Effects of hippotherapy on children with cerebral palsy: systematic review and meta-analysis

Objective: The most important goal of hippotherapy is to improve function, gait, and balance. The purpose of this study was to investigate the effects of hippotherapy on function, gait, and balance of children with cerebral palsy (CP). Design: A systematic review and meta-analysis. Methods: We’ve searched the PubMed, EMBASE, and Cochrane Library CENTRAL databases for English experimental studies published up until September 2018. To analyze the effects of hippotherapy on the function, gait, and balance of children with cerebral palsy, the systematic review and meta-analysis were performed on Patient/Participants/Population Problem, Intervention, Comparison, Outcome with Timing, Setting Study Design. Papers retrieved from the database were removed from the literature management database. Methodological quality evaluation was evaluated using Cochrane’s risk of bias. Data was analyzed using the Revman 5.3 program of the Cochrane library. Results: In this study, we found that the effect size of hippotherapy, denoted as d, was −3.82, and that hippotherapy had the most effect on gait, but no statistical significant difference was observed. We also found no significant difference in function and balance after hippotherapy. It was found from the funnel plot that there was no publication bias as the plot was symmetrically distributed around the dotted line. Conclusions: There are many unclear studies and a lack of randomized controlled trials (RCTs) in this research area. More RCTs on the effects of hippotherapy on children with CP should be conducted in the future.