Therapeutic Riding Research Articles

Effectiveness of equine therapy in children with psychomotor impairment

IntroductionEquine therapy, an intervention method that has been practiced for decades around the world, is used to treat patients susceptible to psychomotor delays. ObjectivesWe examine development of gross motor function compared to other psychomotor skills in patients undergoing this therapy, and analyse how this improvement affects general health status and quality of life. Material and methodsThe study includes 11 children with delayed psychomotor development (aged 8.82±3.89; 6 boys, 5 girls). The main study variables were gross motor function (GMFM-88) and perceived quality of life (Pediatric Quality of Life Inventory, PedsQL). Three measurements were performed: before and after a period of inactivity, and once again 2 months after the second measurement, following completion of a sustained period of therapy. ResultsWe observed significant differences in overall results on the GMFM-88 between the initial and final tests and between the intermediate and final tests. Regarding the PedsQL quality of life scale, no statistically significant results were recorded. ConclusionsNoticeable changes in motor control were recorded throughout the course of the intervention, which suggests that equine therapy may be appropriate treatment in cases of delayed psychomotor development.

Effectiveness of a Standardized Equine-Assisted Therapy Program for Children with Autism Spectrum Disorder.

In this study the effectiveness of an equine-assisted therapy (EAT) in improving adaptive and executive functioning in children with autism spectrum disorder (ASD) was examined (children attending EAT, n = 15, control group n = 13; inclusion criteria: IQ > 70). Therapeutic sessions consisted in structured activities involving horses and included both work on the ground and riding. Results indicate an improvement in social functioning in the group attending EAT (compared to the control group) and a milder effect on motor abilities. Improved executive functioning was also observed (i.e. reduced planning time in a problem-solving task) at the end of the EAT program. Our findings provide further support for the use of animal-assisted intervention programs as complementary intervention strategies for children with ASD.

The Effects of an Equine-Assisted Occupational Therapy Program on Adaptive Behaviors in Children and Youths

Abstract Date Presented 4/16/2015 Equine-assisted therapy utilizes unmounted activities with horses to remediate social participation and emotional regulation deficits. This pilot study measured outcomes of an equine-assisted occupational therapy program to support continued research and recognition of occupational therapists as providers.

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

This study expands previous equine-assisted intervention research by evaluating the effectiveness of therapeutic horseback riding (THR) on self-regulation, socialization, communication, adaptive, and motor behaviors in children with autism spectrum disorder (ASD). Participants with ASD (aged 6-16 years; N=127) were stratified by nonverbal IQ standard scores (≤85 or >85) and randomized to 1 of 2 groups for 10weeks: THR intervention or a barn activity (BA) control group without horses that used similar methods. The fidelity of the THR intervention was monitored. Participants were evaluated within 1 month pre- and postintervention by raters blinded to intervention conditions and unblinded caregiver questionnaires. During the intervention, caregivers rated participants' behaviors weekly. Intent-to-treat analysis conducted on the 116 participants who completed a baseline assessment (THRn= 58; BA control n= 58) revealed significant improvements in the THR group compared to the control on measures of irritability (primary outcome) (p=.02; effect size [ES]= 0.50) and hyperactivity (p=.01; ES= 0.53), beginning by week 5 of the intervention. Significant improvements in the THR group were also observed on a measure of social cognition (p= .05; ES= 0.41) and social communication (p= .003; ES= 0.63), along with the total number of words (p= .01; ES= 0.54) and new words (p= .01; ES=0.54) spoken during a standardized language sample. Sensitivity analyses adjusting for age, IQ, and per protocol analyses produced consistent results. This is the first large-scale, randomized, controlled trial demonstrating efficacy of THR for the ASD population, and findings are consistent with previous equine-assisted intervention studies. Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder; http://clinicaltrials.gov; NCT02301195.

