Rehabilitation of Postural Control and Gait in Children with Cerebral Palsy: the Beneficial Effects of Trunk-Focused Postural Activities

References

• Graham HK, Rosenbaum P, Paneth N, Dan B, Lin J-P, Damiano DL, Becher JG, Gaebler-Spira D, Colver A, Reddihough DS, et al. Cerebral palsy. Nat Rev Dis Primer. 2016; 2(1): 15082. doi:10.1038/nrdp.2015.82.
   PubMed Web of Science ®Google Scholar
• Almutairi A, Cochrane GD, Christy JB. 2019; Vestibular and oculomotor function in children with CP: descriptive study. Int J Pediatr Otorhinolaryngol. 119: 15–21. doi:10.1016/j.ijporl.2018.12.038
   PubMed Web of Science ®Google Scholar
• Rose J, Wolff DR, Jones VK, Bloch DA, Oehlert JW, Gamble JG. Postural balance in children with cerebral palsy. Dev Med Child Neurol. 2002;44(1):58–63. doi:10.1017/S0012162201001669.
   PubMed Web of Science ®Google Scholar
• Assaiante C, Mallau S, Viel S, Jover M, Schmitz C. 2005; Development of postural control in healthy children: a functional approach. Neural Plast. 12(2–3):109–18.10.1155/NP.2005.109.
   PubMedGoogle Scholar
• Rachwani J, Santamaria V, Saavedra SL, Wood S, Porter F, Woollacott MH. Segmental trunk control acquisition and reaching in typically developing infants. Exp Brain Res. 2013;228(1):131–39. doi:10.1007/s00221-013-3544-y.
   PubMed Web of Science ®Google Scholar
• Rachwani J, Santamaria V, Saavedra SL, Woollacott MH. 2015; The development of trunk control and its relation to reaching in infancy: a longitudinal study. Front Hum Neurosci. 9:94. doi:10.3389/fnhum.2015.00094.
   PubMed Web of Science ®Google Scholar
• Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, LaFosse C, Nieuwboer A, De Weerdt W. 2006; Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 20 5: 451–58, 10.1191/0269215505cr955oa.
   PubMed Web of Science ®Google Scholar
• Harbourne RT, Willett S, Kyvelidou A, Deffeyes J, Stergiou N. A comparison of interventions for children with cerebral palsy to improve sitting postural control: a clinical trial. Phys Ther. 2010;90(12):1881–98. doi:10.2522/ptj.2010132.
   PubMed Web of Science ®Google Scholar
• Saxena S, Rao BK, Kumaran S. Analysis of postural stability in children with cerebral palsy and children with typical development: an observational study. Pediatr Phys Ther. 2014;26(3):325–30. doi:10.1097/PEP.0000000000000060.
   PubMed Web of Science ®Google Scholar
• Jensen RK. 1986; Body segment mass, radius and radius of gyration proportions of children. J Biomech. 19(5):359–68.10.1016/0021-9290(86)90012-6.
   PubMed Web of Science ®Google Scholar
• Assaiante C, Amblard B. An ontogenetic model for the sensorimotor organization of balance control in humans. Hum Mov Sci. 1995;14(1):13–43. doi:10.1016/0167-9457(94)00048-J.
   Web of Science ®Google Scholar
• Pierret J, Beyaert C, Paysant J, Caudron S. 2020; How do children aged 6 to 11 stabilize themselves on an unstable sitting device? the progressive development of axial segment control. Hum Mov Sci. 71:102624. doi:10.1016/j.humov.2020.102624.
   PubMed Web of Science ®Google Scholar
• Pin TW, Butler PB, Cheung H-M, Shum S-F. Relationship between segmental trunk control and gross motor development in typically developing infants aged from 4 to 12 months: a pilot study. BMC Pediatr. 2019;19(1):425. doi:10.1186/s12887-019-1791-1.
   PubMed Web of Science ®Google Scholar
• Pin TW, Butler PB, Cheung H-M, Shum S-F. 2019; Longitudinal development of segmental trunk control in full term and preterm infants-a pilot study: part I. Dev Neurorehabilitation.1–8. 3: 10.1080/17518423.2019.1648580.
