Shumbashaba Therapeutic Riding Programme

“Riding for the disabled” is a term with which we are all familiar. However, more recently the term “therapeutic riding” has become popular. Therapeutic riding is a broad term that is used to describe a number of different treatment strategies that use the horse as a medium of therapy. Namely; hippotherapy, developmental riding therapy, psycho-educational vaulting and remedial riding, and riding as a sport and a skill for the disabled/ riding for the disabled.

Hippotherapy is an extension of physiotherapy where the movement of the horse stimulates the passive client psychomotorically. In pure hippotherapy the client remains passive, has no direct influence over the horse, and may perform various exercises on the horse. This occurs in an individual setting and can involve back riding, or side-walkers and a leader. Out of hippotherapy has developed Developmental riding therapy, which uses the principles of hippotherapy and many different neuro-developmental exercises to stimulate the individual. Psycho-educational vaulting and remedial riding use principles of neuro-development, remedial education, and psycho-development in therapeutic strategies. Typically these forms of therapy occur in the group setting and have set developmental, psychological, social and educational goals. Riding as a sport and a skill for the disabled or riding for the disabled involves teaching riding to disabled individuals being aware of the therapeutic benefit. The Special Olympics and the Paralympics provide competition opportunities.

As early as the 16th century, horse riding was recognised as having a healing rhythm, which cheered spirits, as well as being a suitable physical exercise to help one maintain good health (Satter, 1978). In the early 19th century the therapeutic use of the horse was purely as a medical exercise and manipulation. However rapid developments in natural science during the 19th century overlooked the references to the healing nature of horse riding. This led to a decline in the prescription of horse riding as a therapy, and riding became the prerogative of the cavalry and the elite. According to Satter (1978) the modern concept of riding as a form of therapy started in England, Holland and Denmark, and has since spread to Germany, Switzerland, and most other European countries as well as to the United States.

During the last century professionals showed increase awareness of the educational, socializational, and rehabilitational benefits of horse riding therapy (Heipertz, 1989). As a result horse riding therapy has been offered to not only to the physically disabled, but also to the mentally retarded, behaviourally or psychologically impaired and to the learning disabled Longden, 1984; Kroger, 1989; Davies, 1988; Britton, 1991). Consequently the training of the “riding therapists” has evoked much international debate.

Unfortunately there is little consensus in the international acceptance of the usage of terms within therapeutic riding. The term’s hippotherapy and developmental riding therapy are often used interchangeably. In my personal effort to understand the differences it appears that hippotherapy is the pure focus on correct positioning to maximise the movement impulse stimulation of the horse, the focus is on correct motor development. Pure hippotherapy is the realm of the physiotherapist, it falls under the medical model (Strauss, 1995). Whereas developmental riding therapy takes this a little further and incorporates various skilled professionals and emphasises an individual’s psychosomatic entirety (Spink, 1993), it starts to move away from the pure medical model and begins to move into the field of remedial riding and psycho-educational vaulting.

In 1989 Heipertz developed a basic model delineating three areas; medicine, psychology / education; and horsemanship / sport. This model has been accepted by the “Kuratorium für Therapeutisches Reiten”. Contemporary therapists are suggesting that an additional circle be included to represent the psychotherapeutic use of the horse.

Throughout history the man has been evolving with the horse. Infact the human anatomy is very similar to the anatomy of the higher mammalians e.g. the horse.

The structure of the inner ear, with the cochlea and vestibular canals / arches is the same for man and horse. In addition the anatomy of the fore and hind limbs, is similar to that of the human upper and lower limbs respectively. With regard to instincts man and higher mammalia are much closer related than man in his self-deception would accept for a very long time. There are good reasons for the assumption that the elements of depth-psychology – the function of the Id in Freudian theory and the presence of archetypes in Jungian psychology – have roots in the primary repertoire of all higher mammalian behaviour. Comparative ethology of about 50 years ago assumed a simple scheme of inmate mechanisms of stimulation for the animals. Today the ethology has very highly differentiated ideas about the co-ordinated information that rules the instinctive behaviour (Kluwer, 1998). Both humans and mammals have the ability to check back and in so doing can adapt their behavioural response to particular stimuli, this inherited “wisdom” has secured the survival of the mammalia including man over hundred of thousands of years. In addition to the analogy in the primary regulation of behaviour including the ability to mimic and gesture – man and horse also have in common the neurobiological rules of learning. The living cell learns while functioning, with each new action the cell has the experience of previous functioning, so a new outcome could appear. This knowledge allows one to understand how the primary orientations of behaviour on the levels of instincts are neurobiologically co-ordinated with our experience of apperception and computed to emotionally meaningful gestalt (wholes).

