The purpose of this single subject research study was to examine the effects of a once weekly, 10-week hippotherapy program for three children, ages 27-54 months, with cerebral palsy. Participants were rated as Level V on the Gross Motor Function Classification System. The Sitting Dimension of the Gross Motor Function Measure was used to establish a baseline of sitting abilities, and was administered every 2 weeks during intervention. The Sitting Assessment Scale and the Gross Motor Function Measure were administered before, after, and 4 weeks postintervention. Parental perceptions of the hippotherapy intervention were assessed using questionnaires. None of the children made gains on any of the standardized outcome measures. Parental perceptions were very positive, with reported improvements in range of motion and head control.
Background and Purpose. Physical therapists and occupational therapists frequently use adaptive seating devices to improve stability in sitting for children with neuromotor impairments. The purpose of this study was to examine the effects of a contoured foam seat (CFS) on postural alignment and on the ability of infants with neuromotor impairments to engage with toys. Parental perceptions regarding the use and effects of the CFS also were assessed via semistructured interviews. Subjects. Subjects were 4 infants, ages 9 to 18 months, who were unable to sit independently. Method. A time-series, alternating-treatments design was used, with data collected under 3 conditions: (1) a regular highchair, (2) a regular highchair with a thin foam liner, and (3) a CFS used as an insert in a regular highchair. The primary dependent measures were postural alignment and engagement with toys. Engagement with toys was defined as percentage of intervals with 2 hands on a toy and percentage of intervals with no hands on a highchair tray and 1 or 2 hands on a toy. Results. Results showed a sustained effect of the CFS on improving postural alignment for all subjects. Effects of the CFS on increasing the number of intervals of bimanual play were not demonstrated for any subjects, although some improvement in the infant's ability to free the arms from support was observed for 2 subjects. Mothers reported acceptability of the CFS for everyday use and described benefits for themselves and their infants. Discussion and Conclusion. The results support the use of a CFS for improving postural alignment. Future research on adaptive seating should focus on interventions and outcomes that help children participate in functional activities relevant to them and their families.
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