Changes in Motor Skill Proficiency After Equine-Assisted Activities and Brain-Building Tasks in Youth With Neurodevelopmental Disorders

B Rhett Rigby, Ronald W Davis, Melissa D Bittner, Robin W Harwell, Eileen J Leek, Geoben A Johnson, David L Nichols, B Rhett Rigby, Ronald W Davis, Melissa D Bittner, Robin W Harwell, Eileen J Leek, Geoben A Johnson, David L Nichols

Abstract

There is a lack of current research to support the efficacy of a combination of equine-assisted activities (EAA) and brain building activities to influence motor skill competencies in youth with neurodevelopmental disorders (ND). The primary objective of this study was to quantify changes in motor skill proficiency before and after 8 weeks of EAA and brain-building activities in youth with ND. A secondary objective was to quantify changes in motor skill proficiency before and after 1 year of EAA and brain-building activities in youth with ND. Twenty-five youth completed the same 32-week protocol that was separated into 4, 8-week blocks, in the following order: (1) control; (2) EAA-only; (3) washout; (4) GaitWay block (EAA and brain building activities). Before and after each block, motor skills were assessed using the Short Form of the Bruininks-Oseretsky Test of Motor Proficiency-Version 2 (BOT-2). Seven youth continued with the GaitWay intervention for one additional year, and the BOT-2 Short Form was also administered following this intervention. A repeated-measures analysis-of-variance was performed to compare BOT-2 subtest and overall scores between interventions with a significance of 0.05. Manual dexterity was higher at Post-Washout [3.3 (2.4)] vs. Pre-Control [2.2 (2.1); p = 0.018] and Post-Control [2.6 (2.0); p = 0.024], and at Post-GaitWay vs. Pre-Control [3.2 (2.4) vs. 2.2 (2.1); p = 0.037]. Upper-limb coordination was higher at Post-GaitWay vs. Post-Control [6.0 (4.1) vs. 3.9 (3.8); p = 0.050]. When compared to Pre-Control [3.2 (3.0)], strength was higher at Post-EAA [4.9 (3.5); p = 0.028] and at Post-GaitWay [5.2 (2.9); p = 0.015]. Overall scores were higher at Post-GaitWay [39.1 (22.2)] when compared to Pre-Control [32.4 (21.6); p = 0.003] and Post-Control [32.5 (21.9); p = 0.009]. Additionally, motor skills were maintained for 1 year following the Post-GaitWay testing session among seven participants. This is the first known study to include and demonstrate the short-term and long-term effects of a combination of EAA and brain building activities with motor proficiency in youth with ND. Clinical Trial Registration: Motor Skill Proficiency After Equine-Assisted Activities and Brain-building Tasks; www.ClinicalTrials.gov, identifier: NCT04158960.

Keywords: adolescents; children; equine-assisted activities; motor proficiency; neurodevelopmental; plasticity; therapeutic horseback riding.

Copyright © 2020 Rigby, Davis, Bittner, Harwell, Leek, Johnson and Nichols.

Figures

Figure 1
Figure 1
Study timeline.
Figure 2
Figure 2
Overall scores on the Short Form of the Bruininks-Oseretsky Test of Motor Proficiency-Version 2 (BOT-2) between time points (n = 25). *Significantly greater than Pre-C (p < 0.05). Pre-C, Pre-Control time point; Post-C, Post-Control time point; Post-EAA, Post-Equine-Assisted Activities time point; Post-WO, Post-Washout time point; Post-OW, Post-GaitWay time point.
Figure 3
Figure 3
Visual representation of changes in motor skills as assessed using the Short Form of the Bruininks-Oseretsky Test of Motor Proficiency-Version 2 (BOT-2) between time points in the primary analyses (n = 25). *Significantly greater than Pre-C (p < 0.05); ‡significantly greater than Post-C (p < 0.05). Pre-C, Pre-Control time point; Post-C, Post-Control time point; Post-EAA, Post-Equine-Assisted Activities time point; Post-WO, Post-Washout time point; Post-GW, Post-GaitWay time point.
Figure 4
Figure 4
Overall scores on the Short Form of the Bruininks-Oseretsky Test of Motor Proficiency-Version 2 (BOT-2) between time points (n = 7). †Significantly greater than Post-WO (p = 0.035). Post-WO, Post-Washout time point; Post-GW, Post-GaitWay time point; 1 Year, 1 year time point following the Post-GaitWay time point.

