Clinical effects of equine-assisted therapeutic exercises in static and dynamic balance of children with cerebral palsy.

OBJECTIVE: To evaluate the efficacy of equine-assisted therapy for the static and dynamic balance in the rehabilitation of children and adolescents with cerebral palsy maintaining obtained improvement 8-weeks after the end of the intervention. METHOD: The study lasted 28 weeks, of which the intervention lasted 12 weeks. Measurements were taken before, in the middle, after the end of the intervention and follow-up after 12 weeks. Paediatric Balance Scale and dynamic plate were used to evaluate the balance. Wechsler Intelligence Scale for Children (3rd edition) was used to assess mental capacity, and the Gross Motor Function Classification System for the assessment of functional capacity for the participants. Exercises on the horseback were individualised for every participant. RESULTS: The study comprised 27 participants with cerebral palsy. Statistically significant improvements were found for the Paediatric Balance Scale (p<0.001) and the mean dynamic plate pressure for both feet (p<0.05). The Paediatric Balance Scale results remained in the follow-up and were found clinically significant. CONCLUSIONS: The results suggest that this type of approach in rehabilitation can be beneficial with clinical significance for improving the motor dysfunctions and quality of life in cerebral palsy.

Development and pilot of equine facilitated physical therapy outcome measure tool for chronic low back pain patients.

Equine Facilitated Physical Therapy (EFPT) lacks consistent documentation due to being an unconventional physical therapy treatment to chronic low back pain patients (LBP) and lacking rehabilitation outcome measure tools for a stable (equestrian) environment. The objectives were to develop an online evaluation tool as well as to define inter- and intra-rater reliability to validate the outcome measurement tool "Evaluation of maintaining sitting position (on a horse) and walking (short distances)" designed for LBP patients in EFPT". A total of 48 movement related functions (n = 48), were derived from the International Classification of Functioning (ICF) and organized to an online evaluation tool. Depending on the state of validation two to six (2-6) raters scored randomized patient (n = 22) video material, recorded during a 12-week EFPT intervention, with the designed tool. Inter-rater agreement level between the experts reached good (α = 87) reliability for the scoring of the items and calculated per patient excellent (α = 100). Intra-rater reliability reached good (α = 87) and per patient good (α = 80) repeatability. For the healthy adults the reliability between raters reached acceptable (α = 72) levels and per rated excellent (α = 100). The developed assessment tool was found satisfactory to fulfil the requirement for the therapeutic practice. With the use of the tool physical therapist may detect postural changes for LBP patients as outcome report in EFPT. The tool may be used to identify treatment progress and to help design home exercises. The created tool will help to collect similar outcome measures from LBP patients in EFPT and to validate the treatment within industry.