   Google Scholar
• Pin TW, Butler PB, Cheung H-M, Shum S-F. Longitudinal development of segmental trunk control in full term and preterm infants- a pilot study: part II. Dev Neurorehabilitation. 2020;23(3):193–200. doi:10.1080/17518423.2019.1629661.
   PubMedGoogle Scholar
• Heyrman L, Desloovere K, Molenaers G, Verheyden G, Klingels K, Monbaliu E, Feys H. Clinical characteristics of impaired trunk control in children with spastic cerebral palsy. Res Dev Disabil. 2013;34(1):327–34. doi:10.1016/j.ridd.2012.08.015.
   PubMed Web of Science ®Google Scholar
• Saavedra SL, Woollacott MH. Segmental contributions to trunk control in children with moderate-to-severe cerebral palsy. Arch Phys Med Rehabil. 2015;96(6):1088–97. doi:10.1016/j.apmr.2015.01.016.
   PubMed Web of Science ®Google Scholar
• Pierret J, Caudron S, Paysant J, Beyaert C. 2021; Impaired postural control of axial segments in children with cerebral palsy. Gait & Posture [Internet]. [accessed 2021 Mar 9]. doi:10.1016/j.gaitpost.2021.03.012 86: 266–72.
   PubMed Web of Science ®Google Scholar
• Heyrman L, Feys H, Molenaers G, Jaspers E, Monari D, Nieuwenhuys A, Desloovere K. Altered trunk movements during gait in children with spastic diplegia: compensatory or underlying trunk control deficit? Res Dev Disabil. 2014;35(9):2044–52. doi:10.1016/j.ridd.2014.04.031.
   PubMed Web of Science ®Google Scholar
• Liao S-F, Yang T-F, Hsu T-C, Chan R-C, Wei T-S. Differences in seated postural control in children with spastic cerebral palsy and children who are typically developing. Am J Phys Med Rehabil. 2003;82(8):622–26. doi:10.1097/01.PHM.0000073817.51377.51.
   PubMed Web of Science ®Google Scholar
• Curtis DJ, Butler P, Saavedra S, Bencke J, Kallemose T, Sonne-Holm S, Woollacott M. The central role of trunk control in the gross motor function of children with cerebral palsy: a retrospective cross-sectional study. Dev Med Child Neurol. 2014;57(4):351–57. doi:10.1111/dmcn.12641.
   PubMed Web of Science ®Google Scholar
• Jeon J-Y, Shin W-S. Reliability and validity of the Korean version of the trunk control measurement scale (TCMS-K) for children with cerebral palsy. Res Dev Disabil. 2014;35(3):581–90. doi:10.1016/j.ridd.2014.01.009.
   PubMed Web of Science ®Google Scholar
• Kallem Seyyar G, Aras B, Aras O. Trunk control and functionality in children with spastic cerebral palsy. Dev Neurorehabilitation. 2019;22(2):120–25. doi:10.1080/17518423.2018.1460879.
   PubMed Web of Science ®Google Scholar
• Pavão SL, Maeda DA, Corsi C, Mm dos S, Csn da C, Ac DC, Nacf R. Discriminant ability and criterion validity of the trunk impairment scale for cerebral palsy. Disabil Rehabil. 2019;41(18):2199–205. doi:10.1080/09638288.2018.1462410.
   PubMed Web of Science ®Google Scholar
• Pham HP, Eidem A, Hansen G, Nyquist A, Vik T, Sæther R. 2016; Validity and responsiveness of the trunk impairment scale and trunk control measurement scale in young individuals with cerebral palsy. Phys Occup Ther Pediatr. 36(4):440–52.10.3109/01942638.2015.1127867.
   PubMed Web of Science ®Google Scholar
• Yildiz A, Yildiz R, Elbasan B. Trunk control in children with cerebral palsy and its association with upper extremity functions. J Dev Phys Disabil. 2018;30(5):669–76. doi:10.1007/s10882-018-9611-3.
   Web of Science ®Google Scholar
• Abidin N, Ünlü AE, Cankurtaran D, Öz K, Tezel N. 2022; The effect of robotic rehabilitation on posture and trunk control in non-ambulatory cerebral palsy. Assist Technol.10400435.2022.2059592. doi:10.1080/10400435.2022.2059592.
