title: Effects of hippotherapy on brain function, BDNF level, and physical fitness in children with ADHD.
abstract: OBJECTIVE
  The purpose of this study was to examine the effects of hippotherapy on brain function and levels of blood-derived neurotrophic factor (BDNF) in children with attention deficit and/or hyperactivity disorder (ADHD).
  
  
  METHODS
  The hippotherapy group (HRG) included twenty children with ADHD and the control group (CG) included 19 children. All participants' physical fitness, fMRI brain scans, and blood BDNF levels were measured at baseline and after 32 weeks of participating in hippotherapy.
  
  
  RESULTS
  After 32 weeks of participating in hippotherapy, the body fat of the HRG was significantly decreased (-1.12 ± 4.20%) and the body fat of the CG was increased (2.38 ± 6.35%) (p=0.049). There was no significant difference of physical fitness in both groups (p>0.05). Although there was a higher decrease in the activated insular area in the HRG (-1.59 ± 0.99) than in the CG (-1.14 ± 1.41), there was no significant difference between the two groups (p>0.05) Also, there was a higher increase in the activated cerebellum area in the HRG (1.97 ± 1.45) than in the CG (1.92 ± 1.81). However, there was no significant difference between the two groups (p>0.05). BDNF levels showed an increased tendency in the HRG (166.29 ± 277.52pg) compared to the CG (21.13 ± 686.33pg); otherwise, there was not any significant difference in these blood levels between the two groups (p>0.05). It can be assumed that big individual differences in the level of ADHD in the study participants might not cause any significant results, although there might be positive changes in the brain function of children with ADHD.
  
  
  CONCLUSIONS
  Therefore, this study suggests that hippotherapy training would need to be modified and developed to increase the efficacy of hippotherapy in children with ADHD.
authors.affiliation: Department of Sports Medicine, School of Arts & Sports Science, Jungwon University, Chungbuk, Republic of Korea.
authors.forename: Namju
authors.initials: N
authors.lastname: Lee
authors.affiliation: Department of Sports and Health Management, Mokwon University, Daejeon, Republic of Korea.
authors.forename: Sok
authors.initials: S
authors.lastname: Park
authors.affiliation: Aribio Sports Science Institute, Yongin University, Gyeonggi-do, Republic of Korea.
authors.forename: Jongkyu
authors.initials: J
authors.lastname: Kim
keywords: ADHD; brain-derived neurotropic factor; hippotherapy