163 College curricula valued by equine-assisted activity and therapy centers

s / Journal of Equine Veterinary Science 35 (2015) 446e458 453 163 College curricula valued by equine-assisted activity and therapy centers S.V. Burk*, and C.E. Gramlich 2 Otterbein University, Westerville, OH, USA; 2 Slippery Rock University, Slippery Rock, PA, USA With recent growth in the equine-assisted activities and therapies (EAAT) field, an increasing number of colleges and universities are considering the addition of EAAT curriculum. However, there is a paucity of information available on knowledge and skills valued by those making hiring decisions at EAAT centers. The objective of this study was to determine which topics Professional Association for Therapeutic Horsemanship (PATH) International centers value within higher education curricula. A survey was emailed to 801 centers within the United States. Staff members involved in center hiring procedures were encouraged to complete the survey. Surveys were obtained from 133 centers, for a response rate of 16.6%, although complete data for analyses were available from 109 centers. Respondents were asked to rate 37 topics or skills based on importance for inclusion in bachelor’s level EAAT curriculum. Topics were rated on a 4-point scale from unimportant (0 points), neutral (1 point), important (2 points), to very important (3 points). Chi-squared tests of independence or Fisher’s exact tests (SAS v. 9.3) were conducted to compare topic ratings from accredited and non-accredited PATH International centers. The most highly rated items (median 1⁄4 3) included equine behavior, safety, selection, training, conformation, anatomy, physiology, health, stable management, grooming/tacking, and basic English and western riding skills. Other topics that were rated equally high (median 1⁄4 3) included adaptive tack/equipment, lesson planning, teaching methods, disabilities, human anatomy and physiology, PATH International standards, therapeutic riding methods, equine-assisted psychotherapy methods, leadership, and internship experience. Centers rated businessrelated topics lower (median 1⁄4 2). These included accounting, non-profit management, general business management, marketing, and grant writing. The lowest rated item (median 1⁄4 1) was intermediate hunt seat skill. Accredited centers were more likely to rate knowledge of PATH International standards (P 1⁄4 0.010), human anatomy and physiology (P 1⁄4 0.015), liability and insurance (P 1⁄4 0.039), and non-profit management (P 1⁄4 0.017) as “very important” when compared with non-accredited centers. An open-ended question about the biggest challenges faced by centers when hiring new employees indicated that 51% of respondents experienced financial difficulties or had trouble attracting high quality employees due to low wages. Although centers appear to place the most emphasis on equine, disability, and teaching knowledge, a focus on business-related topics may help address financial issues at centers.

177 Incorporating experiential learning for equine-assisted activities and therapies with an in-house equine therapy program for veterans

177 Incorporating experiential learning for equine-assisted activities and therapies with an in-house equine therapy program for veterans

Multiple intravenous injections of allogeneic equine mesenchymal stem cells do not induce a systemic inflammatory response but do alter lymphocyte subsets in healthy horses.

IntroductionIntravenous (IV) injection of mesenchymal stem cells (MSCs) is used to treat systemic human diseases and disorders but is not routinely used in equine therapy. In horses, MSCs are isolated primarily from adipose tissue (AT) or bone marrow (BM) and used for treatment of orthopedic injuries through one or more local injections. The objective of this study was to determine the safety and lymphocyte response to multiple allogeneic IV injections of either AT-derived MSCs (AT-MSCs) or BM-derived MSCs (BM-MSCs) to healthy horses.MethodsWe injected three doses of 25 × 106 allogeneic MSCs from either AT or BM (a total of 75 × 106 MSCs per horse) into five and five, respectively, healthy horses. Horses were followed up for 35 days after the first MSC infusion. We evaluated host inflammatory and immune response, including total leukocyte numbers, serum cytokine concentration, and splenic lymphocyte subsets.ResultsRepeated injection of allogeneic AT-MSCs or BM-MSCs did not elicit any clinical adverse effects. Repeated BM-MSC injection resulted in increased blood CD8+ T-cell numbers. Multiple BM-MSC injections also increased splenic regulatory T cell numbers compared with AT-MSC-injected horses but not controls.ConclusionsThese data demonstrate that multiple IV injections of allogeneic MSCs are well tolerated by healthy horses. No clinical signs or clinico-pathologic measurements of organ toxicity or systemic inflammatory response were recorded. Increased numbers of circulating CD8+ T cells after multiple IV injections of allogeneic BM-MSCs may indicate a mild allo-antigen-directed cytotoxic response. Safety and efficacy of allogeneic MSC IV infusions in sick horses remain to be determined.