   PubMed Web of Science ®Google Scholar
• Curtis DJ, Woollacott M, Bencke J, Lauridsen HB, Saavedra S, Bandholm T, Sonne-Holm S. The functional effect of segmental trunk and head control training in moderate-to-severe cerebral palsy: a randomized controlled trial. Dev Neurorehabilitation. 2018;21(2):91–100. doi:10.1080/17518423.2016.1265603.
   PubMed Web of Science ®Google Scholar
• Eek MN, Blomkvist A, Olsson K, Lindh K, Himmelmann K. 2022. Objective measurement of sitting –application in children with cerebral palsy. Gait & Posture.S0966636222001710. doi:10.1016/j.gaitpost.2022.05.03996.
   Web of Science ®Google Scholar
• Santamaria V, Rachwani J, Saavedra S, Woollacott M. Effect of segmental trunk support on posture and reaching in children with cerebral palsy. Pediatr Phys Ther. 2016;28(3):285–93. doi:10.1097/PEP.0000000000000273.
   PubMed Web of Science ®Google Scholar
• Attias M, Bonnefoy-Mazure A, Lempereur M, Lascombes P, De Coulon G, Armand S. Trunk movements during gait in cerebral palsy. Clin Biomech. 2015;30(1):28–32. doi:10.1016/j.clinbiomech.2014.11.009.
   PubMed Web of Science ®Google Scholar
• Bartonek A, Lidbeck CM, Gutierrez-Farewik EM. Influence of external visual focus on gait in children with bilateral cerebral palsy. Pediatr Phys Ther. 2016;28(4):393–99. doi:10.1097/PEP.0000000000000282.
   PubMed Web of Science ®Google Scholar
• Bonnefoy-Mazure A, Sagawa Y, Lascombes P, De Coulon G, Armand S. A descriptive analysis of the upper limb patterns during gait in individuals with cerebral palsy. Res Dev Disabil. 2014;35(11):2756–65. doi:10.1016/j.ridd.2014.07.013.
   PubMed Web of Science ®Google Scholar
• Delabastita T, Desloovere K, Meyns P. 2016; Restricted arm swing affects gait stability and increased walking speed alters trunk movements in children with cerebral palsy. Front Hum Neurosci. 10:354.10.3389/fnhum.2016.00354.
   PubMed Web of Science ®Google Scholar
• Wallard L, Bril B, Dietrich G, Kerlirzin Y, Bredin J. The role of head stabilization in locomotion in children with cerebral palsy. Ann Phys Rehabil Med. 2012;55(9–10):590–600. doi:10.1016/j.rehab.2012.10.004.
   PubMedGoogle Scholar
• Wallard L, Dietrich G, Kerlirzin Y, Bredin J. 2014; Balance control in gait children with cerebral palsy. [ place unknown]. Gait & posture 40 1: 43–47. 10.1016/j.gaitpost.2014.02.009.
   PubMed Web of Science ®Google Scholar
• Kim CJ, Son SM. Comparison of spatiotemporal gait parameters between children with normal development and children with diplegic cerebral palsy. J Phys Ther Sci. 2014;26(9):1317–19. doi:10.1589/jpts.26.1317.
   PubMedGoogle Scholar
• Katz-Leurer M, Rotem H, Keren O, Meyer S. Balance abilities and gait characteristics in post-traumatic brain injury, cerebral palsy and typically developed children. Dev Neurorehabilitation. 2009;12(2):100–05. doi:10.1080/17518420902800928.
   PubMed Web of Science ®Google Scholar
• Hsue B-J, Miller F, F-C S. The dynamic balance of the children with cerebral palsy and typical developing during gait. part i: spatial relationship between COM and COP trajectories. Gait & Posture. 2009;29(3):465–70. doi:10.1016/j.gaitpost.2008.11.007.
   PubMed Web of Science ®Google Scholar
• Saether R, Helbostad JL, Adde L, Brændvik S, Lydersen S, Vik T. Gait characteristics in children and adolescents with cerebral palsy assessed with a trunk-worn accelerometer. Res Dev Disabil. 2014;35(7):1773–81. doi:10.1016/j.ridd.2014.02.011.
