Date Presented 3/31/2017
The benefits of hippotherapy include posture, dynamic motor skills, sensory processing, and psychosocial factors. Debuse, Gibb, and Chandler (2009) suggested limited evidence supporting hippotherapy; no common assessment tool exists. This presentation will share research about a newly developed assessment.
Primary Author and Speaker: Mary Shotwell
Contributing Authors: Deborah Weissman-Miller, Tara Malone, Brooke O’Kelley, Elizabeth Post, Irma Alvarado
PURPOSE: This study articulates the validity and reliability of a newly developed tool, the Hippotherapy Evaluation and Assessment Tool (HEAT), which may prove useful as both an outcome measure and a tool to monitor client progress during hippotherapy. This presentation discusses the most recent phase of validity and reliability testing of the new tool. The study explored the following research questions: (1) Is the HEAT a reliable tool with respect to interrater reliability? (2) Is the HEAT a valid tool with respect to other gold standard tools such as the Pediatric Evaluation of Disability Inventory (PEDI)? (3) Is the HEAT a valid tool with respect to predictive validity or repeated measures?
DESIGN: This was a nonexperimental study using a convenience sample of 21 children with a variety of diagnoses including autism, cerebral palsy, and genetic disorders. Prior to data collection, six graduate students and two experienced clinicians performed interrater reliability using two cases, achieving an intraclass correlation coefficient of .92. Each participant was scored using the HEAT, an unobtrusive observational tool used during the course of hippotherapy, for at least 12 sessions. Additionally, pre and post PEDI scores were obtained for the participants.
METHOD: Originally developed by Shotwell in 2011, the HEAT has undergone several studies exploring reliability and validity (Cox, Morgan, Smith, & Wiles, 2011; Snyder, Smith, Mapp, & Wade, 2012). The tool has shown adequate reliability in two studies (Cox et al., 2011; Malone et al., 2016). The HEAT has fair to good concurrent validity with the Gross Motor Function Measure, the Sensory Processing Measure, and the Pediatric Inventory of Disability (Snyder et al., 2012). The most recent study with the HEAT explored its ability to show change over time as well as predict scores on the PEDI, a more functional outcome measure.
RESULTS: Results of t tests between HEAT scores for Session 1 and Session 14 indicate statistically significant differences (t = –4.033, p = .002). Results of the t test regarding pre–post PEDI scores did not reach statistical significance; however, only nine of the 21 PEDI forms were returned at Session 14. Results of the situation–problem–response–evaluation (SPRE) analysis indicate that all five participants who met criteria for the SPRE analysis made statistically significant changes in HEAT scores by Sessions 12–14 during their therapy.
CONCLUSION: The HEAT demonstrates ability to show changes in client factors (posture, motor behavior, sensory processing, and psychosocial factors) over time. Further research is warranted regarding the relationship between the HEAT and other functional performance outcome measures.Cox, H., Morgan, T., Smith, E., & Wiles, R. (2011). Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Gainesville, GA: Brenau University.
References
Cox, H., Morgan, T., Smith, E., & Wiles, R. (2011). Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Gainesville, GA: Brenau University.
Debuse, D., Gibb, C., & Chandler, C. (2009). Effects of hippotherapy on people with cerebral palsy from the users’ perspective: A qualitative study. Physiotherapy Theory and Practice, 25, 174–192. https://doi.org/10.1080/09593980902776662
Malone, T., Maney, E., MacSpadden, C., Moss, E., O’Kelley, B., & Post, E. (2016). Predictive validity of the Hippotherapy Evaluation and Assessment Tool (HEAT). Master’s thesis, Brenau University, Gainesville, GA.
Snyder, J., Smith, D., Mapp, K., & Wade, K. (2012). Establishing concurrent validity of the Hippotherapy Evaluation and Assessment Tool. Gainesville, GA: Brenau University.
Weissman-Miller, D., Shotwell, M. P., & Miller, R. J. (2012). New single-subject and small-n design in occupational therapy: Application to weight loss in obesity. American Journal of Occupational Therapy. 66, 455–462. https://doi.org/10.5014/ajot.2012.004788