The Effect of Riding as an Alternative Treatment for Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

Background and Objectives: There is a substantial body of evidence assessing the effects of equine-assisted therapy on physiological and psychological aspects of individuals with disabilities. This study aimed to evaluate the physiological benefits of this alternative therapy for children with cerebral palsy (CP) by means of a systematic review and meta-analysis. Methods: This systematic review included all randomized and nonrandomized clinical trials of hippotherapy (HT), therapeutic horse riding (THR), and artificial saddle (AS) for the treatment of children with CP by a systematic search in Medline, Embase, Cochrane Library, and other databases up to November 2012. Articles were assessed for inclusion eligibility and quality by two independent reviewers. Any discordant case was re-reviewed and consensus was obtained after sufficient discussion. A random effects model of meta-analysis was applied to provide summary statistics for each outcome. Results: Seven randomized controlled trials (RCTs), 4 non-RCTs, and 7 self-controlled studies were included for quality assessment. Ten studies assessed the effect of HT, 5 evaluated THR, and 3 evaluated AS. The sample size differed from 3 to 72, and the quality ranged from low to moderate. Six studies were included in the meta-analysis, and there was a significant improvement in the 66-item Gross Motor Function Measure (GMFM-66), the GMFM-66/88 total score, and the dimension E of the GMFM. Although the asymmetry score tended to be reduced, it failed to reach statistical significance. Conclusions: HT, THR, and AS seem to improve the total score of the gross motor function via improvement of the walking, running, and jumping dimension. However, they are not likely to be of benefit to the symmetry of postural muscle activity. Studies included in this review lack high-quality RCTs with a sufficient number of subjects, which thus warrants further evaluations of these modalities using large-scale well-designed RCTs.

Efeitos da Equoterapia na função motora grossa de pacientes com encefalopatia crônica não progressiva

Objective. The aim of the study was to analyze the influence of hip­potherapy on gross motor function in children with chronic non-pro­gressive encephalopathy (ECNP) spastic quadriparesis type. Method. This is a case series of eight children with spastic quadriparesis ECNP type. Identification of functional performance by Gross Motor Func­tion Classification System (GMFCS) and the measurements of gross motor function through the Gross Motor Function Classification Measure (GMFM) were performed before and after 40 sessions of hippotherapy. The sessions were performed once a week for 30 min­utes for a period of 10 months. Results. One participant was classified at level III of the GMFCS classification, three at level IV and four in level V. The Student’s t test showed a statistically significant difference in scores on dimension A (lying and rolling) and dimension B (sit­ting) of the GMFM, after the end of forty sessions of hippotherapy. Conclusions. The equine therapy treatment can enhance the func­tional performance of children with spastic quadriparesis ECNP type, enabling the development of their gross motor function, especially the ability throw/roll over and sit up.

Equine-assisted therapy for anxiety and posttraumatic stress symptoms.

We tested the efficacy of the Equine Partnering Naturally(©) approach to equine-assisted therapy for treating anxiety and posttraumatic stress disorder (PTSD) symptoms. Participants were 16 volunteers who had experienced a Criterion A traumatic event, such as a rape or serious accident, and had current PTSD symptoms above 31 on the PTSD Checklist (PCL-S; Weathers, Litz, Herman, Huska, & Keane, ). Participants engaged in tasks with horses for 6 weekly 2-hour sessions. Immediately following the final session, participants reported significantly reduced posttraumatic stress symptoms, d = 1.21, less severe emotional responses to trauma, d = 0.60, less generalized anxiety, d = 1.01, and fewer symptoms of depression, d = 0.54. As well, participants significantly increased mindfulness strategies, d = 1.28, and decreased alcohol use, d = 0.58. There was no significant effect of the treatment on physical health, proactive coping, self-efficacy, social support, or life satisfaction. Thus, we found evidence that the Equine Partnering Naturally(©) approach to equine-assisted therapy may be an effective treatment for anxiety and posttraumatic stress symptoms. Future research should include larger groups, random assignment, and longer term follow-up.

