"Characterization of Trunk & Pelvic Response to Mechanical Horse Riding for Children with/without Cerebral Palsy,"

Authors: Gobert D, Silveira J, Bowen J, Suh K, Jorgenson M & Foux R.

Purpose: The primary purpose of this study was to characterize responses in children with and without cerebral palsy (CP) to standardized, mechanical horse-riding methods used in hippotherapy to promote pelvic-trunk stability and balance.

Methods: The aim is to recruit 50 healthy children with and without CP by convenience sample, who are ambulatory with Gross Motor Function Classification System Levels I-III, and between the ages of 6 to 12 years. Volunteer participants were recruited from the Texas State campus and surrounding communities. Inclusion criteria was: if they could stand and walk independently with or without an assistive device and tolerate sitting on a mechanical simulator. Participants were expected to complete two testing sessions within 3-5 days. Testing sessions included electromyography and 3-D accelerometer tracking of pelvic-trunk activity during specific riding conditions and standardized physical performance measures: Bruininks-Oseretsky Test of Motor Proficiency – 2nd Ed. (BOT-2), Segmental Assessment of Trunk Control (SATCO), and the 10 Meter Walk Test (10MWT). Testing takes place at the Gait Analysis clinical lab at Texas State University in Round Rock, Texas.

Data Analysis: IBM SPSS v. 27.0 software was used for descriptive statistics including t-tests, repeated ANOVA, multivariate regressions, and Intraclass Correlation Coefficient to characterize group comparisons (alpha level = 0.05). Project analysis also included innovations in signal processing to characterize trunk muscle coordination and symmetry using the Delsys EMG Works software.

Results: Preliminary data has been collected from four children (M/F = 1/3): 3 without cerebral palsy and 1 with cerebral palsy. The average participants' age was 8.0 years-old, with a range of 6 to 10 years old, height = 133.67(+/- 23.80) cm and weight = 47.75(+/- 11.67) kg. The average SATCO total score was 20 and the average BOT-2 standard score was 54.33 (+/- 9.29) compared to 20. Gait velocity= 101.05 (+/- 6.01) cm/sec compared to 44.86 cm/sec., Walk Ratio = 0.46 (+/- 0.09) compared to 0.38 and Cadence = 114.19(+/- 9.14) steps/min compared to 84.29 steps/min. Gait Variability Index = 110.96 (+/-16.86) which was lower by comparison to 151.94%.

Clinical Impact & Relevance: Concluding results thus far have addressed existing gaps in knowledge about dose-related response to equine-assisted therapies and allow determination of how pelvic-trunk interactions of children with and without CP respond to changes in riding posture, speed, duration and task. Therefore, results will be fundamental to rehabilitation diagnostic, treatment, plan of care, and progression to support strategies specific to children with CP. Results of this project are fundamental to a larger external grant to be submitted to the American Physical Therapy Association Foundation and the Horses & Humans Foundation, Inc.