Cystic fibrosis (CF) is a genetic disease that affects many organs and systems, especially respiratory system problems due to lung damage. Patients often have difficulty in removing the sticky and viscous secretion that accumulates in the respiratory tract, and the risk of mortality increases with the development of respiratory failure. In patients with CF, exercise capacity, peripheral muscle strength, core endurance, flexibility, postural stability, physical activity level, and quality of life also decrease secondarily. Recently published guidelines recommend respiratory physiotherapy for coping with CF-related symptoms and recommend referral of patients to physical activity and exercise.

Hippotherapy simulator is a mechanical exercise tool that imitates the walking movement of a real horse and is used to increase physical fitness parameters.

This study aims to show the effects of exercises performed with a hippotherapy simulator in addition to respiratory physiotherapy on physical fitness, sputum production, physical activity and quality of life of children with CF.

Inclusion Criteria:

• Be in the 8-14 age range
• To be diagnosed with cystic fibrosis according to the American Cystic Fibrosis Association consensus report criteria
• Having mild (FEV1 ≥ 70% predictive) lung disease according to the disease severity classification in the annual report of the American Cystic Fibrosis Society
• To be able to produce phlegm

Exclusion Criteria:

• Contracture or deformity,
• History of diagnosed orthopedic problems affecting mobility or musculoskeletal surgery
• History of previous lung or liver transplant
• Have diagnosed vision, hearing, vestibular or neurological problems that may affect balance,
• History of hospitalization in the last 1 month
• Patients who have participated in any exercise training program in the last 6 months