Linda Kuhlthau

Linda Kuhlthau


The horseback riding program at the Children's Rehabilitation Center includes children with various physiological and psychological problems. Each child is dealt with individually, the goals of the program being adjusted to his particular capabilities. The program is generally designed to have therapeutic value as well as to be an enjoyable experience. The child is encouraged to perform to the best of his physical capabilities. Most important, riding is presented as a sport in which the child can participate independently. The riding program is geared primarily to the use of the English. Forward. Hunter saddle due to the prevalence of this equipment in the Charlottesville area. However, when indicated, as in the case of the rider with spastic cerebral palsy, the child is placed in a Western saddle.

Equitation for the Cerebral-Palsied Rider

Horseback riding for the child with spastic cerebral palsy can be a very rewarding and successful activity. When the child is able to exercise independent control of his mount to walk, trot, canter, or trail ride, he has accomplished a feat of which he can be justly proud. In order to achieve this goal, the cerebral-palsied rider must have a balanced, functional riding seat. Balance is the key word. Lower-limb involvements often associated with the spastic cerebral-palsied person present an obstacle to maintenance of the balanced seat necessary in horseback riding. Some children, in fact, may have such severe motor and mental involvements that it is impossible for them to become functional riders. In such cases equitation would be contraindicated.

English and Western Saddles

One of the predominant riding seats in the Eastern United Stales is the English, Forward, Hunter seat. In such a saddle the body of the rider is for-wardly inclined with the weight centered in the crotch area. However, riding in an English saddle, without any form of binding, can be disastrous for the cerebral-palsied rider. The forward inclination encouraged by the English saddle places the child in an almost totally unfunctional position. The forward shift of weight causes involuntary muscle contractions and flexions at many joints. Thus, the rider loses control and falls forward, often completely off the horse.

In an effort to maintain the cerebral-palsied rider's balance in an English saddle, the instructor might try various methods of strapping the rider to the saddle. The strap could be worn much as a seat belt to keep the rider mounted; or the rider's feet could be strapped to the stirrups. However, these methods are not recommended as they create avoidable safety hazards. It is a generally accepted riding principle that the rider should in no way be "bound" to the saddle: he must be free to fall off in case of an emergency. This freedom avoids the possibility of the rider being dragged by his mount. In addition, tying the rider to the saddle inhibits the desired feeling of confidence and independence on the part of the rider.

The Western, or Stock, saddle was made famous by the early American cowboys of the "Old West." The deep seat, high cantle, and pommel of the Western saddle provide a seat which can be comfortably ridden in for hours at a time. In contrast to the English saddle, the Western saddle makes it possible for many cerebral-palsied riders to assume a functional riding position. The Western saddle provides a seat centered well back on the buttocks region of the rider. The rider, sitting up straight (with no forward inclination as in the English saddle) and with his weight evenly distributed across the buttocks, has functional use of his lower extremities (Fig. 1 ). The stirrups should be adjusted to accommodate any differences in leg lengths. This adjustment further encourages a balanced seat (Fig. 2 ).

Case Study

J.A., a 16-year-old girl with spastic cerebral palsy, had more involvement in the right lower extremity than the left and the right foot would jerk forward with the increased motion of the horse. As a result of the jerking motion the right foot would pass partially or completely through the stirrup. It is a definite safety hazard when the foot is caught in the stirrup. It was found that a shoe with a two- to three-inch heel would alleviate this problem. The heel would stop the foot from going through the stirrup and maintain the leg in a functioning position (Fig. 3 ).

Mounting and Dismounting

Mounting and dismounting are two skills in which the cerebral-palsied rider must receive aid. To mount the rider must stand on a mounting block so that he can lift his left fool into the left stirrup. Next, he must swing his right leg over the horse's back. This swinging motion is accomplished by the scissoring of the rider's torso across the saddle. The attendant then must help the rider straighten up to a sitting position. In dismounting the rider first drops both feet out of the stirrups. The attendant stands on the left side of the horse one hand balancing the rider's left leg, while the other helps to pull the right leg up and over the horse's back (Fig. 4 ). The rider then slowly lowers himself to the ground.

Achieving Independence

Spastic cerebral-palsied children are often introverted and need individual attention or, failing that, to work as members of a small group. Horseback riding develops a remarkable sense of independence in the child. The sport enables him to participate in a challenging physical activity with little or no >dependence on other people. He can independently groom, tack, and ride. In addition, the rider can lead his mount by walking well in front of and to the side of the horse to avoid being stepped on (Fig. 5 ).

Conclusion

The spastic cerebral-palsied patient can be a functional horseback rider when he rides in a Western saddle which enables him to sit independently and utilize the muscles of his lower extremities. In contrast, being bound in an English saddle (or any kind of saddle) is a safety hazard and encourages an undesired attitude of dependence in the rider. In a Western saddle, with stirrup and shoe adjustments if necessary, the cerebral-palsied child can now successfully participate in an active, exciting sport.

Acknowledgments

To Mr. L. C. Collier of Ivy Creek Stables; Mr. R. C. Adams, Director of Recreational Therapy and Adapted Physical Education at the Children's Rehabilitation Center of the University of Virginia Hospital; and Miss Sue Hughes whose assistance made this program possible, we express our grateful appreciation.

Children's Rehabilitation Center University of Virginia Hospital Charlottesville, Virginia