Innovative robotic hippotherapy improves postural muscle size and postural stability during the quiet stance and gait initiation in a child with cerebral palsy: A single case study

Abstract

BACKGROUND: Postural instability is an important pathomarker in children with cerebral palsy (CP), and is often implicated in gait disturbance. OBJECTIVE: The purpose of this study was to investigate the therapeutic effects of long-term robotic hippotherapy (HPOT) on postural muscles size and static and dynamic postural stability in a child with CP. METHODS: Ultrasonography was used to measure postural muscles size. We also evaluated the magnitude of the separation between the center of pressure (COP) and center of mass (COM) during quiet stance and gait initiation (GI) using an eight-camera motion capture system and two force plates. Robotic HPOT was provided as a 45-minute session once per week for 12 weeks. RESULTS: As transverse abdominal (12%) and lumbar multifidus (60%) muscles size improved, normalized sway area (16%) during the quiet stance decreased. Similarly, the maximal resultant COP-COM distance (12.84%) during the initial phase of GI increased. CONCLUSIONS: In a child with CP, robotic HPOT may be an important treatment for improving postural muscles size and postural stability in static and dynamic states.