References

    1. Mullin A, Gokhale A, Moreno-De-Luca A, Sanyal S, Waddington J, Faundez V. Neurodevelopmental disorders: mechanisms and boundary definitions from genomes, interactomes and proteomes. Transl Psychiatry. (2013) 3:e329. 10.1038/tp.2013.108
    1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; (2013).
    1. Boyle C, Boulet S, Schieve L, Cohen R, Blumberg S, Yeargin-Allsopp M, et al. . Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics. (2011) 127:1034–42. 10.1542/peds.2010-2989
    1. Hansen B, Oerbeck B, Skirbekk B, Petrovski B, Kristensen H. Neurodevelopmental disorders: prevalence and comorbidity in children referred to mental health services. Nord J Psychiatry. (2018) 72:285–91. 10.1080/08039488.2018.1444087
    1. Bishop J, Pangelinan M. Motor skills intervention research of children with disabilities. Res Dev Disabil. (2018) 74:14–30. 10.1016/j.ridd.2017.11.002
    1. Physical Activity Guidelines Advisory Committee Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U Department of Health and Human Services; (2018). Available online at: (accessed October 1, 2019).
    1. Healy S, Aigner CJ, Haegele JA. Prevalence of overweight and obesity among US youth with autism spectrum disorder. Autism. (2019) 23:1046–50. 10.1177/1362361318791817
    1. Agranat-Meged A, Deitcher C, Goldzweig G, Leibenson L, Stein M, Galili-Weisstub E. Childhood obesity and attention deficit/hyperactivity disorder: a newly described comorbidity in obese hospitalized children. Int J Eat Disord. (2005) 37:357–9. 10.1002/eat.20096
    1. Hölcke M, Marcus C, Gillberg C, Fernell E. Paediatric obesity: a neurodevelopmental perspective. Acta Paediatr. (2008) 97:819–21. 10.1111/j.1651-2227.2008.00816.x
    1. Mårild S, Gronowitz E, Forsell C, Dahlgren J, Friberg P. A controlled study of lifestyle treatment in primary care for children with obesity. Pediatr Obes. (2013) 8:207–17. 10.1111/j.2047-6310.2012.00105.x
    1. Guo S, Wu W, Chumlea W, Roche A. Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr. (2002) 76:653–8. 10.1093/ajcn/76.3.653
    1. Whitaker R, Wright J, Pepe M, Seidel K, Dietz W. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. (1997) 337:869–73. 10.1056/NEJM199709253371301
    1. Cortese S, Ramos Olazagasti M, Klein R, Castellanos F, Proal E, Mannuzza S. Obesity in men with childhood ADHD: a 33-year controlled, prospective, follow-up study. Pediatrics. (2013) 131:e1731–8. 10.1542/peds.2012-0540
    1. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. . Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol. (2008) 167:875–81. 10.1093/aje/kwm390
    1. Carson V, Hunter S, Kuzik N, Wiebe S, Spence J, Friedman A, et al. . Systematic review of physical activity and cognitive development in early childhood. J Sci Med Sport. (2016) 19:573–8. 10.1016/j.jsams.2015.07.011
    1. Hinkley T, Teychenne M, Downing K, Ball K, Salmon J, Hesketh K. Early childhood physical activity, sedentary behaviors and psychosocial well-being: a systematic review. Prev Med. (2014) 62:182–92. 10.1016/j.ypmed.2014.02.007
    1. Janssen I, LeBlanc A. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act. (2010) 7:40. 10.1186/1479-5868-7-40
    1. Mangerud W, Bjerkeset O, Lydersen S, Indredavik M. Physical activity in adolescents with psychiatric disorders and in the general population. Child Adolesc Psychiatry Ment Health. (2014) 8:2. 10.1186/1753-2000-8-2
    1. Zeng N, Ayyub M, Sun H, Wen X, Xiang P, Gao Z. Effects of physical activity on motor skills and cognitive development in early childhood: a systematic review. Biomed Res Int. (2017) 2017:2760716. 10.1155/2017/2760716
    1. Stodden D, Langendorfer S, Roberton M. The association between motor skill competence and physical fitness in young adults. Res Q Exerc Sport. (2009) 80:223–9. 10.1080/02701367.2009.10599556
