1Nevsehir Haci Bektas Veli University, Faculty of Education, Department of Physical Education and Sport, Nevsehir, Turkey
2Canakkale Onsekiz Mart University, Faculty of Sport Sciences, Canakkale, Turkiye
Effects of Adaptive Riding on Children with Cerebral Palsy
Sport Mont 2026, 24(1), Ahead of Print | DOI: 10.26773/smj.260208
Abstract
This study investigated the effects of adaptive riding exercise on specific physical parameters in children with cerebral palsy (CP). Twenty children with CP (ages 8–12 years) were randomly assigned to an experimental group (n=10) or a control group (n=10). The intervention involved a 12-week adaptive riding program, consisting of 30–45 minute ses sions, three times per week, led by a certified instructor and supported by specially trained horses and volunteer univer sity students. Data collection, executed via pre- and post-intervention assessments, focused on parameters including leg-back strength, unilateral-bilateral flexibility, accuracy, linearity, maximal grip force, and the rate of grip force develop ment. Data were analyzed using a mixed-model ANOVA. The experimental group demonstrated statistically significant improvements over the control group in several measures, including hand-eye coordination, maximal grip strength, flex ibility, and muscle strength. The findings suggest that adaptive riding exercise provides a supportive therapeutic effect for children with CP, specifically those classified as GMFCS Levels II and III. Therefore, it is recommended that children with CP who are GMFCS levels 2 and 3 participate in adaptive riding programs.
Keywords
adaptive horseback riding, cerebral palsy, equine-assisted exercise, equine-assisted services, motor performance, disabled sport

View full article
(PDF – 492KB)
References
Akpinar, S. (2016). Decreased interlimb differences in female basketball players. The Journal of Sports Medicine and Physical Fitness, 56(12), 1448–1454.
Aleknavičiūtė-Ablomkė, V., Savenkovienė, A., Mockevičienė, D., & Miliūnienė, L. (2015). The effect of hippotherapy on trunk muscles EMG, grasping and changes of functional mobility of person after coma: Case study. Social Welfare Interdisciplinary Approach, 5(2), 92–100.
Alemdaroğlu, E., Yanıkoğlu, İ., Öken, Ö., Uçan, H., Ersöz, M., Köseoğlu, B. F., & Kapıcıoğlu, M. İ. S. (2016). Horseback riding therapy in addition to conventional rehabilitation program decreases spasticity in children with cerebral palsy: A small sample study. Complementary Therapies in Clinical Practice, 23, 26–29. https://doi.org/10.1016/j.ctcp.2016.02.002
Angsupaisal, M., Visser, B., Alkema, A., Meinsma-van der Tuin, M., Maathuis, C. G., Reinders-Messelink, H., & Hadders-Algra, M. (2015). Therapist-designed adaptive riding in children with cerebral palsy: Results of a feasibility study. Physical Therapy, 95(8), 1151–1162. https://doi.org/10.2522/ptj.20140146
Beyaz, Ö., Akpınar, S., & Demirhan, G. (2024). Effect of 12-week traditional archery on motor performances and quality of life of adolescents with mild intellectual disability. International Journal of Developmental Disabilities, 1–16. https://doi.org/10.1080/20473869.2024.2436476
Booth, A. T., Buizer, A. I., Meyns, P., Oude Lansink, I. L., Steenbrink, F., & van der Krogt, M. M. (2018). The efficacy of functional gait training in children and young adults with cerebral palsy: A systematic review and meta-analysis. Developmental Medicine & Child Neurology, 60(9), 866–883. https://doi.org/10.1111/dmcn.13708
Champagne, D., Corriveau, H., & Dugas, C. (2017). Effect of hippotherapy on motor proficiency and function in children with cerebral palsy who walk. Physical & Occupational Therapy in Pediatrics, 37(1), 51–63. https://doi.org/10.3109/01942638.2015.1129386
Coldwells, A., Atkinson, G., & Reilly, T. (1994). Sources of variation in back and leg dynamometry. Ergonomics, 37(1), 79–86.
Cortes, J. C., Goldsmith, J., Harran, M. D., Xu, J., Kim, N., Schambra, H. M., ... & Kitago, T. (2017). A short and distinct time window for recovery of arm motor control early after stroke revealed with a global measure of trajectory kinematics. Neurorehabilitation and Neural Repair, 31(6), 552–560. https://doi.org/10.1177/1545968317697034
Davis, E., Davies, B., Wolfe, R., Raadsveld, R., Heine, B., Thomason, P., ... & Graham, H. K. (2009). A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsy. Developmental Medicine & Child Neurology, 51(2), 111–119. https://doi.org/10.1111/j.1469-8749.2008.03245.x
de Araújo, T. B., de Oliveira, R. J., Martins, W. R., de Moura Pereira, M., Copetti, F., & Safons, M. P. (2013). Effects of hippotherapy on mobility, strength and balance in elderly. Archives of Gerontology and Geriatrics, 56(3), 478–481. https://doi.org/10.1016/j.archger.2012.12.007
Hartman, J. G., & Looney, M. (2003). Norm-referenced and criterion-referenced reliability and validity of the back-saver sit-and-reach. Measurement in Physical Education and Exercise Science, 7(2), 71–87.
