Effect of hippo therapy on balance and function in children with spastic diplegia

Introduction: Hippo therapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse. The horse's pelvis has a similar three-dimensional movement to the human's pelvis at the walk. This movement provides physical and sensory input which is variable, rhythmic and repetitive which leads to improvement in spasticity and balance. Objective: The study aimed to find the effect of hippo therapy on balance and function in children with spastic diplegia. Material and methods: A quasi-experimental study was conducted at College of Physiotherapy, Ahmadabad. Sixteen children (8 in control group (A) and 8 in experimental group (B) with spastic cerebral palsy, aged 3 to 10 years with GMFCS level 1, 2, body weight less than 35 kg were included. Children with history of botulism toxin injection within 6 months, selective dorsal rhizotomy or orthopedic surgery within 1 year, moderate to severe intellectual disability, uncontrolled seizures, and poor visual or hearing acuity were excluded. Both groups were given neuro developmental technique (NDT), group B was given additional hippo therapy (riding on horse with minimal support as required) for 15 minutes twice a week. Outcome measures were Pediatric balance scale (PBS), GMFM 66, 88, Modified Ashworth scale. Level of significance was kept at 5%. Result: Within group, analysis did not show significant difference in GMFM scores in group A (W = 1.84, p = 0.066), but showed significant difference in PBS score (W = 2.214, p = 0.027). Within group analysis for group B showed significant difference in both GMFM score (W = 2.207, p = 0.027) and PBS score (W = 2.214, p = 0.027). Between group analysis for GMFM score showed significant difference (U = 0.500, p = 0.005). But there was no significant difference in between group analysis for PBS score (U = 12.00, p = 0.321). Conclusion: Hippo therapy and NDT both have similar effect for improving balance in spastic diplegic children. But Hippo therapy has an additional effect for improving gross motor function.