“Effectiveness of hippotherapy on spasticity and pain in individuals with cerebral palsy: a randomized controlled trial”

Abstract

Background: Cerebral palsy comprises a collection of enduring conditions that affect mobility, posture, and motor abilities, resulting from non-progressive brain disturbances, traumas, or anomalies in an infant's developing brain. Management of spasticity and pain is still a challenge in the field of CP rehabilitation. Research has shown hippo therapy to be effective on spasticity, postural control, balance and motor function in CP and numerous scientific studies supporting its benefits. The aim of the study was to investigate the effectiveness of hippotherapy on spasticity and pain in children with CP. Methodology: A randomized clinical trial was conducted with two groups and divided into experimental (n=16) and control (n=16). The study involved children aged 4-15, with mean ages of 6.94 ± 3.043 years in the experimental group and 5.31 ± 1.078 years in the control group. Both groups were treated by 2 weeks of conventional physiotherapy where the trial group had additional 8 sessions, 30 minutes of hippo therapy. MAS and WBFS was used to determine the outcome and the pretest and posttest scoring were analyzed using parametric test- paired and independent sample t-test. Result: The outcome measures used were the Modified Ashworth Scale (MAS) to assess spasticity and the Wong-Baker Pain Rating Scale (WBFS) to evaluate pain perception during muscle stretching. Before the intervention, control group had MAS mean of 1.98 ± 0.497. Significant decrease was found after the intervention in the experimental group (mean: 1.67 ± 0.481; p = .001). The results demonstrated that both therapies were effective but combined approach showed superior efficacy in reducing spasticity. Similarly, WBFS scores also revealed significant reduction in pain, with posttest (mean: 4.27 ± 1.858; p=002) for control group and (mean: 3.98 ± 1.685; p= .001) for experimental group. These results indicated that hippotherapy, when combined with conventional physiotherapy provides a superior efficacy in reducing pain in children with CP compared to conventional therapy alone. Conclusions: Hippo therapy is combined with conventional therapy offers a short-term synergistic effect in managing spasticity and pain. However, the evidence specifically on pain relief is still growing and more focused research on pain specific outcomes is required. Also, further research on long-term effects is required to fully realize the benefits of this combined therapeutic approach. Word count: 10572