Benefícios da equoterapia em crianças e adolescentes com paralisia cerebral nos níveis GMFCS IVE V: uma revisão de escopo

Abstract

Introduction:Cerebral palsy (CP) is a non-progressive neuromotor condition characterized by movement and posture disorders that compromise functionality and independence. Among rehabilitation strategies, equine therapy has stood out for integrating sensorimotor and emotional stimuli, using the three-dimensional movement of the horse to promote postural adjustments, balance, and motor coordination. This approach is especially indicated for individuals with greater functional limitations, such as those at levels IV and V of the GMFCS (Gross Motor Function Classification System).Objective:To identify, through a literature review, the main benefits of equine therapy on gross motor function and balance in children and adolescents with CP at GMFCS levels IV and V.Methodology:A search was conducted in the Medline/PubMed, Lilacs, Embase, and PEDro databases, using descriptors related to CP and equine therapy. Studies with participants aged 2 to 18 years, of both sexes, who underwent equine therapy sessions on a real horse were included. Reviews, studies with other pathologies, or those that used simulators were excluded.Results:8 studies were included. The findings indicated that equine therapy promotes significant gains in postural control, trunk and head stability, gait symmetry, and gross motor function, assessed mainly by the GMFM-66/88 and Pediatric Balance Scale (PBS). Reductions in spasticity and improvements in autonomic variability were also observed. Qualitative studies have highlighted psychosocial benefits, such as increased self-confidence, engagement, and social interaction. Despite the positive results, most studies had small samples, short intervention durations (8–12 weeks), and a lack of methodological standardization, which limits the generalizability of the findings.Conclusion:This review confirms that equine therapy is an effective and safe intervention to improve gross motor function, balance, and overall well-being in children and adolescents with CP, especially at GMFCS levels IV and V. The results reinforce the potential of this approach as a complement to conventional physiotherapy practices, contributing to greater functional independence and quality of life. However, it is recommended that future research adopt standardized protocols, increase sample sizes, and conduct long-term follow-ups in order to consolidate the scientific evidence and strengthen its clinical applicability.