The effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury.
OBJECTIVE
To determine the effect of hippotherapy on spasticity and on mental well-being of persons with spinal cord injury (SCI), and to compare it with the effects of other interventions.


METHODS
Crossover trial with 4 conditions.


METHODS
Swiss paraplegic center.


METHODS
A volunteer sample of 12 people with spastic SCI (American Spinal Injury Association grade A or B).


METHODS
Hippotherapy, sitting astride a Bobath roll, and sitting on a stool with rocking seat. Each session lasted 25 minutes and was conducted twice weekly for 4 weeks; the control condition was spasticity measurement without intervention.


METHODS
Clinical rating by a blinded examiner of movement-provoked muscle resistance, using the Ashworth Scale; self-rating of spasticity by subjects on a visual analog scale (VAS); and mental well-being evaluated with the self-rated well-being scale Befindlichkeits-Skala of von Zerssen. Assessments were performed immediately after intervention sessions (short-term effect); data from the assessments were analyzed 3 to 4 days after the sessions to calculate the long-term effect.


RESULTS
By analyzing the clinically rated spasticity, only the effect of hippotherapy reached significance compared with the control condition (without intervention); median differences in the Ashworth scores' sum before and after hippotherapy sessions ranged between -8.0 and +0.5. There was a significant difference between the spasticity-reducing effect of hippotherapy and the other 2 interventions in self-rated spasticity by VAS; median differences of the VAS before and after hippotherapy sessions ranged between -4.6 and +0.05cm. There were no long-term effects on spasticity. Immediate improvements in the subjects' mental well-being were detected only after hippotherapy (P=.048).


CONCLUSIONS
Hippotherapy is more efficient than sitting astride a Bobath roll or on a rocking seat in reducing spasticity temporarily. Hippotherapy had a positive short-term effect on subjects' mental well-being.
Lechner
Helga E
HE
Swiss Paraplegic Centre, Nottwil, Switzerland. helga.lechner@paranet.ch
Kakebeeke
Tanja H
TH
Hegemann
Dörte
D
Baumberger
Michael
M
D000328:Adult; D000368:Aged; D000818:Animals; D018592:Cross-Over Studies; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D020336:Paraparesis, Spastic / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D013119:Spinal Cord Injuries / Q000534:rehabilitation*