Sage Journals: Discover world-class research

Abstract

Introduction

Evaluating how therapeutic horse riding improves health for children experiencing disability is made complex by a lack of clarity around mechanisms of treatment effect. This research develops an explanatory theory outlining how health outcomes may be optimised, by exploring what works for which riders, under what conditions and how.

Method

Within a realist research framework, we undertook three phases of study using a mix of qualitative and quantitative data collection and analysis approaches. Findings were then integrated into an overall evaluative account.

Results

Riders with a range of impairments (n = 32; aged 5 to 17 years), caregivers (n = 29) and therapeutic horse riding providers (n = 16) participated. Three key mechanisms of intervention effect are proposed: (1) therapeutic horse riding facilitates development of a rider’s self-concept through opportunities for accessible, meaningful participation; (2) the context in which therapeutic horse riding is provided promotes a focus on riders’ capacities and strengths and (3) therapeutic horse riding provides opportunities for a broad range of learning experiences.

Conclusion

Therapeutic horse riding provides opportunities for meaningful occupational participation for children experiencing disability. Ensuring that the physical and ideological context in which therapeutic horse riding is provided focuses on a rider’s capacities and strengths will enhance self-concept development and participation outcomes.

Keywords

Therapeutic horse riding disabled children occupational participation self-concept treatment effectiveness rehabilitation occupational therapy

Get full access to this article

View all access options for this article.

References

Bransford

Brown

Cocking

(eds) (2004) How People Learn. Washington, DC: National Academies Press.

Braun

Clarke

(2013) Successful Qualitative Research. Los Angeles: SAGE.

Charmaz

(2014) Constructing Grounded Theory. London: SAGE.

Dahan-Oliel

Shikako-Thomas

Majnemer

(2012) Quality of life and leisure participation in children with neurodevelopmental disabilities: A thematic analysis of the literature. Quality of Life Research 21(3): 427–439.

de Souza

(2013) Elaborating the Context-Mechanism-Outcome configuration (CMOc) in realist evaluation: A critical realist perspective. Evaluation 19(2): 141–154.

Debuse

Gibb

Chandler

(2009) Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Physiotherapy Theory and Practice 25(3): 174–192.

Emmel

Greenhalgh

Manzano

, et al. (2018) Doing Realist Research. London: SAGE.

Gibson

Darrah

Cameron

, et al. (2009) Revisiting therapy assumptions in children’s rehabilitation: Clinical and research implications. Disability & Rehabilitation 31(17): 1446–1453.

Gorman

(2017) Therapeutic landscapes and non-human animals: The roles and contested positions of animals within care farming assemblages. Social & Cultural Geography 18(3): 315–335.

10.

Graham

Rodger

Ziviani

(2009) Coaching parents to enable children’s participation: An approach for working with parents and their children. Australian Occupational Therapy Journal 56(1): 16–23.

11.

Hall

(2010) Spaces of social inclusion and belonging for people with intellectual disabilities. Journal of Intellectual Disability Research 54(Suppl 1): 48–57.

12.

Hammel

Magasi

Heinemann

, et al. (2008) What does participation mean? An insider perspective from people with disabilities. Disability & Rehabilitation 30(19): 1445–1460.

13.

Heffernan

(2017) The effect of an equine assisted therapy (EAT) programme on children’s occupational performance – a pilot study. Irish Journal of Occupational Therapy 45(1): 28–39.

14.

Hsieh

Shannon

(2005) Three approaches to qualitative content analysis. Qualitative Health Research 15(9): 1277–1288.

15.

Janssens

Williams

Tomlinson

, et al. (2014) Health outcomes for children with neurodisability: What do professionals regard as primary targets? Archives of Disease in Childhood 99(10): 927–932.

16.

Kendall

Maujean

Pepping

, et al. (2014) Hypotheses about the psychological benefits of horses. Explore 10(2): 81–87.

17.

King

Gibson

Mistry

, et al. (2014) An integrated methods study of the experiences of youth with severe disabilities in leisure activity settings: The importance of belonging, fun, and control and choice. Disability and Rehabilitation 36(19): 1626–1635.

18.

King

Chiarello

Thompson

, et al. (2019) Development of an observational measure of therapy engagement for pediatric rehabilitation. Disability and Rehabilitation 41(1): 86–97.

19.

