The Effect of Hippotherapy and Medication on Children with Attention Deficit Hyperactivity Disorder: A Pilot Study

Jihye Song; Byongsu Jang; Jiwon Kim; Jiyoung Lee; Hye-Yeon Shin; Yunhye Oh; Kounseok Lee; Seonwoo Kim; Yun-Hee Kim; Jeong-Yi Kwon; Yoo-Sook Joung

doi:10.4306/jknpa.2015.54.1.112

Journal List > J Korean Neuropsychiatr Assoc > v.54(1) > 1017722

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Song, Jang, Kim, Lee, Shin, Oh, Lee, Kim, Kim, Kwon, and Joung: The Effect of Hippotherapy and Medication on Children with Attention Deficit Hyperactivity Disorder: A Pilot Study

Original Article

Journal of Korean Neuropsychiatric Association 2015; 54(1): 112-118.

Published online: 28 February 2015

DOI: https://doi.org/10.4306/jknpa.2015.54.1.112

The Effect of Hippotherapy and Medication on Children with Attention Deficit Hyperactivity Disorder: A Pilot Study

Jihye Song, MD¹, Byongsu Jang, MD¹, Jiwon Kim, MS², Jiyoung Lee, MS, HPCS³, Hye-Yeon Shin, MS, HPCS³, Yunhye Oh, MD¹, Kounseok Lee, MD¹, Seonwoo Kim, PhD², Yun-Hee Kim, MD, PhD^2,⁴, Jeong-Yi Kwon, MD, PhD^2,⁴, Yoo-Sook Joung, MD^1,²

¹Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

²Samsung Biomedical Research Institute, Seoul, Korea.

³Samsung RD Center, Samsung Equestrian Team, Gunpo, Korea.

⁴Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address for correspondence: Yoo-Sook Joung, MD, PhD. Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel +82-2-3410-0930, Fax +82-2-3410-0050, yschoung@skku.edu

Received 22 December 2014 Revised 24 December 2014 Accepted 12 January 2015

Abstract

Objectives

This study researched the clinical effects of hippotherapy and medication in attention deficit hyperactivity disorder (ADHD) children.

Methods

The study employed an open label randomized controlled trial. Participants were 10 children of ages between 6 and 12 years. These subjects were placed in 2 groups : the hippotherapy group and the medication group. Evaluation tools used in this study include Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version, the Wechsler Intelligence Scale for Children-IV, Korean Child Behavior Check List (K-CBCL), ADHD rating scale (ARS), Clinical Global Impression (CGI), and Quantitative electroencephalography (QEEG).

Results

Grossly scores of investigator-administered ADHD rating scale (ARS-I), K-CBCL, and CGI-Severity of Illness scale were improved in both the hippotherapy and the medication group. The ARS-I scores of the Hippotherapy group were not significantly different from baseline after 12 weeks. In the QEEG, theta/beta ratio of Pz area in the hippotherapy group was significantly different from baseline. Children treated with medication showed significant difference from baseline in ARS-I, K-CBCL subscales, and QEEG.

Conclusion

The use of hippotherapy could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD. This pilot study provides good prospects for future studies to document these positive trends on larger samples.

Keywords: Attention deficit hyperactivity disorder, Hippotherapy, Psychostimulant, Quantitative electroencephalography

Figures and Tables

Table 1

Patient characteristics

^*: Mann-Whitney U test. M : Men, IQ : Intelligence quotient, ARS-I : Investigator-administered ADHD rating scale, CGI-S : Clinical Global Impression-Severity scale, K-CBCL : Korea-Child Behavior Checklist, SD : Standard deviation, ADHD : Attention deficit hyperactivity disorder

Table 2

Baseline and post-intervention mean (SD) of ARS-I

^*: Wilcoxon signed ranks test. ADHD : Attention deficit hyperactivity disorder, ARS-I : Investigator-administered ADHD rating scale, SD : Standard deviation

Table 3

Baseline and post-intervention mean (SD) of K-CBCL

^*: Wilcoxon signed ranks test. K-CBCL : Korea-Child Behavior Checklist, SD : Standard deviation

Notes

The authors have no financial conflicts of interest.

References

1. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007; 164:942–948.

2. Yang SJ, Cheong S, Hong SD. Prevalence and correlates of attention deficit hyperactivity disorder: school-based mental health services in Seoul. J Korean Neuropsychiatr Assoc. 2006; 45:69–76.

3. Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L, et al. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry. 1996; 53:437–446.

4. Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. Ambul Pediatr. 2007; 7:1 Suppl. 73–81.

5. Greenhill LL, Swanson JM, Vitiello B, Davies M, Clevenger W, Wu M, et al. Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial. J Am Acad Child Adolesc Psychiatry. 2001; 40:180–187.

6. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999; 56:1073–1086.

7. Pfiffner LJ, Calzada E, McBurnett K. Interventions to enhance social competence. Child Adolesc Psychiatr Clin N Am. 2000; 9:689–709. x.

8. Fliers EA, de Hoog ML, Franke B, Faraone SV, Rommelse NN, Buitelaar JK, et al. Actual motor performance and self-perceived motor competence in children with attention-deficit hyperactivity disorder compared with healthy siblings and peers. J Dev Behav Pediatr. 2010; 31:35–40.

9. Skinner RA, Piek JP. Psychosocial implications of poor motor coordination in children and adolescents. Hum Mov Sci. 2001; 20:73–94.

10. Bizub AL, Joy A, Davidson L. "It's like being in another world": demonstrating the benefits of therapeutic horseback riding for individuals with psychiatric disability. Psychiatr Rehabil J. 2003; 26:377–384.

11. Cuypers K, De Ridder K, Strandheim A. The effect of therapeutic horseback riding on 5 children with attention deficit hyperactivity disorder: a pilot study. J Altern Complement Med. 2011; 17:901–908.

12. So YK, Noh JS, Kim YS, Ko SG, Koh YJ. The reliability and validity of Korean parent and teacher ADHD rating scale. J Korean Neuropsychiatr Assoc. 2002; 41:283–289.

13. Ha EH, O GG, Lee HR, Hong GU. Reconstruction of the Behavior Problem Scales of the Korean CBCL. Seoul J Psychiatry. 1995; 20:245–253.

14. Monastra VJ, Lubar JF, Linden M, VanDeusen P, Green G, Wing W, et al. Assessing attention deficit hyperactivity disorder via quantitative electroencephalography: an initial validation study. Neuropsychology. 1999; 13:424–433.

15. Ogrim G, Kropotov J, Hestad K. The quantitative EEG theta/beta ratio in attention deficit/hyperactivity disorder and normal controls: sensitivity, specificity, and behavioral correlates. Psychiatry Res. 2012; 198:482–488.

16. Song DH, Shin DW, Jon DI, Ha EH. Effects of methylphenidate on quantitative EEG of boys with attention-deficit hyperactivity disorder in continuous performance test. Yonsei Med J. 2005; 46:34–41.

17. Pliszka SR, McCracken JT, Maas JW. Catecholamines in attentiondeficit hyperactivity disorder: current perspectives. J Am Acad Child Adolesc Psychiatry. 1996; 35:264–272.

18. Tantillo M, Kesick CM, Hynd GW, Dishman RK. The effects of exercise on children with attention-deficit hyperactivity disorder. Med Sci Sports Exerc. 2002; 34:203–212.

19. Azrin NH, Ehle CT, Beaumont AL. Physical exercise as a reinforcer to promote calmness of an ADHD child. Behav Modif. 2006; 30:564–570.

20. Dykens EM, Rosner BA, Butterbaugh G. Exercise and sports in children and adolescents with developmental disabilities. Positive physical and psychosocial effects. Child Adolesc Psychiatr Clin N Am. 1998; 7:757–771. viii.

21. Kang KD, Choi JW, Kang SG, Han DH. Sports therapy for attention, cognitions and sociality. Int J Sports Med. 2011; 32:953–959.

22. Ko IG, Kim SE, Kim TW, Ji ES, Shin MS, Kim CJ, et al. Swimming exercise alleviates the symptoms of attention-deficit hyperactivity disorder in spontaneous hypertensive rats. Mol Med Rep. 2013; 8:393–400.

23. Nieoullon A. Dopamine and the regulation of cognition and attention. Prog Neurobiol. 2002; 67:53–83.

24. Vitte E, Derosier C, Caritu Y, Berthoz A, Hasboun D, Soulié D. Activation of the hippocampal formation by vestibular stimulation: a functional magnetic resonance imaging study. Exp Brain Res. 1996; 112:523–526.

25. Haffner J, Roos J, Goldstein N, Parzer P, Resch F. [The effectiveness of body-oriented methods of therapy in the treatment of attention-deficit hyperactivity disorder (ADHD): results of a controlled pilot study]. Z Kinder Jugendpsychiatr Psychother. 2006; 34:37–47.

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