Development and reliability of the seated posture control measure for therapeutic horseback riding/hippotherapy for children and youth with neuromotor disorders
Bibliographic record
Abstract
INTRODUCTION: The purpose of this study was to produce an evaluative instrument for pediatric therapists to measure change in seated postural control in the context of therapeutic horseback riding/hippotherapy (THR/HPT) for use with children and youth with neuromotor disorders. A clinical evaluation tool, known as the seated postural control measure (SPCM) was identified as the most feasible outcome measure that could be adapted for this purpose. The second aim of the study was to examine the intra- and inter-rater reliability of the adapted clinical measurement tool. METHODS: The study contained three phases: Phase 1: Preparation of the preliminary version of the measure; Phase 2: Examining content validity of the measure in a nominal group workshop online consensus surveys with acknowledged experts in THR/HPT; and Phase 3: Examining test-retest and inter-rater reliability. Twenty-four children and youth with neuromotor disorders categorized by Gross Motor Function Classification System levels 1-4, participated. Physiotherapists and occupational therapists at three centers were involved as raters in the reliability study. All participants were assessed simultaneously by two raters scoring independently, to determine inter-rater reliability. The adapted SPCM consisted of 22 items in two domains. Using visual observation and an ordinal three-point scale for scoring, the postural alignment domain included 14 items, observing the alignment of each body segment and categorizing neutral alignments as well as mild and moderate angular deviations. The functional movement domain consisted of 8 functional movement items, using four criterion-referenced levels (0–3), describing the attainment of seated functions such as head and trunk control, reach, grasp and release, and bimanual manipulation both with the horse stationary and walking. Higher grades represent better achievement. The test–retest components were conducted by one rater at each site after a 2-week time interval, to minimize recall bias. The participants had no restrictions or interruptions of usual care or therapies during this period. RESULTS: Once the child was seated and rode the horse for 10 min to acclimate, the testing was completed in approximately 20 min. Inter-rater and test–retest reliability was high. For inter-rater reliability 16 out of 22 items obtained excellent reliability, with Intra-class Correlation Coefficient (ICC) values above 0.90, and 6 items scored from 0.81 to 0.90, which is considered good reliability. Similar ICC values obtained for test–retest reliability showed 16 items above 0.90 (excellent reliability) and 6 items with good reliability. Complete agreement of raters occurred for some items in both the alignment and functional sections. Cronbach's alpha was 0.93 for the overall THR/HPT SPCM. Internal consistency for the alignment and functional domains were (0.88 and 0.92, respectively). CONCLUSION: The overall goal to develop a descriptive outcome measure to assess seated postural control for children and youth with neuromotor disorders, that would be quick, easy to use, inexpensive, valid, and reliable in the context of THR/HPT was achieved.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".