Changes in Gait Balance and Brain Connectivity in Response to Equine-Assisted Activity and Training in Children with Attention Deficit Hyperactivity Disorder.
Abstract: Equine-assisted activity and training (EAAT) is thought to improve body balance and clinical symptoms in children with attention deficit hyperactivity disorder (ADHD). The study hypostheses were that EAAT would improve the clinical symptoms and gait balance in children with ADHD and that these improvements would be associated with increased brain connectivity within the balance circuit. Methods: A total of 12 children with ADHD and 12 age- and sex-matched healthy control children were recruited. EAAT consisted of three training sessions, each 70 minutes long, once a week for 4 weeks. Brain functional connectivity was assessed by using functional magnetic resonance imaging. Results: After 4 weeks of EAAT, children with ADHD showed improved scores on the Korean ADHD scale (K-ARS), while the K-ARS scores of healthy children did not change. During the 4 weeks, the plantar pressure difference between the left foot and right foot decreased in both the healthy control group and the ADHD group. After 4 weeks of EAAT, healthy controls showed increased brain connectivity from the cerebellum to the left occipital lingual gyrus, fusiform gyrus, right and left thalami, right caudate, right precentral gyrus, and right superior frontal gyrus. However, children with ADHD showed increased brain connectivity from the cerebellum to the right insular cortex, right middle temporal gyrus, left superior temporal gyrus, and right precentral gyrus. In contrast, children with ADHD exhibited decreased brain connectivity from the cerebellum to the left inferior frontal gyrus. Conclusions: EAAT may improve clinical symptoms, gait balance, and brain connectivity, the last of which controls gait balance, in children with ADHD. However, children with ADHD who have deficits in the fronto-cerebellar tract did not exhibit changes in brain connectivity as extensive as those in healthy children in response to EAAT.
Publication Date: 2016-03-16 PubMed ID: 26982567DOI: 10.1089/acm.2015.0299Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates the positive effects of Equine-Assisted Activity and Training (EAAT) on gait balance, symptoms, and brain connectivity in children with attention deficit hyperactivity disorder (ADHD).
Research Methods
- In the study, 12 children diagnosed with ADHD and 12 healthy children were engaged in EAAT. The training consisted of three sessions every week, lasting for 70 minutes each across 4 weeks.
- The researchers employed functional magnetic resonance imaging to evaluate the brain’s functional connectivity among the children both before and after the training period.
Research Findings
- Post 4 weeks of EAAT, the children with ADHD demonstrated enhanced scores on the Korean ADHD scale (K-ARS), indicating an improvement in their clinical symptoms. On the other hand, the K-ARS scores for healthy children remained unaffected.
- In the 4-week period, there was a decrement in the plantar pressure gap between the left and right foot in both ADHD children and their healthy counterparts, demonstrating an improvement in gait balance.
- Brain connectivity also differed between the groups following EAAT. Healthy children showed an upsurge in brain connectivity from the cerebellum to specific areas, including left occipital lingual gyrus, fusiform gyrus, right and left thalami, right caudate, right precentral gyrus, and right superior frontal gyrus. However, children with ADHD exhibited an increased brain connectivity from the cerebellum to different areas, such as the right insular cortex, right middle temporal gyrus, left superior temporal gyrus, and right precentral gyrus.
- The research also found that children with ADHD showed a decrease in brain connectivity from the cerebellum to the left inferior frontal gyrus after the EAAT.
Research Conclusions
- The research concludes that EAAT may lead to improvements in clinical symptoms, gait balance, and brain connectivity in children with ADHD. In particular, the improvements in brain connectivity are associated with controlling gait balance.
- However, the study found that ADHD children with deficits in the fronto-cerebellar tract did not exhibit as significant changes in their brain connectivity as was observed among the healthy children in response to the EAAT.
Cite This Article
APA
Hyun GJ, Jung TW, Park JH, Kang KD, Kim SM, Son YD, Cheong JH, Kim BN, Han DH.
(2016).
Changes in Gait Balance and Brain Connectivity in Response to Equine-Assisted Activity and Training in Children with Attention Deficit Hyperactivity Disorder.
