Impact of adaptive devices on horses, assisting persons, and riders with cerebral palsy in a therapeutic riding program

Lana Kaiser (1), Mathew J. Edick (6), Katherine Smith Buckler (1), Camie Heleski (2), Sherman Gorbis (3), Bonnie DePue (6), Liz Lewis (2), LeeAnn J. Kaiser (5)

1. Michigan State University Department of Medicine, College of Human Medicine; 2. Michigan State University Department of Animal Science, College of Natural Science; 3. Michigan State University College of Osteopathic Medicine; 4. Michigan State University Department of Large Animal Clinical Sciences, 5. Michigan State University College of Veterinary Medicine; 6. CHUM Therapeutic Riding.

Abstract
Hypothesis: The goal of this study was to evaluate the impact of three different adaptive devices used to facilitate therapeutic horseback riding for riders with cerebral palsy (CP), the horses, and the assisting persons. The study hypothesis was that there is no difference in clinical benefit to the rider; stress or physical saddle pressure to the horse; or the level of exertion required from assisting persons when using any of the three adaptive devices.

Population: Individuals with varying disability due to cerebral palsy who participated in a therapeutic horseback riding program at a Professional Association of Therapeutic Horsemanship (PATH) Premier Accredited Center.
Intervention: Therapeutic horseback riding sessions using one of three adaptive devices.

Comparators: Two commonly used adaptive devices (English saddle and bareback pad with backrider), and one recently developed, less-used device (Independence saddle).

Outcomes: Clinical benefit for the individual with Cerebral Palsy was evaluated using an osteopathic musculoskeletal exam score. Equine stress was evaluated using a horse stress behavior ethogram. Physical pressure under the saddle of the horse was evaluated using a Pliance Saddle pad under each adaptive device. Required level of exertion by assisting persons was measured using an assistant exertion score.

Conclusion: Therapeutic riding using an English saddle, a backriding pad with backrider, or an Independence saddle, by individuals with various degrees of disability, does not cause excessive stress or result in excessive pressure to the horse. Using one assistive device over another also does not appear to change the likelihood of clinical benefit to the rider. However, exertion scores for assisting persons were lower when the Independence saddle was used compared to the English saddle or backriding pad. Adaptive devices that allow an individual with CP to improve function, ride more independently, provide some respite for the side walker and do not cause undue stress or frustration to the horse would be a great addition to the therapeutic regimen. Based on the results of this study, the Independence saddle is a viable alternative to the English saddle or the backriding pad for riders that would otherwise need extensive assisting person support in a therapeutic riding program.