Post Traumatic Stress Disorder, Traumatic Brain Injury
Conditions
Brief summary
The project partnered with U.S. military veterans with a premier accredited therapeutic riding center for six weeks. The veterans interacted with horses by grooming and learning about them, as well as riding them for one hour per week during which they gained a variety of skills. We hoped the veterans would experience a reduction in Post Traumatic Stress Disorder (PTSD) symptoms, depression, and loneliness, while improving their social and emotional health and self-efficacy.
Detailed description
Large numbers of post-deployed U.S. veterans diagnosed with Post Traumatic Stress Disorder (PTSD) and/or Traumatic Brain Injury make effective interventions urgent, to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. Symptoms expand health care costs for stress-related illnesses making veterans' civilian life difficult. The proposed study used a randomized experimental design with repeated measures and waitlist control group testing the efficacy of a 6-week human-horse interaction and systematic therapeutic horseback riding program in: decreasing PTSD symptoms, increasing coping self efficacy, emotion regulation, and social engagement. The Riding Group spent one hour weekly interacting with and riding the same horse at one of two PATH-accredited riding centers in Mid-Missouri supervised by an Occupational Therapist, Profession Association of Therapeutic Horsemanship (PATH) International-certified instructor, leader and side walkers as needed. Riding was directed by a systematic lesson plan. Data collection occured at baseline, 3 weeks, and 6 weeks. The Control Group was assessed at the same intervals and again 3 weeks and 6 weeks after joining the Riding Group.
Interventions
BEHAVIORALTherapeutic Horseback Riding
Veterans were matched to a horse for best fit and the same horse was ridden each week. The warm-up exercises involved various repeated physical movements while the horse was walking or standing steady, such as head rotations, lifting arms, rotating ankles, flexing toes. The exercises began with riding at a walk during the early weeks, learning reining skills and riding positions, and progressed to light trotting. Veteran participants were able to build on skill sets related to grooming, tacking, mounting, and riding that were introduced in prior weeks. Skill progression was based on individual abilities and safety as determined by certified riding instructor and occupational therapist.
OTHERStandard Care
Standard Care: Participants received standard care
Sponsors
Harry S. Truman Memorial Veterans' Hospital
Horses and Humans Research Foundation
University of Missouri-Columbia
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * Veterans, left active military service (not serving in reserve units.) * Diagnosed with Post Traumatic Stress Disorder/Traumatic Brain Injury or both according to ICD-9 diagnostic codes. * Weight less than 220 pounds. * Able to walk at least 25 feet without the assistance of a person (but potentially with assistive devices). * Willing to interact with and ride a horse. * Have not ridden a horse in the past year. * Care Provider assent
Exclusion criteria
* Age less than 18 years * Veterans in active military service (including reserve units). * No diagnosis of PTSD/TBI or both according to ICD-9 diagnostic codes. * Weight greater than 221 pounds. * Unable to walk at least 25 feet without the assistance of a person (but potentially with assistive devices.) * Unwilling to interact with and ride a horse. * Have been riding a horse in the past year. * Care Provider unwilling to provide assent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Coping Self-Efficacy Scale (CSES) | Day 1, 3 weeks and 6 weeks | 26 item, 11 point analog scale |
| Change in Post-Traumatic Stress Disorder Checklist-Military Version (PCL-M) | Day 1, 3 weeks and 6 weeks | 17 item, 5 point scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Social and Emotional Loneliness Scale for Adults (SELSA) scale | Day 1, 3 weeks and 6 weeks | 15 item, 7 point Likert-type scale. |
| Change in Difficulties in Emotion Regulation Scale (DERS) | Day 1, 3 weeks and 6 weeks | 36 item, 5 point Likert-type scale |
Outcome results
None listed