Therapeutic Horsemanship in Veterans

September 1, 2016 updated by: Rebecca Johnson, University of Missouri-Columbia

Effects of Equine Assisted Activities on PTSD Symptoms, Coping Self-efficacy, Emotion Regulation, and Social Engagement in U.S. Military Veterans

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Actual)

38

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Therapeutic Horseback Riding
Therapeutic Horseback Riding: Veterans were matched to a horse by the instructor and occupational therapist for best fit and the same horse was ridden each week
Behavioral: Therapeutic 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.
Other: Standard Care
Participants received standard care.
Other: Standard Care
Standard Care: Participants received standard care

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Coping Self-Efficacy Scale (CSES)
Time Frame: Day 1, 3 weeks and 6 weeks
26 item, 11 point analog scale
Day 1, 3 weeks and 6 weeks
Change in Post-Traumatic Stress Disorder Checklist-Military Version (PCL-M)
Time Frame: Day 1, 3 weeks and 6 weeks
17 item, 5 point scale
Day 1, 3 weeks and 6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Social and Emotional Loneliness Scale for Adults (SELSA) scale
Time Frame: Day 1, 3 weeks and 6 weeks
15 item, 7 point Likert-type scale.
Day 1, 3 weeks and 6 weeks
Change in Difficulties in Emotion Regulation Scale (DERS)
Time Frame: Day 1, 3 weeks and 6 weeks
36 item, 5 point Likert-type scale
Day 1, 3 weeks and 6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Missouri-Columbia

Collaborators

Harry S. Truman Memorial Veterans' Hospital
Horses and Humans Research Foundation

Investigators

  • Principal Investigator: Rebecca A Johnson, PhD, University of Missouri-Columbia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2013

Primary Completion (Actual)

February 1, 2015

Study Completion (Actual)

February 1, 2015

Study Registration Dates

First Submitted

September 1, 2016

First Submitted That Met QC Criteria

September 1, 2016

First Posted (Estimate)

September 7, 2016

Study Record Updates

Last Update Posted (Estimate)

September 7, 2016

Last Update Submitted That Met QC Criteria

September 1, 2016

Last Verified

September 1, 2016

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1207664-1

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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