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Updated 31 August 2016

Horses as a therapy tool

The use of horses in the therapeutic treatment of children is becoming more popular. But does it work and how?

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The use of horses in the therapeutic treatment of children with psychological, mental, emotional, physical, learning and speech problems is growing in popularity. 

"Saddling up and riding a horse is an enjoyable experience for many people, but for someone with a disability it can signify much more – a road to recovery. Each year people with disabilities are discovering the benefits of therapeutic horse riding, ," said Lisa McCallum of the Sleepy Hollow Therapeutic Riding Centre and South African Riding for the Disabled Association (Sarda).

McCallum is a qualified occupational therapist, a senior instructor for Sarda and a South African National Equestrian Federation (Sanef) Instructor

According to McCallum, therapeutic riding has three chief fields: education, sport and medicine. The three may be integrated, or each can be practiced as a specialty.

What's the difference?

Education and sport: This refers to the teaching of riding skills and is aimed at people with various special needs. It is designed to be more recreational and sport-orientated. It is carried out by trained instructors, although educational specialists, such as teachers and school social workers, may assist the instructors in determining which skills a rider needs to develop.

Therapeutic riding: These are activities conducted by medical professionals such as physiotherapists, occupational therapists, speech therapists and psychologists are referred to as equine-assisted therapy and hippotherapy:

  • Equine-assisted therapy: Therapists, in conjunction with riding instructors and volunteers, use this therapy to focus on the student’s performance of the exercises either on horseback while accommodating the motion of the horse, or with the child on the ground, next to the horse.

    The therapist plans the activities to achieve specific physical, psychological, cognitive and behavioural goals (such as speech development, self esteem, coordination, balance, motor planning and relaxation). Riding instruction may or may not be a secondary goal.

  • Hippotherapy: Translated, this means "treatment with the help of a horse". This type of therapeutic riding involves the patient sitting on the horse and responding to the three-dimensional swinging motions of the horse's back while a trained therapist controls the horse. The rider does not attempt to influence the horse in any way.

Horse therapy in South Africa
"Horses are one of the best treatment modalities; they are a unique vehicle for exercising one’s mind body and spirit," said McCallum.

Sadly there is very little awareness about this form of therapy locally. The horse is non-judgemental, said McCallum. It provides honest, immediate and direct feedback and if it's not treated well, it will not perform the services asked of it – which, she points out, adds up to a picture of consistency and reliability often missing in the lives of the disabled.

"The benefits of therapeutic riding are as numerous as the types of disabilities and conditions served; riders who participate can experience physical, emotional and mental rewards.

"The horse’s soothing rhythm, strength, warmth and three-dimensional movement patterns provides healthy exercise while improving circulation and muscle tone and control, balance, and strength of the rider," she said.

She added that riding also motivates the children with learning disorders to increase their levels of gross and fine motor control, concentration, attention, self-awareness, self confidence and patience.

"Unique relationships form between horse and rider helping to overcome fears and develop trust the therapeutic team and themselves."

McCallum said that horses are also the best animal for the job because of the way they move: when a horse walks it mirrors the human gait. This helps people who have difficulty walking, or cannot walk at all.

How the horses' walk helps
"If the child is physically disabled, or cannot walk due to their condition, the horse almost 'teaches' them to be aware of how their muscles should move and activates the nerves. I have personally seen it make a huge difference and it can take as little as five minutes to see it begin to work," she said.

She explained that the horse’s movement moves the human pelvis in exactly the way the pelvis would move when the human is walking.

This, she said, is how the human body learns what it feels like to walk without having to actively do the movement.

"It allows for increased sensation, weight shift, rotation, range of movement and normalisation of muscle tone and learning what the movement of the walk should feel like. In one walk stride of the horse, the seated child has to re-balance eight times, so the horse becomes one of the most dynamic therapeutic tools and modalities available."

The psychological benefits
According to McCallum, the psychological benefits are huge– and horse therapy does not carry the same stigma as some other therapies.

"Children who need to go to therapy do not like admitting to it because of the connotations. In this instance, they can just say they're going horse riding, and that makes an unbelievable difference to their self-esteem and confidence."

She added that riding motivates those with learning disorders or mental disabilities to increase their levels of concentration, patience and discipline.

"For those that are wheelchair bound, riding allows independence and freedom to walk in areas that would normally be inaccessible to them. During the time they are on the horse, they form a bond with the animal, which addresses those with emotional disabilities, such as autism, to overcome fears and develop trust in the therapeutic team and themselves."

Other benefits:

  • Riding helps the individual adjust to their disability;
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  • There is emotional stimulus and motivation through the responsiveness of the horse;
  • Riding romotes decision making and thinking ahead, and eaches anticipatory response and sequencing of actions – rider nudges horse, thus forward motion;
  •  
  • It'sseful for behaviour modification, especially in the area of self-control;
  • It enhances the ability to cope with and recognise fear;
  • It nhances social interaction and independence;and
  • Riding promotes relaxation and the release of tension.

The physical benefits
Apart from helping those who cannot walk feel the sensation of walking, other physical benefits include:

  • The stimulation of righting and equilibrium reflexes, and the inhibition of tonic neck reflexes;
  • It improves posture;
  • It normalises muscle tone and builds strength;
  • Increases range of motion;
  • The exercise improves cardiovascular functioning and stimulates metabolism;
  • It develops eye-hand co-ordination, fine and gross motor skills;
  • The ride itself offers sensory stimulation through activity and surroundings;
  • Offers comfort as riding is a natural reflex inhibiting activity.

'It's phenomenal'
Andrea Boettger is the mother of Alex (6) who has congenital muscular dystrophy.She said that he has been riding horses with McCallum since he was two years old and described the impact it has had on him as "phenomenal."

"At first I was nervous, because I'm petrified of horses, but after the first lesson I was gobsmacked at the change in Alex – it wasn't a big change, but he seemed more stable and was in tune with his body more than he had ever been. It was instant. I didn't know how or why it worked, I just knew that it had!" she said.

She added that Alex loves it, because he does not see it as therapy, but as horse riding, and claimed it has improved his balance and body alignment and boosted his confidence.

Conditions horse therapy works on
McCallum listed these as some of the conditions the various horse therapies work for:

Amputations, Attention Deficit Disorders (ADD/ADHD), pervasive developmental disorders, brain injuries, cerebral palsy, Down syndrome, emotional disabilities, hearing impairments, learning disabilities, mental disabilities, multiple sclerosis, muscular dystrophy, post polio, speech impairments, spina bifida, spinal cord injuries, visual impairments, cardiovascular accident/stroke, substance abuse, sensory integration dysfunction and those with low muscle tone.

Want to get involved?
McCallum said there was a need for more qualified instructors – courses are available through Sarda – as well as volunteers and helpers.. Sarda operates in Cape Town, Johannesburg, Durban, Pietermaritzburg and Port Elizabeth, and is a non-profit organisation reliant on donations and sponsorship. More information: www.sarda.co.za.

Sources: Lisa McCallum, BSc Occupational Therapy, Sarda instructor, Sanef instructor. Sleepy Hollow Therapeutic Riding Centre. Phone 021-789-2341

Belinda Bain, Equine Management and Technology, BHSAI, RDA1

(Amy Henderson, Health24.com, November 2007)

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