    1. Williams H, Pfeiffer K, O'Neill J, Dowda M, McIver K, Brown W, et al. . Motor skill performance and physical activity in preschool children. Obesity. (2008) 16:1421–6. 10.1038/oby.2008.214
    1. Rinehart N, Jeste S, Wilson R. Organized physical activity programs: Improving motor and non-motor symptoms in neurodevelopmental disorders. Dev Med Child Neurol. (2018) 60:856–7. 10.1111/dmcn.13962
    1. Howells K, Sivaratnam C, May T, Lindor E, McGillivray J, Rinehart N. Efficacy of group-based organised physical activity participation for social outcomes in children with autism spectrum disorder: a systematic review and meta-analysis. J Autism Dev Disord. (2019) 49:3290–308. 10.1007/s10803-019-04050-9
    1. Rigby B, Grandjean P. The efficacy of equine-assisted activities and therapies on improving physical function. J Altern Complement Med. (2016) 22:9–24. 10.1089/acm.2015.0171
    1. Quint C, Toomey M. Powered saddle and pelvic mobility. An investigation into the effects on pelvic mobility of children with cerebral palsy of a powered saddle which imitates the movements of a walking horse. Physiotherapy. (1998) 84:376–84. 10.1016/S0031-9406(05)61458-7
    1. Bertoti DB. Effect of therapeutic horseback riding on posture in children with cerebral palsy. Phys Ther. (1988) 68:1505–12. 10.1093/ptj/68.10.1505
    1. Garner B, Rigby B. Human pelvis motions when walking and when riding a therapeutic horse. Hum Mov Sci. (2015) 39:121–37. 10.1016/j.humov.2014.06.011
    1. Giagazoglou P, Arabatzi F, Dipla K, Liga M, Kellis E. Effect of a hippotherapy intervention program on static balance and strength in adolescents with intellectual disabilities. Res Dev Disabil. (2012) 33:2265–70. 10.1016/j.ridd.2012.07.004
    1. Jang B, Song J, Kim J, Kim S, Lee J, Shin HY, et al. . Equine-assisted activities and therapy for treating children with attention-deficit/hyperactivity disorder. J Altern Complement Med. (2015) 21:546–53. 10.1089/acm.2015.0067
    1. Ajzenman H, Standeven J, Shurtleff T. Effect of hippotherapy on motor control, adaptive behaviors, and participation in children with autism spectrum disorder: a pilot study. Am J Occup Ther. (2013) 67:653–63. 10.5014/ajot.2013.008383
    1. Del Rosario-Montejo O, Molina-Rueda F, Muñoz-Lasa S, Alguacil-Diego I. Effectiveness of equine therapy in children with psychomotor impairment. Neurologia. (2015) 30:425–32. 10.1016/j.nrl.2013.12.023
    1. Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. Perspectives on sensory processing disorder: a call for translational research. Front Integr Neurosci. (2009) 3:22. 10.3389/neuro.07.022.2009
    1. Centers for Disease Control and Prevention . Defining Childhood Obesity. US Department of Health and Human Services (2018). Available online at: (accessed October 1, 2019).
    1. Bruininks R, Bruininks B. Bruininks-Oseretsky Test of Motor Proficiency. 2nd ed. Minneapolis, MN: NCS Pearson; (2005).
    1. Deitz J, Kartin D, Kopp K. Review of the Bruininks-Oseretsky test of motor proficiency, second edition (BOT-2). Phys Occup Ther Pediatr. (2007) 27:87–102. 10.1080/J006v27n04_06
    1. Jírovec J, Musálek M, Mess F. Test of motor proficiency second edition (BOT-2): compatibility of the complete and Short Form and its usefulness for middle-age school children. Front Pediatr. (2019) 7:153. 10.3389/fped.2019.00153
    1. Fransen J, D'Hondt E, Bourgois J, Vaeyens R, Philippaerts R, Lenoir M. Motor competence assessment in children: convergent and discriminant validity between the BOT-2 Short Form and KTK testing batteries. Res Dev Disabil. (2014) 35:1375–83. 10.1016/j.ridd.2014.03.011
