Development of an ICF-based assessment tool for an innovative documentation and evaluation of equine assisted therapy


Researcher – Research Institute for Inclusion through Physical Activity and Sport, affiliated Institute of the German Sport University Cologne

In clinical contexts, the classification system of the International Classification of Functioning, Disability and Health (ICF) has been used increasingly in the past years for standardization and interdisciplinary cooperation in therapy and rehabilitation. In equine assisted therapy, a systematization and quantification of effects could be proficient, whereas effects are recorded objectively, reliably and validly and documented in regard to the common international language of the ICF and the health care system of the WHO.

Objectives In the period from 01.09.2019 – 31.08.2021, the PED-Study (Horse: Evaluation, Documentation) aims to develop and test an ICF-based, standardized, modularized documentation- and survey-tool for the global assessment of functioning in equine assisted therapy. Method (subjects, procedure, instruments) In a qualitative conceptual study-part 21 therapists and experts were questioned about therapy contents and goals within 5 focus groups. Each representing one discipline in equine assisted therapy.

The results have been linked to the ICF via Cieza Linking Rules for item-construction. In a subsequent practical quantitative part of the study, the pilot-tool has been field-tested with 116 participants of six locations for equine assisted therapy in Germany. Subsequently the tool has been reduced and modified for a second longitiudinal practial approach.

Results and Discussion

The focus groups provided reliable content for scale building and link to ICF-categories. Performed explorative factor analysis indicates good construct-validity and reliabilibility (α =.96; α =.96; α =.95), for a three factor structure with the factors psychosocial-, motor- and mental functioning for the global assessment tool with 28 items in total.


The formed scale-structure explains a large extent of the of the total variance of the tool. Further item-reductions optimized the economy of the measurement. The mixed-methods approach of focus groups, ICF- Linking and practical field-test seems to lead to a valid test-construction.