King

Shields

Imms

, et al. (2013) Participation of children with intellectual disability compared with typically developing children. Research in Developmental Disabilities 34(5): 1854–1862.

20.

Kolb

(2015) Experiential Learning, 2nd edn. New Jersey: Pearson Education.

21.

Kratochwill

Hitchcock

Horner

, et al. (2013) Single-case intervention research design standards. Remedial and Special Education 34(1): 26–38.

22.

McEvoy

Richards

(2006) A critical realist rationale for using a combination of quantitative and qualitative methods. Journal of Research in Nursing 11(1): 66–78.

23.

Majnemer

Shikako-Thomas

Schmitz

, et al. (2015) Stability of leisure participation from school-age to adolescence in individuals with cerebral palsy. Research in Developmental Disabilities 47: 73–79.

24.

Martin

(2018) Evaluating the effectiveness of therapeutic horse riding in changing health outcomes for children experiencing disability: A critical realist approach (Thesis, Doctor of Philosophy). University of Otago. Available at: http://hdl.handle.net/10523/8142 (accessed 28 June 2019).

25.

Martin

Graham

Taylor

, et al. (2017) Mechanisms of change for children participating in therapeutic horse riding: A grounded theory. Physical & Occupational Therapy in Pediatrics 58(1): 1–17.

26.

Martin

Taylor

Surgenor

, et al. (2019) Evaluating the effectiveness of therapeutic horse riding for children and young people experiencing disability: A single-case experimental design study. Disability & Rehabilitation. Epub ahead of print 13 May 2019. DOI: 10.1080/09638288.2019.1610083.

27.

Meregillano

(2004) Hippotherapy. Physical Medicine and Rehabilitation Clinics of North America 15(4): 843–854.

28.

Nyquist

Moser

Jahnsen

(2016) Fitness, fun and friends through participation in preferred physical activities: Achievable for children with disabilities? International Journal of Disability, Development and Education 63(3): 334–356.

29.

Palisano

Chiarello

King

, et al. (2012) Participation-based therapy for children with physical disabilities. Disability and Rehabilitation 34(12): 1041–1052.

30.

Palisano

Di Rezze

Stewart

, et al. (2017) Life course health development of individuals with neurodevelopmental conditions. Developmental Medicine & Child Neurology 59(5): 470–476.

31.

Poulsen

Ziviani

Cuskelly

(2015) Goal Setting and Motivation in Therapy. London: Jessica Kingsley Publishers.

32.

Rosenbaum

Gorter

(2012) The “F-words” in childhood disability: I swear this is how we should think! Child: Care, Health and Development 38(4): 457–463.

33.

Russo

Goodwin

Miller

, et al. (2008) Self-esteem, self-concept, and quality of life in children with hemiplegic cerebral palsy. The Journal of Pediatrics 153(4): 473–477.

34.

Ryan

Deci

(2000) Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist 55(1): 68–78.

35.

Salter

Kothari

(2014) Using realist evaluation to open the black box of knowledge translation: A state-of-the-art review. Implementation Science 9(115): 1–14.

36.

Shannon-Baker

(2016) Making paradigms meaningful in mixed methods research. Journal of Mixed Methods Research 10(4): 319–334.

37.

Shikako-Thomas

Kolehmainen

Ketelaar

, et al. (2014) Promoting leisure participation as part of health and well-being in children and youth with cerebral palsy. Journal of Child Neurology 29(8): 1125–1133.

38.

von der Luft

DeBoer

Harman

, et al. (2008) Improving the quality of studies on self concept in children with cerebral palsy. Journal of Developmental and Physical Disabilities 20(6): 581–594.

39.

Wong

Greenhalgh

Westhorp

, et al. (2012) Realist methods in medical education research: What are they and what can they contribute? Medical Education 46(1): 89–96.

40.

World Health Organization (2001) International classification of functioning, disability and health. Available at: www.who.int/classifications/icf/en/ (accessed 5 February 2018).

41.

Ylvisaker

Feeney

(2002) Executive functions, self-regulation, and learned optimism in paediatric rehabilitation: A review and implications for intervention. Pediatric Rehabilitation 5(2): 51–70.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.23 MB

Exploring how therapeutic horse riding improves health outcomes using a realist framework

Abstract

Introduction

Method

Results

Conclusion

Keywords

Get full access to this article

References

Supplementary Material