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European journal of physical and rehabilitation medicine2021; 58(1); 60-67; doi: 10.23736/S1973-9087.21.06816-7

Development of an ICF-based assessment tool for equine-assisted therapy: model structure and reliability.

Abstract: Scientific investigation and documentation of equine-assisted therapy has increased over the past several years. Yet there are no standardized and validated tools for evidence-based measurement of processes and outcomes to assess equine-assisted interventions. Objective: The objective of this cross-sectional survey study was to develop a standardized assessment tool for the effective measurement of equine-assisted therapy based on the common language of the International Classification of Functioning, Disability and Health (ICF) framework of the World Health Organization (WHO). Methods: Cross-sectional study. Methods: Six equine-assisted therapy rehabilitation centers in Germany. Methods: Persons with indications for equine-assisted therapy. Methods: In a qualitative conceptual portion of the study, four semi-structured focus group interviews were conducted and analyzed with a total of 17 experts and therapists according to the aims, content, and sphere of influence of equine-assisted therapy via structured content analysis. Based on these findings and a linkage to the classification system of ICF, a standardized assessment tool (a general module and three specialized submodules) for equine-assisted therapy was developed. It was field-tested with 116 participants at six locations in a multicenter practical field approach and statistically analyzed via explorative factor analyses and reliability tests. Results: Explorative factor analysis provided support for a three-factor structure for the general module, including psychosocial, motor, and mental functioning scales. For both submodules, i.e., the individual and group settings, a two-factor structure was indicated. Reliability was in the good to excellent range for all modules. Conclusions: A global 80-item assessment tool, divided into a general and three submodules, provides a first step toward a standardized ICF-based assessment of the effects of equine-assisted therapy. A common language in measuring therapy outcomes could increase synchronization and integration of equine-assisted therapy interventions into the international healthcare system. By applying the ICF in multidisciplinary services in rehabilitation management, improved coordination and networking of all necessary services can be provided. Conclusions: The developed assessment tool contributes to evidence-based outcome-measurement and therapy monitoring of equine-assisted interventions. Prospectively, it could enable cost-effectiveness analyses and comparability with other health system interventions.
Publication Date: 2021-11-08 PubMed ID: 34747578PubMed Central: PMC9980525DOI: 10.23736/S1973-9087.21.06816-7Google Scholar: Lookup
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  • Journal Article
  • Multicenter Study

Summary

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This study looks into creating a standardized tool to evaluate the effectiveness of equine-assisted therapy, based on the International Classification of Functioning, Disability and Health (ICF) structure shared by the WHO. The tool underwent thorough testing and showed excellent reliability.

Study Objective

The research focuses on creating a reliable, standardized tool to measure the benefits and processes of equine-assisted therapy. Existing studies lack standardized, validated tools for such a purpose, and thus this study plugs an important gap. The tool being proposed is based on the International Classification of Functioning, Disability, and Health (ICF) framework proposed by the World Health Organization (WHO).

Methodology

  • The research was conducted across six equine-assisted therapy centers in Germany, involving several individuals who require such therapy.
  • Researchers conducted four semi-structured focus group interviews with 17 therapists and experts in the field. These interviews were designed to gain insight into the objectives, content, and influences of equine-assisted therapy.
  • Based on the data collected from these interviews, a standardized assessment tool was created. It consists of a general module and three submodules, all firmly grounded in the ICF classification system.
  • To test the tool, it was used with 116 participants across the six locations. Results were statistically analyzed using explorative factor analyses and reliability tests.

Results

  • The explorative factor analysis backed a three-factor structure within the general module. These factors included scales for psychosocial, motor, and mental function.
  • Two-factor structures were used in both submodules, which were created for individual and group settings.
  • All modules showed good to excellent levels of reliability.

Conclusions

  • The study furnished an 80-item global assessment tool, which includes a general module and three submodules. This fills the gap for a standardized measurement tool for the impacts of equine-assisted therapy.
  • This tool proposes a common language to measure therapy outcomes, paving the way for greater integration and synchronization of equine-assisted therapies within international healthcare systems.
  • The use of the ICF framework in multi-disciplinary services could enhance coordination and networking in service provision.
  • The tool is a step forward in contributing to evidence-based measurement and monitoring of equine-assisted therapy outcomes. In the future, it might enable the performance of cost-effectiveness analyses and comparisons with other interventions in the health system.

Cite This Article

APA
Stolz I, Tillmann V, Anneken V, Froboese I. (2021). Development of an ICF-based assessment tool for equine-assisted therapy: model structure and reliability. Eur J Phys Rehabil Med, 58(1), 60-67. https://doi.org/10.23736/S1973-9087.21.06816-7

Publication

ISSN: 1973-9095
NlmUniqueID: 101465662
Country: Italy
Language: English
Volume: 58
Issue: 1
Pages: 60-67

Researcher Affiliations

Stolz, Isabel
  • Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany - stolz@fi-bs.de.
  • Institute of Movement and Neurosciences, German Sport University, Cologne, Germany - stolz@fi-bs.de.
Tillmann, Vera
  • Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany.
Anneken, Volker
  • Research Institute for Inclusion through Physical Activity and Sport at the German Sport University, Cologne, Germany.
Froboese, Ingo
  • Research Institute for Institute of Health Promotion and Clinical Movement Science, German Sport University, Cologne, Germany.

MeSH Terms

  • Animals
  • Cross-Sectional Studies
  • Disability Evaluation
  • Disabled Persons / rehabilitation
  • Equine-Assisted Therapy
  • Horses
  • Humans
  • International Classification of Functioning, Disability and Health
  • Reproducibility of Results

Conflict of Interest Statement

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

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Citations

This article has been cited 1 times.
  1. Stolz I, Anneken V, Froböse I. Measuring Equine-Assisted Therapy: Validation and Confirmatory Factor Analysis of an ICF-Based Standardized Assessment-Tool. Int J Environ Res Public Health 2022 Feb 26;19(5).
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