Heyn, P. C., Tagawa, A., Pan, Z., Reistetter, T., Ng, T. K. S., Lewis, M., & Carollo, J. J. (2023). The association between isometric strength and cognitive function in adults with cerebral palsy. Frontiers in Medicine, 10, 1080022. https://doi.org/10.3389/fmed.2023.1080022
Kousar, F., Sultana, A., Sultana, S., Banu, T., & Begum, A. (2023). Individualized therapy to manage quadriplegic spastic cerebral palsy with Unani treatment modalities. CellMed, 13(14), 3–1. https://doi.org/10.5667/CellMed.2023.016
Lassell, R., Wood, W., Schmid, A. A., & Cross, J. E. (2021). A comparison of quality of life indicators during two complementary interventions: Adaptive gardening and adaptive riding for people with dementia. Complementary Therapies in Medicine, 57, 102658. https://doi.org/10.1016/j.ctim.2020.102658
Liptak, G. S. (2005). Complementary and alternative therapies for cerebral palsy. Mental Retardation and Developmental Disabilities Research Reviews, 11(2), 156–163.
Merino-Andres, J., Garcia de Mateos-Lopez, A., Damiano, D. L., & Sanchez-Sierra, A. (2022). Effect of muscle strength training in children and adolescents with spastic cerebral palsy: A systematic review and meta-analysis. Clinical Rehabilitation, 36(1), 4–14. https://doi.org/10.1177/026921552110401
Ruiz Brunner, M. M., & Cuestas, E. (2019). The construction of cerebral palsy definition: A historical journey to the present. Revista de la Facultad de Ciencias Médicas (Córdoba, Argentina), 76(2), 113–117. https://doi.org/10.31053/1853.0605.v76.n2.23649
Mockford, M., & Caulton, J. M. (2008). Systematic review of progressive strength training in children and adolescents with cerebral palsy who are ambulatory. Pediatric Physical Therapy, 20(4), 318–333. https://doi.org/10.1097/PEP.0b013e31818b7ccd
Moreau, N. G., Falvo, M. J., & Damiano, D. L. (2012). Rapid force generation is impaired in cerebral palsy and is related to decreased muscle size and functional mobility. Gait & Posture, 35(1), 154–158. https://doi.org/10.1016/j.gaitpost.2011.08.027
Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39(4), 214–223.
Patel, D. R., Bovid, K. M., Rausch, R., Ergun-Longmire, B., Goetting, M., & Merrick, J. (2024). Cerebral palsy in children: A clinical practice review. Current Problems in Pediatric and Adolescent Health Care, 54(11), 101673. https://doi.org/10.1016/j.cppeds.2024.101673
Paul, S., Nahar, A., Bhagawati, M., & Kunwar, A. J. (2022). A review on recent advances of cerebral palsy. Oxidative Medicine and Cellular Longevity, 2022(1), 2622310. https://doi.org/10.1155/2022/2622310
Przybyla, A., Coelho, C. J., Akpinar, S., Kirazci, S., & Sainburg, R. L. (2013). Sensorimotor performance asymmetries predict hand selection. Neuroscience, 228, 349–360. https://doi.org/10.1016/j.neuroscience.2012.10.046
Ross, S. M., MacDonald, M., & Bigouette, J. P. (2016). Effects of strength training on mobility in adults with cerebral palsy: A systematic review. Disability and Health Journal, 9(3), 375–384. https://doi.org/10.1016/j.dhjo.2016.04.005
Sadowska, M., Sarecka-Hujar, B., & Kopyta, I. (2020). Cerebral palsy: Current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatric Disease and Treatment, 1505–1518. https://doi.org/10.2147/NDT.S235165
Sainburg, R. L., & Wang, J. (2002). Interlimb transfer of visuomotor rotations: Independence of direction and final position information. Experimental Brain Research, 145(4), 437–447.
Scholtes, V. A., Becher, J. G., Comuth, A., Dekkers, H., Van Dijk, L., & Dallmeijer, A. J. (2010). Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: A randomized controlled trial. Developmental Medicine & Child Neurology, 52(6), e107–e113. https://doi.org/10.1111/j.1469-8749.2009.03604.x
Sterba, J. A. (2007). Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Developmental Medicine & Child Neurology, 49(1), 68–73.
Stergiou, A. N., Mattila-Rautiainen, S., Varvarousis, D. N., Tzoufi, M., Plyta, P., Beris, A., & Ploumis, A. (2023). The efficacy of equine assisted therapy intervention in gross motor function, performance, and spasticity in children with cerebral palsy. Frontiers in Veterinary Science, 10, 1203481. https://doi.org/10.3389/fvets.2023.1203481
Stergiou, A., Tzoufi, M., Ntzani, E., Varvarousis, D., Beris, A., & Ploumis, A. (2017). Therapeutic effects of horseback riding interventions: A systematic review and meta-analysis. American Journal of Physical Medicine & Rehabilitation, 96(10), 717–725. https://doi.org/10.1097/PHM.0000000000000726
Wood, W., Alm, K., Benjamin, J., Thomas, L., Anderson, D., Pohl, L., & Kane, M. (2021). Optimal terminology for services in the United States that incorporate horses to benefit people: A consensus document. The Journal of Alternative and Complementary Medicine, 27(1), 88–95. https://doi.org/10.1089/acm.2020.0415
Žalienė, L., Mockevičienė, D., Kreivinienė, B., Razbadauskas, A., Kleiva, Ž., & Kirkutis, A. (2018). Short-term and long-term effects of riding for children with cerebral palsy gross motor functions. BioMed Research International, 2018(1), 4190249. https://doi.org/10.1155/2018/4190249