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Purpose: Comprehensively and systematically map peer-reviewed studies of hippotherapy published over 30 years, from 1980 through 2018, from the perspective of a phased scientific approach to developing complex interventions as a guide to future research and practice.
Methods: A systematic mapping review of research of hippotherapy was conducted. Searches of nine databases produced 3,528 unique records; 78 full-text, English-written studies were reviewed, the earliest of which was published in 1998. Data relevant to study aims were extracted electronically from these studies and analyzed using queries and pivot tables.
Results: Children with cerebral palsy and physical therapists were most prevalent as participants and providers. Equine movement was hippotherapy's core component and mechanism. Early-phase outcomes-oriented research predominated. "Hippotherapy" was ambiguously defined as treatment strategies and comprehensive professional services, even as interventions grew more distinctive and complex. A treatment theory and proof of concept related to motor outcomes were established, and efficacy research with comparison conditions emerged.
Conclusions: Continuing research of complex interventions that integrate hippotherapy, equine movement as a therapy tool, is warranted. Attention to gaps in foundational scientific work concurrent with continued piloting and efficacy work will help to identify the most promising interventions worthy of replication, evaluation and widespread adoption.IMPLICATIONS FOR REHABILITATIONTo advance the evidence base of complex interventions that incorporate hippotherapy:•Proponents of hippotherapy need to define and represent hippotherapy to the public and in practice and research contexts as a therapy tool involving the use of the movement of horses by qualified professionals, rather than simply as a generic therapy with the help of a horse or simulated horse;•Providers of hippotherapy need to identify their professional degrees and certifications, and explicate their disciplinary perspectives that influence their selected components of intervention, related methods, and outcomes; and•Providers and researchers need to partner to develop an enablement theory of hippotherapy that links improved body functions with improved participation in everyday life and quality of life.
