Effects of hippotherapy on the thickness of deep abdominal muscles and activity of daily living in children with intellectual disabilities.

Only seven children were studied, and the authors noted that the small sample size and short period make generalisation difficult. There was no control group, random allocation, or comparison condition, so the changes cannot be separated from natural development, practice effects, or other influences. The follow-up was only 6 weeks, so long-term effects are unknown. Participants had mild intellectual disability, could sit alone, and had no visual or auditory impairments, so the results may not apply to more impaired children. The authors noted uncontrolled variation in hippotherapy, including walking speed, road surface, and horse differences. Muscle thickness was measured only on the right, and the paper does not report whether the ultrasound assessor or the FIM evaluators were blinded.

Do not read the transverse abdominis and FIM changes as proof that hippotherapy improves these outcomes in children with intellectual disabilities. Seven children were studied without a control group, and the paper cannot separate the intervention from natural development, practice effects, or other influences.