The link to the article is https://pediatrics.aappublications.org/content/134/1/e4 I have added the worksheet to the drop box. I will also copy and paste an example of another article analysis and the questions that were answered for reference. Article Outline: Effect of Hippotherapy Intervention Program on Balance and Strength in Adolescents with Intellectual Disabilities I. Purpose: assess effects of hippotherapy program on static balance and strength in adolescents w/ intellectual disabilities (ID) a. Hypothesis: hippotherapy will improved balance, strength, mobility necessary for daily activities b. ID: causes limitations to cognitive and motor functions i. People w/ ID: inactive, lower physical filness levels, usually fall due to poor balance & deficits in their proprioceptive system c. Basis of Hippotherapy: horse’s gait (walking) precise and smooth pattern similar to the mechanics of a human gait i. Encourages adaptive behavior and movement strategies to adjust of horses movements 1. Involves use of muscle/ joints to improve strength, balance, gross motor skills, sensory integration, coordination, and range of motion 2. Promotes reorganization of CNS ii. Reduces displacement of center of gravity to keep them on the moving horse iii. Rhythmic movement and warmth of horses body provides proprioception, sensory input II. Method: Adolescents w/ moderate ID (age ~15 yrs old) assigned to experimental group (n=10) who attended 10 weeks of hippotherapy program & a control group (n=9) who attended their regular school schedule a. Equally split into groups based on height weight age school placement IQ level b. Then assessed them on 3 exercises of increasing difficulty & were weighed i. Double leg stance (DLS) w/ opened or closed eyes, 1 leg stance (OLS) w/ opened eyes performed while standing on EPS pressure platform 1. DLS w/ opened eyes: asked to stand shoulder width apart barefoot and look at a black board 3 m away for 30 sec. a. Conducted 3 times with a 5 min rest in between 2. OLS w/ opened eyes were instructed to flex bent leg 90° w/ both hands haning on their sides a. Instructed to look at a pt. 65 cm away b. Ample time provided for familiarization c. If trial was not maintained for 10 sec then it was not recorded & measurement were repeated c. Strength measurements from 2 half squats from the seating position w/ knee joint angle at 90° 1. Ground reaction forces (vGRF) captured during isometric ½ squats & recorded w. an AMTI force platform https://www.coursehero.com/file/40212562/ArticleOutlineWkshtpdf/ This study resource was shared via CourseHero.com d. Intervention program: experimental group took part in 30 min hippotherapy intervention, twice a week performed by the same therapist i. Warm-up: child relaxed to horse rhythmic movements and adjusted into centered sitting position ii. Assumed different positions ex) facing forward, backward, side sitting & performed therapeutic activities on a moving horse iii. Gradual increase in difficulty of activities by including games such as catching, throwing, placing rings, & stretching activities to touch neck, tail of horse iv. Result: participants developed postural control to ride and trot independently III. Statistical analysis: mean, SD calculated for each participant, analysis of variance (ANOVA) to examine the effects of time and group on each dependent variable IV. Results: improved strength parameters and on more complex balance tasks a. ANOVA test: no stat significant relationship between time or group in the DLS and OLS (left leg) tasks b. OLS (right leg) task showed a significant group VS time interaction V. Conclusion: Hippotherapy is an effective intervention to improve balance and strength thus influences a better quality of life a. Results demonstrate significant improvement in their ability to balance on 1 leg due to gradual alterations in complex sensory motor stimulation due to horses movements i. Improvements in anticipatory and feedback postural control ii. Demonstrated that these improvements were difficult to replicate in traditional therapy https://www.coursehero.com/file/40212562/ArticleOutlineWkshtpdf/ This study resource was shared via CourseHero.com Article Analysis Worksheet Topic: Giagazoglou et al. assessed the effects of hippotherapy program on the balance and strength of a group of 19 adolescents with intellectual disabilities (ID) through 3 main tasks for a 10-week period of time and strength measurements were taken. The experimental group performed the tasks while the control group continued with their regular routine and schooling. Goal: Researchers investigated whether adolescents with intellectual disabilities could develop adaptive behavior and movement strategies after a 10-week hippotherapy program where they learned how to ride a horse while performing therapeutic activities. Hippotherapy is the use of horse-riding that allows participants to imitate the precise and smooth pattern of a horse’s gait. Research Questions and Hypothesis: This study investigated whether adolescents with moderate ID would show improvements in their proprioceptive system, physical fitness levels, sensory input and gross motor skills. It was hypothesized that hippotherapy or the use of horse riding therapy would allow adolescents to mimic the horse gait and promote a better, functional quality of life for adolescents with intellectual disabilities. Kind of Study: Intervention study that allowed researchers to evaluate the incidence for an experimental and control group on hippotherapy over 10 weeks. This study focused on various topics such as developmental disabilities, neuromechanics, sports science, physical and occupational therapy. Method: The experimental and control group were asked to perform the double leg stance (DLS) with their eyes opened and closed and one leg stance (OLS) with opened eyes while standing on an EPS pressure platform and weighed afterwards. Each participant was given three trials for each task with a five minute rest and asks were performed in increasing difficulty. For all the tasks, participants had to look at a point a few meters away and ample time was given for familiarization. If participants did not hold their position for more then 10 seconds then measurements were not recorded and participants were allowed to repeat the task. Afterwards, balance and strength measurements were taken using the AMTI flat platform to measure ground reaction forces and strength measurements were taken on an EPS pressure platform. During the 10 weeks, adolescents were also required to participate in a intervention program twice a week where they learned how to adjust to the horse’s movements, sat in various positions, and participated in various activities such as catching or throwing rings. Sample: 19 adolescents around the age of 15 with moderate intellectual disabilities (ID) were split into an experimental and control group and were asked to perform three hippotherapy tasks. Participants were split equally based on age, height, weight, school placement, IQ level. Biological samples such as saliva, blood, or urine were not collected for this study. https://www.coursehero.com/file/40212562/ArticleOutlineWkshtpdf/ This study resource was shared via CourseHero.com Ethical Issues: All participants and legal guardians were provided written consent forms beforehand and the study was approved by Institutional Review Board. Study did not specify the safety measures that would be taken to prevent adolescents from getting hurt during horseback riding lessons and no physical, emotional, or mental harm was mentioned in this study. Limitations: The sample size (n=19) was very small and lacks external validity. Since sampling was limited to a small group of adolescents at the age of 15, we cannot generalize the results to the rest of the population with intellectual disabilities. For further investigation, researchers should conduct the hippotherapy program on other age groups and a bigger sample size. Even though the results demonstrate that hippotherapy was beneficial in improving balance and strength it is unclear whether participants had prior experience in horseback riding that may have skewed data. It is also unclear whether the 19 adolescents were chosen randomly or specifically selected from the population. Therefore for further investigation, to avoid bias a group of adolescents with moderate ID should be selected randomly. Results: After conducting strength measurements and ground reaction forces statistical analysis was performed and results demonstrate there was improvement in strength parameters for complex balancing tasks. For the ANOVA test, the study found that there was no significant difference between time or group for the DLS or OLS left leg task while the OLS right leg task showed a significance between the interaction of group and time. Why the Study Matters: This investigation was necessary because provides researchers, healthcare providers, occupational therapists, and many others a better understanding of whether hippotherapy is an effective treatment method for kids with intellectual disabilities. It also allowed researchers to compare hippotherapy with regular physical and occupational therapy to see if there were significant improvements in balance and strength. Keywords: hippotherapy interventions, intellectual disabilities (ID), horse riding, proprioception, double and one legged stance (DLS & OLS) with eyes opened and closed, balance and strength analysis, ANOVA