Horses as Therapeutic Animals

Posted Posted in Continuing Education, Elder Care, Homestudy, Psychology, Webinars

horse-1330690_640By Barbara Sternberg, Ph.D.

Hippotherapy is the technical term for therapy with horses. While it has been around for more than a century, hippotherapy came to the fore when a woman named Liz Harwell, whose legs were essentially paralyzed by polio, won the Silver Medal in dressage at the 1952 Helsinki Olympic Games. Today, half a century later, hippotherapy programs are ongoing in multiple countries, and therapeutic riding programs have been developed for people with physical, psychological, cognitive, social, and behavioral problems including cerebral palsy, spina bifida, mental retardation, and depression. The North American Riding for the Handicapped Association makes a distinction between hippotherapy, or horse-based physical therapy under the direction of a licensed therapist, and therapeutic riding, which utilizes different methods to improve strength, muscle control, eye-hand coordination, and social skills.

Riding a horse involves what physical therapists refer to as three-dimensional movement. With each step, the person’s pelvis tilts up, sideways and forward, and back. The horse repeats the sequence and the sensation of these bodily motions for people with physical or neurological handicaps, reacquainting their muscles with how they are supposed to move. The pressure of the horse’s hooves hitting the ground is also three-dimensional, and stimulates the rider’s knees, hips, and spine. It is believed that this movement stimulates the brain, directly affecting the nervous system.

Even speech and language therapy can be enhanced by therapeutic riding programs. Ruth Dismuke-Blakely, a speech therapist from New Mexico, has been working with patients on horseback since 1981. She believes that most speech therapy addresses only the mouth and the brain, disconnected from the rest of the body, but that in fact, the rest of the body is very important for speech. Horses, with their well organized neurological systems, “lend their ordered system to a disordered one.”

Other speech therapists also find horseback riding a therapeutic venue in which to conduct treatment because patients learn more quickly when engaged in real-life settings than when in an office. Hippotherapy is actually approved by the American Speech and Hearing Association as a therapeutic modality.

Psychotherapy takes place in the realm of horses, too, specifically in the stall, along with the horse, the patient, and the therapist. According to psychotherapist Marilyn Sokoloff, PhD the additional aspect of having a horse to touch and interact with speeds up the pace of psychotherapy. The human-horse interaction gives the therapy a here-and-now component to analyze that can cut through resistances that have hindered progress for years. Sokoloff has used horses in group therapy sessions with women, convening the sessions in a horse barn with the women seated in chairs in a circle and the horses in their stalls all around them. Physical contact with the horses is encouraged as a mode of putting the women in touch with their feelings. These women suffer from depression, anxiety, eating disorders, and physical and sexual abuse and are challenged by the horses to find new ways of control. Getting a horse to do what you want raises issues of power and control which are confronted by the women in the group, often to powerful effect.


Rheumatic Diseases

Posted Posted in Continuing Education, Homestudy, Pain

marseille-142394_640Rheumatic diseases have been with us for centuries—since at least the early Bronze Age. According to the Arthritis Foundation, American Indians living in 3000 BC showed signs of rheumatoid arthritis.

The symptoms of rheumatic disease were first formalized in 1680 by the British physician, Thomas Sydenham. At the time, he described the pain of acute gout flares in his patients as “so exquisite and lively…it cannot bear the weight of bedclothes nor the jar of a person walking into the room.”

As Sydenham observed, many types of arthritis can be painful and even disabling. Today’s treatments, including new pain relievers, Disease Modifying Anti-Rheumatic Drugs (DMARDs), and biologic agents can help reduce symptoms and slow the progression of arthritis. Surgery can repair joints, bones, and tendons damaged by arthritic disease. Lifestyle changes, including diet, exercise and assistive devices, make it possible for many people with arthritis to live fully functional, even active lives.

Approximately 50 million U.S. adults—about one in five—have physician-diagnosed arthritis. However, nearly one in three adults have arthritis or chronic joint symptoms. Arthritis is the most prevalent cause of disability in the United States, and results in upwards of 66 million physician visits each year.

As the population ages, the incidence of arthritis will rise dramatically and is expected to increase to 67 million by 2030.  Arthritis will create an important public health problem as well as tremendous personal suffering.  The societal costs of arthritis are immense. The estimated yearly medical care costs for arthritis total nearly $81 billion in the U.S. The cost of medical care plus lost work productivity is even larger—approximately $128 billion.

In general, rheumatic diseases are characterized by:

  • Inflammation
  • Redness and/or heat in a joint
  • Swelling in the joints
  • Recurring or constant pain
  • Decreased range of motion in joints
  • Stiffness
  • Fever, weight loss, and fatigue — in some types of rheumatic disease.
  • Loss of function in connective tissues
  • Involvement of joints, tendons, ligaments, bones, and muscles

Rheumatic diseases are systemic and often involve internal organs.  Though arthritis is a growing problem by virtue of demographics, the disease is also becoming increasingly manageable. With improved screening and today’s treatments, people with arthritis may live active, independent lives. Every effort should be made to protect sleep, preserve functional independence, and provide for effective pain management.

New research is also pointing the way toward increased knowledge about the causes of arthritis, which will ultimately improve available treatments. Appropriate diagnosis, comprehensive treatment, and prevention of complications will continue to improve in the next decade, enhancing quality of life for millions.

Rheumatic Disease and Arthritis are just two of the topics covered in our Homestudy Courses.  Click below for more information.