H. Chinniah1, M. Natarajan1, R. Ramanathan2, F. AJW3
1Rajah Muthiah Medical College and Hospital, Annamalai University, Department of Physical Medicine and Rehabilitation, Annamalai Nagar, Chidambaram, India, 2Rajah Muthiah Medical College and Hospital, Annamalai University, Department of Paediatrics, Annamalai Nagar, Chidambaram, India, 3Rajah Muthiah Medical College and Hospital, Annamalai University, Department of Community Medicine, Annamalai Nagar, Chidambaram, India
Background: Hippotherapy simulator (HS) is an electronic horse riding simulator and produces rhythmical and repetitive movements. It is working under the principles of hippotherapy and considered as an alternative method for hippotherapy, which could be recommended in the rehabilitation of cerebral palsy (CP). Spastic diplegia is the most common type of CP, which primarily affects the lower limb. The most common clinical features of spastic diplegia are hypertonicity and stiffness or tightness in lower limb muscles. Management of hip adductor spasticity is the biggest challenge in the rehabilitation of CP. Hip adductor spasticity leads to reduced hip abduction range of motion, which interferes with positioning and difficulties in performing self-care activities.
Purpose: This study aimed to find out the effectiveness of HS on hip abduction range of motion in children with spastic diplegia and evaluate the magnitude of improvement at different periods of time (2 weeks, 4 weeks, and 6 weeks).
Methods: This study was a randomized controlled trial, which includes 30 children with spastic diplegia and divided into two groups, the experimental and the control group. The experimental group received therapy with a hippotherapy simulator for 30 minutes, 3 days/ week for 6 weeks and the control group received conventional physiotherapy for 30 minutes (range of motion exercise, stretching, and strengthening exercise) with the same protocol. Hip abduction passive range of motion (PROM) was measured with Goniometer at baseline, 2 weeks, 4 weeks, and 6 weeks. Pre and post-intervention scores were recorded and analyzed with appropriate statistical tools.
Results: The baseline characteristics were similar in both groups before the intervention with the p-value (p>0.01). The observed mean value of hip abduction PROM has been improved in both groups over a period of 6 weeks and the experimental group shows significantly better improvement (p<0.01) than the control group in all the weeks.
Conclusion(s): The study results confirmed that gradual improvement of Hip abduction passive range of motion (both sides) observed in both groups. Children exposed to HS shows better improvement than the children in the control group. It was concluded that the HS is effective in reducing adductor spasticity and improving hip abduction passive range of motion (both sides) in children with spastic diplegia and the provision of HS in longer duration provides more benefits than the shorter duration.
Implications: The observed results suggested that the HS is effective in reducing adductor spasticity and improving hip abduction range of motion and recommended to include this type of innovative therapy in the rehabilitation of children with CP.
Funding, acknowledgements: nil
Keywords: Hippotherapy Simulator, Spastic diplegia, hip abduction range of motion
Topic: Paediatrics: cerebral palsy
Did this work require ethics approval? Yes
Institution: Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, Tamilnadu, India
Committee: Institutions Human Ethics Committee
Ethics number: IHEC/0289/2017
All authors, affiliations and abstracts have been published as submitted.
