The benefits of Therapeutic Horseback Riding are threefold: physical, psychological and social. The first is mainly applicable to the rider; the second and third are beneficial not only to the rider but to the people around them. More will be said of this shortly.
In most of the conditions and disorders that people with disabilities have, there has been a serious disruption in the ability of the person to perform basic purposive functions. Balance, ambulation, posture and manual dexterity are limited, many times severely. Therapeutic Horseback Riding is well suited to treating people with some or all of the dysfunctions cited when used in conjunction with a planned, progressive exercise program.
The aim of our treatment program is to improve circulation, respiration, balance, coordination, agility, self-confidence and mental relaxation. In addition, one would hope for significant ‘carry-over’ of improvements from the therapy sessions to activities of daily living.
By forming a partnership with a horse or pony, several of these goals are brought into focus: by eliminating the need to concentrate on standing, the handicapped rider can devote his or her efforts and attention to refining their balance and coordination and improving their ability to function in a more rhythmic manner. Once astride his or her horse, the animal functions as a surrogate cerebellum, providing the rider’s neuromuscular system with varying inputs that closely approximate those that are experienced during normal human ambulation. Sensations are transmitted from the stirrups and through the rider’s feet and legs that reflect the surface being transferred by the horse. The rider is thus exposed to differing qualities, textures and grades of surface, a new experience for many of the handicapped. Moreover, the motion of the horse brings into play spinal reflexes, especially the ‘righting’ reflex, which are rarely, if ever, used by wheelchair-bound persons.
It should be pointed out that it is important to approach the process of Therapeutic Horseback Riding with an eye to treating the abilities, as well as the disabilities, of the rider. In many cases, a diagnosis is allowed to eliminate therapeutic possibilities that are quite feasible if given the opportunity to develop. We will return to this aspect in a moment.
The warmth and motion of the horse’s body can significantly reduce spasms (especially in the muscles of the legs) and enhance coordinated action in other muscle groups. Head and trunk control can be improved as a result of the need for the rider to look up in order to see where he or she is going. Learning to manipulate the reins facilitates upper extremity and hand control.
The second major benefit of Therapeutic Horseback Riding is concerned with the psychological state of the rider. While this aspect of Therapeutic Horseback Riding is more subtle, there is a definite relationship between the psychological set of the handicapped person and exposure to the riding experience.
At the outset it should be understood that much of the life experience of a handicapped person consists of feeling that they cannot participate in most physical activities. They are solitary spectators for all their lives, isolated from their peers in a way that seems impossible to be around. By introducing a horse into this situation, the nature of the circumstances is greatly changed. To be sure, the handicap is still precisely the same, but the individual’s perception of his limitations and capabilities will never be the same.
Once mounted onto the horse or pony, the handicapped rider no longer looks up at other people; they look up at him or her. Visual obstacles become fewer; the rider’s view of the world is literally opened up. On top of a horse, the rider becomes a participant in a sport in which few, if any, of his or her peers have any experience. Horseback Riding carries with it overtones of elegance, grace, risk and power that few other activities can claim. The positive effects on self-esteem, self-image and self-confidence in the handicapped rider cannot be overstated.
Moreover, the ability to take an active role in moving from point to point without the necessity of relying on a wheelchair or other people is of immeasurable value to the morale of the handicapped rider. Add the benefit of exposure to fresh air and sunshine (at least part of the time), and the result is an experience that is anxiously anticipated by handicapped riders each week.
The third main area of benefit is that of social adjustment. As in the case of physical activities, the scope of most handicapped people’s social experience is quite limited, in many cases restricted to family members and a small group of medical specialists. Many handicapped people, both adults and children, are further impeded by a lack of communication and interpersonal skills.
The placement of the handicapped in new surroundings with new people is the first step in the process of learning to deal with the demands and pressures of a more “normal” social atmosphere.
Most new riders are very apprehensive and insecure. In younger persons this may persist for quite some time, but that is when we use ‘on-the-ground’ techniques of touching and grooming the horse. Eventually, it is possible to detect a genuine change in the attitudes of the riders from reluctance to a more confident and outgoing mental set. It is not unusual, especially in the case of autism, for a child to verbally communicate naturally for the first time with “his” or “her” horse.
