Effect of mechanical horseback riding on sitting performance in children with spastic cerebral palsy : a pilot study

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Effect of mechanical horseback riding on sitting performance in children with spastic cerebral palsy : a pilot study

 

Author: Kwan, Fung-kuen Sophia
Title: Effect of mechanical horseback riding on sitting performance in children with spastic cerebral palsy : a pilot study
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Cerebral palsied children -- Rehabilitation.
Horsemanship -- Therapeutic use.
Cerebral palsy -- Treatment.
Department: Dept. of Rehabilitation Sciences
Pages: xi, 67 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2302519
URI: http://theses.lib.polyu.edu.hk/handle/200/3660
Abstract: Purpose: This study aims to investigate the effects of mechanical horseback riding (MHR) training on the sitting performance in non-ambulatory children with spastic cerebral palsy (CP). Methods: This study was a cohort of within-series case studies with ABA experimental design. Four non-ambulatory children with spastic CP and severe cognitive impairments (mean age 12 y 9 mo; 2 males, 2 females at GMFCS levels III-FV; 3 involved bilaterally and 1 unilaterally) were evaluated at baseline, intervention and second baseline period, with each phase lasted for 3 weeks for a total of 9 weeks. During the invention phase, all children received 3-week intensive MHR training (15 minutes daily, 5 days a week). Sitting performance and postural control of children were evaluated by GMFM (Dimension B, Sitting) at the beginning and end of each study phase. Amount of body sway was evaluated at the beginning and once every week during the 9-week study period. Amount of sway was quantified by root mean square (RMS) of amplitude of center of pressure (COP) in antero-posterior (AP) and medio-lateral (ML) directions while the child sit still and upon perturbation on the force plate. Results: Mechanical horseback riding was well accepted by children with CP associated with severe cognitive impairment. Following 3 weeks of MHR training, 1 child with unilateral CP at GMFCS level HI showed large improvements in GMFM scores (15% and 18.3%, respectively, as evaluated by two assessors), co-committed with a decrease in COP RMS values in AP direction upon perturbation. Three children with bilaterally CP and GMFCS level FV did not show improvement after MHR training. Conclusion: Preliminary results suggest that MHR training improve sitting performance of children with less severe form of CP at GMFCS level III. Compare to traditional manual facilitation, MHR is relatively easier to administer in children with severe cognitive impairment to elicit postural responses. Further study is recommended to focus on the effects of MHR in children with different severity level of CP, in order to explore the best treatment options in enhancing sitting postural control in non-ambulatory children with CP.

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