Acta Gymnica 2015, 45(1):27-32 | DOI: 10.5507/ag.2015.004

The benefit of hippotherapy for improvement of attention and memory in children with cerebral palsy: A pilot study

Eva Krejčí1,2, Miroslav Janura1, Zdeněk Svoboda1
1 Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic;
2 The Czech Therapeutic Riding Association, Prague, Czech Republic

Background: The research is based on an assumption that the hypokinesia induced by cerebral palsy (CP) leads to inhibition of some mental functions. The method we used to treat patients with CP, hippotherapy (HT), is a treatment using horses and belongs to proprioceptive-neuromuscular-facilitative methods.

Objective: The aim of the research was to determine the benefit of HT on attention and memory of patients with CP.

Methods: There were two groups of patients: short-term HT (n = 11; 8 females and 3 males, age 15.4 ± 5.3 years) and long-term HT (n = 9; 7 females and 2 males, age 10.8 ± 2.7 years). The short-term HT group participated in daily 30 minute-long HT sessions for duration of a week-long summer therapy camp; while with the long-term HT group, HT sessions of the same length were used weekly for 5-6 weeks. Attention and memory skills were assessed with "Numeric square test" and "Verbal learning test", respectively. Both tests were undertaken before starting and after concluding the camp or the 5-6 week long HT period.

Results: Attention improvement demonstrated in a significant decrease of an average time of "Numeric square test". The improvement was seen in both long-term HT (15.7 seconds overall average time reduction after HT, p < .01) and short-term HT (20.8 seconds reduction, p < .01) groups. Short-term memory improvement was found in the long-term HT group, demonstrated by a higher number of memorized words (more than half of the patients memorized on average 10.5 more words after HT) (p < .05). While the short-term HT group did not show significant improvement of attention or short-term memory, the average number of memorized words after a diversion of attention and a 30 minute delay increased by 4.1, showing an improvement (p < .05) of long-term memory.

Conclusions: Our results suggest that hippotherapy as a part of comprehensive therapy in patients with CP leads to improvement of memory and attention skill.

Keywords: memory, attention, equine-assisted therapy, horse, movement, brain

Published: March 31, 2015  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Krejčí, E., Janura, M., & Svoboda, Z. (2015). The benefit of hippotherapy for improvement of attention and memory in children with cerebral palsy: A pilot study. Acta Gymnica45(1), 27-32. doi: 10.5507/ag.2015.004
Download citation