   PubMed Web of Science ®Google Scholar
• Summa A, Vannozzi G, Bergamini E, Iosa M, Morelli D, Cappozzo A, Lebedev MA. 2016; Multilevel upper body movement control during gait in children with cerebral palsy. PLoS One. 11(3):e0151792. 10.1371/journal.pone.0151792.
   PubMed Web of Science ®Google Scholar
• Perry J, Burnfield JM. 2010. Gait analysis: normal and pathological function. 2nd. Thorofare, New Jersey: Slack Inc.
   Google Scholar
• Iosa M, Marro T, Paolucci S, Morelli D. Stability and harmony of gait in children with cerebral palsy. Res Dev Disabil. 2012;33(1):129–35. doi:10.1016/j.ridd.2011.08.031.
   PubMed Web of Science ®Google Scholar
• Balzer J, Marsico P, Mitteregger E, van der Linden Ml, Mercer TH, van Hedel Hja, van der Linden ML, van Hedel HJA. 2017. Influence of trunk control and lower extremity impairments on gait capacity in children with cerebral palsy. Disabil Rehabil.1–7. doi:10.1080/09638288.2017.1380719 40 26
   Web of Science ®Google Scholar
• Van de Walle P, Hallemans A, Truijen S, Gosselink R, Heyrman L, Molenaers G, Desloovere K. Increased mechanical cost of walking in children with diplegia: the role of the passenger unit cannot be neglected. Res Dev Disabil. 2012;33(6):1996–2003. doi:10.1016/j.ridd.2012.05.029.
   PubMed Web of Science ®Google Scholar
• Meyns P, Kerkum YL, Brehm MA, Becher JG, Buizer AI, Harlaar J 2020. Ankle foot orthoses in cerebral palsy: effects of ankle stiffness on trunk kinematics, gait stability and energy cost of walking. Eur J Paediatr Neurol. 26 68–74 10.1016/j.ejpn.2020.02.009
   PubMed Web of Science ®Google Scholar
• Armand S, Watelain E, Mercier M, Lensel G, Lepoutre F-X 2006. Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method. Gait & Posture. 23(2):240–48.10.1016/j.gaitpost.2005.02.007
   PubMed Web of Science ®Google Scholar
• Armand S, Decoulon G, Bonnefoy-Mazure A. Gait analysis in children with cerebral palsy. EFORT Open Rev. 2016;1(12):448–60. doi:10.1302/2058-5241.1.000052.
   PubMed Web of Science ®Google Scholar
• Beyaert C, Pierret J, Vasa R, Paysant J, Caudron S. Toe walking in children with cerebral palsy: a possible functional role for the plantar flexors. J Neurophysiol. 2020;124(4):1257–69. doi:10.1152/jn.00717.2019.
   PubMed Web of Science ®Google Scholar
• Kurz MJ, Stuberg WA, DeJong SL. Mechanical work performed by the legs of children with spastic diplegic cerebral palsy. Gait & Posture. 2010;31(3):347–50. doi:10.1016/j.gaitpost.2009.12.004.
   PubMed Web of Science ®Google Scholar
• Worthen-Chaudhari L, Bing J, Schmiedeler JP, Basso DM. A new look at an old problem: defining weight acceptance in human walking. Gait & Posture. 2014;39(1):588–92. doi:10.1016/j.gaitpost.2013.09.012.
   PubMed Web of Science ®Google Scholar
• Colborne GR, Wright FV, Naumann S 1994. Feedback of triceps surae EMG in gait of children with cerebral palsy: a controlled study. Arch Phys Med Rehabil. 75(1):40–45.10.1016/0003-9993(94)90335-2
   PubMed Web of Science ®Google Scholar
• Dietz V, Quintern J, Berger W 1981. Electrophysiological studies of gait in spasticity and rigidity. evidence that altered mechanical properties of muscle contribute to hypertonia. Brain J Neurol. 104(3):431–49. 10.1093/brain/104.3.431
   Google Scholar
• Hodapp M, Klisch C, Mall V, Vry J, Berger W, Faist M 2007. Modulation of soleus H-reflexes during gait in children with cerebral palsy. J Neurophysiol. 98(6):3263–68.10.1152/jn.00471.2007
   PubMed Web of Science ®Google Scholar
• Nielsen JB, Christensen MS, Farmer SF, Lorentzen J 2020. Spastic movement disorder: should we forget hyperexcitable stretch reflexes and start talking about inappropriate prediction of sensory consequences of movement? Exp Brain Res [Internet]. [accessed 2020 May 29]. doi:10.1007/s00221-020-05792-0 238 7–8 1627–36
   PubMed Web of Science ®Google Scholar
• Willerslev-Olsen M, Andersen JB, Sinkjaer T, Nielsen JB. Sensory feedback to ankle plantar flexors is not exaggerated during gait in spastic hemiplegic children with cerebral palsy. J Neurophysiol. 2014;111(4):746–54. doi:10.1152/jn.00372.2013.
