A Randomized Feasibility Study of Rehabilitation Targeting Upper Extremity Function and Participation Using Hippotherapy and the Equine Environment for Children with Cerebral Palsy and Autism Spectrum Disorder.

Introduction: Children with upper extremity neuromotor impairments often have decreased participation in life activities. Hippotherapy and rehabilitation in the equine environment might be effective in targeting participation, given the community context and natural activity involvement. This random...

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Publicado en:Journal of Integrative & Complementary Medicine Vol. 31; no. 2; pp. 196 - 209
Autores principales: Mazzarella, Julia, Heathcock, Jill C.
Formato: pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Mary Ann Liebert, Inc. Feb2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2025
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      pub: Mary Ann Liebert, Inc.
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        10.1089/jicm.2024.0292
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        atl: A Randomized Feasibility Study of Rehabilitation Targeting Upper Extremity Function and Participation Using Hippotherapy and the Equine Environment for Children with Cerebral Palsy and Autism Spectrum Disorder.
      aug:
        au:
          Mazzarella, Julia
          Heathcock, Jill C.
        affil: School of Physical Therapy and Rehabilitation Science, College of Health, University of Montana, Missoula, MT, USA.
      sug:
        subj:
          Upper Extremity Physiology
          Cerebral Palsy Rehabilitation
          Autism Spectrum Disorder Rehabilitation
          Equine-Assisted Therapy In Infancy and Childhood
          Patient Participation
          Task Performance and Analysis
          Outcomes (Health Care)
          Human
          Funding Source
          Ohio
          Male
          Female
          Child
          Adolescence
          Randomized Controlled Trials
          Random Assignment
          Pilot Studies
          Pretest-Posttest Control Group Design
          Kinematics
          Videorecording
          Patient Attitudes
          Attitude to Health
          Scales
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Introduction: Children with upper extremity neuromotor impairments often have decreased participation in life activities. Hippotherapy and rehabilitation in the equine environment might be effective in targeting participation, given the community context and natural activity involvement. This randomized controlled feasibility trial assessed recruitment, retention, treatment fidelity, and acceptability of rehabilitation using hippotherapy and the equine environment, targeting upper extremity function and participation for children with neuromotor impairments to inform a larger trial. Methods: This 6-month trial occurred in Ohio, June–December 2021. Participants were 6–17 years old with upper extremity neuromotor impairment (and primary diagnosis of cerebral palsy and/or autism). Participants were randomized into treatment or waitlist control using REDCap. Treatment was 16 h (4 h/week/4 weeks) of rehabilitation using hippotherapy and the equine environment. Control participants completed a 4-week waiting period, then received the treatment. Recruitment, screening, enrollment, attendance, and retention were tracked. Nonblinded assessments of body structures and functions, activity, and participation were administered pre- and postcontrol and treatment. Assessment measure completion, treatment fidelity, and acceptability were recorded. Results: Twenty-six participants were screened between July and October 2021; 77% (20/26) met inclusion criteria; 70% (14/20) enrolled and randomized: 6 control and 8 treatment. Two withdrew after randomization and one was excluded for fear of horses. In total, n = 5 control and n = 6 treatment completed initial assessment. Retention was 80% (4/5) control and 83% (5/6) treatment, just below the a priori criteria (85%). Assessment measure completion was variable (77%–100%) and replacement of some should be considered before advancing to a clinical trial. Treatment fidelity and acceptability were moderate to high. There were no adverse events from study participation. Conclusions: Results demonstrated preliminary evidence of fidelity and acceptability of rehabilitation using hippotherapy and the equine environment for children with upper extremity neuromotor impairments. Some changes should be made to improve enrollment, retention, and outcome measure completion before advancing to a definitive trial. Trial registration: ClinicalTrials.gov identifier: NCT0653068. Trial funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Foundation for Physical Therapy Research, American Academy of Cerebral Palsy and Developmental Medicine, and Pedal With Pete Foundation.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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