Outcomes following physical therapy incorporating hippotherapy on neuromotor function and bladder control in children with Down syndrome: A case series.

Aims: The objective of this case series was to document gross motor function, gait parameter, and bladder control outcomes following physical therapy incorporating hippotherapy in children with Down syndrome (DS).
Methods: Four children between three and five years of age received eight-weekly physical therapy sessions incorporating hippotherapy. Outcome measures included the Gross Motor Function Measure-88 (GMFM-88), parental perception of function during every day activities, spatiotemporal parameters of gait and bladder control.
Results: Total change scores on the GMFM-88 exceeded the standardized response mean in all four children, while scores on Dimension E improved in two children. From the mothers' perspectives, all children showed at least some improvement in walking, running, and jumping; sitting, kneeling, and standing; symmetry and comfort; balance; coordination and social interactions and there were inconsistent changes in bladder control. Only one child demonstrated changes greater than 20% in any of the gait parameters. Conclusions: Physical therapy incorporating hippotherapy may be a potential treatment to assist in improving gross motor function in children with DS, but eight sessions may not be long enough to show major improvements in gait parameters or bladder control. Further research in the form of larger controlled trials is warranted to provide more support for the intervention in those with DS.