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International journal of environmental research and public health2022; 19(5); 2738; doi: 10.3390/ijerph19052738

Measuring Equine-Assisted Therapy: Validation and Confirmatory Factor Analysis of an ICF-Based Standardized Assessment-Tool.

Abstract: The International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO) was established as an international framework for monitoring rehabilitation outcomes and the impacts of health interventions since, as the term "functioning" implies, it emphasizes a person's "lived health" in addition to their biological health status. Equine-assisted therapy (EAT) represents a holistic intervention approach that aims to improve both biomedical functioning and the patient's lived health in relation to performing activities and participating in social situations. In this study, the psychometric properties of an ICF-based digital assessment tool for the measurement of the rehabilitation impacts of EAT were analyzed via simultaneous confirmatory factor analyses (CFA) and reliability and sensitivity tests. In total, 265 patients from equine-assisted therapy centers in Germany were included for CFA. Change sensitivity was assessed via multi-level analyses based on 876 repeated assessments by 30 therapists. Results show satisfactory model-fit statistics; McDonald's omega (ML) showed excellent scores for the total scale (ω = 0.96) and three subscales (ω = 0.95; ω = 0.95, ω = 0.93). The tool proved itself to be change sensitive and reliable (change sensitivity 0.001), retest r = 0.745 **, ≤ 0.001). Overall, the developed assessment tool satisfactorily fulfills psychometric requirements and can be applied in therapeutic practice.
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Publication Date: 2022-02-26 PubMed ID: 35270430PubMed Central: PMC8910427DOI: 10.3390/ijerph19052738Google Scholar: Lookup
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  • Journal Article
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  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study focused on validating and testing a digital assessment tool based on the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF). This tool was developed to measure the impacts of equine-assisted therapy (EAT) on the rehabilitation of patients.

About the Study

  • The research aimed to explore the psychometric properties of a digital assessment tool grounded in the principles of the ICF. This tool’s purpose was to measure the rehabilitation impacts of EAT on patients, focusing on both their biomedical functioning and their ability to participate in social situations.
  • The study embraced a holistic intervention approach, which is a marked characteristic of EAT.

Methodology

  • The study analyzed the tool’s psychometric properties using confirmatory factor analysis (CFA), reliability, and sensitivity tests.
  • In total, 265 patients from various EAT centers in Germany offered data for the CFA.
  • Change sensitivity, another important aspect of the study, was assessed using multi-level analyses from a series of 876 repeated assessments performed by 30 therapists.

Results

  • The results demonstrated satisfactory model-fit statistics, indicating that the assessment tool delivered accurate results.
  • The McDonald’s omega (ML) showed excellent scores for the total scale (ω = 0.96) and three subscales (ω = 0.95; ω = 0.95, ω = 0.93). This suggested that the tool’s consistency and reliability were above average.
  • Importantly, the tool proved to be change sensitive and reliable, with a change sensitivity score of less than 0.001 and a retest result of r = 0.745.

Conclusion

  • The digital assessment tool developed in this study meets the necessary psychometric requirements, and as such, it can be successfully integrated into therapeutic practice. It is specifically designed for use in the context of EAT, but its ICF-based structure renders it flexible and potentially applicable in other therapies as well.

Cite This Article

APA
Stolz I, Anneken V, Froböse I. (2022). Measuring Equine-Assisted Therapy: Validation and Confirmatory Factor Analysis of an ICF-Based Standardized Assessment-Tool. Int J Environ Res Public Health, 19(5), 2738. https://doi.org/10.3390/ijerph19052738

Publication

International journal of environmental research and public health
ISSN: 1660-4601
NlmUniqueID: 101238455
Country: Switzerland
Language: English
Volume: 19
Issue: 5
PII: 2738

Researcher Affiliations

Stolz, Isabel
  • Research Institute for Inclusion through Physical Activity and Sport, German Sport University Cologne, 50226 Frechen, Germany.
  • Research Institute of Movement and Neurosciences, German Sport University Cologne, 50933 Cologne, Germany.
Anneken, Volker
  • Research Institute for Inclusion through Physical Activity and Sport, German Sport University Cologne, 50226 Frechen, Germany.
Froböse, Ingo
  • Institute of Health Promotion and Clinical Movement Science, German Sport University, 50933 Cologne, Germany.

