The PEDI-FSS has been widely used to evaluate the daily functional performance of children with CP.The PEDI is intended for children up to 7.5 years of age, but this can be extended to children with functional disabilities. In our study, the PEDI-FSS was used to measure the actual performance in daily life of children older than 7.5 years. On review of the literature, the PEDI was used as an outcome measure in only one study by Casady and Nichols Larsen. In that study, significant improvement was found in the total PEDI score as well as its 3 domains of selfcare, mobility and social functioning. However, the small sample size (n=10), lack of a control group and large variability in the frequency of physical, occupational and speech therapy (none 10 weeks) limits the applicability of these results.
Our study demonstrated significant improvements in all 3 PEDI domains of selfcare, mobility and social functioning in the hippotherapy group, but not in the control group. These findings suggest some positive effects of hippotherapy on the child’s actual performance in daily life. The mobility domain is closely related to gross motor function based on GMFCS level, while the selfcare domain is related to both GMFCS level and hand function based on Manual Ability Classification System score. According to a previous report, hippotherapy improved dynamic trunk stability and functional reach in children with spastic diplegia. Those beneficial effects of hippotherapy seem likely to contribute the significant gains of selfcare and mobility domains in our study.