Evaluating the effectiveness of therapeutic horse riding for children and young people experiencing disability: a single-case experimental design study

How to Evaluate a Tailor-made Social Work Intervention? Some Practice-Based Solutions with Single-Case Designs

PURPOSE

With the increased attention to the principles of evidence-based practice (EBP), social workers are challenged to adapt their daily interventions accordingly when treating clients. They usually work with individual clients, all with their own specificities. Single-Case Experimental Designs (SCEDs) can be used to inform a social worker about the effectiveness of an intervention at the individual client level. In everyday social work practice, however, it is difficult to meet methodological requirements of SCEDs to find causal explanations. A concern is that repeated measurements prior to an intervention are required in most situations. This study aims to provide researchers with alternatives to repeated measurement when using the logic of SCED to apply EBP in their everyday practice.

METHODS

In this study, we reviewed published single-case designs between January 1 and December 31, 2019, on types of SCEDs in the social domain, and how is dealt with baseline conditions.

RESULTS

SCEDs and quasi-experimental alternatives are hardly published in situations when baseline data are not available. Four underused quasi-experimental strategies that can be employed when repeated measurement during baseline is not possible are as follows: retrospective baselines, theoretical inference, multiraters, and triangulation with qualitative data.

DISCUSSION AND CONCLUSION

The suggestions to work with single-case designs with quasi-experimental elements are meant to enable social workers to evaluate their interventions in a way that enhances mere narrative evaluations of the experiences of an intervention.

Does Hippotherapy Improve the Functions in Children with Cerebral Palsy? Systematic Review Based on the International Classification of Functioning

Objective: To perform a systematic review of the literature regarding scientific reality of hippotherapy in children with cerebral palsy graded according to France HAS (Haute Autorité de Santé) recommendations and applied to the International Classification of Functioning. Methods: The research in MEDLINE and Cochrane Library databases was performed using the keywords: "Equestrian therapy," "Riding for the disabled," "Hippotherapy," "Equine-movement therapy," and "Therapeutic horse (back) riding." The methodological quality of the articles was assessed using four levels of proof and three guideline grades (A: strong; B: moderate; C: poor). Results: Seven prospective, randomized controlled studies and one systematic review confirm the level of proof of hippotherapy in children with cerebral palsy with grade B. Hippotherapy in children with cerebral palsy contributes to improve motor function, symmetry of muscle contraction, spasticity, posture, and walking. Fifty prospective no randomized studies confirm the level with grade C for balance, motor coordination, lumbopelvic mobility, walking speed, functional development, and social behavior. Conclusions: Hippotherapy in children with cerebral palsy can be recommended. Regarding the literature data, the level of proof of hippotherapy in children with cerebral palsy is moderate (grade B).

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

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.