Therapeutic Riding Research Articles

Assessment of Native Lithuanian Horses for Therapeutic Riding Purposes

ABSTRACT Hippotherapy is considered as a beneficial field of activity for Žemaitukas, a Lithuanian native horse breed. The aim of this study is to analyze the suitability of Žemaitukas breed horses for hippotherapy by using a set of tests based on the temperament, behavioral reactions, and zoometric measurements. Results of these tests inform whether the future use of Lithuanian native horses in hippotherapy can ensure their welfare. In total, 32 horses were evaluated. Twenty-nine of the evaluated horses were horses of the Žemaitukas breed that had never been used for hippotherapy, the others were hippotherapy horses representing different breeds, which were considered the control group. As expected, control hippotherapy horses scored better in many tests, thus confirming the suitability of these tests for the evaluation of horses for hippotrapeutic use. Žemaitukas breed horses scored an average of 15.9% less points for the test of temperament and 21.3% less points for “Hippo-test” compared with the hippotherapy horses. Nevertheless, the results suggest that Žemaitukas breed horses could be used in hippotherapy after special training courses.

Equine-assisted therapy in quality of life and functioning of people with active epilepsy: A feasibility study

People with active epilepsy, which is often associated with specific neurological conditions, endure significant impairments in quality of life (QoL) and functioning, particularly those in middle-income countries. Physical intervention plays an essential role in addressing these challenges. This study investigated the impact of equine-assisted therapy (EAT) on QoL, functional independence, sleep quality, antiseizure medications, and frequency of seizures among people with epilepsy (PWE), with or without additional neurological conditions. Fourteen participants aged 4–34 years old diagnosed with focal epilepsy participated in a structured EAT program. The EAT program consisted of 36 sessions, each lasting 30 min and conducted weekly. Data were collected at four different times: baseline (T1), after 12 sessions (T2), after 24 sessions (T3), and after 36 sessions (T4). The assessments included the Quality of Life in Epilepsy (QOLIE-31), Functional Independence Measure (FIM), Pittsburgh Sleep Quality Index (PSQI), and Liverpool Adverse Event Profile (LAEP) scores. Seizure frequency was monitored continuously. Horse welfare was evaluated using the Horse Welfare Assessment Protocol (HWAP). After the EAT intervention, significant improvements were observed in the QoL scores (from 62.18 [57.88 – 70.25] to 80.18 [65.30 – 86.78]) and in FIM values (from 70.00 [36.50 – 97.75] to 70.00 [51.75 – 116.75]), particularly in the self-care and social cognition domains. Additionally, there was also a decrease in seizure frequency, adverse effects of antiseizure medications, and sleep quality. The HWAP indicated satisfactory welfare conditions for the horses. These findings indicate that EAT holds promise as a therapeutic intervention for improving the QoL and functioning of PWE. Tailored interventions are essential to address the diverse challenges faced by PWE, emphasizing the need for further research on effective therapeutic approaches.

Contributions of Equine Therapy after Stroke

Introduction: Cerebral Vascular Accident (CVA) is an injury to the central nervous system that occurs due to a lack of tissue oxygenation due to congestion (ischemic) or vascular disruption (hemorrhagic) in a certain location of the brain. Stroke has been a considerable factor in disability, functional limitations or even death throughout the world. Objective: To investigate and describe the contributions of hippotherapy in patients undergoing this intervention after suffering a stroke. Methods: This study is designed as an integrative literature review. The electronic search was carried out through scientific databases: Scientific Electronic Library Online (Sicelo), US National Library of Medicine National Institutes of Health (PubMed), Latin American and Caribbean Literature (Lilacs) and Cochrane Library, accessed by Capes Periodicals (CAFe), from September to November 2023. Results: This research consisted of 110 articles, of which 6 articles valid for this review were maintained after selection, remaining as they met the determined inclusion and exclusion criteria. Conclusion: The hippotherapy method provides several benefits to practitioners, such as improving static and dynamic functional balance, gait performance, mobility, body posture, motor coordination, autonomy of movement, breathing, spatial and temporal orientation, verbal communication, relationships, improves sleep, attention, emotional control, self-esteem, communication and participation.

