Horse therapy lets disabled riders feel the freedom By Naomi Leithold• photos by Josh Hawkins
There is nothing better than running in the forest on a sunny afternoon. The wind is whizzing past my face and I feel as if I'm flying through the air. As my body moves swiftly though space, I cherish the feelings of freedom, control and relaxation.
Sound like fun? It's also a major accomplishment for someone like me, who usually relies on a wheelchair. Riding a horse hasn't given me a miracle cure for my multiple sclerosis, but it has provided me with four strong legs and a muscular back, allowing me to feel as if I am running, to improve my balance and to strengthen my leg muscles.
I couldn't do this without the certified instructors and many volunteers (one to lift me onto the horse, one on either side holding on to my legs and one leading the horse) at EquiTherapy in Morton Grove, a center that offers both therapeutic horseback riding and hippotherapy programs.
EquiTherapy is just one of the many programs across the country that provide equine-assisted therapy used to improve the level of functioning in people with disabilities. There are several programs in the Chicago area that are certified by the North American Riding for the Handicapped Association (NARHA), which was founded in 1969 to provide education, safety standards and evaluation procedures. It benefits children and adults with a range of conditions-including cerebral palsy, multiple sclerosis, Down syndrome, developmental delay, autism, spina bifida, and muscular dystrophy.
Two types of equine-assisted therapy are therapeutic riding and hippotherapy. Therapeutic horseback riding is recreational riding supervised by a riding instructor, with the goal of teaching disabled students to ride independently. Horseback riding requires and develops balance, strong leg and lap muscles, good trunk support, the ability to follow directions and awareness of surroundings-all important skills for riders who are weak in any of these areas. According to Dr. Susan Rubin, a neurologist at Evanston Northwestern Health Care, "This is a wonderful program that not only helps people physically, but it also offers psychological benefits. It gets people, who are often housebound, out into a social environment."
Hippotherapy can be performed only by a licensed physical, occupational or speech and language pathologist. According to the American Hippotherapy Association (AHA), hippotherapy refers to the use of the movement of the horse as a treatment tool. The therapist identifies specific goals for each client and uses the horse to achieve these goals. For example, physical therapist Sue Lutz, at the Equestrian Connection NFP in Lake Forest, has a child sit in various positions in order to strengthen different muscles and to create different balance challenges.
Diana Schnell, the mother of Willie and Tomi, 12-year-olds who were born with cerebral palsy, has seen a definite change in her children since they began riding in a program in Geneva, Wis., seven years ago (the program is now the Equestrian Connection NFP). Her sons can now walk to their horses with assistance instead of being wheeled there. "A horse doesn't set limitations or judge, so the child is in control of his own success, which increases self-confidence," Schnell says.
Equestrian-assisted therapy has a long history, but only recently has been growing in the United States. "Hippo" is derived from the ancient Greek word for "horse," and even in those times, Hippocrates recommended horseback riding as a form of exercise. During Word War I, the Oxford Hospital in England was offering riding therapy for wounded soldiers and, by the 1950s, British physiotherapists were investigating the use of riding with all types of handicaps. This method of therapy didn't come to the world's attention until 1952 when Liz Hartzel, who used riding to battle polio, won a silver medal in equestrian sports at the Helsinki Olympics. In the 1960s therapeutic riding centers developed throughout Europe, Canada and the United States. According to Michael Kaufman, director of education for NARHA, the number of programs has grown from just four in 1969 to about 700 nationwide today.
Kaufman says many of the programs began as the dream of people who established centers in their back yards or farms. This was true for Robyn Conway, who is founder and director of Ready, Set, Ride Therapeutic Recreation Facility in suburban Plainfield. Conway is a NARHA certified instructor and mother of Maria, a 5-year-old with autism.
Based on her many years of horseback riding, Conway thought that riding the family's horse would stretch Maria's tight muscles and that the gentle, rhythmic movements would relax her. Shortly after Maria began to ride, she no longer needed leg bands to release her legs from their rigid position, and her social development began to blossom as she bonded with her four-legged friend.
When Conway brought Meagan Grimaldi, a speech therapist, in to work with Maria, she made even more progress. Grimaldi uses the horse to help Maria sit upright, the best position for speech. Before the horse could move, Maria had to communicate what she wanted with a picture, sign or word and eventually she was speaking in sentences. Based on Maria's success, Conway established Ready, Set, Ride to benefit other children.
Hippotherapy is often used to augment traditional therapies. Susan Rosen, a licensed occupational therapist from Maryland, says, "A horse has the same movement pattern as humans. When a child who has never walked sits on a horse, he feels how it is to move through space and motor pathways begin to develop in the brain." She also notes that horseback riding can help children with sensory processing problems. The rider receives a great deal of sensory input from the experience, such as the movement and feel of the horse and the positions of their bodies, which can be modulated by the therapist.
