment, which allows further development of motor and cognitive skills www.horsepowerforability.com www.horseshelpingpeoplema.com www.3gaits.com