Current evidence does not support equine-assisted interventions as best practice for promoting health and well-beingThis umbrella review (i.e., a review of systematic reviews) aimed to ascertain the extent of evidence in support of equine-assisted interventions for improving the biological, psychological and social health and well-being of children, adults and older people. Inclusion criteria consisted of any interventions that included a live horse for a therapeutic purpose for people of any age. Thirteen systematic reviews met the inclusion criteria and were included in this umbrella review.
The reviews included in this research covered 79 individual studies. The number of participants per study ranged from 36 to 601. The participants – ranging in age from 2 to 85 – included children with cerebral palsy, children and adolescents with autism spectrum disorder (ASD), and adults with a variety of physical, mental, and/or emotional challenges or illnesses. Of the 13 studies, 6 focused exclusively on children/adolescents. Most of the equine-assisted sessions were provided once or twice per week and lasted between 30 and 60 minutes. Interventions included in the individual studies lasted anywhere from 4 to 33 weeks. The included reviews represented both quantitative and qualitative research designs. All of the selected reviews were critically appraised for methodological quality.
The analysis of the reviews focused on phenomena of interest and outcomes of interest, along with a number of other factors. Phenomena of interest were the experiences (both positive and negative) of those receiving animal-assisted interventions involving horses. Outcomes of interest were any outcomes relating to the health and well-being of those receiving the interventions. Outcomes were grouped according to the biopsychosocial model: biological (e.g., blood pressure, heart rate, mobility), psychological (e.g., depression, anxiety, quality of life, cognitive status), and social (e.g., social functioning, social interaction). Of these, biological outcomes – especially in relation to gross motor functioning -- were the most frequently measured outcomes. For people with ASD, psychosocial outcomes were often considered. Two reviews – which included 14 unique studies – reported positive social and behavioral outcomes for children and/or adolescents with ASD. While a number of studies reported positive outcomes of interest, others did not.
This umbrella review found that studies of equine-assisted interventions for human health all have methodological flaws which compromise the evidence. This means that the current evidence is not strong enough to advocate the use of equine-assisted interventions as best practice for improving human health and well-being. More rigorous research is needed to determine the value of equine-assisted interventions.
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