Riding may benefit children with cerebral palsy

~ Researchers found that hippotherapy significantly improved head and trunk stability.

ST. LOUIS -- The gentle, rocking motion of a horse is believed to help children with cerebral palsy by strengthening core muscles and neural connections.

Researchers at Saint Louis University are trying to add to the scientific evidence with a new study that will quantify a child's disability before and after a 12-week course of weekly sessions.

On a recent afternoon, Beau, a 17-year-old Arabian gray, ambled through a paddock at Ride On St. Louis, a therapeutic riding center in Kimmswick, south of St. Louis.

Nathan Collier, an 8-year-old with cerebral palsy, struggled to remain upright on the horse but smiled through the exercise.

Nathan Collier, 8, of St. Louis rode a horse named Beau during a hippotherapy session Tuesday at the Ride On St. Louis in Kimmswick, Mo. Researchers at Saint Louis University are trying to add to the scientific evidence with a new study that will quantify a child's disability before and after a 12-week course of weekly sessions. (HUY RICHARD MACH ~ St. Louis Post-Dispatch)

"The children don't know they're getting therapy," physical therapist Anne Cochran told the St. Louis Post-Dispatch. "They're just having fun."

Seeing results

A small but growing number of scientific studies are showing how hippotherapy -- from the Greek word "hippos," for horse -- can help children with cerebral palsy, a neurological disability that keeps them from smoothly controlling their muscles. The theory: The rocking motion of a horse creates more than 100 small shoves a minute. A child would therefore strengthen core muscles and neural connections about 3,000 times in a 30-minute therapy session.

"The people that do it, know and see the results," said Ride On St. Louis director Rick Wassman. "But the insurance companies don't recognize that."

Saint Louis University biomechanist Jack Engsberg has used his motion analysis laboratory to study the gaits of amputees and the post-surgery posture of people with scoliosis. Now, he's using six special cameras to capture the movements of children with cerebral palsy.

He and occupational therapist Tim Shurtleff will stick 21 reflective balls on the children's bodies, concentrating on the spine. The cameras capture the movement of the balls, and a computer transforms the images into a 3-D model of how the child moves over time.

Before and after the 12-week course, the children will ride a mechanical horse built by Shurtleff.

In a pilot study of six children, the researchers found that hippotherapy significantly improved head and trunk stability. Now, they want to test 12 children and see how long the benefits last.

Insurance companies balk

Using the motion analysis laboratory to study hippotherapy is a novel idea -- and needed, said Dr. John A. Sterba, a physician and physiologist who does pediatric rehabilitation research at the Women and Children's Hospital of Buffalo, N.Y.

"There's very little research because it's extremely hard to do it," he said.

In a 2007 review paper, Sterba found 11 published studies of the effects of horse therapy on children with cerebral palsy. All but one showed the therapy improved the children's motor skills.

But insurance companies remain suspicious. A recent policy bulletin from Aetna said hippotherapy was "experimental" because the science was still "insufficient."

At Ride On St. Louis, Wassman says the total cost of hippotherapy runs about $400 per hour, though foundation grants allow families to pay 10 percent of that.