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

Purpose: Therapeutic horse riding aims to improve the health of children and young people experiencing disability; however, its benefits across a range of health domains, particularly the impact on participation outcomes, are not well known. This research evaluated to what extent there was a change in riders balance, functional performance, social responsiveness, quality of life and participation outcomes as a result of therapeutic horse riding. Methods: A multiple-baseline across participants (n = 12) single-case experimental design, with randomly allocated baseline phase lengths, quantitatively evaluated how riders responded to a 20-week intervention. Results: Social participation outcomes measured using the Canadian Occupational Performance Measure demonstrated the most consistent positive between-phase differences (performance ES = 1.20, 95% CI [0.82, 1.63]; satisfaction ES = 1.11, 95% CI [0.73, 1.55]). A causal relationship was seen in three riders, but improvements only reached clinical significance for two riders when accounting for phase data trends. No significant outcome patterns were found comparing riders with principally physical impairments to those with principally psychosocial impairments. Conclusions: Being involved in therapeutic horse riding may improve rider’s social participation in home, school and community settings. We postulate that rider self-concept development may be a mechanism of treatment effect leading to participation-level changes.Implications for rehabilitationSocial participation was the health outcome demonstrating the most consistent change following therapeutic horse riding, regardless of rider impairment.Therapeutic horse riding can improve social participation in settings beyond the riding arena.Greater intervention tailoring based on rider responses may enhance therapeutic horse riding intervention effects. Social participation was the health outcome demonstrating the most consistent change following therapeutic horse riding, regardless of rider impairment. Therapeutic horse riding can improve social participation in settings beyond the riding arena. Greater intervention tailoring based on rider responses may enhance therapeutic horse riding intervention effects.

研究目的：治疗性马术疗法（therapeutic horse riding）旨在改善存在残疾的儿童与青少年的健康状况，但目前学界对其在多类健康领域的获益，尤其是对参与度结局的影响，仍缺乏充分认知。本研究评估了接受治疗性马术疗法后，受试者的平衡能力、功能表现、社会反应性、生活质量及参与度结局的改善程度。
方法：本研究采用跨受试者多基线单病例实验设计（multiple-baseline across participants single-case experimental design），通过随机分配的基线阶段时长，对12名受试者（n=12）展开定量分析，评估其对20周干预方案的响应情况。
结果：采用加拿大职业表现评估量表（Canadian Occupational Performance Measure）测评的社会参与结局，显示出最一致的阶段间正向差异（表现维度效应量ES=1.20，95%置信区间CI[0.82, 1.63]；满意度维度效应量ES=1.11，95%置信区间CI[0.73, 1.55]）。3名受试者呈现出明确的因果关联，但结合阶段数据趋势分析后，仅2名受试者的改善达到临床显著性。对比以躯体障碍为主与以社会心理障碍为主的受试者，未发现显著的结局模式差异。
结论：参与治疗性马术疗法或可改善受试者在家庭、学校与社区场景中的社会参与能力。我们推测，受试者自我概念的发展可能是介导治疗效应、进而带来参与水平变化的潜在机制。
康复启示：无论受试者的障碍类型如何，社会参与均为治疗性马术疗法后改善最一致的健康结局；治疗性马术疗法可提升受试者在马术训练场以外场景中的社会参与能力；基于受试者响应制定更具针对性的干预方案，或可增强治疗性马术疗法的干预效果。
无论受试者的障碍类型如何，社会参与均为治疗性马术疗法后改善最一致的健康结局；治疗性马术疗法可提升受试者在马术训练场以外场景中的社会参与能力；基于受试者响应制定更具针对性的干预方案，或可增强治疗性马术疗法的干预效果。