MeSH Terms

  • Animals
  • Disability Evaluation
  • Disabled Persons / rehabilitation
  • Equine-Assisted Therapy
  • Factor Analysis, Statistical
  • Horses
  • Humans
  • International Classification of Functioning, Disability and Health
  • Reproducibility of Results

Conflict of Interest Statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

References

This article includes 27 references
  1. Maritz R, Aronsky D, Prodinger B. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.. Appl Clin Inform 2017 Dec 20;8(3):964-980.
    doi: 10.4338/ACI2017050078pmc: PMC6220695pubmed: 28933506google scholar: lookup
  2. Stucki G, Bickenbach J. Functioning: the third health indicator in the health system and the key indicator for rehabilitation.. Eur J Phys Rehabil Med 2017 Feb;53(1):134-138.
    doi: 10.23736/S1973-9087.17.04565-8pubmed: 28118696google scholar: lookup
  3. German Curatorship for Therapeutic Riding The Areas of Therapeutic Riding Horse Assisted Therapy, Promotion and Sport. [(accessed on 21 November 2021)]. Available online: https://www.dkthr.de/therapeutisches-reiten/
  4. Wood W, Alm K, Benjamin J, Thomas L, Anderson D, Pohl L, Kane M. Optimal Terminology for Services in the United States That Incorporate Horses to Benefit People: A Consensus Document.. J Altern Complement Med 2021 Jan;27(1):88-95.
    doi: 10.1089/acm.2020.0415pubmed: 33252244google scholar: lookup
  5. Borioni N, Marinaro P, Celestini S, Del Sole F, Magro R, Zoppi D, Mattei F, Dall' Armi V, Mazzarella F, Cesario A, Bonassi S. Effect of equestrian therapy and onotherapy in physical and psycho-social performances of adults with intellectual disability: a preliminary study of evaluation tools based on the ICF classification.. Disabil Rehabil 2012;34(4):279-87.
    doi: 10.3109/09638288.2011.605919pubmed: 21988646google scholar: lookup
  6. Hsieh YL, Yang CC, Sun SH, Chan SY, Wang TH, Luo HJ. Effects of hippotherapy on body functions, activities and participation in children with cerebral palsy based on ICF-CY assessments.. Disabil Rehabil 2017 Aug;39(17):1703-1713.
    doi: 10.1080/09638288.2016.1207108pubmed: 27440177google scholar: lookup
  7. Lanning BA, Wilson AL, Krenek N, Beaujean AA. Using Therapeutic Riding as an Intervention for Combat Veterans: An International Classification of Functioning, Disability, and Health (ICF) Approach. Occup. Ther. Ment. Health 2017;33:259–278.
    doi: 10.1080/0164212X.2017.1283282google scholar: lookup
  8. DKThR Standardized Procedure Regulations. [(accessed on 25 February 2022)]. Available online: https://www.dkthr.de/wp-content/uploads/2020/07/Durchfuehrungsbestimmungen_in_den_vier_Fachbereichen_des_Therapeutischen_Reitens__Stand_06.2019.pdf.
  9. Cieza A, Fayed N, Bickenbach J, Prodinger B. Refinements of the ICF Linking Rules to strengthen their potential for establishing comparability of health information.. Disabil Rehabil 2019 Mar;41(5):574-583.
    doi: 10.3109/09638288.2016.1145258pubmed: 26984720google scholar: lookup
  10. Sherer M, Poritz JMP, Tulsky D, Kisala P, Leon-Novelo L, Ngan E. Conceptual Structure of Health-Related Quality of Life for Persons With Traumatic Brain Injury: Confirmatory Factor Analysis of the TBI-QOL.. Arch Phys Med Rehabil 2020 Jan;101(1):62-71.
    doi: 10.1016/j.apmr.2017.04.016pubmed: 28527644google scholar: lookup
  11. Bortz JDN. Research Methods and Evaluation for Human and Social Sciences. 4th ed. Springer; Berlin/Heidelberg, Germany: 2006.
  12. Kovaleva A, Beierlein C, Kemper CJ, Rammstedt B. A Short Scale for Measuring Impulsivity According to the UPPS Approach: The Impulsive Behavior Scale-8 (I-8): GESIS-Working Papers. GESIS—Leibnitz Institute for the Social Sciences; Mannheim, Germany: 2012.
