Cerebral Palsy (CP), Fascia, Hippotherapy, Motor Coordination or Function, Quality of Life, Rehabilitation
Conditions
Brief summary
The effects of hippotherapy on gross motor function, balance, and spasticity in children with cerebral palsy (CP) are well-documented, but its impact on the thoracolumbar fascia (TLF) remains unexplored area to date. This research protocol aims to investigate the short-term effects of hippotherapy on the viscoelastic and biomechanical properties of the TLF and quality of life (QoL) in children with spastic CP and their parents/caregivers. A 4-week randomized control trial will compare the effects of once-weekly and twice-weekly hippotherapy sessions to a control group without intervention. The study will assess the viscoelastic and biomechanical properties of the TLF using the MyotonPRO device in children with spastic CP aged 4-12 years. Myotonometer parameters, including oscillation frequency, stiffness, logarithmic decrement, stress relaxation, and creep, will be analyzed before, during, and after the intervention. Functional tests, such as the 10-meter walk test (comfortable and fast walking), cadence, one-leg stance test (eyes open and closed), and functional reach test (forward and lateral), will also be monitored. QoL will be assessed using the CP QOL-Child questionnaire. The primary outcomes will include changes in myotonometer parameters, their correlation with functional tests, and differences between intervention groups. Secondary outcomes will explore whether hippotherapy impacts QoL and the relationship between QoL domains and TLF properties. Results will evaluate whether twice-weekly therapy yields statistically significant differences in the specified parameters compared once-weekly sessions and contribute to understanding hippotherapy's mechanisms, supporting more individualized therapies to improve QoL for children with CP and their families.
Interventions
OTHERHippotherapy 1x/week
This group will perform hippotherapy once per week for 12 weeks
OTHERHippotherapy 2x/week
This group will perform hippotherapy twice per week for 12 weeks
Sponsors
University Medical Centre Ljubljana
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
4 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* classified as level II or III according to the GMFCS, and who, according to the assessment of a specialist physician, are indicated for hippotherapy aged between 4 and 12 years * who are undergoing neurophysiotherapeutic treatment * who have not undergone orthopedic surgery in the last six months and do not have uncontrolled epilepsy * are willing to be randomly assigned to any group (or whose parents/caregiver's consent) * understand instructions in Slovene and are willing to participate in the study for four weeks (or whose parents/ caregiver's consent) * without skin diseases, scars, or wounds on the examined part of the back
Exclusion criteria
* who have previously participated in a hippotherapy program * with a known and diagnosed psychiatric disorder for which hippotherapy is contraindicated * with limitations due to hearing or visual impairment * with painful adductor contractures, painful subluxation, or hip dislocation are not willing to be randomly assigned to any group (or whose parents/caregiver's consent) * who are afraid of horses or have an allergy to horsehair * with skin diseases, scars, or wounds on the examined part of the back
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in viscoelastic properties in TLF (5 measurable parameters) | 1. baseline (before hippotherapy starts): all groups 2. in 2 weeks (midway through the therapy): all groups 3. in 4 weeks (at the end of hippotherapy): all groups 4. one day after the completion of the 4-week hippotherapy: only experimental groups | 1. oscillation frequency (F)-Hz 2. dynamic stiffness (S)-N/m 3. oscillation decrement (D)-arb 4. mechanical stress relaxation time (R)-ms (milliseconds) 5. creep (C)-arb |
| Functional tests (7 measurable parameters) | 1. baseline (before hippotherapy starts): all groups 2. in 2 weeks (midway through the therapy): all groups 3. in 4 weeks (at the end of hippotherapy): all groups 4. one day after the completion of the 4-week hippotherapy: only experimental groups | 1. 10-meter walk test (comfortable walking)-10 m/time spent in seconds 2. 10-meter walk test ( fast walking)-10 m/time spent in seconds 3. cadence (steps/minute) 4. a one-leg stance test with eyes open-seconds 5. a one-leg stance test with eyes closed-seconds 6. functional reach test forward-centimetres 7. functional reach test lateral-centimetres |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life of children and Quality of live of their parents/caregivers | 1. baseline (before hippotherapy starts) 2. in 4 weeks (at the end of hippotherapy) | CP QOL-Child questionnaire (version for children) to children aged between 9 and 12 years in both experimental groups. CP QOL-Child questionnaire (version for parents) to the parents/caregivers of all children in both experimental groups. |
Countries
Slovenia
Contacts
Primary ContactSabina Devjak Novak, PhD
Outcome results
None listed