Usefulness of hippotherapy

PICHON-RIVIERE A,; AUGUSTOVSKI, F; ALCARAZ A; BARDACH, ARIEL; FERRANTE, D; GARCIA MARTÍ, SEBASTIAN; GLUJOVSKY, D; LOPEZ, A; REGUEIRO, A

Documentos de Evaluación de Tecnologías Sanitarias

IECS

Año: 2006 p. 1 - 30

1668-2793

The aim of this report was to analyze the scientific evidence available on the efficacy and safety of hippotherapy as a rehabilitation strategy for different pathologies.A search was carried out on the main literature databases (PubMed, LILACS, EMBASE, Cochrane Library, CENTRAL, HTA database, NHS EED and DARE), in health technology assessment agencies and health sponsors. Finally, another search was done using the medical information search engines SCOPUS and TRIPDATABASE.3 controlled clinical trials, 27 non controlled studies or case reports and 2 additional studies which used an alternative to hippotherapy were found.One controlled study analyzed the progress of 17 patients who receive hippotherapy after undergoing a nucleotomy (low back intervertebral disc surgery) in comparison with 16 patients who underwent the same surgery but with conventional follow-up. Improvement was observed in the patient's self-assessment as regards their post-surgical condition as well as a reduction in the time to return to work. In another controlled study, 15 patients with spastic cerebral palsy between 4 and 12 years old were randomized to receive 8-minute sessions of hippotherapy or 8-minute sessions of riding on a fixed barrel (control group). After the sessions, the trunk and upper limbs muscle activity was measured with a surface electromyogram. The authors reported a tendency towards improvement in the symmetry of muscle activity of those patients receiving hippotherapy.The biggest controlled study, randomized 100 patients between 3 and 14 years old with cerebral palsy to hippotherapy vs. gym. The patients were assessed using a score developed by the authors which measures functional ability as regards movement, balance and spasticity. Improvement was observed in both groups once the intervention was completed, which was better in the hippotherapy group. Among the non-controlled studies, 9 whose main indication was muscle spasticity related to cerebral palsy and other 4 where the patients studied presented spasticity related to other neurological disabilities were identified. In general, these studies reported a varying extent of improvement in motor function, posture and gait with an increase in joint motility and reduction in muscle tone. The rest of the studies discussed several conditions, 5 of them related to the field of psychotherapy.In our setting, the approximate cost of a 60 minute session averages 60$ (50$ to 75$). Rates are expressed in Argentine pesos, July, 2006.