J Altern Complement Med, 22(4), 286-293.
https://doi.org/10.1089/acm.2015.0299 Publication
Researcher Affiliations
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, Korea.
- 2 Department of Therapeutic Riding, JeonJu KiJeon College , JeonJu, Korea.
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, Korea.
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, Korea.
- 3 Department of Industry Academic Cooperation, Chung Ang University , Seoul, Korea.
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, Korea.
- 4 Department of Biomedical Engineering, Gachon University , Incheon, Korea.
- 5 Uimyung Research Institute for Neuroscience, School of Pharmacy, Sahmyook University , Seoul, Korea.
- 6 Division of Child and Adolescent Psychiatry, Clinical Research Institute, Seoul National University Hospital , Seoul, Korea.
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, Korea.
MeSH Terms
- Animals
- Attention Deficit Disorder with Hyperactivity / diagnostic imaging
- Attention Deficit Disorder with Hyperactivity / physiopathology
- Attention Deficit Disorder with Hyperactivity / therapy
- Brain / diagnostic imaging
- Brain / physiopathology
- Case-Control Studies
- Child
- Equine-Assisted Therapy
- Female
- Gait / physiology
- Horses
- Humans
- Magnetic Resonance Imaging
- Male
- Postural Balance / physiology
Citations
This article has been cited 11 times.- Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. Int J Environ Res Public Health 2023 Jul 16;20(14).
- Mutoh T, Kunitoki K, Tatewaki Y, Yamamoto S, Thyreau B, Matsudaira I, Kawashima R, Taki Y. Impact of medium-chain triglycerides on gait performance and brain metabolic network in healthy older adults: a double-blind, randomized controlled study. Geroscience 2022 Jun;44(3):1325-1338.
- Yu L, Yu P, Liu W, Gao Z, Sun D, Mei Q, Fernandez J, Gu Y. Understanding Foot Loading and Balance Behavior of Children with Motor Sensory Processing Disorder. Children (Basel) 2022 Mar 9;9(3).
- Si FF, Liu L, Li HM, Sun L, Cao QJ, Lu H, Wang YF, Qian QJ. Cortical Morphometric Abnormality and Its Association with Working Memory in Children with Attention-Deficit/Hyperactivity Disorder. Psychiatry Investig 2021 Jul;18(7):679-687.
- Kemeny B, Burk S, Hutchins D, Gramlich C. Therapeutic Riding or Mindfulness: Comparative Effectiveness of Two Recreational Therapy Interventions for Adolescents with Autism. J Autism Dev Disord 2022 Jun;52(6):2438-2462.
- Marchand WR, Andersen SJ, Smith JE, Hoopes KH, Carlson JK. Equine-Assisted Activities and Therapies for Veterans With Posttraumatic Stress Disorder: Current State, Challenges and Future Directions. Chronic Stress (Thousand Oaks) 2021 Jan-Dec;5:2470547021991556.
- Tymofiyeva O, Gaschler R. Training-Induced Neural Plasticity in Youth: A Systematic Review of Structural and Functional MRI Studies. Front Hum Neurosci 2020;14:497245.
- Ohtani N, Kitagawa K, Mikami K, Kitawaki K, Akiyama J, Fuchikami M, Uchiyama H, Ohta M. Horseback Riding Improves the Ability to Cause the Appropriate Action (Go Reaction) and the Appropriate Self-control (No-Go Reaction) in Children. Front Public Health 2017;5:8.
- Baby M, Priya V, Pallavi J, Karthik Chand B, Srinivasan LV, Rana SS, Tawil S, Haque S, Ghosh P, Bhattacharya P, Khan MO, Perwez SK, Ahmad F. A Narrative Review of Outcomes, Comorbidities, and Alternative Behavioral Interventions in Adolescent and Adult Women with ADHD. Int J Womens Health 2025;17:3201-3228.
- Silva FGD, Paula DD, Alves LM, Santos JN. Benefits of horseback riding for neurotypical children and adolescents: a scoping review. Codas 2025;37(3):e20240083.
- Amado-Fuentes M, Denche-Zamorano A, Barrios-Fernandez S, Gozalo M. Bibliometric Analysis on Equine-Assisted Interventions. Animals (Basel) 2024 Jun 13;14(12).
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