On the Behaviour-Altering Effect of Horses and Dogs in theTherapy of Attention-Deficit/ Hyperactivity Disorders

The effects of horses and dogs on disorder-specific behavior were examined in amovement-oriented behavioral training for children and adolescents with attention-deficit/hyperactivity disorders. This was done using two behavioral experiments, a two-group experimental plan and a three-group experimental plan, in a within-subject design. In small group settings (3-4 subjects), a total sample of N = 13 was examined in two experiments. In Experiment I, an equineassisted therapy session was compared to a therapy session using an additional person as a control condition (the horse is replaced by a sports student).This experiment was carried out three times in a small group setting with a total of nine subjects (n = 9). In Experiment II, an equineassisted therapy session was compared to a dog-assisted therapy session, using an additional person as a control condition (sports student). Experiment II (n = 4) was carried out once with a small group. In both experiments, symptom-oriented behavior was assessed by Conner's scales and by physical activity measured using accelerometry. As a control variable, the attitudes towards horses, dogs, and sports teachers were recorded by drawings and verbal statements.The results show that in both experiments, the equine-assisted therapy session reduced symptom behavior.The results of accelerometry indicate a superiority of equine-assisted interventions, as physical activity in the equine-assisted setting was lower than in the settings assisted by dog or human, which is considered a desired behavior change in hyperactivity.

Can equine communication via audible exhales improve the welfare of therapy horses? – A pilot practice project

Abstract Background: Human-animal interactions in human services are on the rise, with an increased focus on the welfare of animals involved as well as on client safety. Based on scientifically based training methods, it has been proposed that horses involved in therapy settings could benefit from learning proactive strategies to reduce stress. One possible strategy is audible exhale communication (AEC). Inviting horses to actively use this strategy with humans could enhance the welfare of horses in equine-assisted therapy (EAT), thereby increasing client safety. Methods: A pilot project was conducted to test the feasibility of training 20 therapy horses to use AEC as a veto signal for an activity, while therapists responded to the signals. The number of audible exhales from the horses was compared between the initial and final training sessions. Furthermore, we tested whether age, years of training experience, and therapy experience served as moderating variables for the outcome. Additionally, qualitative observations were made by therapists working with the horses. Results: It has become apparent that training the horses to use AEC was successful. After 6 months of training, the horses showed a significantly higher number of audible exhales than in the initial training session, with a large effect size. Neither age nor years of training or therapy experience was found to be a moderating variable. The horses were eagerly engaged with newly acquired tools. These showed fewer indications of stress, greater sense of relaxation, and more positive emotions. Conclusion: Based on the findings of this pilot study, training horses to use AEC might be a feasible approach to reduce stress in horses working in therapeutic settings, increase client safety, enhance human-animal relationships, and open up new possibilities for improving the therapeutic process. This method is applicable to all horses, regardless of their age, training level, or experience in therapy. For future research, it would be interesting to replicate and extend the approach by addressing the aforementioned limitations and using a randomized controlled design to investigate the introduction and impact of AEC in a therapeutic setting and to gain more comprehensive insights.

The potential usefulness of standardized assessments to measure participant outcomes of adaptive/therapeutic horseback riding: a survey study.

