The Effect of Hippotherapy Simulator in Cerebral Palsy

Study Overview
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Brief Summary
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Hippotherapy simulators imitate the passive movements of the horse, producing simple movements similar to those of the horse. Hippotherapy simulators are intended to improve sitting balance, postural control and trunk balance. The aim of this study was to research the therapeutic effects of hippotherapy simulator on sitting balance, trunk control and upper extremity skills in individuals with Cerebral Palsy (CP).

Detailed Description
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Spastic CP will be participate the study between the ages of 4 and 18 years. Children's classified with GMFCS and MACS. The eligible participants will be allocated two groups, including hippotherapy simulator training group and traditional physiotherapy control group. All the assessments will be performed before and after the training in the 8-week training groups. The control group individuals will be given a traditional physiotherapy two days per week for a total of 8 weeks (traditional physiotherapy session will last 45 minutes). Hippotherapy simulator training group will receive a traditional physiotherapy and hippotherapy simulator training, two days a week for a total of 8 weeks (30 minutes traditional physiotherapy session+15 minutes hippotherapy simulator training). All sessions will be performed in the clinic with the specialist physiotherapist.

Official Title
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The Effect of Hippotherapy Simulator on Sitting Balance, Trunk Control and Upper Extremity Skills in Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Hippotherapy simulator training
* Other: Traditional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Spastic Cerebral Palsy voluntary participation Age between 4-18 years, GMFCS Level I-II-III MACS Level I-II-III Have the ability to sit upright with support Exclusion Criteria: Not voluntary to participate in the research, Botox in the last 6 months Hip or spine surgeries in the last 6 months

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hippotherapy simulator training group<br>Hippotherapy simulator training group will receive a traditional physiotherapy and hippotherapy simulator training, two days a week for a total of 8 weeks (30 minutes traditional physiotherapy session+15 minutes hippotherapy simulator training). | Other: Hippotherapy simulator training<br>* Hippotherapy simulator training will be designed for the individual basis.<br>Other: Traditional physiotherapy<br>* Traditional physiotherapy within a specific program<br>|
| Active Comparator: Traditional physiotherapy group<br>Traditional physiotherapy group individuals will be given a traditional physiotherapy two days per week for a total of 8 weeks (traditional physiotherapy session will last 45 minutes). | Other: Traditional physiotherapy<br>* Traditional physiotherapy within a specific program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gross Motor Function Classification System (GMFCS) | Assessing functional level and motor function. Gross motor functions of children with CP are classified in five levels with GMFCS. This is a classification system based on the child's self-initiated movements with emphasis on sitting, displacement and mobility. | At Baseline | 
| Manuel ability classification system (MACS) | This is a classification system based on the grasping and releasing objects in daily life, and how they use their hands while holding objects. It is classify the hand skills of children with CP between the ages of 4-18.Children with CP are classified in five levels with MACS. The higher level indicates worse hand function | At Baseline | 
| Change from Baseline Gross Motor Function Measure-88 at 8 weeks | It is used to show gross motor functions and changes in these functions. It consists of five main sections. Each section can be used by calculating separately within itself. The total score ranges from 0 to 100, with a high score indicating better function. | Change from Baseline at 8 weeks | 
| Change from Baseline Trunk Control Measurement Scale at 8 weeks | This scale consists of two main parts as dynamic and static sitting balance. The scale consists of 15 questions. The scoring of the items is 0, 1, 2 or 3. The total score ranges from 0 to 58, with a high score indicating better trunk control. | Change from Baseline at 8 weeks | 
| Change from Baseline Pediatric Evaluation of Disability Inventory at 8 weeks | The Pediatric Evaluation of Disability Inventory (PEDI) is designed for the functional evaluation of children with special needs. This will be used to evaluate functional ability and performance. 0: can not do, 1: can do in the form of scoring is done. At the end of the evaluation, the points of the related section are collected. Higher score indicates a better level of functional independence. | Change from Baseline at 8 weeks | 
| Change from Baseline ABILHAND-Kids at 8 weeks | Abilhand Kids evaluates manual ability in children with upper extremity disorders. It consists of 21 items and confirmed in CP. The lowest score that can be obtained from the scale is 21 and the highest score is 63. It can be stated that higher scores correspond to more difficulty in activities. | Change from Baseline at 8 weeks | 
| Change from Baseline The Jebsen Taylor Hand Function Test at 8 weeks | The Jebsen Taylor Hand Function Test (JTHFT) will be used to evaluate hand function in daily life. Both hands are tested separately. The time for all activities is recorded with a stopwatch. Higher duration indicates worse hand function. | Change from Baseline at 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral palsy, Hippotherapy simulator