Effects of Hippotherapy on Adolescents with Intellectual Disabilities

Effects of Hippotherapy on Adolescents with Intellectual Disabilities

A review of the article: Effect of a hippotherapy intervention program on static balance and strength in adolescents with intellectual disabilities

Paraskevi Giagazoglou *, Fotini Arabatzi, Konstantina Dipla, Maria Liga, Eleftherios Kellis Laboratory of Neuromechanics, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Serres, Greece

Abstract

Intellectual disability (ID) is a condition where one has certain intellectual limitations that hinders them from developing with the normal rate. Studies indicate that it is a very common disorder among children but it has different variationswhich range from mild, moderate to severe disabilities. This study was the first of its kind to be carried out on adolescents with ID as previous studies had been done on children with cerebral palsy. The study was carried out in order to find out the effect of a hippotherapy program on the static balance and strength on adolescents with ID. The method used was case control where one group was subjected to hippotherapy and the other group was not. After a 10-week hippotherapy program, the group that was taking part in the program showed significant improvement in strength and balance. This study was successful as it proved that hippotherapy can be used to improve on the functionality of people with ID. However, the study was limited by the sampling method where the only adolescents chosen for the study were suffering from moderate ID. There are different levels of ID and the experimental group should have consisted of adolescents suffering from all levels of ID. This would have yielded a variation of results showing how adolescents with different levels of ID respond to hippotherapy. Also, the age of the experimental group does not qualify to generalize all adolescents as it only included children aged 15-17. The study should have included adolescents aged 10-19 which is the adolescent age bracket to show whether hippotherapy effect is determined by age.

Introduction

Intellectual disability is a condition that affects mostly children. Surveyed regions show the 40.7% of individuals suffering from ID are aged between 4-18 (Einfield and Tonge, 1996). This disorder is overlooked because although the children develop at a slower rate, they still develop. As such, most of them do not receive specialized specialist assistance. Generally, adolescents with ID fall more often compared to adolescents without ID and this is because they have poor posture balance and weak muscle performance (Sven, Josephine, Louise, Anita and Borje,2013). This study shows the effect of hippotherapy on the static balance and strengths on adolescents with ID in order to determine whether hippotherapy can be used to improve on their strength and balance. This study is limited by the sampling method where participants were suffering from only one from of ID and non-generalizability where the whole adolescent age bracket was not represented. Improving on these weak points would provide a better conclusion because all levels of ID will be sampled and adolescents of different ages would participate in the study.

Narrative

Although the study was conducted on a group of adolescents suffering from intellectual disability, it had a poor sampling method because it only studied one type of ID. The impact of impairment caused by ID varies on different levels. Experts classify Intellectual disabilities into four major categories namely: mild intellectual disability, moderate intellectual disability, severe intellectual disability and profound disability (Samantha 2015). Adolescents suffering from these different levels of ID exhibit different symptoms in terms of IQ, rate of development, social skills, balance and strength. According to Alejandra (2017) Adolescents with mild ID have a relatively higher IQ compared to the rest and they have better social skills, their muscles have more strength and they do not require much help when moving around since they have better balance. Those with moderate ID can interpret some social cues but they need communicative support in order to establish a successful conversation, their muscle strength and balance is weak and they do not have a strong static balance and they therefore need continuous assistance. For adolescents with mild and moderate ID, learning and longer training can help them develop some skills and abilities. Those with severe and profound ID however have a relatively low IQ compared to the other two. Their gross and fine motor functions are disabled and they need assistance since they are dependent on all aspects. This variation in adolescents suffering from ID suggests that they need different intensity in hippotherapy. For the study to have a more accurate conclusion, asolescents suffering from the different levels of ID should have been included; this would have showed the different variation of time needed in order to improve on static balance and muscle strength for the different levels. This implies that the results about the different levels of ID could have been more specific and the findings can help any adolescent suffering from any level of ID.

Generalizability of the study on the effect of hippotherapy in adolescents living with ID is limited because it did not include all adolescents in the adolescent age bracket. According to WHO (World Health Organization, 2018), adolescents are individuals between the ages of 10-19. About 20% of teenagers from the age of 13 to 18 suffer from different levels of Intelligence disorder (Marie, 2016).  They have a hard compared to their counterparts who do not suffer from ID. This is because they have poor static balance, weak muscle strength, and they take much longer to learn and develop. Other studies indicate that adolescents suffering from Intellectual Disability have an increased risk of psychiatric disorder compared to their peers who do not suffer from ID (Emerson, 2003). This proves that adolescents suffering from ID are at a higher risk compared to other adolescents and hence it is important to carry out a study that can find out ways to help those adolescents living with ID learn skills that can improve their lives; among them being how hippotherapy can improve stability and muscle strength. This particular study had adolescents between the age of 15-17 and this is not a representation of all adolescents. The proper age bracket fot this study should have been 10-18 since that is the adolescent age bracket. By conducting a study considering all the ages within the adolescent age bracket, the sudy will find out whether intelligence Disability intensity differs with age. With this knowledge, more effective ways on how help adolescents of specific ages will be discovered. There is notable difference in muscle strength between adolescents of different ages. Older adolescents have more muscle strength compared to the younger ones. This implies that the intensity of hippotherapy will differ between the adolescents because their muscle strength is different. Studies have shown that muscle strength is variable among adolescents fo different ages (André Luiz Demantova Gurjão; Edilson Serpeloni Cyrino; Lúcio Flávio Soares Caldeira; Fábio Yuzo Nakamura; Arli Ramos de Oliveira; Emanuel Péricles Salvador; Raphael Mendes Ritti Dias, 2005). The study would have been more effective if all ages of the adolescent age bracket would have been sampled.

Conclusion

Despite the successful study on how hippotherapy can help improve muscle strength and static balance on teenagers, there are several limitations that if corrected could yield better results. The study should have used a better sampling method by including adolescents suffering from all levels of intelligence disorder and therefore come up with specific methods for each level of ID. Also, since the study is on adolescents, there was poor generization since the adolescents who took part in the study did not represent all the ages within the adolescent age bracket. By representing all ages, the study would have found out whether the standard hippotherapy procedure applies for all ages or differs with age. If implemented, this changes would help the study yield better results.

References

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