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

Abstract

Purpose: To assess the effects of equestrian rehabilitation (ER) and onotherapy (Ono) on physical and psycho-social performances of subjects affected by intellectual disability (ID), and to develop a measurement tool based on the International Classification of Functioning Disability and Health-Children and Youth (ICF-CY). Methods: A tool based on the ICF-CY classification was designed to evaluate subjects undergoing equine rehabilitation within a bio-psychosocial approach. A simplified version of this evaluation form was developed for the equestrian instructors. The agreement between the two tools was evaluated with the Cohen’s κ coefficient. Treatment benefits were evaluated in the different areas covered by the evaluation tool. Results: A general improvement in the autonomy and social integration of subjects with ID undergoing horse and donkey therapy was observed. ER and Ono produced maximum benefits respectively at six and 3 months in the large majority of patients, and benefits persisted over time. Although the agreement between the two tools proposed was rather slight, both evaluation groups measured similar improvements in subjects undergoing equine rehabilitation. Conclusions: There is an improvement in autonomy and social integration for subjects with ID, undergoing horse and donkey therapy. Ono emerged as a suitable and effective alternative to equestrian therapy. The simplified measurement tool proved to be sensitive and easy to apply, even if further improvements will be necessary.

Implications for Rehabilitation

• The equine rehabilitation program is designed to recover and/or develop interpersonal interactions capacity and mental functions.

• An evaluation tool based on the International Classification of Functioning Disability and Health (ICF) and ICF-Children and Youth systems was developed to quantify the beneficial effect of equine rehabilitation.

• Rehabilitation therapy with horse and donkey produces improvements in autonomy and social integration in subjects with intellectual disability.

Keywords::

• Equestrian rehabilitation
• ICF-CY
• intellectual disability
• onotherapy

Acknowledgments

The authors thank the Angelucci Family, the president of San Raffaele S.p.A. Carlo Trivelli, the Scientific Director Massimo Fini, and the Operating Director of Villa Buon Respiro Bruno Mereu for making possible this research. Special thanks to the Medical Director Natale Santucci for his support, and to Dr. Patrizia Reinger Cantiello for her collaboration in the development of the onotherapy treatment. We acknowledge the contribution of the Villa Buon Respiro equestrian rehabilitation team: Mauro Perelli, Elisabetta Zetari, Cristina Lucchesi, Tania Sacconi, Valentina Toti, Elisa Bersaglia. The help of Candida Nastrucci in translating evaluation tools is recognized.

Declaration of interest: The authors report no conflicts of report.

Appendix I.  Matching codes of Villa Buon Respiro program with ICF-CY (equestrian rehabilitation).

Appendix II.  Matching codes of Villa Buon Respiro rehabilitation program with ICF-CY (onotherapy).