In conclusion, hippotherapy has become a popular modality for children with CP that is believed to enhance gross motor function, although there is insufficient evidence to support its benefits. This study has demonstrated modest but significant benefits in gross motor function over physical and occupational therapy, indicating that its clinical application in this area may be limited. The relatively greater improvements in PEDI scores observed suggest that hippotherapy helps children to engage more meaningfully in the functional activities of daily life. Investigation is warranted into the effects of hippotherapy on the child’s selfconfidence, motivation and other emotional areas. Further studies to determine who would benefit most from hippotherapy would be useful to expand the use of hippotherapy as a therapeutic intervention to maximize gross motor function and functional performance in children with CP.