Hippotherapy Versus Swiss Ball Training to Improve Trunk Control and Balance on Spastic Daiplegic Cerebral Palsy

Hippotherapy Versus Swiss Ball Training to Improve Trunk Control and Balance on Spastic Daiplegic Cerebral Palsy

Effects of Hippotherapy Versus Swiss Ball Training to Improve Trunk Control and Balance on Spastic Daiplegic Child

In this study we will compare the effects of hippotherapy and swiss ball therapy. Our objectives of the study are To compare the effects of hippotherapy and Swiss ball training, to improve trunk control and balance on spastic diplegic cerebral palsy Hypothesis: Alternative hypothesis: There will be significant difference between the effects of hippotherapy and Swiss ball training to improve trunk control and balance on spastic diplegic cerebral palsy Null hypothesis: There will be no significant difference between the effects of hippotherapy and Swiss ball training to improve trunk control and balance on spastic diplegic cerebral palsy. This study will include total 64 participants. Calculated by Open Epitool.64patients will be divided in to 2 groups with equal sample size through sealed envelop method. Group A will receive hippotherapy while group B will receive swiss ball therapy. Group A Intervention: The child is seat astride the horse wearing a helmet and was encouraged to perform various activities designed to emphasize movement in a forward and upward reaching and side to side direction to encourage active postural control, trunk strength, balance and trunk/pelvic dissociation.30 minutes with a frequency ranging from 4 sessions per week and the total duration of horseback riding 6 weeks .Position the child to sit on the ball and giving forward, backward and side to side movement to the child. This will facilitate trunk rotation by which the upper body is towards the weight bearing hip and away from the weight bearing hip. Training program 4 times per weeks with the treatment session of 30. Group B Intervention: Position the child to sit on the ball and giving extension rotation and flexion rotation to the child. This will facilitate trunk rotation by which the upper body is towards the weight bearing hip and away from the weight bearing hip.Training program 4 times per weeks with the treatment session of 30 minutes for 6 weeks duration minutes for 6 weeks duration. Trunk Control Will be measured by three outcome measures which include trunk control measurement scale ,gross motor function scale and pediatric balance scale. Intervention will be given for 6 weeks.Assesment will be done on baseline, after 3 and 6 weeks.

Patients suffering with diplegic therapy will perform their exercise protocols on a stationary horse.The child is seat astride the horse wearing a helmet and was encouraged to perform various activities designed to emphasize movement in a forward and upward reaching direction to encourage active postural control, trunk strength, balance and trunk/pelvic dissociation.30 minutes to 1 hour with a frequency ranging from 4 sessions per week and the total duration of horseback riding 6 weeks.

Children of second group will receive swiss ball therapy. Position the child to sit on the ball and giving extension rotation and flexion rotation to the child. This will facilitate trunk rotation by which the upper body is towards the weight bearing hip and away from the weight bearing hip.Training program 4 times per weeks with the treatment session of 30 minutes for 6 weeks duration

Changes from baseline The Gross Motor Function Measure (GMFM) is an observational clinical tool designed to evaluate change in gross motor function in children with cerebral palsy. There are two versions of the GMFM - the original 88-item measure (GMFM-88) and the more recent 66-item GMFM (GMFM-66) (12).

Changes from Baseline The TCMS scale assesses seated trunk control in three dimensions. The maximum score is 58 points where 20 points correspond to static balance, 28 to selective movement control, and 10 to the ability to perform dynamic reaching

Changes from Baseline Pediatric Balance Scale is a modified version of the Berg Balance Scale that is used to assess functional balance skills in school-aged children. The scale consists of 14 items that are scored from 0 points (lowest function) to 4 points (highest function) with a maximum score of 56 points

Inclusion Criteria:• Children (male and female) Age group 4 to 11 years Subject diagnosed with CP Mild Spastic Diaplegic of the lower limbs according to the modified ashworth scale grade 1 to 1+ GMFM scale sitting balance score less than 20 Medically stable and able to understand commands Exclusion Criteria:• Children with mental retardation, Epilepsy, other associated neurological disorders, other type of cerebral palsy, Attention deficit hyperactivity disorder and sensory issues(poor visual or hearing acuity)