  13. Bühner M. Introduction to Test and Questionnaire Construction. 3rd Updated and Expanded ed. Pearson Studium an imprint of Pearson Education; London, UK: 2011.
  14. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol. Assess. 1994;6:284–290.
    doi: 10.1037/1040-3590.6.4.284google scholar: lookup
  15. Brown TA. Confirmatory Factor Analysis for Applied Research. 2nd ed. The Guilford Press; New York, NY, USA: 2015.
  16. Casale G, Grosche M, Volpe RJ, Hennemann T. Reliability of behavioral progression diagnostics across raters and measurement time points in students with externalizing behavior problems. Empir. Sonderpädagogik 2017;9:143–164.
  17. Conley L, Marchant M, Caldarella P. A Comparison of Teacher Perceptions and Research-Based Categories of Student Behavior Difficulties. Education 2014;134:439–451.
  18. Huber C, Rietz C. Behavior Assessment Using Direct Behavior Rating (DBR)—A Study on the Criterion Validity 163 Zuverlässigkeit von Verhaltensverlaufsdiagnostik of DBR Single-Item-Scales. Insights Learn. Disabil. 2015;12:73–90.
  19. Hintze JM, Owen SV, Shapiro ES, Danl EJ III. Generalizability of oral reading fluency measures: Application of G theory to curriculum-based measurement. Sch. Psychol. Q. 2000;15:52–68.
    doi: 10.1037/h0088778google scholar: lookup
  20. Goudy LS, Rigby BR, Silliman-French L, Becker KA. Effects of Simulated Horseback Riding on Balance, Postural Sway, and Quality of Life in Older Adults With Parkinson's Disease.. Adapt Phys Activ Q 2019 Oct 1;36(4):413-430.
    doi: 10.1123/apaq.2019-0008pubmed: 31323643google scholar: lookup
  21. Fízková V, Krejčí E, Svoboda Z, Elfmark M, Janura M. The effect of hippotherapy on gait in patients with spastic cerebral palsy. Acta Gymnica 2013;43:17–23.
    doi: 10.5507/ag.2013.020google scholar: lookup
  22. Vermöhlen V, Schiller P, Schickendantz S, Drache M, Hussack S, Gerber-Grote A, Pöhlau D. Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO).. Mult Scler 2018 Sep;24(10):1375-1382.
    doi: 10.1177/1352458517721354pubmed: 28770664google scholar: lookup
  23. Anderson SK, Loy DP, Janke MC, Watts CE. The Effects of Therapeutic Horseback Riding on Balance. TRJ 2019;53:307–321.
    doi: 10.18666/TRJ-2019-V53-I4-9773google scholar: lookup
  24. Gabriels RL, Pan Z, Dechant B, Agnew JA, Brim N, Mesibov G. Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder.. J Am Acad Child Adolesc Psychiatry 2015 Jul;54(7):541-9.
    doi: 10.1016/j.jaac.2015.04.007pmc: PMC4475278pubmed: 26088658google scholar: lookup
  25. Johnson RA, Albright DL, Marzolf JR, Bibbo JL, Yaglom HD, Crowder SM, Carlisle GK, Willard A, Russell CL, Grindler K, Osterlind S, Wassman M, Harms N. Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans.. Mil Med Res 2018 Jan 19;5(1):3.
    doi: 10.1186/s40779-018-0149-6pmc: PMC5774121pubmed: 29502529google scholar: lookup
  26. . The International Classification of Functioning, Disability and Health. An expertise on behalf of the German Society for Rehabilitation Sciences (DGRW e.V.). Volume 10. Stendal. 2015.
  27. Stolz I, Tillmann V, Anneken V, Froboese I. Development of an ICF-based assessment tool for equine-assisted therapy: model structure and reliability.. Eur J Phys Rehabil Med 2022 Feb;58(1):60-67.
    doi: 10.23736/S1973-9087.21.06816-7pubmed: 34747578google scholar: lookup

Citations

This article has been cited 1 times.
  1. Stolz I, Braunsmann L, Rosiny F, Poehlau D, Abel T, Anneken V, Drache M, Knaepen K. Effectiveness of hippotherapy on balance performance, neurophysiological parameters and clinical symptoms of multiple sclerosis: Study protocol of a randomized controlled multicenter study (MS-HIPPO II - Movement in Balance). Contemp Clin Trials Commun 2026 Feb;49:101583.
    doi: 10.1016/j.conctc.2025.101583pubmed: 41551574google scholar: lookup
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