Many positive changes in relationships are made as a result of positive interaction with volunteer aides and instructors. Through such contact, the riders begin to experience goal-oriented behavior. The attitude of the able-bodied helper is of extreme importance in this process. It is essential that the aides and instructors be firm and consistent in their dealings with the handicapped rider; it must be made clear to him or her that a certain level of performance is expected (within, of course, the rider’s limitations). The point is that the riders must learn that their abilities and capacities are greater than they think and that they must strive to improve the level of their performance just as an able-bodied rider would. Once the first goal is achieved, it becomes progressively easier to work toward and accomplish positive results within the rider.
An important aspect of Therapeutic Horseback Riding is the fact that it is a form of therapy “hidden,” so to speak, in the process of mastering riding skills. Most physical therapy participants associate treatment with specific, repetitive and highly structured exercise regimens. Riding is seen as a recreational activity, and therefore it is not connected with therapy by the patients. In this way, many preconceived ideas and established negative attitudes toward therapy can be effectively eliminated. In many cases, the handicapped rider will be more enthusiastic, will make a greater effort and will benefit more than from such self-motivated therapy than from some of the other conventional modes of treatment.
Finally, the effects on the members of the handicapped person’s family should be considered. A common reaction in family members to the fact of a handicapped rider is a sense of being alone with a problem of unmanageable proportions. This feeling, along with feelings of guilt and helplessness, can be as emotionally hard on the family as the physical problem is to the rider.
Therapeutic Horseback Riding, can provide significant help to parents and other close family members on at least two important levels.
First, the sense of isolation being experienced by family is avoided. They are afforded the opportunity to share experiences, ideas, successes and disappointments with people who are able to lend understanding and support, particularly in times of stress. The family is the most important source of motivation and support for the handicapped rider. It is of the very important that they be given as much assistance as possible in fulfilling this role.
Second, by participating in the program, family members see for themselves the possibilities for improvement that Therapeutic Horseback Riding offers. In many cases, the manner in which the family perceives the handicapped member is greatly changed. As this occurs, the self-image and self-confidence of the handicapped improves, which opens up the way for more improvement and achievement. This attitude change is the key to a continuing process of improvement and accomplishment that can last over the course of a lifetime.
TECHNIQUE
The primary concern of Therapeutic Horseback Riding of all involved must be safety. As I’ve mentioned before, one of the benefits of Therapeutic Horseback Riding is the element of risk inherent in the activity. In the case of the handicapped rider, it is significant that the risks referred to are perceived risks. Exercises and activities are designed to reduce actual risks to a definite minimum. It is for this reason that the single most important piece of equipment used in any program is the helmet. Under no circumstances should a rider be without one.
The next consideration should be the ponies and horses intended for use in a Therapeutic Horseback Riding program. The basic quality to be sought is calm and even tempered. For example, the animals that are used in our programs at Hooves and Angels are used to a wide variety of riders on all levels of skill and experience. As a result, they are very accepting of handicapped riders, and tolerate the unusual sensations handicapped riders might cause in mounting and sitting them.
Another consideration to be taken into account is the size of the horse. The size and build of the horse need to be matched to the rider’s size and handicap. For example, for a small child with severe muscle problems of the legs, the ideal mount would be a small to medium sized pony with narrow shoulders. The small size of the pony would better treat the patient; reduce the degree of fear in the child and reduce the amount of stress on the muscles in the child’s legs.
Our exercise programs are based on neuromuscular facilitation, which maintains that motor activity is organized into patterns of muscle movement. Movement in these patterns against minimal resistance guided by a trained handler will enhance motor control in weak muscles. When using neuromuscular facilitation, the resistance offered to muscular action should be proportional to the strength of the muscles involved in order to avoid damage to bones, joints or musculature.
In the course of a session of Therapeutic Horseback Riding the ideal objective is to bring the appropriate therapeutic exercise into play while providing effective instruction in horsemanship. A major advantage of Therapeutic Horseback Riding is that it is not thought of as a conventional session of physical therapy; therefore, the more emphasis that can be place on the horsemanship aspect of each session, the better.
