Exploration of measurement instruments and the effects on sitting balance after hippotherapy intervention in children with Cerebral Palsy

Abstract

Sitting balance deficits are a common problem in children with Cerebral Palsy (CP), for which hippotherapy is an effective intervention. However, its effectiveness cannot be assessed yet while seated on the back of a horse. Therefore, the current study aims to explore and analyze different measurement instruments used to evaluate the effectiveness of hippotherapy in children with CP. A systematic literature search was conducted in PubMed, Web of Science and Scopus. Methodological quality was assessed by the PEDro and SIGN-checklist. Characteristics of the population, interventions and measurement instruments were extracted. Functional and technological measurement instruments can be used to assess sitting balance. Three functional scales were reported: Sitting Assessment Scale, Segmental Assessment of Trunk Control and Gross Motor Function Measurement. Technological measurements included Center of Pressure movement/velocity and lateral trunk deviation. Both types of measurement instruments were sensitive to change. Measurement instruments that could be used to evaluate the effect of hippotherapy on sitting balance in children with CP are limited and none are specifically designed to assess balance on the back of a horse. Therefore, development of a new scale is recommended.