THE EFFECTS OF THERAPEUTIC HORSEBACK RIDING ON BALANCE by Susan Keel Anderson

122 Pages·2014·0.73 MB·English

THE EFFECTS OF THERAPEUTIC HORSEBACK RIDING ON BALANCE
by
Susan Keel Anderson
May 2014
Director of Thesis: Dr. David Loy, LRT/CTRS
Major Department: The Department of Recreation and Leisure Studies

The purpose of this study was to determine the effects of therapeutic horseback riding as a
therapeutic intervention to improve the balance of thirty individuals who participated in a
Professional Association of Therapeutic Horsemanship International (PATH) therapeutic riding
member program. The study lasted ten weeks, with each participant receiving the intervention
for thirty minutes, once a week. The Multi-Directional Reach Test (MDRT) (Newman, 2001)
was used as an instrument to quantify balance before and after the first intervention, the
beginning of the second intervention, and after the last intervention. The therapeutic riding
program began with active arm movements to encourage stretching, and required two forms of
external perturbations involving at least three transitions, and the completion of at least one
figure eight to challenge balance of riders with disabilities. This quasi-experimental study used a
one-group pretest-posttest design to examine the effects of therapeutic horseback riding on
balance. Paired t-tests and repeated measures ANOVAs were used to examine a relationship
between therapeutic horseback riding and balance. The discussion presents practitioner
applications and research implications.

THE EFFECTS OF THERAPEUTIC HORSEBACK RIDING ON BALANCE
A Thesis
Presented to
The Faculty of the Department of Recreation and Leisure Studies
East Carolina University

In Partial Fulfillment
of the Requirements for the Degree
Master of Science in Recreational Therapy Administration

by
Susan Keel Anderson
East Carolina University
© Susan-Keel Anderson, 2014
THE EFFECTS OF THERAPEUTIC HORSEBACK RIDING ON BALANCE
by
Susan Keel Anderson

APPROVED BY:
DIRECTOR OF THESIS:
_______________________________________________
David P. Loy, Ph.D., LRT/CTRS

COMMITTEE MEMBER:
________________________________________________
Megan Janke, Ph.D., LRT/CTRS

COMMITTEE MEMBER:
________________________________________________
Clifton Watts, Ph.D.

COMMITTEE MEMBER:
________________________________________________
Amy Gross McMillan, Ph.D., PT

COMMITTEE MEMBER:
________________________________________________
Linda Moran, PT

CHAIR OF THE DEPARTMENT OF RECREATION AND LEISURE STUDIES:
________________________________________________
Debra Jordan, Re.D.

DEAN OF THE GRADUATE SCHOOL:

_________________________________________________
Paul J. Gemperline, Ph.D.
ACKNOWLEDGEMENTS
Thank you to everyone who supported me along the way of this endeavor, I couldn’t have
done it without you all! A special thanks to my parents and my thesis mentor.
TABLE OF CONTENTS
SECTION I: MANUSCRIPT
Introduction ........................................................................................................................... 1
Children and Adults with Disabling Conditions ............................................................... 1
Balance ............................................................................................................................ 2
Therapeutic Horseback Riding & Balance ....................................................................... 5
Methods ................................................................................................................................. 6
Research Questions ........................................................................................................... 6
Participants ....................................................................................................................... 6
Research Design ............................................................................................................... 7
Setting ............................................................................................................................... 7
Independent Variable ........................................................................................................ 8
Dependent Variable .......................................................................................................... 9
Procedure ....................................................................................................................... 10
Data Analysis ................................................................................................................. 12
Results ................................................................................................................................. 12
Daily Session Effects of THR on Balance (RQ1) .......................................................... 14
Comprehensive Balance Changes Post 10-Week Intervention (RQ2) ........................... 16
Programmatic Carry-Over Balance Effects Post Intervention (RQ3) ............................ 18
Discussion ............................................................................................................................ 21
Daily Session Effects of THR on Balance (RQ1) .......................................................... 21
Comprehensive Balance Changes Post 10-Week Intervention (RQ2) ........................... 22
Programmatic Carry-Over Balance Effects Post Intervention (RQ3) ............................ 23
Conclusion ........................................................................................................................... 25
Limitations ...................................................................................................................... 25
Future Research .............................................................................................................. 27
Section I References ........................................................................................................... 29
SECTION II: EXTENDED LITERATURE REVIEW
Animal Assisted Therapy .................................................................................................... 35
Horse Therapy ..................................................................................................................... 36
Children and Adults with Disabling Conditions ................................................................. 41
Theoretical Frameworks ...................................................................................................... 42
Functional Determinants of Balance ................................................................................... 46
Therapeutic Horseback Riding and Balance ...................................................................... 49
Summary ............................................................................................................................ 51
SECTION III: EXTENDED DISCUSSION
Daily Session Effects of THR on Balance (RQ1) ............................................................... 53
Comprehensive Balance Changes Post 10-Week Intervention (RQ2) ................................ 61
Programmatic Carry-Over Balance Effects Post Intervention (RQ3) ................................. 68
Conclusion ........................................................................................................................... 79
Limitations ........................................................................................................................... 80
Future Research ................................................................................................................... 82
APPENDIX A: IRB Approval Form ............................................................................................. 85
APPENDIX B: Agency Letter of Permission ............................................................................... 86
APPENDIX C: Study Cover Letter .............................................................................................. 87
APPENDIX D: Adult Informed Consent ..................................................................................... 88
APPENDIX E: Parental Assent .................................................................................................... 92
APPENDIX F: Assent .................................................................................................................. 96
APPENDIX G: Correlation Table: Number of Years Riding & Balance Change ........................ 99
APPENDIX H: Full References .................................................................................................. 100
SECTION I: MANUSCRIPT

Introduction
Children and Adults with Disabling Conditions
Approximately 54 million people in the United States are living with a disabling
condition, which equates to one in every five people (US Department of Health and Human
Services, 2013). Disabilities can be caused by birth, an accident, or age (US Department of
Health and Human Services, 2013). Physical inactivity is a common problem among individuals
with a disabling condition (Shih, Chen, & Shih, 2012) and increases the risk for limitations and
secondary health issues (Rimmer, 2007). Rimmer (2007) suggested that physical activity is low
for individuals with disabilities as a direct result of their disabling condition and the barriers
presented by the environment. Furthermore, Rimmer, Riley, Wahg, Rauworth, and Jurkowski
(2004) suggested that access to physical activities remains a limiting barrier among individuals
with disabilities.
More importantly, individuals with disabilities may lose function as a result of inactivity
(Rimmer, 2007) and this may ultimately decrease independence (Shih, Chen, & Shih, 2012) and
balance abilities (Silkwood-Sherer, 2012). Impaired balance can often lead to greater physical
disability, and problems with activities of daily living (Edgren et al., 2013). Balance is equally an
issue among individuals in wheelchairs who are unable to perform activities that are pertinent to
their everyday lives without the ability to achieve sitting balance (Petrofsky, 2006). Balance
affects an individual’s task performance and mobility as it is involved in all levels of tasks that
humans engage in from infancy to adulthood.
While partaking in tasks, humans are presented with balance challenges. Balance
challenges are activities that cause the balance system to work. To improve the success rate of