   PubMed Web of Science ®Google Scholar
• Lorentzen J, Willerslev-Olsen M, Hüche Larsen H, Farmer SF, Nielsen JB 2019. Maturation of feedforward toe walking motor program is impaired in children with cerebral palsy. Brain. 142(3):526–41. doi:10.1093/brain/awz002
   PubMedGoogle Scholar
• Neptune RR, Kautz SA, Zajac FE. Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. J Biomech. 2001;34(11):1387–98. doi:10.1016/S0021-9290(01)00105-1.
   PubMed Web of Science ®Google Scholar
• Liu MQ, Anderson FC, Pandy MG, Delp SL. Muscles that support the body also modulate forward progression during walking. J Biomech. 2006;39(14):2623–30. doi:10.1016/j.jbiomech.2005.08.017.
   PubMed Web of Science ®Google Scholar
• Correa TA, Schache AG, Graham HK, Baker R, Thomason P, Pandy MG 2012. Potential of lower-limb muscles to accelerate the body during cerebral palsy gait. Gait & Posture. 36(2):194–200.10.1016/j.gaitpost.2012.02.014
   PubMed Web of Science ®Google Scholar
• Cabanas-Valdés R, Cuchi GU, Bagur-Calafat C 2013. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: a systematic review. NeuroRehabilitation. 33(4):575–92. 10.3233/NRE-130996
   PubMed Web of Science ®Google Scholar
• Martín-Valero R, Vega-Ballón J, Perez-Cabezas V. Benefits of hippotherapy in children with cerebral palsy: a narrative review. Eur J Paediatr Neurol. 2018;22(6):1150–60. doi:10.1016/j.ejpn.2018.07.002.
   PubMed Web of Science ®Google Scholar
• Santamaria V, Khan M, Luna T, Kang J, Dutkowsky J, Gordon AM, Agrawal SK. Promoting functional and independent sitting in children with cerebral palsy using the robotic trunk support trainer. IEEE Trans Neural Syst Rehabil Eng. 2020;28(12):2995–3004. doi:10.1109/TNSRE.2020.3031580.
   PubMed Web of Science ®Google Scholar
• Hazari A, Agouris I, Wakode PS, Jadhav RA, Sharma N, Jena S, Sharma M 2019. Head and trunk kinematics and kinetics in normal and cerebral palsy gait: a systematic review. Eur J Physiother.1–10. doi:10.1080/21679169.2019.1573919 22 3
   Web of Science ®Google Scholar
• Heyrman L, Molenaers G, Desloovere K, Verheyden G, De Cat J, Monbaliu E, Feys H. A clinical tool to measure trunk control in children with cerebral palsy: the trunk control measurement scale. Res Dev Disabil. 2011;32(6):2624–35. doi:10.1016/j.ridd.2011.06.012.