Narrative synthesis of equine-assisted psychotherapy literature: Current knowledge and future research directions.

Equine-assisted psychotherapy (EAP) is an innovative emerging approach to mental health treatment. This narrative synthesis explores the current state of knowledge and areas for future research in EAP. Specifically reviewed are qualitative and quantitative empirical studies, including both articles published in peer-reviewed journals and research presented in theses and dissertations. We selected 24 studies for final inclusion in this study, dating between 2005 and 2013, and including the first EAP empirical research completed in 2005. Four of these studies are peer-reviewed journal articles, while 20 are master's theses or doctoral dissertations. The reviewed qualitative research provides initial evidence for the value of EAP for enhancing adolescents' communication and relationship skills. The reviewed experimental and quasi-experimental research provides initial evidence for the value of EAP for enhancing children's and adolescents' emotional, social and behavioural functioning. Yet, conclusions about the effectiveness of EAP must still be considered preliminary due to various methodological limitations in the reviewed research. The narrative review describes these methodological limitations and concludes with recommendations for future research.

A review on the effects of horseback riding therapy in children with autism disorder

Introduction: with some signs such as communication problems in social interaction, cognitive functioning, and Sensorimotor functions. Many interventions are used for children diagnosed with autism that one of these interventions is the use of animal therapy, including horseback riding therapy. Based on previous studies autistic children prefer to communicate with animals so this study was aimed to examine published articles on the use of this therapy in children with autistic disorder. Materials and methods: Initially, we determined keywords similar to horseback riding that were used in literatures through the Mesh database and then it was began to search using selected keywords in the literatures published from 2000 to 2013 in SCOPUS, ProQuest, Google Scholer, and Pubmed database. With regard to the inclusion and exclusion criteria, 17 articles were selected. Results: The findings of this study could be categorized in some different groups. Articles had investigated the effect of this therapy on the improvement in communication, socialization, self-esteem, positive behavior, respect, accountability, cognitive areas, increase strength, balance and flexibility, and also improvement the gross motor, growth performance, and finally reduce the autism severe symptoms. Conclusion: Results showed that different studies reported beneficial effects of this treatment in children with autism. It seems that further researches should be carried out to propose a specific treatment protocol for children with autism. Key Words: Autism, Horseback riding therapy, Hippotherapy

A systematic review of the efficacy of equine-assisted interventions on psychological outcomes

Much research attests to the beneficial effects of equine interventions on physical development and ability. However, less is known about the possible psychological benefits of horse activities, such as therapeutic riding or interactions with horses. Although there is public consensus that horses can have psychological benefits, it is an under-researched area and conclusions are largely based on anecdotal data. The little empirical evidence that is available about the efficacy of equine-assisted interventions on psychological outcomes tends to be mixed and is often difficult to interpret due to the lack of rigorous research designs. The purpose of this review was to examine the current state of the literature regarding the psychological effects of equine-assisted interventions, and to make recommendations for future research. Findings from this review suggest that equine-assisted interventions hold much promise, particularly in terms of child/adolescent social and behavioural issues, and perhaps adult affective disorders. However, the current state of the literature does not allow us to definitively conclude that equine-assisted interventions are efficacious. Well-designed randomised controlled trials are greatly needed in this area, as it is an appreciation of the need to standardise and document equine-assisted interventions and outcomes in future research.

The evaluation of an equine-assisted therapy programme with a group of boys in a youth care facility

The goal of this study was to evaluate the efficacy of an equine-assisted therapy programme aimed at improving the psychological well-being of boys in a custodial school of industry. Participants were 39 boys who live in a youth care facility for boys who display problem behaviour. They were from different cultural groups (Black, Coloured, and White) and aged between 14 and 18 years. Horses were utilised in the structured sessions to help the boys learn different coping skills through experiential learning. Data were collected on the boys’ level of coping and subjective well-being in order to assess the efficacy of the programme. The data were analysed using independent groups t-test comparisons. The results showed that the programme significantly improved the boys’ subjective well-being, problem focused coping, and emotion focused coping. However, their levels of dysfunctional coping were unchanged following the intervention. An equine-assisted therapy programme appears to show modest evidence of enhancing psychological well-being of adolescent boys in custodial care.