Adaptive or therapeutic riding (A/TR) is a recreational activity which provides mounted and ground-based horsemanship opportunities adapted to the abilities of the participants. A/TR provides physical and psychological benefits to participants with diverse disabilities, including physical, developmental, cognitive, and age-related disabilities, promoting higher quality of life. A/TR professionals may be limited in their capacity to implement outcome assessments and report the benefits of their community-based A/TR services to a broad audience. The purpose of this study was to identify whether and how A/TR professionals currently measure participant outcomes; benefits and barriers to implementing standardized assessments in A/TR; and characteristics which would make assessments useful in the community-based A/TR environment. To address this purpose, we conducted a survey among A/TR professionals. We found that while A/TR professionals measure outcomes among their participants, they typically do not use standardized assessments. Survey respondents believed benefits of implementing standardized assessments included bolstering the A/TR profession, acquiring funding, and communicating about A/TR services to a broad audience. Respondents also identified several barriers to implementing standardized assessments including time, systemic, and expertise constraints. Respondents reported that useful standardized assessments would be relevant to all age groups and populations who receive A/TR services. Finally, respondents shared that for standardized assessments to be useful, they would need to be low-cost, require less than 10-20 min, and available in either paper or computer format. This study revealed that standardized assessments may be a strong support to the A/TR profession; however, assessments must meet the unique needs of A/TR professionals.

The Future of Behavioral Health Services for Youth With Foster Care Experience

Youth with foster care experience are far more likely to face mental health challenges than their peers in the general population. Non-talk alternative treatments such as art therapy, movement therapy, music therapy, and equine-assisted psychotherapy show promise for these youth. However, as of now, there is no clear agreement between or guidance offered to states on whether alternative therapies are covered by Medicaid, which is the primary insurance for most youth with foster care experience. This paper offers policy recommendations on this issue in order to achieve equitable access to mental health care for youth with foster care experience.

Motor Interventions for Children with Autism Spectrum Disorder: A Scoping Review

Though not considered a core diagnostic criterion, most children with Autism Spectrum Disorder (ASD) present with motor impairments that persist into adolescence. In addition, compared to same-age peers, children with ASD participate less in physical, leisure, and recreation activities. The World Health Organization considers participation to be critical to quality of life. This scoping review presents the types of interventions used to address gross motor impairments, and the standardized outcome measures within the domains of the International Classification of Functioning, Disability and Health (ICF), used to evaluate the impact of the interventions. Results produced 17 articles and five types of motor interventions, including land-based exercise, motor physical activity interventions; sports-based, active recreation; movement-based mind-body interventions; equine or therapeutic horseback riding, and active video games/virtual and augmented reality. The interventions were provided by either a single discipline or an interprofessional team, with physical and recreational therapy being underrepresented as team members. Most studies used outcome measures in the body functions and structures, and activities domains of the ICF and few in the participation domain. The results of this study will be important to professionals for planning, implementing, and monitoring interventions for children with ASD.

Insights on cognitive effects of hippotherapy in children with Autism Spectrum Disorder and intellectual disability in Brazil

Hippotherapy has been used as a rehabilitative treatment in several pathologies, with behavioral and cognitive changes. Therefore, this study aimed to analyze the profile of hippotherapy practitioners in Brazil and identify the effects of hippotherapy on the cognitive aspects of children with Autism Spectrum Disorder (ASD) and Intellectual Disability (ID). Mixed procedures were carried out with professionals and guardians of practitioners present in centers located in the state of Paraíba, Brazil, and application of online questionnaires based on pre-existing assessments. Resulting in a neurological clinical profile of the practitioners and a similarity between the structures and organization of the analyzed riding therapy centers. There were significant responses in the cognitive areas associated with behavior, environmental interaction and empathy of practitioners with ASD and ID. These results indicate that hippotherapy promotes the cognitive development of children with ASD and ID.

Equine-assisted therapy effectiveness in improving emotion regulation, self-efficacy, and perceived self-esteem of patients suffering from substance use disorders

