Hippotherapy Simulator in Children With Cerebral Palsy
Condition: Rehabilitation; Cerebral Palsy, Spastic
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      The aim of this study was to research the effects of hippotherapy simulator in children with
      Cerebral Palsy. In order to evaluate its effectiveness, assessment of gross motor functions,
      lower extremity functions, muscle tone and spasticity, trunk control, sitting and standing
      balance, walking functions and functional independence were being applied.
    

Detailed description: 
      "Cerebral Palsy (CP) describes a group of permanent disorders of the development of movement
      and posture, causing activity limitation, that is attributed to nonprogressive disturbances
      that occurred in the developing fetal or infant brain." The motor disorders of CP are often
      accompanied by disturbances of sensation, perception, cognition, communication, and behavior,
      by epilepsy, and by secondary musculoskeletal problems.

      CP is the most common neurodevelopmental disorder that begins in early childhood, continues
      for life and causes physical impairment. Damage occurring in the developing brain results in
      voluntary movement, postural and motor control disorders, balance problems and gait
      disorders.

      Hippotherapy is used effectively in increasing the participation of children with CP by
      improving their balance, motor function, posture and mobility and improving their quality of
      life. Although hippotherapy has many physical, functional, emotional and social benefits for
      children with CP, it also has some disadvantages that limit its use in the treatment of these
      children. There are risks such as serious injuries caused by children being afraid of a
      horse, falling from a horse or kicking a horse, increased hypertonicity due to fear and
      stress on the horse and exposure to allergic reactions due to environmental antigens. In
      order to overcome these conditions and reach more patients, hippotherapy simulator systems,
      which have been increasing rapidly in recent years, have been developed.

      Hippotherapy simulators are systems that mimic the walking and movements of a real horse. As
      they are a newly developed system, studies investigating their effectiveness, especially in
      children with CP, are very limited. The aim of this study is to research the effects of
      hippotherapy simulator on gross motor functions, lower extremity functions, muscle tone and
      spasticity, trunk control, sitting and standing balance, walking functions and functional
      independence in children with Cerebral Palsy.
    

Intervention name(s): Neurodevelopmental Therapy; Hippotherapy Simulator
Intervention type(s): Other; Device
Intervention description(s): The Neurodevelopmental Therapy rehabilitation program was determined according to the children's level of gross motor function, age, gender, mental state, and preferences. Neurodevelopmental Therapy program consists of the rehabilitation of muscle tone disorders, increasing sensory-perception-motor integrity, exercises to increase limb functions and body control, stretching and strengthening exercises for muscle shortness and weakness, exercises that include movements in daily life and training activities such as standing, walking, body care.; Horse Riding Simulator (HRS) device was used as a hippotherapy simulator device. HRS is a device that moves forward, backward, backward-to-back, right-to-left swing and up-and-down swing in 3 dimensions, similar to the movements of a real horse, forming an 8-shaped movement on five axes. After the children sat in the saddle section, they were first taken to the warm-up speed program for 5 minutes, then to another one of the other speed levels (gradually moved to other speed levels as appropriate for the development and tolerance of children) and finally to the warm-up speed program for 5 minutes.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Two different treatment methods were applied to the participants (n=30). Rehabilitation programs based on individual Neurodevelopmental Therapy were applied to the participants included in the study for eight weeks (first group). In the next eight weeks, the Hippotherapy Simulator system was applied to the same participants in addition to individual Neurodevelopmental Therapy-based rehabilitation programs (study group).
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cerebral Palsy; Hippotherapy; Postural Balance; Gait; Postural Control