Effectiveness of the hippotherapy simulator in children and adolescents with cystic fibrosis: A randomized controlled trial

Background: Patients with cystic fibrosis (CF) frequently experience both pulmonary and extrapulmonary complications that impair physical function and quality of life, highlighting the need for multidimensional rehabilitation strategies. Objectives: The study aims to investigate the effects of hippotherapy simulator (HS) added to comprehensive chest physiotherapy (CCP) on pulmonary and extrapulmonary manifestations in cystic fibrosis (CF). Methods: Thirty-two patients (8–14 years) with CF were randomized into either CCP group (received CCP only), or CCP+HS group (received HS alongside CCP). CCP was performed twice daily. The HS program consisted of two 30-minute sessions per week. Functional capacity, pulmonary functions, amount of sputum, ease of expectoration, sense of chest congestion, core muscle endurance, postural stability, dynamic balance, peripheral muscle strength, flexibility, physical activity (PA), and quality of life (QoL) were assessed at baseline and after the 8-week treatment. Results: Functional capacity, pulmonary functions, amount of sputum, core muscle endurance, postural stability, peripheral muscle strength, PA, and emotional functioning and body image scores in QoL improved only in the CCP+HS group (p < 0.05). Improvements in extensor and lateral group core muscle endurance and dynamic balance were greater in the CCP+HS group compared to the CCP group (p < 0.05). Conclusions: HS alone appears insufficient to improve functional capacity, pulmonary functions, amount and ease of expectoration, postural stability, flexibility, and PA in children and adolescents with CF; however, it may be used as an adjunctive approach to enhance core muscle endurance and dynamic balance.