Sunday, 28 October 2007

Hippotherapy

In Bad Science circles, a regular gripe is the BBC providing what is in effect advertorial for unproven therapies via news items with little or no balance. For instance, A canna' change the laws of physics just posted See The Light, a critique of unquestioning TV coverage of a dubious light therapy for Seasonal; Affective Depression.
Along those lines, BBC's online health section just featured 'Horse therapy helped my daughter', an account of a child with cerebral palsy being treated with "hippotherapy", a physio technique in which "Treatment involves putting patients on horseback in a variety of positions and adapting to the horse's movements and working on co-ordination and posture". This is not the well-established Riding for the disabled, an activity of clear benefits in terms of enjoyment, fitness and independence. In hippotherapy, the rider doesn't control the horse (and indeed might sit facing backwards). A therapist leads the horse around, and the claim is that keeping balance in relation to the specific 3D movement of the horse provides neurological benefits.
While I suppose the intention is to provide a harmless human interest story, the BBC coverage is largely uncritical. In the token criticism section at the end, a spokesperson for Scope (the cerebral palsy charity) comments that while horse-riding is relaxing, hippotherapy shouldn't be viewed as a cure for cerebral palsy. Nevertheless, the piece completely fails to analyse the problems of proving claims made for hippotherapy.
Compare and contrast, then, Horse Power: When Riding Turns Into Treatment, hosted at the American Hippotherapy Association's own website, and Hippotherapy explained at the American Equestrian Alliance website. Both of these are reasonably-balanced articles that describe the claims for hippotherapy, but also are very clear about the lack of evidence-based research and the problems of measuring any benefits objectively.
The Research and Training Center (RTC) on Early Childhood Development, which focuses on evidence-based practice in the childhood development field, has a review paper, Influences of Hippotherapy on the Motor and Social-Emotional Behavior of Young Children with Disabilities (PDF) by Pamela S. Rolandelli and Carl J. Dunst, analysing the general faultiness of studies into hippotherapy. Its findings, summarised in a terser article, Saddle up, but... (PDF), are that "Most studies reported some positive physical, language, or social-emotional effects for hippotherapy study participants. As a whole, however, the RTC researchers found that the studies were not conducted with the kind of scientific rigor needed to conclude that hippotherapy was responsible for the observed improvements".
You won't find any link to such counterevidence at the BBC story.

6 comments:

Anonymous said...

Why would anyone want to be so critical of a service/treatment that would help someone with a physical disability? This form of therapy is the highlight of my childs week! It has helped her with her upper body strength, her posture and the overall stability of her neck. I don't need a scientist to tell me that this therapy is beneficial. Maybe you should go out and take a look for yourself sometime at the wonderful children who benefit from this type of therapy.

Poor Pothecary said...

Did I say anywhere that it wasn't beneficial? I merely quoted assessments that its benefits are difficult to measure in a properly objective way, and that it may be no better than other physical therapies.

As to not needing scientists: I hope parents would want the therapy that produces the best outcome for their children, rather than (say) one that is subjectively great fun for all concerned but produces poorer results. Evidence based assessment is the only way to find that out.

Anonymous said...

Poorly written opinion pieces such as these are the reason you're on Blogspot and not your own website.

Did you not get enough hugs as a child?

Poor Pothecary said...
This comment has been removed by the author.
Poor Pothecary said...

I have my own website and could host it there; this is on Blogspot because the weblog management options - for instance, archive threading - are better with templates hosted on blogspot.com.

wealth2own said...

I am a student researching and volunteering for an equine based organization. Field study suggests that the students within the organization have improved. However, to say that all improvements happened because of Hippo therapy is being naive.

I enjoy horses and enjoy working with the students however anyone that works at any given activity will see improvement.

I know this may be the highlight for many of the students but it may be because they are doing a fun, healthy activity rather than true beneficial therapy. Really, their needs to be more research to conclude that this therapy is beneficial. Just because it is fun and exciting activity, and you may see improvements, it may be more beneficial (physically) to receive therapy from scientifically proven methods of therapy.

This really is a touchy subject that can easily offend others!