The benefits of Therapeutic

Riding for individuals with

cerebral palsy

Trish Dooley, March 2018

‘Man often becomes what he believes

himself to be. If I keep on saying to myself

that I cannot do a certain thing, it is

possible that I may really become

incapable of doing it. On the contrary, if I

have the belief that I can do it, I shall

surely acquire the capacity to do it even if I

may not have it at the beginning’

Mahatma Gandhi

What are equine therapies?Equine therapies are a form of experiential therapy that

involve interactions with individuals and horses. Horses

are used in therapy to promote emotional and physical

growth. There are four categories of equine therapy:

• Equine facilitated psychotherapy (EFP);

• Equine Facilitated Learning / Equine Assisted Learning

(EFL/EAL);

• Hippotherapy; and

• Therapeutic riding (TR).

These therapies are used for individuals with and without

special needs, including those with physical, cognitive

and emotional issues.

Equine facilitated psychotherapy (EFP)

EFP is defined as an interactive process in which a

licensed mental health professional working with equine

professional partners and suitable horses, addresses

psychotherapy goals established by the mental health

professional and the client. Issues addressed, to name a

few, are depression, anxiety, eating disorders, substance

abuse, PTSD and anger management.

The horse is perhaps the most important partner in EFP.

As a domesticated prey animal, they are extremely

sensitive to changes in a human being and will react

differently to people depending on their emotional state.

In essence, the horse acts as a large biofeedback machine

and mirrors each individuals behaviour.

Equine Facilitated Learning (EFL)

Equine Assisted Learning (EAL)

EFL/EAL is experiential so participants learn by doing

with the horse being the facilitator. The horse is loose

and their size alone encourages an increased sense of

awareness by the participant.

Sessions involve non-verbal communication between the

participant and the horse, with specific tasks being set.

The overall aim is that the participant will focus totally on

the task in hand and its’ successful completion. EFL /

EAL could be described as a fusion between therapy,

education and fun.

Hippotherapy

Hippos is the Greek word for horse. Hippotherapy is a

medically based treatment tool. It is a physical,

occupational or speech and language therapy treatment

strategy that utilises the horses movement.

Hippotherapy helps with coordination, balance and

strength. It is an evidence based practice which involves

the purposeful manipulation of equine movement to

engage sensory, neuromotor and cognitive systems to

achieve functional outcomes.

Therapeutic Riding (TR)

TR is an equine assisted activity for the purpose of

providing constructively to the cognitive, physical,

emotional and social well being of individuals with

special needs. TR delivers benefits in the areas of health,

education, sport, recreation and leisure.

TR improves sensory and motor skills which aid

coordination, balance, posture and core strength. TR

sessions are one to one and are person centred.

Therapeutic Riding (TR)

Horses provide sensory input through movement which is

variable, rhythmic and repetitive, with the three

dimensional movement of the horse’s hips, pelvis and

shoulders at walk facilitating a movement response from

the rider. The walk of the horse mirrors the walk of a

person thus providing transfer movement patterns to the

rider’s lower spine and pelvic regions.

A horse can transfer 110 multi-dimensional swinging

motions in the walk to the rider each minute. As the horse

walks, the rider makes subtle adjustments in his / her body

position in order to try and maintain stability. By being

astride the horse, with the coach giving specific

instructions, the horse naturally helps to increase body

strength, control and balance. This is the basis of TR.

Trish’s Rockin’ Horses

Therapeutic Riding Centre

I qualified as a Therapeutic Riding Coach (FETAC Level

6, Festina Lente, Bray, Co. Wicklow) in 2013 and set up

Trish’s Rockin’ Horses in March of 2014. Based near

Dungarvan in County Waterford, my client base has

increased steadily and to date, I have approximately 60

clients attending therapeutic riding sessions at both my

centre and another equitation centre near Waterford city

where I coach 3 days per week. All therapeutic riding

sessions are person centred and one to one. Assessments

are free of charge as they allow me to plan future sessions

for each individual.

Trish’s Rockin’ Horses

Client base includes individuals with:

• Autism

• Down Syndrome

• ADHD

• Cerebral Palsy

• Dyspraxia

• Low self esteem

• Trauma

• A wish to experience horse riding in a non-stressful

environment.

Case Study: Ciara

Ciara is 17 years old (she’ll be 18 this year).

She was born six and a half weeks prematurely

and diagnosed with severe cerebral palsy at nine

months due to difficulties at birth. Ciara has

spastic quadriplegic cerebral palsy with no

mobility. Spastic quadriplegia affects all four

limbs and is the most severe of spastic cerebral

palsy marked by the inability to use the legs,

arms and body. Spastic quadriplegia also

affects the face and torso.