    1. Dennison G, Dennison P. Menu for the Brain Gym® Course. Ventura, CA: Edu-Kinesthetics Inc; (2017).
    1. Gabriels R, Pan Z, Dechant B, Agnew J, 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) 54:541–9. 10.1016/j.jaac.2015.04.007
    1. Macauley B, Gutierrez K. The effectiveness of hippotherapy for children with language-learning disabilities. Commun Disord Q. (2004) 25:205–17. 10.1177/15257401040250040501
    1. Majnemer A, Shevell M, Law M, Poulin C, Rosenbaum P. Level of motivation in mastering challenging tasks in children with cerebral palsy. Dev Med Child Neurol. (2010) 52:1120–6. 10.1111/j.1469-8749.2010.03732.x
    1. Kipp LE. Psychosocial aspects of youth physical activity. Pediatr Exerc Sci. (2017) 29:35–8. 10.1123/pes.2017-0005
    1. MacPhail HEA, Edwards J, Golding J, Miller K, Mosier C, Zwiers T. Trunk postural reactions in children with and without cerebral palsy during therapeutic horseback riding. Pediatr Phys Ther. (1998) 10:143–7.
    1. Benda W, McGibbon N, Grant K. Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). J Altern Complement Med. (2003) 9:817–25. 10.1089/107555303771952163
    1. Chvatal S, Ting L. Common muscle synergies for balance and walking. Front Comput Neurosci. (2013) 7:48. 10.3389/fncom.2013.00048
    1. Kern J, Geier D, Adams J, Troutman M, Davis G, King P, et al. . Handgrip strength in autism spectrum disorder compared with controls. J Strength Cond Res. (2013) 27:2277–81. 10.1519/JSC.0b013e31827de068
    1. Dey A, Bhowmik K, Chatterjee A, Chakrabarty P, Sinha S, Mukhopadhyay K. Down syndrome related muscle hypotonia: association with COL6A3 functional SNP rs2270669. Front Genet. (2013) 4:57. 10.3389/fgene.2013.00057
    1. Jeoung B. The relationship between attention deficit hyperactivity disorder and health-related physical fitness in university students. J Exerc Rehabil. (2014) 10:367–71. 10.12965/jer.140175
    1. Ehrman JK, Gordon PM, Visich PS, Keteyian SJ. Clinical Exercise Physiology. Champaign, IL: Human Kinetics; (2019).
    1. Kamal Nor N, Ghozali A, Ismail J. Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors. Front Pediatr. (2019) 7:38. 10.3389/fped.2019.00038
    1. Champagne D, Corriveau H, Dugas C. Effect of hippotherapy on motor proficiency and function in children with cerebral palsy who walk. Phys Occup Ther Pediatr. (2017) 37:51–63. 10.3109/01942638.2015.1129386
    1. Cans C, Guillem P, Arnaud C, Baille F, Chalmers J, McManus V, et al. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. (2002) 44:633–40. 10.1017/S0012162201002675
    1. Gabriels R, Agnew J, Holt K, Shoffner A, Zhaoxing P, Ruzzano S, et al. Pilot study measuring the effects of therapeutic horseback riding on school-age children and adolescents with autism spectrum disorders. Res Autism Spectr Disord. (2012) 6:578–88. 10.1016/j.rasd.2011.09.007
    1. Pan CY, Chu CH, Tsai CL, Sung MC, Huang CY, Ma WY. The impacts of physical activity intervention on physical and cognitive outcomes in children with autism spectrum disorder. Autism. (2017) 21:190–202. 10.1177/1362361316633562
    1. Kern J, Fletcher C, Garver C, Mehta J, Grannemann B, Knox K, et al. . Prospective trial of equine-assisted activities in autism spectrum disorder. Altern Ther Health Med. (2011) 17:14–20.
    1. Ward S, Whalon K, Rusnak K, Wendell, Paschall N. The association between therapeutic horseback riding and the social communication and sensory reactions of children with autism. J Autism Dev Disord. (2013) 43:2190–8. 10.1007/s10803-013-1773-3
    1. Gabriels R, Pan Z, Guérin N, Dechant B, Mesibov G. Long-term effect of therapeutic horseback riding in youth with autism spectrum disorder: a randomized trial. Front Vet Sci. (2018) 5:156. 10.3389/fvets.2018.00156

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir