Keywords
Hippotherapy
Robot-Assisted Rehabilitation
Equine Movement Simulation
Postural Control
Standing Kinematics
Pediatric Neurorehabilitation
Gross Motor Function
Balance
Range of Motion
How to Cite
Abstract
Introduction. Hippotherapy and horse-riding simulators have been proposed as complementary approaches to improve postural control and motor function in children with cerebral palsy, but evidence remains heterogeneous and advanced robotic equine-movement systems require further clinical investigation. To describe the short-term clinical and standing kinematic changes associated with a HIROB-based rehabilitation intervention in children with cerebral palsy characterized by impaired axial control and immature standing posture.
Methods. This preliminary observational case series included four children with cerebral palsy. Participants underwent a three-week HIROB-based intervention delivered 5 sessions per week, 45 minutes per session. Assessments were performed at baseline and after treatment using the Gross Motor Function Measure-88 (GMFM-88), the first-generation Paediatric Balance Scale (PBS), passive range of motion assessed with a goniometer, and instrumented standing analysis using the BTS Smart-DX-1000 system with the Davis protocol.
Results. All participants showed improvements in GMFM-88 total scores and PBS scores after treatment. Joint range of motion improved across the assessed parameters, with the most consistent changes observed in hip abduction and unilateral popliteal angle. Standing kinematic analysis showed a trend toward improved postural alignment, particularly in pelvic and hip parameters, with reduced asymmetry and closer approximation to normative values.
Discussion. These preliminary findings suggest that HIROB-based rehabilitation may be feasible and may contribute to short-term improvements in standing alignment, joint mobility, and balance-related outcomes in selected children with cerebral palsy. Given the small sample size, absence of a control group, and concomitant rehabilitation context, the results should be interpreted as exploratory and hypothesis-generating.
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Copyright (c) 2026 Riccardo Carbonetti, Giulia Giorgi, Giampietro Cordone, Pamela Cherubini, Jacopo Iovalé, Rossana Toglia, Donatella Lettori, Enrico Castelli