Improving trunk posture control in children with CP through a cable-driven robotic hippotherapy: A randomized controlled feasibility study.
Ming Wu, Janis Kim, Deborah Gaebler-Spira
PMID 38943825WHAT IT FOUND
Children with cerebral palsy tolerated a robot horse that rocks the pelvis while they sit astride, and their trunk control improved more than with conventional training after 6 weeks.
The difference was gone 8 weeks later.
Key findings
01Children tolerated the robotic horse and its pelvis perturbations, and 9 of the 10 completed all training and assessments; the single dropout was in the robotic group, so that group's results come from 4 children.
02Average trunk control score rose 6 points in the robotic group and fell 1 point in the conventional group between baseline and the end of training, a between-group difference the paper reports as significant (p = 0.048), but the robotic group's own change was not statistically significant (p = 0.37) and the groups did not differ at the 8-week follow-up (p = 0.52).
03Standing and walking gross motor scores did not change in either group, and fast walking speed, 6-minute walking distance and all other outcomes showed no significant change in either group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 10 children were enrolled and only 4 finished in the robotic group, so every comparison rests on very few children. The authors' own calculation says 10 children per group (20 in total) would be needed to show a significant difference. The person who scored the children's trunk control knew which group each child was in, and the authors accept this may have biased scores in favour of the robotic group. The children varied widely in how affected they were (levels I to IV on the Gross Motor Function Classification System), and the control group contained more children at level IV than the robotic group. The groups also differed on fast walking speed at the start. The advantage of robotic training over conventional training seen straight after 6 weeks was no longer present at the 8-week follow-up, so any gain was only partly retained. Eighteen training sessions may simply have been too few for gains to last; the authors suggest booster sessions might be needed, but this was not tested. The robotic horse is a machine and may be less comfortable than a real horse, which could affect how children respond to it. This was a feasibility study, so it was designed to see whether the training could be delivered and tolerated, not to prove that it works.
Declared interests
The authors state that they reported no potential conflict of interest. No funder is named in the article's disclosure statement; the journal record lists NIH extramural research support.
The easy way to misread this
Do not read the significantly greater trunk control change at 6 weeks as proof that robotic hippotherapy works for children with cerebral palsy. Only 10 children took part, 4 finished in the robotic group, the robotic group's own improvement was not statistically significant (p = 0.37), the assessor knew which group each child was in, and the groups no longer differed at the 8-week follow-up. Equally, do not read the 29% average rise as a change every child can expect, because it comes from 4 children.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →