Article

It is debatable whether adaptive riding (AR) in children with
cerebral palsy (CP) improves postural control and gross motor development.
The study aim was to explore the feasibility of an extensive
assessment protocol for a randomized controlled trial of therapist-designed
adaptive riding (TDAR) in children with CP, with the goals of assessing the
effect on child outcomes and evaluating working mechanisms of sitting postural
control. DESIGN: A pretest-posttest group design with 2 baseline measurements was
used. METHODS: Six children (1 girl, 5 boys; age range=6-12 years, median age=8
years 9 months) with bilateral spastic CP (Gross Motor Function Classification
System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2)
at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a
TDAR intervention including an integrated program of postural challenge exercises
(2 times per week for 1 hour) was applied. The complex protocol included the
88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG)
recording of postural muscle activity during reaching while sitting (EMG
recording at T1 and T2 only). RESULTS: The protocol was feasible. Median GMFM-88
scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2.
The change scores for all children exceeded the minimal clinically important
difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped
top-down recruitment between T1 and T2. LIMITATIONS: Study limitations included
the lack of a control group, small sample size, and potential assessor bias for
all but the EMG parameters. CONCLUSIONS: The feasibility of the complex protocol
was established. The data suggested that a 6-week TDAR intervention may improve
gross motor function and may reduce stereotyped postural adjustments in children
with CP. The limited results warrant replication in a well-powered randomized
controlled trial.
CI - (c) 2015 American Physical Therapy Association.
- Equithérapie - Hippotherapy

Langue : ANGLAIS