   PubMed Web of Science ®Google Scholar
• Baker R, Leboeuf F, Reay J, Sangeux M 2017. The conventional gait model - success and limitations. In: Müller B, Wolf S, Brueggemann G-P, Deng Z, McIntosh A, Miller F Selbie W, Handb H, editors Motion [Internet]. Cham: Springer International Publishing; [accessed 2019 Feb 25]; p. 1–19. doi:10.1007/978-3-319-30808-1_25-2
   Google Scholar
• Hof AL 1996. Scaling gait data to body size. Gait & Posture. 3(4):222–23.10.1016/0966-6362(95)01057-2
   Google Scholar
• Nair SP, Gibbs S, Arnold G, Abboud R, Wang W 2010. A method to calculate the centre of the ankle joint: a comparison with the vicon® plug-in-gait model. Clin Biomech. 25(6):582–87.10.1016/j.clinbiomech.2010.03.004
   PubMed Web of Science ®Google Scholar
• Jeong B, Ko C-Y, Chang Y, Ryu J, Kim G 2018. Comparison of segmental analysis and sacral marker methods for determining the center of mass during level and slope walking. Gait & Posture. 62:333–41. doi:10.1016/j.gaitpost.2018.03.048
   PubMed Web of Science ®Google Scholar
• Beyaert C, Vasa R, Frykberg GE. 2015. Gait post-stroke: Pathophysiology and rehabilitation strategies. Neurophysiol Clin Neurophysiol. 45(4–5):335–3555. doi:10.1016/j.neucli.2015.09.005.
   PubMed Web of Science ®Google Scholar
• El Shemy SA. Trunk endurance and gait changes after core stability training in children with hemiplegic cerebral palsy: a randomized controlled trial. J Back Musculoskelet Rehabil. 2018;31(6):1159–67. doi:10.3233/BMR-181123.
   PubMed Web of Science ®Google Scholar
• Reddy S, Balaji G. Dynamic surface exercise training in improving trunk control and gross motor functions among children with quadriplegic cerebral palsy: a single center, randomized controlled trial. J Pediatr Neurosci. 2020;15(3):214. doi:10.4103/jpn.JPN_88_19.
   PubMed Web of Science ®Google Scholar
• Sah A, Balaji G, Agrahara S. Effects of task-oriented activities based on neurodevelopmental therapy principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy: a single-blinded randomized clinical trial. J Pediatr Neurosci. 2019;14(3):120. doi:10.4103/jpn.JPN_35_19.
   PubMed Web of Science ®Google Scholar
• Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W 2004. The trunk impairment scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 18(3):326–34.10.1191/0269215504cr733oa
   PubMed Web of Science ®Google Scholar
• Bleyenheuft Y, Ebner-Karestinos D, Surana B, Paradis J, Sidiropoulos A, Renders A, Friel KM, Brandao M, Rameckers E, Gordon AM. Intensive upper- and lower-extremity training for children with bilateral cerebral palsy: a quasi-randomized trial. Dev Med Child Neurol. 2017;59(6):625–33. doi:10.1111/dmcn.13379.
   PubMed Web of Science ®Google Scholar
• Novak I, Mcintyre S, Morgan C, Campbell L, Dark L, Morton N, Stumbles E, Wilson S-A, Goldsmith S. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol. 2013;55(10):885–910. doi:10.1111/dmcn.12246.
   PubMed Web of Science ®Google Scholar
• Sakzewski L, Gordon A, Eliasson A-C. The state of the evidence for intensive upper limb therapy approaches for children with unilateral cerebral palsy. J Child Neurol. 2014;29(8):1077–90. doi:10.1177/0883073814533150.
   PubMed Web of Science ®Google Scholar
• Friel KM, Kuo H-C, Fuller J, Ferre CL, Brandão M, Carmel JB, Bleyenheuft Y, Gowatsky JL, Stanford AD, Rowny SB, et al. Skilled bimanual training drives motor cortex plasticity in children with unilateral cerebral palsy. J Neurol Rehabil. 2016;30(9):834–44. doi:10.1177/1545968315625838.
   Google Scholar
• Hung Y-C, Brandão MB, Gordon AM 2017. Structured skill practice during intensive bimanual training leads to better trunk and arm control than unstructured practice in children with unilateral spastic cerebral palsy. Res Dev Disabil. 60:65–76. doi:10.1016/j.ridd.2016.11.012
   PubMed Web of Science ®Google Scholar
• Assaiante C, Barlaam F, Cignetti F, Vaugoyeau M. Body schema building during childhood and adolescence: a neurosensory approach. Neurophysiol Clin Neurophysiol. 2014;44(1):3–12. doi:10.1016/j.neucli.2013.10.125.