Horses’ Roles in Equine-Assisted Psychotherapy: Perspectives of Mental Health Practitioners

Horses’ Roles in Equine-Assisted Psychotherapy: Perspectives of Mental Health Practitioners

HORSE SPECIES SYMPOSIUM: Use of mesenchymal stem cells in fracture repair in horses.

Equine bone fractures are often catastrophic, potentially fatal, and costly to repair. Traditional methods of healing fractures have limited success, long recovery periods, and a high rate of reinjury. Current research in the equine industry has demonstrated that stem cell therapy is a promising novel therapy to improve fracture healing and reduce the incidence of reinjury; however, reports of success in horses have been variable and limited. Stem cells can be derived from embryonic, fetal, and adult tissue. Based on the ease of collection, opportunity for autologous cells, and proven success in other models, adipose- or bone marrow-derived mesenchymal stem cells (MSC) are often used in equine therapies. Methods for isolation, proliferation, and differentiation of MSC are well established in rodent and human models but are not well characterized in horses. There is recent evidence that equine bone marrow MSC are able to proliferate in culture for several passages in the presence of autologous and fetal bovine serum, which is important for expansion of cells. Mesenchymal stem cells have the capacity to differentiate into osteoblasts, the bone forming cells, and this complex process is regulated by a number of transcription factors including runt-related transcription factor 2 (Runx2) and osterix (Osx). However, it has not been well established if equine MSC are regulated in a similar manner. The data presented in this review support the view that equine bone marrow MSC are regulated by the same transcription factors that control the differentiation of rodent and human MSC into osteoblasts. Although stem cell therapy is promising in equine bone repair, additional research is needed to identify optimal methods for reintroduction and potential manipulations to improve their ability to form new bone.

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

Animal-Assisted Therapy With Chronic Psychiatric Inpatients: Equine-Assisted Psychotherapy and Aggressive Behavior

Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

The effects of horseback riding participation on the muscle tone and range of motion for children with spastic cerebral palsy.

The objective of this research is to verify the effects of horseback riding participation on the muscle tone of pelvic limbs and articular range of motion for children with spastic cerebral palsy. The research target is 16 children with spastic cerebral palsy, 8 children for the experimental group and 8 children for the control group. As a tool to measure the muscle tone, Modified Ashworth Scale (MAS), was used and a goniometer was used to measure the range of motion (ROM). A therapeutic horseback riding program was conducted to an experimental group of 8 children with spastic cerebral palsy in the therapeutic horseback riding for 60 min a day, 2 days a week and a total of 12 weeks. The results are as follows: First, the participation in the therapeutic horseback riding program showed a statistically significant difference in the muscle tone for the knee of children with spastic cerebral palsy (P< 0.01). Second, though the difference in knee muscle tone between the experimental group and the control group was statistically insignificant, the average was improved by the participation. Third, the participation in the therapeutic horseback riding program showed a statistically significant difference in the hip-joint motion range for the knee of children with spastic cerebral palsy (P< 0.01). Fourth, though the difference in the hip joint motion range between the experimental group and the control group was statistically insignificant, the average was improved by the participation.

Material de montaria para equoterapia em indivíduos com síndrome de Down: estudo eletromiográfico

Introdução: Os indivíduos com síndrome de Down apresentam características peculiares da anomalia, sendo a principal e mais frequente a hipotonia muscular. Objetivo: Verificar o melhor material de montaria e posicionamento dos pés para o recrutamento da musculatura de tronco de crianças com síndrome de Down que utilizam do tratamento da equoterapia. Métodos: Foram avaliados cinco praticantes com síndrome de Down por meio da eletromiografia, durante quatro sessões de equoterapia. Para análise estatística, foi utilizado o teste de Kruskal-Wallis para comparações múltiplas de dados não paramétricos. Resultados: O material de montaria de manta associado com os pés fora do estribo proporcionou maior recrutamento dos músculos estudados, sendo o músculo da região cervical o mais acionado. Conclusão: Por meio desse estudo piloto, infere-se que a manta com pés fora do estribo promoveu uma melhor otimização do tônus dos indivíduos analisados.