References

  1. Barca, L., Frascarelli, F., & Pezzulo, G. (2012). Working memory and mental imagery in cerebral palsy: A single case investigation. Neurocase, 18, 298-304. Go to original source... Go to PubMed...
  2. Bass, M. M., Duchowny, C. A., & Llabre, M. M. (2009). The effect of therapeutic horseback riding on social functioning in children with autism. Journal of Autism and Developmental Disorders, 39, 1261-1267. Go to original source... Go to PubMed...
  3. Bax, M., Goldstein, M., Rosenbaun, P., Leviton, A., Paneth, N., Dan, B., … Damiano, D. (2005). Proposed definition and classification of cerebral palsy (April 2005). Developmental Medicine and Child Neurology, 47, 571-576. Go to PubMed...
  4. Benjamin, J. (2000). Introduction to hippotherapy. Retrieved from http://www.americanhippotherapyassociation.org/aha_hpot_A-intro.htm
  5. Casady, R. L., & Nichols-Larsen, D. S. (2004). The effect of hippotherapy on ten children with cerebral palsy. Pediatric Physical Therapy, 16, 165-172. Go to original source... Go to PubMed...
  6. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York, NY: Academic Press.
  7. Debuse, D., Gibb, C., & Chandler, C. (2009). Effects of hippotherapy on people with cerebral palsy from the users' perspective: A qualitative study. Physiotherapy Theory and Practice, 25, 174-192. Go to original source... Go to PubMed...
  8. Engel, B. T. (Ed.). (2003). Therapeutic riding II: Strategies for rehabilitation (3rd ed.). Durango, CO: Barbara Engel Therapy Services.
  9. Ewing, C. A., MacDonald, P. M., Taylor. M., & Bowers, M. J. (2007). Equine-facilitated learning for youths with severe emotional disorders: A quantitative and qualitative study. Child Youth Care Forum, 36, 59-72. Go to original source...
  10. Frank, A., McCloskey, S., & Dole, R. (2011). Effect of hippotherapy on perceived self-competence and participation in a child with cerebral palsy. Pediatric Physical Therapy, 23, 301-308. Go to original source... Go to PubMed...
  11. Granados, A., & Agís, I. (2011). Why children with special needs feel better with hippotherapy sessions: A conceptual review. The Journal of Alternative and Complementary Medicine, 17(3), 35-52. Go to original source... Go to PubMed...
  12. Hollý, K., & Hornáček, K. (2005). Hipoterapie: léčba pomocí koně [Hippotherapy: Treatment using the horse]. Ostrava: Montanex.
  13. Jirásek, J. (1992). Číselný čtverec [Numeric square]. Bratislava: Psychodiagnostika.
  14. Jiskrová, I., Casková, V., & Dvořáková, T. (2010). Hiporehabilitace [Hipporehabiltiation]. Brno: Mendelova univerzita v Brně.
  15. Kendall, E., Maujean, A., Pepping, C. A., & Wright, J. J. (2014). Hypotheses about the psychological benefits of horses. Explore: The Journal of Science and Healing, 10, 81-87. Go to original source...
  16. Kern, J. K., Fletcher, C. L., Garver, C. R., Mehta, J. A., Grannemann, B. D., Knox, K. R., … Trivedi, M. H. (2011). Prospective trial of equine-assisted activities in autism spectrum disorder. Alternative Therapies in Health and Medicine, 17(3), 14-20. Go to PubMed...
  17. Komárek, V., Zumrová, A., et al. (2008). Dětská neurologie: vybrané kapitoly [Pediatric neurology: Selected chapters] (2nd ed.). Praha: Galén.
  18. Liptak, G. S. (2005). Complementary and alternative therapies for cerebral palsy. Mental Retardation and Developmental Disabilities Research Reviews, 11, 156-163. Go to original source... Go to PubMed...
  19. Macauley, B. L. (2006). Animal-assisted therapy for persons with aphasia: A pilot study. Journal of Rehabilitation Research and Development, 43, 357-365. Go to original source... Go to PubMed...
  20. Macauley, B. L., & Guiterrez, K. M. (2004). The effectiveness of hippotherapy for children with language-learning disabilities. Communication Disorders Quarterly, 25, 205-217. Go to original source...
  21. McGibbon, N. H., Andrade, C., Widener, G., & Cintas, H. L. (1998). Effect of an equine-movement therapy program on gait, energy expenditure, and motor function in children with spastic cerebral palsy: A pilot study. Developmental Medicine and Child Neurology, 40, 754-762. Go to original source... Go to PubMed...
  22. McGibbon, N. H., Benda, W., Duncan, B. R., & Silkwood-Sherer, D. (2009). Immediate and long-term effects of hippotherapy on symmetry of adductor muscle activity and functional ability in children with spastic cerebral palsy. Archives of Physical Medicine and Rehabilitation, 90, 966-974. Go to original source... Go to PubMed...
  23. Meberg, A., & Broch, H. (2004). Etiology of cerebral palsy. Journal of Perinatal Medicine, 32, 434-439. Go to original source... Go to PubMed...
  24. Meregillano, G. (2004). Hippotherapy. Physical Medicine and Rehabilitation Clinics of North America, 15, 843-854. Go to original source... Go to PubMed...
  25. Oppenheim, W. L. (2009). Complementary and alternative methods in cerebral palsy. Developmental Medicine & Child Neurology, 51(4), 12-29. Go to original source...
  26. Palisano, R. J., Hanna, S. E., Rosenbaum, P. L., Russell, D. J., Walter, S. D., Wood, E. P.,  … Galuppi, B. E. (2000). Validation of a model of gross motor function for children with cerebral palsy. Physical Therapy, 80, 974-985. Go to original source...
  27. Preiss, M. (1999). Pamě»ový test učení [Verbal learning test]. Bratislava: Psychodiagnostika.
  28. Rothaupt, D., Laser, T., & Ziegler, H. (1998). Hippoterapia a jej miesto v rehabilitacii [Hippotherapy and its place in rehabilitation]. Rehabilitácia, 31, 34-37.
  29. Schultz, P. N., Remick-Barlow, G., & Robbins, L. (2007). Equine-assisted psychotherapy: A mental health promotion/intervention modality for children who have experienced intra-family violence. Health & Social Care in the Community, 15, 265-271. Go to original source...
  30. Shurtleff, T. L., Standeven, J., & Engsberg, J. R. (2009). Changes in dynamic trunk/head stability and functional reach after hippotherapy. Archives of Physical Medicine and Rehabilitation, 90, 1185-1195. Go to original source... Go to PubMed...
  31. Strauss, I. (2007). Hippotherapie - Physiotherapie mit und auf dem Pferd [Hippotherapy: Physiotherapy with and on the horse]. Stuttgart: Thieme.
  32. Talic, A., & Honemeyer, U. (2010). Cerebral palsy: State of art. Donald School Journal of Ultrasound in Obstetrics and Gynecology, 4, 189-198. Go to original source...
  33. Taylor, R. R., Kielhofner, G., Smith, C., Butler, S., Cahill, S. M., Ciukaj, M. D., & Gehman, M. (2009). Volitional change in children with autism: A single-case design study of the impact of hippotherapy on motivation. Occupational Therapy in Mental Health, 25, 192-200. Go to original source...
  34. Winchester, P., Kendall, K., Peters, H., Sears, N., & Winkley, T. (2002). The effect of therapeutic horseback riding on gross motor function and gait speed in children who are developmentally delayed. Physical and Occupational Therapy in Pediatrics, 22(3-4), 37-50. Go to original source... Go to PubMed...
  35. Zadnikar, M., & Kastrin, A. (2011). Effects of hippotherapy and therapeutic horseback riding on postural control or balance in children with cerebral palsy: A meta-analysis. Developmental Medicine and Child Neurology, 53, 684-691. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.