Substance Use Disorders (SUD) is a universal overwhelming public health problem and is associated with other psychological and mental health ailments such as emotion regulation, perceived self-esteem, and self-efficacy problems. Complementary and alternative medicine may be beneficial. The aim of this study was to assess the effectiveness of equine-assisted therapy in improving emotion regulation, self-efficacy, and perceived self-esteem among patients suffering from substance use disorders. It was carried out using a randomized controlled trial design at Behman hospital, Cairo, Egypt. It included 100 patients suffering from SUD attending the setting, equally randomized into an intervention group to receive the equine assisted therapy and a control group to receive the regular care. Data were collected using a self-administered questionnaire with standardized tools for assessment of emotion regulation, General Self-Efficacy (GSE), and perceived self-esteem. The intervention group received weekly equine-assisted therapy sessions over 6 weeks in addition to their standard regular therapy. Patients in both groups had similar demographic and SUD characteristics, as well as baseline scores of reappraisals, suppression, GSE and perceived self-esteem. At post-intervention, the intervention group had significant improvements in all these scores in comparison with the control group, as well as their baseline. The multivariate analysis identified the study intervention as a significant positive predictor of the reappraisal and GSE scores, and a negative predictor of the suppression and perceived self-esteem negative score. In conclusion, equine assisted-therapy as a complementary treatment in patients suffering from SUD is effective in improving their emotion regulation, self-efficacy, and perceived self-esteem. A wider use of this approach is recommended in SUD patients along with provision of needed facilities and resources, and training nurses in its administration. Further research is proposed to assess its long-term effectiveness. The clinical trial was registered in the “Clinical Trials.gov Protocol Registration and Results System (PRS);” registration number is (05632185/2022) and the full date of first registration is 10/11/2022.

Psychotherapy Incorporating Equine Interaction as a Complementary Therapeutic Intervention for Young Adults in a Residential Treatment Program during the COVID-19 Pandemic

Substance use disorder has become an epidemic in the young adult population across the United States, and these numbers rose during the COVID-19 pandemic. Psychotherapy incorporating equine interaction has emerged to show promise in the mental health community as a complementary form of therapy for this age group and offered a viable treatment option during the pandemic due to the outdoor nature of the treatment environment. However, research concerning its use within a residential treatment program was lacking. The objective of this study was to evaluate the efficacy of psychotherapy incorporating equine interaction in a residential treatment program during the COVID-19 pandemic for developing an emotionally safe environment for learning for young adults. Participants (ages 18–25 years) were those in a substance abuse residential treatment program utilizing psychotherapy incorporating equine interaction during the COVID-19 pandemic. Participants were involved in weekly equine therapy for 2–7 weeks. Participants were divided according to length of stay at the residential facility and participation level with equine interactive activities. Assessment of emotional safety and long-term memory development was performed at the beginning and end of the treatment program. The development of memories centered around equine information that was covered during the treatment program. Semantic memory was assessed using a self-reporting knowledge exam and procedural memory was assessed using a skill evaluation. Emotional safety was determined using a self-reporting survey instrument. Paired t-tests determined significant improvement in emotional safety (p = 0.02) and semantic (p = 0.01) and procedural (p = 0.00) memory for all participants by the end of the program. The one-way analysis of variance indicated length of stay and participation level were not significant indicators of emotional safety (length of stay: p = 0.91, participation level: p = 0.98) and semantic (length of stay: p = 0.09, participation level: p = 0.60) and procedural (length of stay: p = 0.25, participation level: p = 0.09) memory development. These results suggest psychotherapy incorporating equine interaction was an efficient complementary therapeutic intervention for developing emotional safety and encouraging learning in a young-adult residential addiction treatment program during the COVID-19 pandemic.

Equine-assisted psychotherapy with acceptance and commitment therapy for older adults: A promising approach to enhancing psychological flexibility

Equine-Assisted Psychotherapy (EAP) is a therapeutic approach which promotes mental wellbeing through a range of activities with horses. Acceptance and Commitment Therapy (ACT) is an evidence-based therapy which promotes acceptance and committed actions in line with an individual’s values. The current evidence base suggests that an integrated approach, utilising aspects of both ACT and EAP, may offer a unique approach to therapy. This research update briefly outlines both therapeutic approaches, and considers their potential synergy, before positing that a combined approach could be an effective therapy for older adults, given the unique setting, emphasis on values and sensory stimulation. We conclude by discussing potential challenges and the service contexts of a combined EAP and ACT approach, and how we intend to evaluate this approach.

