Rachel is 10. She has cerebral palsy. She has a twin brother who is unaffected. She uses a walking frame but still needs the help of an adult. She has bladder and bowel control but because she can’t stand unaided, needs help with toileting. Rachel’s speech is also affected and she has poor fine motor skills making her very slow to complete written work. He r maths work is also extremely weak. She is a very bubbly happy child and is very popular with her peers.
As a result of her problems with fine motor skills she has been given an Alpha Smart word processor which allows her to type up work. Although her typing speed is still slow, it is easier for her to type than to try to form letters with a pencil.
Rachel wants to be part of all the class activities and, using her walking frame moves around the playground quite freely. She always takes part in P.E. using her frame if it is a team game such as rounders. If the class is doing activities which Rachel cannot do, her classroom assistant will work with her to improve her skills, e.g. throwing and catching different sized balls from a seated position.
This case study followed a 6-year-old child with cerebral palsy for an additional 24 weeks after a 12-week pilot study of hippotherapy (HPOT).
Pre-post measures were performed using a video motion capture system before and after 12 weeks, showing head/trunk control improvements.
The third measure after 24 more weekly treatments showed no further improvement on the original variables. However, an unanticipated improvement in postural sway was found at the end of 9 months.
This suggests that additional investigations are needed with more children with cerebral palsy over longer periods to identify outcomes from extended interventions beyond the 6–12 weeks of most published HPOT studies. Such further work could support better treatment planning and inform discharge criteria considering diminishing returns. The information would provide better evidence-based criteria for referrals and funding. This may make HPOT more accessible for those with disabilities who can benefit in specific and predictable ways.