Efficacy of simulated equestrian therapy in improving gait parameters among children with Down syndrome: a randomized controlled trial

OBJECTIVES: To compare the effectiveness of Simulated Equestrian Therapy (SET) and Standard Physical Therapy (SPT) in improving gait parameters among children with Down syndrome (DS). METHODS: This single-blinded, randomized controlled trial was conducted at Dar-ul-Sukun Institute and Dr. Zaiuddin Hospital, Karachi, Pakistan, from April to August 2023. Sixty individuals, meeting the selection criteria were randomly assigned to either the treatment group (n=30) receiving SET or the control group (n=30) undergoing SPT. Nevertheless, two participants from each group either discontinued the treatment or failed to comply with the therapy and 56 participants (n=28 in each group) were included for analysis. Safety measures included recording blood pressure and heart rate before and after each session. Temporal gait parameters were assessed using the 10-Meter Walk Test at baseline, 6 weeks, and 12 weeks. Data was analyzed using Medcalc software. RESULTS: Temporal gait parameters were analyzed for 56 (33 males and 23 females) children with DS in both groups. Mean age of patients in SET and SPT groups was 7.89 +/- 1.7 and 8.07 +/- 0.76 years respectively. Baseline showed similar scores in both groups. At 6 weeks, SET demonstrated significant improvement in cadence (1.78 SPM to 1.35) and gait velocity (2.11 MPS to 2.79), paralleled by SPT (cadence: 2.01 to 1.32 SPM, gait velocity: 2.12 to 2.83 MPS). Between-group analysis revealed no significant differences. CONCLUSION: Both SET and SPT effectively improve gait parameters in children with Down syndrome. The comparable outcomes highlight SET as a viable alternative, providing clinicians and caregivers additional options for personalized therapeutic approaches. Clinical Trial Registration Number: NCT05912803