   PubMed Web of Science ®Google Scholar
• Cignetti F, Chabeauti P-Y, Sveistrup H, Vaugoyeau M, Assaiante C 2013. Updating process of internal models of action as assessed from motor and postural strategies in children. Neuroscience. 233:127–38. doi:10.1016/j.neuroscience.2012.12.040
   PubMed Web of Science ®Google Scholar
• Kim D-H, D-H A, Yoo W-G 2018. Changes in trunk sway and impairment during sitting and standing in children with cerebral palsy. Technol Health Care. 26(5):761–68.10.3233/THC-181301
   PubMed Web of Science ®Google Scholar
• Kurz MJ, Arpin DJ, Corr B. Differences in the dynamic gait stability of children with cerebral palsy and typically developing children. Gait & Posture. 2012;36(3):600–04. doi:10.1016/j.gaitpost.2012.05.029.
   PubMed Web of Science ®Google Scholar
• Kavanagh J, Barrett R, Morrison S. The role of the neck and trunk in facilitating head stability during walking. Exp Brain Res. 2006;172(4):454–63. doi:10.1007/s00221-006-0353-6.
   PubMed Web of Science ®Google Scholar
• Flores FM, Dagnese F, Copetti F 2019. Do the type of walking surface and the horse speed during hippotherapy modify the dynamics of sitting postural control in children with cerebral palsy? Clin Biomech. 70:46–51. doi:10.1016/j.clinbiomech.2019.07.030
   PubMed Web of Science ®Google Scholar
• Koca TT 2016. What is hippotherapy? the indications and effectiveness of hippotherapy. North Clin Istanb [Internet]. [accessed 2022 Nov 28]. doi:10.14744/nci.2016.71601
   Google Scholar
• Moraes AG, Copetti F, Angelo VR, Chiavoloni LL, David AC. The effects of hippotherapy on postural balance and functional ability in children with cerebral palsy. J Phys Ther Sci. 2016;28(8):2220–26. doi:10.1589/jpts.28.2220.
   PubMedGoogle Scholar
• Mutoh T, Mutoh T, Tsubone H, Takada M, Doumura M, Ihara M, Shimomura H, Taki Y, Ihara M 2019. Impact of long-term hippotherapy on the walking ability of children with cerebral palsy and quality of life of their caregivers. Front Neurol. 10:834. doi:10.3389/fneur.2019.00834
   PubMed Web of Science ®Google Scholar
• Tseng S-H, Chen H-C, Tam K-W. Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy. Disabil Rehabil. 2013;35(2):89–99. doi:10.3109/09638288.2012.687033.
   PubMed Web of Science ®Google Scholar
• Santos de Assis G, Schlichting T, Rodrigues Mateus B, Gomes Lemos A, dos Santos AN. Physical therapy with hippotherapy compared to physical therapy alone in children with cerebral palsy: systematic review and meta‐analysis. Dev Med Child Neurol. 2022;64(2):156–61. doi:10.1111/dmcn.15042.
   PubMed Web of Science ®Google Scholar
• Nott CR, Zajac FE, Neptune RR, Kautz SA. All joint moments significantly contribute to trunk angular acceleration. J Biomech. 2010;43(13):2648–52. doi:10.1016/j.jbiomech.2010.04.044.
   PubMed Web of Science ®Google Scholar
• Davids JR, Foti T, Dabelstein J, Bagley A 1999. Voluntary (normal) versus obligatory (cerebral palsy) toe-walking in children: a kinematic, kinetic, and electromyographic analysis. J Pediatr Orthop. 19(4):461–69.10.1097/01241398-199907000-00008
   PubMed Web of Science ®Google Scholar
• Lance JW 1980. Disordered muscle tone and movement. Clin Exp Neurol. 18:27–35.
   Google Scholar
• Wren TAL, Patrick Do K, Kay RM. Gastrocnemius and soleus lengths in cerebral palsy equinus gait—differences between children with and without static contracture and effects of gastrocnemius recession. J Biomech. 2004;37(9):1321–27. doi:10.1016/j.jbiomech.2003.12.035.
   PubMed Web of Science ®Google Scholar
• Kuo AD, Donelan JM 2010. Dynamic principles of gait and their clinical implications. Phys Ther. 90(2):157–74.10.2522/ptj.20090125
   PubMed Web of Science ®Google Scholar