Theraputic
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By Louise Groom
- What it is - The benefits - Equipent - The horse/pony - A word from two riders.
Right: Riders untacked their mount after session
On Thursday 7th
March 2013 I visited Blackdyke Farm in Blackford, Cumbria to photograph a weekly Riding for the Disabled (RDA) lesson. They run weekly on Tuesday evenings(twice a month) and Thursday afternoon(around 1.30pm) apart from holidays.
What is the RDA ? The riding for the disabled was formed in 1965 and is a charity devoted to improving the lives of people with disabilities by horse riding and carriage driving. The RDA depends on voluntary help, donations and legacies to deliver their services. All over the UK there is more than 500 volunteer groups where about 18,000 enthusiastic
volunteers give a total of 3.5 million hours to help they also arrange activities such as riding, carriage driving, vaulting and show jumping. All thanks to the horses and ponies at RDA they offer therapy, achievement and enjoyment, they also improve health, wellbeing, self confidence and improving mobility and co-ordination.
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Young rider gets assistance with mounting
The RDA has been helping disabled people for over 40 years and offers activities for all age groups to people with any disability. The RDA gives individuals the chance to reach therapeutic goals, accomplish their personal ambitions, expand life skills, experience the outdoors, increase social interaction and to connect with the horses.
What is Therapeutic riding?
It is horse riding lessons tailored to individuals with disabilities. The lessons is carried out by a professional riding instructor along with volunteers. Individuals are taught
in a group which run in sessions. Instructors must respond to the group as a whole. The instructor normally teaches from the centre of the school, occasionally there is hands on assistance by the instructor and/or volunteers. Horses used for therapeutic riding have to be made sure they have the appropriate temperament for the session. In therapeutic riding it’s based on the proper riding position and rein skills, not functional therapeutic goals.
What is Hippotherapy? In Hippotherapy the horse is used as a tool for treatment because of the movement. It’s a occupational, physical
or speech therapy. This therapy is prescribe by a physician and delivered by a team of a licensed credentialed therapist (occupational or physical therapist or speech language pathologist), professional horse handlers and a specially screened and trained therapy horse. To meet the therapy goals the assistance of the horses movement is essential. Hippotherapy is a one to one treatment and the goals are to improve neurological functioning in cognition, organisation, body movement and attention levels. The rider sits on the horse in walk in a number of positions, they adjust to the movement and work on co-ordination
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and posture. The horses movement stimulates postural responses and increases the base area of support. Additionally it also has an effect on muscle tone and reducing muscle spasm. In the UK this is practiced by chartered physiotherapists who have carried out additional specialist training and are insured to do the work.
Brief History:
Originally the idea to use horses in this way was from Mme Lis Hartel a world renowned dressage rider from Denmark who had poliomyelitis and was severely paralysed and who won a silver medal at the Helsinki Olympic games in 1952. Mrs Elsebet BÜdthker who was a Norwegian physiotherapist noted Lis’s physical progress
Practicing standing up and balancing in the stirrups .
What are the benefits ? and the psychological benefits that were gained from riding. Below: Young rider on Nancy reaching to put cup on stick
According to the RDA website the benefits are; that it is recommended by medical professions, suitable for physical and learning difficulties and its great physiotherapy. Benefits can also be seen in different areas such as Psychological, Physical, Social and Education. Psychological benefits include improvements in self-confidence which is built up by being able to perform a skill in exactly the same way as an able bodied person.
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Increase in general sense of well being, greater interest in the outside world and their own life, improved risktaking abilities, patience development, emotional control and self-discipline and a sense of normality. Physical benefits are; improvements in balance, strengthened muscles, improved coordination, quicker reflexes and better thinking process/ brain activity, stretching of tight or spastic muscles, decreased spasticity, increased range of motion of the joints, reduced abnormal movement patterns, it also improves circulation, respiration, appetite and digestion. Another physical benefit is sensory integration as it stimulates senses through touch and environmental stimuli. Social benefits are; Friendship, increased experiences, enjoyment and developing a respect and love for animals as riders find themselves bonding with the horse. Finally the Education benefits are; remedial reading and maths, sequencing, patterning and motor planning, an improvement in eye-hand coordination, visual/ spatial perception and Differentiation. Above right: Rider listens to volunteers instructions.
According to research by Bertoti (1988), 8 of 11 children showed an improvement in their posture. The results also showed clinically subjective improvement in quality of muscle tone, balance and weight-bearing abilities noted by physical therapists. The study established that therapeutic riding can be a valuable therapy for children with cerebral palsy. The aim of the sessions should be to help the rider control the affected part of the body and to improve balance, posture, coordination and boost the range of motion. They also improve muscle
tone, reduce spasticity and contractions as well as improved circulation. Some other gains are improvement in health. Those with muscle spasms also benefit because of the relaxing effect on the muscles after demanding exercise. The disabled rider will progress slower physically than psychologically. Instant results should not be expected. Balance, posture, physical improvement and coordination will develop slower. Lunging also has benefits it can help improve natural balance,
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self carriage and can be useful when teaching the rider a new pace.
