Equine-assisted activities and therapies in children with attention-deficit/hyperactivity disorder: A systematic review

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems of inattention and impulsive hyperactivity in children. Equine-assisted activities and therapies (EAATs) have been used as alternative non-pharmacological intervention option in patients with ADHD. WHAT DOES THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Nowadays, more studies of high methodological quality are needed to determine whether EAAT is an effective intervention for the treatment in children with ADHD. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Between 15 and 40 min of rising horses, 8-32 total sessions, for 4-32 weeks, seem to be beneficial to reduce the symptoms of ADHD.

Abstract: INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a disorder characterized by problems of inattention and impulsive hyperactivity. Equine-assisted activities and therapies (EAATs) have become an emerging non-pharmacological intervention option in patients with ADHD.

Aim: To perform a systematic review of updated literature about EAAT in children with ADHD.

Method: A systematic review was performed until 28 November 2019, in four electronic databases: PubMed, Web of Science, Embase and Google Scholar. The inclusion criteria were as follows: (a) intervention programme, with pre- and post-data, based on EAAT, (b) children with ADHD and (c) articles written in English.

Results: A total of 9 articles were found that meet the inclusion criteria. The evidence level was C for 7 studies and B for 2 studies. The level of conclusion was 3.

Discussion: There are few studies with high methodological quality, and there is a high heterogeneity in the variables included, what make that the level of evidence and conclusion are low.

Conclusion: There is no account with enough studies of high methodological quality to determine whether EAAT is an effective intervention for the treatment in children with ADHD.

Keywords: animal-assisted therapy; equine-assisted therapy; hippotherapy; horseback riding therapy; personal relationships; quality of life.