The Effects Of Equine-assisted Therapy On Gait In Adults With Parkinson's Disease: A Preliminary Analysis

The Effects Of Equine-assisted Therapy On Gait In Adults With Parkinson's Disease: A Preliminary Analysis

The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy.

To evaluate the efficacy of Equine Assisted Therapy in children with Cerebral Palsy, in terms of gross motor function, performance, and spasticity as well as whether this improvement can be maintained for 2 months after the end of the intervention. Children with Cerebral Palsy participated in this prospective cohort study. The study lasted for 28 weeks, of which the equine assisted therapy lasted 12 weeks taking place once a week for 30 min. Repeated measures within the subject design were used for the evaluation of each child's physical performance and mental capacity consisting of six measurements: Gross Motor Function Measure-88 (GMFM-88), Gross Motor Performance Measure (GMPM), Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS) and Wechsler Intelligence Scale for Children (WISC III). Statistically significant improvements were achieved for 31 children in Gross Motor Function Measure and all its subcategories (p < 0.005), also in total Gross Motor Performance Measure and all subcategories (p < 0.005). These Gross Motor Function Measure results remained consistent for 2 months after the last session of the intervention. Regarding spasticity, although an improving trend was seen, this was not found to be statistically significant. Equine Assisted Therapy improves motor ability (qualitatively and quantitatively) in children with Cerebral Palsy, with clinical significance in gross motor function.

The Impact of Equine-Assisted Therapy Rehabilitation Modalities on Perceived Psychosocial Functioning and Quality of Life

The Impact of Equine-Assisted Therapy Rehabilitation Modalities on Perceived Psychosocial Functioning and Quality of Life

HORSE THERAPY IN THE TREATMENT OF CEREBROVASCULAR ACCIDENT

Cerebrovascular accident is the pathology with the greatest development of clinical signs and focal and/or global disturbances in brain function, with various symptoms lasting 24 hours and resulting from vascular origin. Bringing sequelae to the patient, functional, sensitive, emotional and mental. And to alleviate this damage, it is necessary for the patient to have access to all treatments aimed at their needs, observing their capabilities and potential. Physiotherapy used techniques with the aim of stimulating CNS connections, with the intention of promoting sensorial stimuli for the recovery of functional movements, and in the prevention of deformities and complications, bringing independence and better quality of life. Treatment with equine therapy will bring results in tonic adjustments, improvement in posture, balance, stimulation of tactile and visual sensibilities, body awareness and increased self-esteem, in this therapeutic method of rules and disciplines it increases the capacity for decisions and independence in different situations.

Physical therapy and rehabilitation for improvement of quality of life of breast cancer patients.

e18711 Background: One of the most critical factors that cancer patients need to consider when it comes to their rehabilitation is the availability of effective and personalized rehabilitation programs. Aside from being a vital part of cancer rehabilitation, exercise can also improve the quality of life for cancer patients and help them maintain a healthy and balanced lifestyle. The purpose of this study is to adapt an evidence-based exercise program and rehabilitation techniques for breast cancer patients undergoing adjuvant chemotherapy and test the efficacy of this approach combining physical therapy, massage therapy, equine therapy (intervention group) compared to chemotherapy only (control group) for improving quality of life. Methods: This is two-armed, randomized controlled trial to test the efficacy of physical therapy and rehabilitation for improving quality of life of breast cancer patients undergoing adjuvant chemotherapy. The intervention program included physical therapy, massage therapy, equine therapy. Control group received standard care, treatment group received standard care plus intervention. All patients completed the quality of life questionnaire (EORTC-QLQ-C30) at baseline and at 4 months. All participants randomized to treatment group first received one-on-one consultation with oncologist, Physical Medicine and Rehabilitation (PM&amp;R) physicians and physical therapists. The intervention components include tri-weekly program that included physical therapy, massage therapy and equine therapy. Statistical methods (STATA) were used to analyze the data. We began data analyzes with observational statistics and independent variable analyzes. Results: Even though we did not find any difference in some aspects of intervention group during observational study, we saw a significant difference in DID model which showed significant improvement in data. Compared to control group, intervention group showed improved Quality of life (43.57***), improved PF (48.76***), RF (53.3***), EF (56***), CF (37.66**) and SF (52.85***). Another important observation is a fact that age and stage of the disease had no effect on quality of life or affected any aspect of this study, reasons of which has to be further analyzed. Conclusions: Our study proved that physical therapy and rehabilitation can be useful in improving the quality of life of breast cancer patients undergoing chemotherapy.

