Factors Influencing Motor Outcome of Hippotherapy in Children with Cerebral Palsy.

OBJECTIVE: This study was aimed to identify individual factors influencing the gross motor outcome of hippotherapy in children with cerebral palsy (CP). METHODS: One hundred and forty-six children with CP (mean age: 5.78 ± 1.72 years, male: 56.2%) presenting variable function (gross motor function classification system [GMFCS], levels I-IV) participated in this study. Participants received 30 minutes of hippotherapy twice a week for 8 weeks. Clinical information including GMFCS level, age, sex, CP distribution, CP type, gross motor function measure-88 (GMFM-88), GMFM-66, and pediatric balance scale (PBS) score were collected retrospectively. We regarded the children with GMFM-66 score increased by 2.0 points as good responders to hippotherapy. Further we analyzed factors affecting good responders. RESULTS: GMFCS level I and II compared with IV (odds ratio [OR] = 6.83) and III compared with IV (OR = 4.45) were significantly associated with a good response to hippotherapy. Higher baseline GMFM E (OR = 1.05) and lower baseline GMFM B (OR = 0.93) were also significantly associated with a good response to hippotherapy. Sex, age, CP type, and distribution were not factors influencing gross motor outcome of hippotherapy. CONCLUSIONS: The children with CP, GMFCS level I-III, with relatively poor postural control in sitting might have a greater chance to improve their GMFM-66 scores through hippotherapy. This supports the hypothesis that hippotherapy is a context-focused therapy to improve postural control in sitting.

The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study

OBJECTIVE: Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates. METHODS: Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals. RESULTS: After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul’s ADHD Rating Scale-Korean version. CONCLUSION: Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.

The Effect of Hippotherapy and Medication on Children with Attention Deficit Hyperactivity Disorder: A Pilot Study / 신경정신의학

OBJECTIVES: This study researched the clinical effects of hippotherapy and medication in attention deficit hyperactivity disorder (ADHD) children. METHODS: The study employed an open label randomized controlled trial. Participants were 10 children of ages between 6 and 12 years. These subjects were placed in 2 groups : the hippotherapy group and the medication group. Evaluation tools used in this study include Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version, the Wechsler Intelligence Scale for Children-IV, Korean Child Behavior Check List (K-CBCL), ADHD rating scale (ARS), Clinical Global Impression (CGI), and Quantitative electroencephalography (QEEG). RESULTS: Grossly scores of investigator-administered ADHD rating scale (ARS-I), K-CBCL, and CGI-Severity of Illness scale were improved in both the hippotherapy and the medication group. The ARS-I scores of the Hippotherapy group were not significantly different from baseline after 12 weeks. In the QEEG, theta/beta ratio of Pz area in the hippotherapy group was significantly different from baseline. Children treated with medication showed significant difference from baseline in ARS-I, K-CBCL subscales, and QEEG. CONCLUSION: The use of hippotherapy could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD. This pilot study provides good prospects for future studies to document these positive trends on larger samples.