Autism Spectrum Disorder
Conditions
Keywords
Autism spectrum disorder, Hippotherapy, Physical function, Postural balance, Bladder and bowel dysfunction, Social communication, Children, Hand grip strength, Trunk control
Brief summary
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and interaction, as well as impairments in physical function domains such as postural control, balance, coordination, and motor planning. This study is designed as a randomized controlled trial to determine the effects of hippotherapy, applied in addition to a special education program, on physical function, bladder-bowel symptoms, and social communication level in children with ASD.
Detailed description
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and interaction, along with restricted and repetitive patterns of behavior. During hippotherapy, the child must continuously make postural adjustments to adapt to the rhythmic movements of the horse. The literature has demonstrated that hippotherapy has positive effects on balance, postural control, functional independence, and motor performance, particularly in children with cerebral palsy and Down syndrome. However, evidence regarding the effects of hippotherapy in children with ASD remains limited, particularly in relation to physical function, bladder and bowel symptoms, and social communication. Therefore, the present study aims to investigate the effects of hippotherapy on physical function-including balance, trunk control, posture, and handgrip strength-as well as bladder and bowel symptoms and social communication in children with ASD. By addressing this gap in the literature, the findings of the study may contribute to the existing evidence and provide guidance for rehabilitation practices.
Interventions
Participants will receive 30-minute hippotherapy sessions once weekly for 8 weeks in addition to their ongoing special education program. The program will include exercises targeting balance, postural control, trunk stabilization, coordination, muscle strength, upper extremity function, and sensory processing.
Participants will continue their ongoing special education program throughout the 8-week study period. The program includes educational activities, speech and language therapy, occupational therapy, proprioceptive activities, and sensory-based interventions according to the individual needs of the child.
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of autism spectrum disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria * Ability to understand and follow basic verbal instructions * Ability to stand independently for at least 30 seconds * Voluntary participation in the study and written informed consent provided by a parent or legal guardian
Exclusion criteria
* Presence of an active infection * Bladder or bowel symptoms attributable to an organic condition, such as anorectal malformation or Hirschsprung disease * Presence of another neurological or orthopedic condition that may affect participation or study outcomes, such as cerebral palsy or hip dislocation * Inability to attend the treatment program regularly * Receipt of hippotherapy within the previous 12 months * History of epilepsy or seizures * Surgery involving the spine or abdominopelvic region within the previous 12 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Balance | Baseline and at the end of the 8-week intervention | Balance will be assessed using the Pediatric Balance Scale, a 14-item scale evaluating sitting balance, standing balance, transfers, reaching, turning, and stepping activities. The total score ranges from 0 to 56, with higher scores indicating better balance performance. The scale will be administered by a physiotherapist. |
| Trunk Control | Baseline and at the end of the 8-week intervention | Trunk control will be assessed using the Trunk Control Measurement Scale. The total score ranges from 0 to 58, with higher scores indicating better trunk control. The assessment will be administered by a physiotherapist. |
| Posture | Baseline and at the end of the 8-week intervention | Postural alignment will be assessed using the New York Posture Rating Chart. The total score ranges from 13 to 65, with higher scores indicating better postural alignment. The assessment will be performed by a physiotherapist. |
| Handgrip Strength | Baseline and at the end of the 8-week intervention | Handgrip strength will be measured in kilograms using a hand dynamometer. Three measurements will be obtained for each hand, with a 1-minute rest period between measurements. The mean value of the three measurements will be used in the analysis. Higher values indicate greater handgrip strength. |
| Bladder and Bowel Symptoms | Baseline and at the end of the 8-week intervention | Bladder and bowel symptoms will be assessed using the Bladder and Bowel Dysfunction Questionnaire. The total score ranges from 0 to 52, with higher scores indicating greater symptom severity. The questionnaire will be completed by the child with parental assistance. |
| Social Communication | Baseline and at the end of the 8-week intervention | Social communication will be assessed using the Autism Social Skills Profile-Turkish Form. The scale consists of 45 items and includes three subscales: social reciprocity, social participation/avoidance, and detrimental social behaviors. Items are rated on a 4-point Likert scale. Higher total scores indicate better social skills. The questionnaire will be completed by the participant's parent. |
Countries
Turkey (Türkiye)