However human ontogenesis has certain characteristics that are very different from that of the higher mammals. With our upright posture came an anatomical change of the cranium. The arms were freed from providing support and the widening of the skull made possible an increase in brain volume. Our hands became highly sensitive and effective instruments. One only has to watch a developing child to see that they have inherited the same gaits as our four legged relatives. They walk on all fours like little bears, showing the same gaits as the horse; walk, trot, and canter. Humans have to learn to go upright. The observation of others and the computing of this together with sensomotoric and psychomotoric integrative processes is of great importance for our own development. In essence we learn and develop a sense of reality purely through intersubjective phenomenon /social learning. In addition to this typical human development is characterised by the development of speech. Due to erection and the anatomy of the head the inner space of the nose and pharynx has widened such that subtle nuances of sound can be produced – the prerequisite of speech. Neither the baby nor the Neanderthal can do this. The baby plays with sounds like psch-brr-mamamam-dadada, which are given cultural meaning by the parents; like mum and dad. It is these names which make possible the specific human communication. Hence words, grammar, syntax and the lie govern our world. The verbal tradition brought about by culture. Our minds are all filled with many observations as well as the thoughts and opinions of many other people. In essence a sense of collective reality and rationality unless ideological short-cuts lead into social pathology. This results in the relative freedom of man from the primordial orders of behaviour on the level of instincts: There is the second repertory of behaviour out of the order of culture, and in the “hiatus” between them is the chance for the subject to have a will. This together with delayed sexual maturity gives rich possibilities for the human life, but simultaneously it can cause several conditions of inevitable conflicts and may end in disaster.

This has provided us with a brief background on the evolution of man and his development of higher functions, which we can use to explore the therapeutic possibilities of the horse.

Around the same era when the erection and the development of the human brain occurred, the horse shoed an extension with the lengthening of its legs and the erection of its neck resulting in the horse-typical bearing of the head and also in a growing of the neocortex. The sensitive toes became surrounded by a hoof, and developed into a highly perceptive organ for vibrations and oscillations. The horse became a herbivore and a running animal whose survival depended on vigilance,, power of observation and the tendency for timely flight rather than aggression. It became domesticated and through history has served man as packhorse, riding-horse, and draught-horse. No doubt skilful breeding through the millennia resulted in the horse becoming a more convenient companion for man in war and peace.

The height, the flow of movement with the typical impulse on the rider, the frequency of the steps and swinging, with not too much pushing movement with the rider, are important attributes. Kluwer developed the following scheme, which shows the specific aspects of the horse that are important for Hippotherapy and remedial riding. Namely the three-dimensional swinging in the position of the saddle for the neuromuscular facilitation of the patient; the self-balance of the horse working as a kind of biofeedback to the balance of the rider; the motion-dialogue of rider and horse, that functions as a pre-gestural communication; finally the herd-typical behaviour of the horse also with the human group together with the therapist and the rider. This triangular interaction is like that in early childhood – the basic condition of social learning. These effects can easily be related to the neuro-, senso-, psycho-, and socio-motoric development.

Since 1965 there has been great emphasis on the acceptance of therapeutic riding as a scientific method of movement therapy. It has been classified within the field of Animal Active / Facilitated Therapy. The effects of Animal Active / Facilitated therapy can be summarized as follows:

PSYCHOLOGICAL EFFECTS

1. Positive affective state (elation / joy)
2. Affiliation – need to be in close proximity to living things
3. Humour
4. Play
5. Self-esteem – through trusting dependence
6. Need to be needed
7. Independence
8. Increased motivation – to overcome impairments
9. Education – animals provide excellent educational tools
10. Sense of achievement
11. Stimulus to be active (busy) – the habits of animals can serve as an organising and an orienting influence – feeding, grooming, walking / exercising.
    

SOCIAL BENEFITS

1. Catalyst effect – creating topics of conversation
2. Social cohesion – stimulate social interaction
3. Co-operative play (sports)
4. Increase co-operation with care givers.
   

PHYSICAL BENEFITS

1. Recovery form illness
2. Coping with illness
3. Neuromuscular rehabilitation – especially in therapeutic riding
4. Life expectancy.
   

This summary indicates that the potential value of Animal Active / Facilitated Therapy as an holistic therapy is huge; as are the possibilities for therapeutic riding. Nevertheless one must be aware that this form of therapy is adjunctive and not panacea.

For the optimum effect of the horse in the therapeutic setting, one must understand that the correct, especially trained horse can have an almost unbelievable co-operation with its trainer. In this way the horse is the ideal mediator between the therapist and the patient. Kluwer emphasises that this is absolutely depending on the professional knowledge and skill of trained and experienced therapists.