Greg Borzo, a correspondent for the American Medical Association newsletter, says hippotherapy still is not totally accepted because of the lack of hard research supporting the anecdotal success stories. Scientific evidence is building, and he cites a 1998 study in Developmental Medicine & Child Neurology, which followed five children with spastic cerebral palsy. Lead author Nancy McGibbon, who has an advanced degree in neurologic physical therapy and is the co-founder of Therapeutic Riding of Tucson, Ariz., reports that hippotherapy helped the children to walk using less energy. A research center at the State University of New York is working to devise objective measures of success for this emerging therapy.
Until this happens, many insurance companies will not reimburse for these services. Patty Caballero, director of public relations for Cigna, says, "Therapeutic horseback riding would not be a covered benefit because its medical value hasn't been established in the peer-reviewed clinical literature." Aetna has issued a similar statement.
Meanwhile, parents of children with disabilities find these therapies are helping their children in very real ways. All the stories I heard had a common thread: The parents, therapists and riders I interviewed all cited the physical benefits of horseback riding and ended with a resounding, "And it's fun!"
As Missy Slattery, mother of 8-year-old Claire who rides at the Hanson Center Horsemanship Program in Burr Ridge, says, "She will never be able to play team sports, but her peers think this is the coolest thing." Justin Herbst, 16, who has cerebral palsy and also rides in the Hanson program, agrees. "A horse listens to you. I can be its kind and gentle master. I can go outside and experience the weather-I don't have to be a hermit anymore."
Where to go
Here is a list of equestrian-assisted therapy programs in the Chicago Area with NARHA certified programs.
Cowboy Dreams of Illinois Barrington (847) 381-9323; www.cowboydreams.com Programs: therapeutic horseback riding and hippotherapy Ages: 4 to 18 (under 3 with physician's release) Cost: $50 for initial screeing; $20 for 30-minute sessions When: year-round (no riding when temps are below 30 degrees)
The Equestrian Connection NFP Lake Forest (847) 615-8696 Programs: hippotherapy and therapeutic horseback riding. Various programs are offered that are tailored to meet specific needs: therapeutic power hour (transition from hippotherapy), therapeutic sports riding program (horsemanship and riding with independent riding as a goal), developmental vaulting (advanced skills), reverse inclusion (for siblings of special needs riders), recreational riding (for adults and school groups with special needs), one-week camp programs (includes riding, crafts and horse care) Ages: 2 to adult Cost: $150 for one-hour hippotherapy session, $30 to $50 for one-hour therapeutic horseback riding session (Cost depends on the amount of staff interaction required.). $300 for a five-day camp program from 8:30 a.m. to noon each day When: year-round
EquiTherapy Morton Grove (847) 965-1632 Programs: therapeutic horseback riding and hippotherpy Ages: 1 to senior citizen Cost: $40 for initial screening with physical therapist (required for everyone), then prices range from $35 for a 30-minute therapeutic horseback riding session to $70 for a 30-minute hippotherapy session, finacial aid is available. When: year-round
Friends for Therapeutic Equine Activities Winfield (630) 588-8543 Programs: therapeutic horseback riding Ages: 3 to senior citizen Cost: $25 for 45-minute session When: year-round (closed end of December through third week of January)
The Hanson Center Horsemanship Program Burr Ridge (630) 325-5330 Programs: therapeutic horseback riding Ages: 3 to senior citizen Cost: $180 for six-week semi-private lessons, $270 for six-week private lessons (An individual's needs determines whether a lesson is private or semi-private. All children under 5 must have private lessons.) When: year-round
The Light Center Foundation, Inc. Union (815) 923-2613; [email protected]
Main Stay Therapeutic Riding Richmond (815) 653-9374; www.mstrp.org Programs: therapeutic horseback riding and hippotherapy Ages: 3 to senior citizen Cost: $20 for 45-minute therapeutic horseback riding session, $25 for 45-minute hippotherapy session When: hippotherapy in the summer only; therapeutic riding runs April-November
Ready, Set, Ride Therapeutic Recreation Facility Plainfield (815) 439-3659; www.readysetride.org Programs: therapeutic riding Ages: all children and adults Cost: a required donation of $200 per quarter per student (Donations can be raised through fundraising) When: May-November programs are held in an outdoor arena. In winter, programs take place in a barn in Oswego.
North American Riding for the Handicapped Association (NARHA) P.O. Box 33150 Denver, Colo. 80233 (800) 369-RIDE (7433); www.narha.org
Strides Therapeutic Riding Northridge, Caif. www.strides.org
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