Case Study: Ciara

Ciara and her mother, Jean, first

contacted Trish’s Rockin’ Horses in

March 2017, with a view to Ciara

commencing TR. As I previously

had had a client with ‘locked in’

syndrome who, with voluntary

assistance, did a few sessions of TR,

I was open to meeting Ciara and

Jean and assessing Ciara’s needs

with regard to undertaking TR as a

regular activity. Despite the

challenges Ciara faces on a daily

basis, she is a determined young

lady with a strong advocate, Jean, by

her side.

Ciara’s Assessment

Assessments involve a ‘meet and greet’ to see

how the individual engages with the horse and

usually a short ride so future TR sessions can be

planned based on the individual’s abilities,

strengths and weaknesses. When Ciara arrived

at Kilotteran Equitation Centre (approximately 5

miles from Waterford city centre), we had

arranged a suitable time when it would be quiet

and the centre’s usual commercial activity was

not taking place. This allows the individual

time to take in their new environment and

absorb the sensory experience.

Ciara’s Assessment

When I brought Ernie, the horse, into the arena

to meet Ciara, he walked purposefully towards

her and put his head down to wheelchair level to

engage with her. Ciara’s response was a delight

and it was evident that there was an instant

human equine bond / attachment.

The assessment allowed me to discover that

Ciara is very aware of what is going on around

her and expresses her opinions strongly! Her

main words are ‘yes’, ‘no’ and ‘ridiculous’ and

she was up for any challenge to achieve her

dream of riding a horse.

Ciara’s Assessment

As a TR coach, I have to risk assess and

problem solve on my feet. With the

assistance of volunteers and Ciara’s

family, we lay Ciara across Ernie as this

was the only option available to us at this

time.

For Ciara, it was a totally new experience

and for all who helped that day, it was a

joy to witness.

It was agreed that Ciara would attend

every week for a period of time that

would be measured by her enjoyment

versus discomfort levels.

TR Sessions and Cerebral Palsy

Trish’s Rockin’ Horses had other clients attending also

diagnosed with CP. Being young children, it was much easier

for myself, leaders and sidewalkers to assist during a TR

session.

TR Sessions and Cerebral Palsy

Conducting research, I purchased a ‘double saddle’ from the

US. This allows an individual with limited mobility to ride a

horse with another rider behind them, thus supporting them.

With much excitement, all riders at the centre, had the

opportunity to ride in the double saddle, being supported by

either a parent, carer or myself.

For children with CP, this opened up a whole new world as

they were able to ride sitting upright, and the parents enjoyed

the experience also.

TR Sessions and Ciara

Assessing Ciara and Jean’s

combined weight, it was

decided to trial the double

saddle. As Jean commented

later ‘all we’ve met through life

is barriers, barriers and barriers

and then this happens….’

TR Sessions – double saddle

TR Sessions – double saddle and

Ernie the superstar!

The Independence Saddle

Although Ernie appeared quite comfortable carrying the

combined weight of Ciara and Jean, it was quite difficult at

times for Jean, myself and volunteers to support Ciara.

Researching further, I found the Independence Saddle which is

the result of more than six years research and development.

The saddle is designed to afford rider’s more independence

than any other available adaptive technology.

The Independence Saddle

The saddle is designed to adapt to the needs of each rider. As

strengths and skills improve, the support prompts may be

reduced or even removed. These support prompts include a

head rest, backrest, side arms, forearm supports with hand

grips. There is also an emergency release system should the

rider have to be dismounted in the event of an emergency.

Providing physical, occupational and psychological therapeutic

opportunities, the saddle offers each rider an immeasurable

sense of success and self fulfillment, maximizing quality of

life.

At a cost of €6,000, the centre organised a successful ‘Go Fund

Me’ campaign and the money was raised in 36 hours.

The

Independence

Saddle

The day the saddle was

launched was indeed a

memorable time in my life and

of many others.

Ciara gave me a big hug to

express her joy. Ernie just

chilled and enjoyed the treats.

The Independence Saddle

Today

Ciara was never able to sit unassisted until she commenced TR.

She has an increased core strength and she can now sit for a

couple of seconds with little support. There has been a massive

improvement noted in her physiotherapy sessions since Ciara

started riding a horse. Her well being has also improved.

Sometimes when we see disability, that is all we see. Given the

right environment, people and therapeutic aids, strengths and

abilities can blossom and flourish.

Thank you – any questions?

Bibliography

American Hippotherapy Association, Inc., available from: www.americanhippotherapyassociation.org

Australian Equine Assisted Learning, available from www.efl.net.au

Circles Network, available from www.circlesnetwork.org.uk

Festina Lente, available from www.festinalente.ie

Freedom Rider, available from www.freedomrider.com

Hertfordshire Equine Assisted Learning, available from www.hertsequine.co.uk

Independent Strides, available from www.independentstrides.com

Path International available from: www.pathintl.org

Spastic Quadriplegia Cerebral Palsy, available from www.cerebralpalsyguidance.com

Strides, available from www.strides.ie

Trish’s Rockin’ Horses Therapeutic Riding Centre, available from www.trishsrockinhorses.com