Effects of Hippotherapy and Horse-Riding Simulators on Gross Motor Function in Children with Cerebral Palsy: A Systematic Review.

: Cerebral palsy (CP) can have a negative impact on gross motor function. Conventional hippotherapy and horse-riding simulators (HRS) have shown promising results on gross motor function in populations with neurological disorders. This review aims to update the knowledge on the effectiveness of hippotherapy on gross motor function in children with CP. : A search was conducted in Academic Search Ultimate, CINAHL, Medline complete, and PEDro covering publications between 2012 and 2022. Two authors identified studies that met the inclusion criteria; a third author resolved discrepancies. Studies were included if they analyzed the effects of hippotherapy on the gross motor function of children with CP. The quality of the methodology was assessed according to the PEDro scale. : Of the 150 studies initially identified, 9 were included in this review. The studies showed fair (N = 3) and good (N = 6) methodological quality on the PEDro scale. The majority used conventional hippotherapy (N = 7), while a minority used HRS (N = 2). The most commonly used protocol for conventional hippotherapy was 1-2 sessions of 30-45 min per week for 8 weeks (N = 4), whereas for HRS, these protocols were varied. Seven studies on conventional hippotherapy and one study on HRS showed improvements in gross motor function. However, the hippotherapy protocols were not very standardized and the samples were neither homogeneous nor representative. : Conventional hippotherapy and HRS appear to have evidence to support their benefits on gross motor function in children with CP. However, more clinical trials with standardized protocols and more representative samples are needed to confirm these effects.