What conditions can benefit:
The name disabled rider refers to people who are affected or have been by one of the following conditions and who may gain benefits in one way or another from this therapeutic activity. Orthopaedic conditions - Amputees (varying types), Scoliosis, Legg Perthes disease (crumbling hip joint) Arthritis (osteo and rheumatoid).Neurological diseases: Poliomyelitis (varying involvement), Spina bifida, Multiple (disseminated) sclerosis, Cerebral palsy (varying types), Traumatic paraplegia (spinal cord injuries), Cerebral
vascular accidents (strokes), Spinal meningitis, Traumatic brain damage (acquired by accident). Other classifications: Muscular dystrophy, Autism, Blindness, Hearing and speech impairments, mental sub-normality (varying types), Epilepsy (varying types), Learning disabilities and Emotionally disturbed.
Equipment:
Most of the equipment is the same that abled bodied riders use, but there are some special/ modified equipment used which this section of the article will cover. Equipment for mounting - Normal mounting blocks can be used, they must be sturdy and non-slip and must allow room for two people to
stand on. Platforms with ramps can also be used which permits riders in wheelchairs to mount. It can also be used as a mounting block at various points. The ramp must have a non slip surface and have hand and safety rails. Platform - min 4ft square which can hold a wheelchair and two helpers, rails on two sides, non slip surface. Hydraulic platforms are used in some centres, they can be used for mouthing from a raised platform when space is limited for a ramp. Pits and hoists are also sometimes used.
Below: Saftey stirrups
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Stirrups - Peacock safety stirrups can be used and these have a snap-off rubber band attachment which is helpful for those with a weakness in the lower limb particularly post-polio, spina, bifida, paraplegics, and lower limb amputees. This is also helpful for those who are unaware of their foot position due to lack of sensation. The Devonshire boot is also another option, it promotes downward heel flexion and allows the iron to be kept on the ball of the foot. It also adds protection to the toes from knocks and the cold. It also prevents the foot slipping through the open iron. Reins - Because of the nature of some riders disability they can have difficulty holding the reins correctly. The looped rein has a number of loops or handles stitched to either side of the reins. They are large enough to slip the whole hand in and out. The reins can be used using the wrist, back of hand or elbow. Ladder reins have three or four rungs of rolled leather about 6 inches apart making a ladder like appearance. This type of rein is helpful for those with deformed or weak hands, riders with false limbs or hooks.
They offer the rider a grasp area which cannot slip through the hands. Various types of nonslip reins are also used that are rubber covered or webbing with leather stops. Rainbow reins are particularly helpful as they help riders achieve the correct and even length of reins. Some disabled riders with poor balance or weak posture may require an adjustable body harness or safety belt. Riders who have little use of their lower limbs or limp muscles will benefit from this.
The horse/pony:
They vary in size from 11hh to 15hh. They should have a kind and willing temperament. Normally the horses used are in there teens or late teens. Conformation is also important as a horse that is over 15.2hh may
“Riding has benefited me hugely, because it has given me a freedom that I previously haven’t had.� make it hard for the side walker to help the rider. A horse with a wing-back is difficult for a cerebral palsy rider with tight adduction in the legs.
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The movement of the changes in rhythm cause persistent adaptations and corrections that the rider has to make to maintain balance. The change of the correction of balance and recovery is thought to be the most therapeutic benefit of riding. Through movement, warmth and the changing patterns of rhythm the horse becomes the therapist. Paces - The slow consistent massaging effect of the walk develops balance and feel. Sitting trot can be bone jarring for the cerebral palsy and the athetoid so they may find rising trot easier but the sitting trot may be easier for those with lower weaknesses amputees and paraplegics. You may well be thinking well is this activity safe for a disabled person.
There are always some risks involved but risks can be prevented and preventative measures are taken. Side walkers walk alongside to aid the rider, the horse is also matched with the riders level of ability.
Above: Reins and equipment prepared for session. Below: Rider dropping rubber duck into bucket.
A word from two disabled riders: Helen Povey, 20 has Hemiplegia down her left side this causes stiffness in all the muscles down one side of the body. Helen says “Being able to horse ride has been a great physiotherapy for me! Keeping all my joints moving and exercising my muscles - avoiding them getting tighter. It’s also helped an awful lot with my everyday balance and co-ordination, I’m a lot more steadier than I used to be”. Katherine Cooksley, 19 is a grade III dressage rider on the World Class Start Programme and hopes to compete in the 2016 Paralympics. When Katherine was 21 months old she contracted pneumococcal meningitis and septicaemia.
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This left her with hemiplegia, which made the left side of the body weak, amputations to the middle 3 fingers on both hands and also loss of binocular vision. Since this Katherine has been diagnosed with Fibromyalgia which is likely to have come from the meningitis. Katherine says “Riding has benefited me hugely, because it has given me a freedom that I previously haven’t had. It improved my balance so that I was able to walk properly again and it was good physiotherapy for my limbs. It has made me more stable on my feet and has also strengthened me which would have taken a lot longer with physiotherapy alone and I was told it may never have happened with pure physiotherapy. It has also allowed me to feel less isolated and be on a level with other riders, where I wasn’t judged for how I looked or moved, which was lovely.”
Above: Trotting. Below: Rider reaching for cup.
Thanks to Blackdyke Farm (left)and RDA Carlisle for permitting me to photograph the session.
For more information or to find your local group please visit: www.rda. org.uk
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