title: Therapist-Designed Adaptive Riding in Children With Cerebral Palsy: Results of a Feasibility Study.
abstract: BACKGROUND
  It is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development.
  
  
  OBJECTIVE
  The study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed adaptive riding (TDAR) in children with CP, with the goals of assessing the effect on child outcomes and evaluating working mechanisms of sitting postural control.
  
  
  METHODS
  A pretest-posttest group design with 2 baseline measurements was used.
  
  
  METHODS
  Six children (1 girl, 5 boys; age range=6-12 years, median age=8 years 9 months) with bilateral spastic CP (Gross Motor Function Classification System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2) at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a TDAR intervention including an integrated program of postural challenge exercises (2 times per week for 1 hour) was applied. The complex protocol included the 88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG) recording of postural muscle activity during reaching while sitting (EMG recording at T1 and T2 only).
  
  
  RESULTS
  The protocol was feasible. Median GMFM-88 scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2. The change scores for all children exceeded the minimal clinically important difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped top-down recruitment between T1 and T2.
  
  
  CONCLUSIONS
  Study limitations included the lack of a control group, small sample size, and potential assessor bias for all but the EMG parameters.
  
  
  CONCLUSIONS
  The feasibility of the complex protocol was established. The data suggested that a 6-week TDAR intervention may improve gross motor function and may reduce stereotyped postural adjustments in children with CP. The limited results warrant replication in a well-powered randomized controlled trial.
authors.affiliation: M. Angsupaisal, PT, MSc, Division of Developmental Neurology, Department of Paediatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Mattana
authors.initials: M
authors.lastname: Angsupaisal
authors.affiliation: B. Visser, PT, MPPT, Division of Developmental Neurology, Department of Paediatrics, University of Groningen, University Medical Center Groningen.
authors.forename: Baudina
authors.initials: B
authors.lastname: Visser
authors.affiliation: A. Alkema, BSc, Division of Developmental Neurology, Department of Paediatrics, University of Groningen, University Medical Center Groningen.
authors.forename: Anne
authors.initials: A
authors.lastname: Alkema
authors.affiliation: M. Meinsma-van der Tuin, MD, Rehabilitation Center Revalidatie Friesland, Beetsterzwaag, the Netherlands.
authors.forename: Marja
authors.initials: M
authors.lastname: Meinsma-van der Tuin
authors.affiliation: C.G.B. Maathuis, MD, PhD, Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen.
authors.forename: Carel G B
authors.initials: CG
authors.lastname: Maathuis
authors.affiliation: H. Reinders-Messelink, PhD, Rehabilitation Center Revalidatie Friesland.
authors.forename: Heleen
authors.initials: H
authors.lastname: Reinders-Messelink
authors.affiliation: M. Hadders-Algra, MD, PhD, Division of Developmental Neurology, Department of Paediatrics, University of Groningen, University Medical Center Groningen, Y3208, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. m.hadders-algra@umcg.nl.
authors.forename: Mijna
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D000818:Animals; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D004576:Electromyography; D056147:Equine-Assisted Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D016896:Treatment Outcome