Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does hippotherapy improve gross motor function in children with cerebral palsy?”.

STUDY DESIGN: A systematic review of three randomized controlled trials (RCTs), with one being a randomized crossover trial. All three were published between 2015 and 2018.

DATA SOURCES: Three RCTs published in peer-reviewed journals were chosen from PubMed. The studies were selected based on their relevance to the clinical question.

OUTCOMES MEASURED: The outcome measured was improvement in gross motor function. Either hip adductor spasticity using Modified Ashworth Scale (MAS) or the Gross Motor Function Measure 66 (GMFM-66) was used to assess the outcomes. Scores were assessed before and after treatments were conducted.

RESULTS: The statistical analyses used were mean change from baseline and p-values. In the RCT conducted by Lucena-Antón et al., hippotherapy led to a reduction in hip adductor spasticity by an average of 0.27 in the left and 0.45 in the right. In the randomized crossover trial led by Deutz et al., the mean change in GMFM-66 between hippotherapy intervention period and no hippotherapy period was 2.99 in the early treatment group (ETG) and 1.60 in the late treatment group (LTG). In the RCT conducted by Kwon et al., the mean change in GMFM-66 from baseline in the hippotherapy group was 2.7. All three studies found a statistically significant difference between the intervention and the control group with a p-value <0.05.

CONCLUSIONS: All three studies found statistically significant improvement in gross motor function in the intervention group compared to the control group. The results of this selective review suggest that hippotherapy is more effective in improving gross motor function in children with cerebral palsy than conventional physical therapy alone. Further studies should be conducted in the United States comparing the effectiveness of hippotherapy to the standard physical therapy administered in the States.