Hippotherapy Practice and Safety Patterns in the United States: A Descriptive Survey Study.

Objective: The use of equine movement as a therapy tool in a plan of care, or hippotherapy, has grown considerably over the past three decades. However, there is little evidence of safety rates and related practice patterns to guide key stakeholders such as clients, therapists, the health care team, and third-party payers. The purpose of this article is to describe the safety and practice patterns of contemporary use of hippotherapy. Design: A survey was distributed to occupational therapy (OT), physical therapy (PT), and speech-language pathology clinicians who incorporate hippotherapy into their practice. The survey included questions about clinicians' practice patterns, safety procedures, and rates of safety incidents. Results: Results indicate that hippotherapy is most often used by PT and OT clinicians for pediatric clients. Use of hippotherapy varies by geographic location, and frequency and duration vary widely. Clinicians most often contract their services to a program that provides a facility and horses. Recommended safety practices are widely adopted, and rates of safety incidents requiring basic first aid (0.05% of sessions) or off-site care (0.01% of sessions) are low. Emergency dismounts are frequently practiced and often effective in preventing an incident. Conclusions: Although there are inherent risks to incorporating horses into a therapeutic plan of care, these risks appear to be well managed by recommended safety practices. Results of this study can (1) help clinicians to make informed decisions regarding practice and safety procedures, (2) provide evidence of safety practices and incident rates to clients, members of the health care team, and third-party payers, and (3) maximize safety for clients who participate in hippotherapy.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans.

BACKGROUND: Large numbers of post-deployment U.S. veterans are diagnosed with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI), leading to an urgent need for effective interventions to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. The symptoms increase health care costs for stress-related illnesses and can make veterans' civilian life difficult. METHODS: We used a randomized wait-list controlled design with repeated measures of U.S. military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding (THR) program for decreasing PTSD symptoms and increasing coping self-efficacy, emotion regulation, social and emotional loneliness. Fifty-seven participants were recruited and 29 enrolled in the randomized trial. They were randomly assigned to either the horse riding group (n = 15) or a wait-list control group (n = 14). The wait-list control group experienced a 6-week waiting period, while the horse riding group began THR. The wait-list control group began riding after 6 weeks of participating in the control group. Demographic and health history information was obtained from all the participants. PTSD symptoms were measured using the standardized PTSD Checklist-Military Version (PCL-M). The PCL-M as well as other instruments including, The Coping Self Efficacy Scale (CSES), The Difficulties in Emotion Regulation Scale (DERS) and The Social and Emotional Loneliness Scale for Adults-short version (SELSA) were used to access different aspects of individual well-being and the PTSD symptoms. RESULTS: Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR (P ≤ 0.01) as well as a statistically and clinically significant decrease after 6 weeks of THR (P ≤ 0.01). Logistic regression showed that participants had a 66.7% likelihood of having lower PTSD scores at 3 weeks and 87.5% likelihood at 6 weeks. Under the generalized linear model(GLM), our ANOVA findings for the coping self-efficacy, emotion regulation, and social and emotional loneliness did not reach statistical significance. The results for coping self-efficacy and emotion regulation trended in the predicted direction. Results for emotional loneliness were opposite the predicted direction. Logistic regression provided validation that outcome effects were caused by riding longer. CONCLUSION: The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

Intervenciones asistidas por animales en neurorrehabilitación: una revisión de la literatura más reciente / Animal assisted interventions in neurorehabilitation: A review of the most recent literature

Introducción: Aunque siempre se ha afirmado el valor de los animales en la promoción del bienestar y la salud del ser humano, solo recientemente su papel terapéutico en medicina se ha convertido en el foco de investigación especializada. Las intervenciones asistidas poranimales pueden dividirse en actividades asistidas por animales, terapia asistida por animales y programas de animales de servicio. Objetivo: El objetivo de esta revisión es analizar las publicaciones realizadas entre 2001 y 2012 en las revistas médicas más importantes, relacionadas con el campo de la rehabilitación de las enfermedades neurológicas, y discutir estos hallazgos a la luz de lo que pueda ser de interés para la neurología. Discusión: Se seleccionaron un total de 23 artículos de intervenciones en el campo de la parálisis cerebral infantil, trastornos generalizados del desarrollo, esclerosis múltiple, lesión medular, accidente cerebrovascular y trastornos mentales. Los principales resultados terapéuticos fueron: mejoría en la Gross Motor Function y en el manejo del miembro superior (parálisis cerebral infantil); aumento de la socialización y el contacto con el medio ambiente, reducción del estrés y la ansiedad y sentimientos de soledad (trastornos generalizados del desarrollo y trastornos mentales); disminución de la espasticidad y mejoría del equilibrio (esclerosis múltiple, lesión medular, accidente cerebrovascular). Conclusiones: Estas intervenciones asistidas con un tipo de animales muy limitado utilizadas en grupos clínicos neurológicos muy específicos muestran cada vez más pruebas científicas, como método complementario a otras terapias ya existentes. En estas enfermedades, se necesitan más estudios de alta calidad metodológica que permitan definir los programas más apropiados para la aplicación terapéutica

Introduction: While conventional wisdom has always affirmed the value of animals in promoting human health and well-being, only recently has their therapeutic role in medicine become a topic for dedicated research. Animal assisted interventions (AAI) can be classified as animal-assisted activities, animal-assisted therapy, and service animal programs. Objective: The aim of this review is to analyse original papers addressing AAI and neurological diseases and published in the most influential medical journals between 2001 and 2012, and discuss their findings in the light of what may be of interest in the field of neurology.Discussion: We selected a total of 23 articles on neurorehabilitation in cerebral palsy, pervasive developmental disorders, multiple sclerosis, spinal cord injury, stroke, and mental disorders. The main therapeutic results were improvement on the Gross Motor Function Classification Scale and in upper limb dexterity (cerebral palsy); improvement in social functioning and interaction; reductions in stress, anxiety, and loneliness (pervasive developmental disorders andmental disorders); and decreased spasticity with improved balance (multiple sclerosis, spinal cord injury, stroke). Conclusion: These interventions, performed with highly specialised animals in very specific neurological populations, deliver an increasing body of scientific evidence suggesting that theyare an effective complement to other existing therapies. In these diseases, further high-quality studies are warranted in order to define the most appropriate programmes for therapy

The effect of horse simulator riding on visual analogue scale, body composition and trunk strength in the patients with chronic low back pain.

BACKGROUND: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders, and thus effective treatments are required. Recently, real horseback riding has been reported to be beneficial for the patients. However, it has some limitations, such as limited approaches and safety issues. OBJECTIVE: The purpose of this study was to investigate the effect of horse simulator riding on back pain, body composition and trunk strength in the patients with CLBP. PARTICIPANTS: Forty-seven men with CLBP (mean age 20.55 ± 1.38 years) were randomly divided into a control group (n = 23) and a horse simulator riding group (n = 24), and visual analogue scale (VAS), body composition and isokinetic trunk strength were measured after 8 weeks for which subjects in a horse simulator riding group had performed the horse simulator exercise (HSE). RESULTS: Horse simulator exercise significantly reduced pain scores of VAS and enhanced isokinetic torques of trunk at 30 and 90°/s. There were also significantly increased muscle mass and decreased fat mass in horse simulator riding group. CONCLUSION: It can be inferred that HSE may be helpful in relief of back pain and recovery of back function through developing trunk strength and balancing the ratio of trunk flexor/extensor muscles.