Date of Award

2018

Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)

Department

Occupational Therapy

First Advisor

Cherie Graves

Keywords

Equine-Assisted Therapy; Occupational Therapy; Treatment Outcome; Review

Abstract

Purpose: The purpose of this scholarly project is to examine existing literature pertaining to hippotherapy and conditions impacting physical health through completion of a systematic review. According to the American Hippotherapy Association (AHA, 2017), hippotherapy is defined as “how occupational therapy, physical therapy, and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement to engage sensory, neuromotor, and cognitive systems to achieve functional outcomes” (What is Hippotherapy, para. 1). Hippotherapy was initially cited in occupational therapy practice in the 1980’s, but minimal attention and research have been applied to the topic as time has progressed (Govender, Barlow, & Ballim, 2016). Further review of existing evidence has the potential to increase its acceptance by healthcare practitioners and therapists (Rigby & Grandjean, 2016).

Methodology: The literature search was conducted across six databases- PubMed, CINAHL, PsychInfo, SPORTDiscus, SCOPUS, and Cochrane. Articles included in the systematic review must have been quantitative research published in a peer-reviewed journal in the past 15 years. Additionally, articles must have been published in English, refer to a condition impacting one’s physical health, have intervention conducted by an occupational, physical, or speech-language therapy practitioner and be relevant to intervention with a horse.

Results/Conclusions: In total, 1955 articles were reviewed from the six databases, and 17 were determined to meet inclusion criteria. Themes identified were client factors, performance skills, and occupational therapy based outcomes. Specific client factors identified in the literature benefitting from hippotherapy included neuromusculoskeletal and movement-related functions and sensory functions such as pain. Some improvements noted in the area of client factors included muscle symmetry, muscle stability, muscle control, muscle tone functions, muscle strength, control of voluntary movement, postural alignment, gait pattern functions, and sensorimotor experiences. Performance skills evident in the literature were identified motor skills, specifically reaching and functional mobility. Although no occupational therapy-specific outcome measures were documented in the literature, outcomes connecting the literature and the Occupational Therapy Practice Framework (OTPF) were identified by the student researchers and included occupational performance, prevention, role competence, and quality of life. Evidence does exist pertaining to the efficacy of hippotherapy related to conditions impacting physical health, but there is a lack of evidence in the fields of occupational therapy, physical therapy, and speech-language therapy. There is a need for conduction of studies with high-level evidence in this area to promote usage of hippotherapy with conditions affecting physical health in the occupational therapy profession. With improvements in client factors and performance skills, occupation-based outcomes are hopeful. Thus, it is recommended future studies explicitly measure occupation-based outcomes related to hippotherapy intervention and physical health conditions.

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