Development of transdisciplinary hippotherapy practice guidelines for clients with spastic cerebral palsy

Abstract

The aim of this study was to develop transdisciplinary hippotherapy practice guidelines for clients with spastic cerebral palsy by involving occupational therapists, physiotherapists and speech and language pathologists from different countries to participate in the study. When treating the spastic cerebral palsy population by using hippotherapy, guidelines will benefit hippotherapy providers to effectively plan and execute hippotherapy. However, few resources and no guidelines were found by the researcher, which revealed the need for guidelines that are transdisciplinary in nature and that encompass the hippotherapy concepts applicable to all three professions. The guidelines were developed in three phases that used a qualitative, exploratory, descriptive, contextual research design. In Phase 1, a theoretical enquiry was done through a scoping review that addressed objective one: To identify, describe and explore concepts that were referred to in selected literature to constitute hippotherapy practices for clients with spastic cerebral palsy. A total of 51 documents were analysed in the scoping review that led to the identification and description of 19 transdisciplinary hippotherapy concepts. Phase 2 led to the construction of guideline statements. This phase firstly addressed objective two, namely: To explore transdisciplinary hippotherapy practices for clients with spastic cerebral palsy through the involvement of hippotherapy practitioners. Eleven therapists from six countries completed a questionnaire regarding the use of the hippotherapy concepts that were identified in Phase 1. Secondly, Phase 2 addressed objective three, namely: To construct practice guidelines for transdisciplinary hippotherapy by integrating the information gathered from objectives one and two. Phase 3 led to 166 final transdisciplinary hippotherapy practice guidelines through a consensus-building process that addressed objective four, namely: To obtain consensus from an expert panel on the transdisciplinary hippotherapy practice guidelines using a modified Delphi technique. Eleven selected expert panel members took part in three Delphi rounds. The 19 identified concepts provided a novel basis for hippotherapy research. Furthermore, the 166 newly developed transdisciplinary hippotherapy practice guidelines for clients with spastic cerebral palsy will help to structure future hippotherapy research, and more importantly, improve effective client outcomes for the spastic CP population.