Context: Equine-assisted therapy in different facets aims to improve the clinical condition of children with cerebral palsy. A more comprehensive overview on the overall effects and on the differences between different treatment modalities seems desirable.
Objective: We compared the effectiveness of various equine-assisted treatments on motor capabilities and quality of life of children with cerebral palsy.
Data sources: We conducted systematic searches of PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials.
Study selection: Randomized and nonrandomized controlled parallel-group or crossover studies on equine-assisted therapies in comparison with standard of care were included.
Data extraction: Data on motor function assessed by different instruments were considered as the primary outcome. Secondary outcomes included global, social, physical, and emotional scores of quality of life.
Results: Strong evidence for a positive effect of equine-assisted therapies, particularly hippotherapy, on global gross motor function and motor capabilities during walking in children with cerebral palsy was identified (SMD 0.24, 95% CI 0.05 to 0.43, P = .01, t2 = 0.00, I2 = 15%; SMD 2.68, 95% CI 1.02 to 4.34, P = .002, t2 = 0.0, I2 = 0%). No evidence for the improvement in quality of life could be shown in the global assessment, nor in any subscore.
Conclusions: Equine-assisted therapy, particularly hippotherapy, can be a therapeutic tool for children who are learning to walk.
Limitation: The heterogeneity of tools used in different studies and the low number of studies addressing quality of life issues limited the number of studies available for distinct analyses.