{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:27:04Z","timestamp":1777930024395,"version":"3.51.4"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NeuroRehabilitation"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Hippotherapy uses horse movement to promote physical and psychosocial rehabilitation and may benefit children with cerebral palsy (CP). Standardised instruments such as the Activity Scale for Kids-Performance (ASK\n                      <jats:sup>\u00a9<\/jats:sup>\n                      ), the Gross Motor Function Classification System (GMFCS) and the Gross Motor Function Measure (GMFM) are needed to quantify effects on motor function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically review the effects of hippotherapy on gross motor skills in children with CP. Although autism spectrum disorder (ASD) was included in the search strategy, no eligible ASD studies were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines, six databases (PubMed, EMBASE, Web of Science, SCOPUS, Cochrane and SciELO) were searched for English, Portuguese or Spanish studies employing ASK\n                      <jats:sup>\u00a9<\/jats:sup>\n                      , GMFCS or GMFM. Two reviewers independently screened records, extracted data and assessed risk of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-five studies (602 participants, mean age 7.1 years, 3\u201314) met inclusion criteria; all involved CP, none ASD. Interventions lasted 8\u201324 weeks (1\u20133 sessions\/week). Two ASK\n                      <jats:sup>\u00a9<\/jats:sup>\n                      studies showed significant motor gains (Hedges g\u2009=\u20090.48\u20130.62). GMFM was used in 22 studies; 20 reported clinically relevant improvements, particularly in dimensions D (standing) and E (walking, running, jumping). The sole GMFCS study reported no change in classification. Methodological quality was moderate, limited by small samples and lack of blinding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Hippotherapy improves gross motor function in CP, best demonstrated with GMFM. Evidence for ASD is absent, highlighting a research gap. Broader application of ASK\n                      <jats:sup>\u00a9<\/jats:sup>\n                      and GMFCS is still needed to better define benefits across neurodevelopmental disorders.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538135251387278","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:31:56Z","timestamp":1764739916000},"page":"489-503","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Hippotherapy Improves Gross Motor Function in Children with Cerebral Palsy: Evidence from a Systematic Review"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2004-1604","authenticated-orcid":false,"given":"In\u00eas","family":"Bernardino","sequence":"first","affiliation":[{"name":"Centro de Responsabilidade Integrado de Pneumologia, Unidade Local de Sa\u00fade do Baixo Mondego, Figueira da Foz, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-7908","authenticated-orcid":false,"given":"Daniel Filipe","family":"Borges","sequence":"additional","affiliation":[{"name":"Center for Translational Health and Medical Biotechnology Research (TBIO) | Health Research and Innovation (RISE-Health), E2S, Polytechnic University of Porto, Porto, Portugal"},{"name":"Department of Neurophysiology, E2S, Polytechnic University of Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5215-7542","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Casalta-Lopes","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3549-6873","authenticated-orcid":false,"given":"Joana Isabel","family":"Soares","sequence":"additional","affiliation":[{"name":"Center for Translational Health and Medical Biotechnology Research (TBIO) | Health Research and Innovation (RISE-Health), E2S, Polytechnic University of Porto, Porto, Portugal"},{"name":"Department of General Sciences, Polytechnic University of Coimbra, Coimbra, Portugal"},{"name":"H&amp;TRC - Health &amp; Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2016.02.002"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtumed.2022.01.011"},{"issue":"4","key":"e_1_3_2_4_1","first-page":"8","article-title":"What about the hippotherapy benefit-cost ratio in everyday clinical practice? 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