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Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature.

ABSTRACT: Cerebral palsy is described as a group of permanent neuromotor-type disorders caused by non-progressive injuries in the developmental stages of the central nervous system, and which have serious repercussions on the quality of life of affected children due to the physical and psychological damage it entails for them. Today, it is the leading cause of physical disability in childhood. Since there is no cure for this disorder, treatment is based on the improvement of symptoms, which is not always achieved through conventional therapies. For this reason, the need arises to investigate other alternative therapies, such as hippotherapy, to determine the main effects of hippotherapy as a rehabilitation therapy in children with cerebral palsy. The review was performed in accordance with the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and was registered under the number CRD42021233003. The databases used were PubMed, Dialnet and the web browser Google Scholar. After applying the inclusion criteria, we included 11 articles. As a conclusion, we found that hippotherapy provides benefits at physical, psychological, cognitive and social levels in children with cerebral palsy, and thus it should be considered as a complementary rehabilitation therapy to conventional treatments.

SUBMITTER: Menor-Rodriguez MJ

PROVIDER: S-EPMC8230898 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature.

Menor-Rodríguez María José MJ Sevilla Martín Mar M Sánchez-García Juan Carlos JC Montiel-Troya María M Cortés-Martín Jonathan J Rodríguez-Blanque Raquel R

Journal of clinical medicine 20210611 12

Cerebral palsy is described as a group of permanent neuromotor-type disorders caused by non-progressive injuries in the developmental stages of the central nervous system, and which have serious repercussions on the quality of life of affected children due to the physical and psychological damage it entails for them. Today, it is the leading cause of physical disability in childhood. Since there is no cure for this disorder, treatment is based on the improvement of symptoms, which is not always ...[more]

PMID: 34208206

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Project description:BackgroundCerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy.AimSystematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy.MethodsA search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284).ResultsFifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%.ConclusionSome promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias.

Project description:BACKGROUND: Inborn errors of metabolism (IEMs) have been anecdotally reported in the literature as presenting with features of cerebral palsy (CP) or misdiagnosed as 'atypical CP'. A significant proportion is amenable to treatment either directly targeting the underlying pathophysiology (often with improvement of symptoms) or with the potential to halt disease progression and prevent/minimize further damage. METHODS: We performed a systematic literature review to identify all reports of IEMs presenting with CP-like symptoms before 5 years of age, and selected those for which evidence for effective treatment exists. RESULTS: We identified 54 treatable IEMs reported to mimic CP, belonging to 13 different biochemical categories. A further 13 treatable IEMs were included, which can present with CP-like symptoms according to expert opinion, but for which no reports in the literature were identified. For 26 of these IEMs, a treatment is available that targets the primary underlying pathophysiology (e.g. neurotransmitter supplements), and for the remainder (n?=?41) treatment exerts stabilizing/preventative effects (e.g. emergency regimen). The total number of treatments is 50, and evidence varies for the various treatments from Level 1b, c (n?=?2); Level 2a, b, c (n?=?16); Level 4 (n?=?35); to Level 4-5 (n?=?6); Level 5 (n?=?8). Thirty-eight (57%) of the treatable IEMs mimicking CP can be identified by ready available metabolic screening tests in blood or urine, while the remaining IEMs require more specific and sometimes invasive tests. CONCLUSIONS: Limited by the rare nature of IEMs and incomplete information in the literature, we conclude that (1) A surprisingly large number of IEMs can present with CP symptoms, as 'CP mimics', (2) although individually rare, a large proportion of these diseases are treatable such that neurological damage can either be reversed or prevented, (3) clinician awareness of treatable CP mimics is important for appropriate screening, diagnosis, and early intervention, and (4) systematic studies are required to elucidate the collective frequency of treatable IEMs in CP.

Dataset Information

Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature.

Publications

Role and Effects of Hippotherapy in the Treatment of Children with Cerebral Palsy: A Systematic Review of the Literature.

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