Equine mesenchymal stem cell derived extracellular vesicle immunopathology biomarker discovery

AbstractThe use of mesenchymal stem cells (MSCs) in human and veterinary clinical applications has become a subject of increasing importance due to their roles in immunomodulation and regenerative processes. MSCs are especially relevant in equine medicine because they may have the ability to treat prevalent musculoskeletal disorders, among other conditions. However, recent evidence suggests that the components secreted by MSCs, particularly extracellular vesicles (EVs), are responsible for these properties. EVs contain proteins and nucleic acids, which possess an active role in intercellular communication and can be used as therapeutics. However, because the intersection of equine veterinary medicine with EVs remains a relatively new field, there is a demand to identify biomarkers that can discern and enrich for therapeutic EVs, progressing their clinical efficacy. In this study, we identified and characterized 84 miRNAs, between three equine donors involved in immunomodulation in cell and EV subjects. We discovered distinct groups of shared miRNAs, like miR‐21‐5p and miR‐451a, that are abundant and enriched between the donors’ EVs, respectively. By mapping and comparing the MSC‐EV miRNA expression, we discovered many pathways that are involved in immunomodulation and tissue regenerative processes related to equine clinical applications. Therefore, the miRNAs highlighted in this article can be used as valuable biomarkers for screening MSC‐derived EVs for potential equine therapy.

153 Comparison of cortisol concentrations between traditional group therapy and equine assisted psychotherapy for substance use disorder residential treatment patients

Equine assisted psychotherapy (EAP) is emerging as an effective supplemental substance use disorder (SUD) treatment due to documented improvements in treatment retention, patient-therapist alliances, and patient communication skills within the therapeutic environment. Benefits are attributed to decreased cortisol concentrations associated with horse interaction during the therapy process, however, there is limited research on stress parameters related to EAP during SUD recovery. Due to the prolific nature of this disorder, there is an urgency in exploring effective treatment options for SUD. Therefore, the purpose of this study was to investigate concentrations of cortisol in SUD patients within a residential treatment program participating in EAP compared with those participating in traditional group therapy. Salivary cortisol samples were collected from 2 sample populations of young adults: A) residential SUD patients (n = 18) before and after 2 successive weeks of EAP-supplemented therapy sessions and B) residential population of SUD patients (n = 5) before and after 2 successive weeks of traditional group therapy sessions. The impacts of treatment, week of sampling, and treatment by week interactions were analyzedusing a mixed linear model in SAS. Significance level was set at 0.05. No significant impacts of therapy type (P = 0.74), week of sampling (P = 0.69), or any week by treatment interactions (P = 0.86) on patient cortisol concentrations were observed over the 2 week period. Results indicate that despite the therapeutic environment moving to an outdoor setting and the inclusion of exercise in the form of horseback riding within the EAP sessions that EAP did not introduce additional stress responses reflected in the cortisol measures than that seen within the traditional therapeutic setting. As such, EAP presents an opportunity to offer an alternative therapeutic experience where traditional approaches may have faltered, however, further research is needed looking at a larger sample population and additional physiological measures to determine the complete physiological impact this therapy has on SUD patients in comparison to other forms of therapeutic interventions.

Norm-Referenced Standard for Pre-Assessment of Sensory Perception in Children with Autism for Participation in Therapeutic Horseback Riding Activities

Norm-Referenced Standard for Pre-Assessment of Sensory Perception in Children with Autism for Participation in Therapeutic Horseback Riding Activities