Therapeutic horse riding at the RDAD

Twelve-year-old Abdullah Shahid Hasan Khan can barely contain his excitement as he waits at the mounting ramp watching his instructor lead his favourite horse from a nearby stable.

He has been waiting eagerly for this Saturday morning ride all week and his anticipation is palpable as the horse draws closer.

His affection for Tyke, a grey pony, is overwhelming and Abdullah greets him with great enthusiasm. This morning, he needs just a little help from his instructor as he places his foot in the stirrups, holds the reins and mounts Tyke effortlessly.

There is cheering all around, especially from his father, and the young Bahraini boy is mighty pleased by this well-deserved praise.

Straddling a horse may not be a cause for celebration if you have been taking riding lessons for two years like Abdullah. But this is no simple joy ride, nor is Abdullah just another kid pursuing a new sport.

Abdullah has Down's syndrome and the riding lessons he is taking at the Riding for the Disabled Association of Dubai (RDAD) are part of a form of physical therapy that uses the multidimensional movements of the horse to improve posture, balance, mobility and function – particularly in those that have movement dysfunction.

Known as therapeutic riding or equine-facilitated therapy, the horse is used as a treatment tool to achieve a variety of therapeutic goals. The gentle and rhythmic movement of the horse moves the rider's body in a manner similar to the human gait, leading to improvements in flexibility, balance and muscle strength in children with physical disabilities.

For mentally, physically and emotionally challenged children, horse riding is seen as a unique form of exercise and rehabilitation. Besides the therapeutic physical benefits, horse riding and horse-related activities also assist greatly in the development and restoration of personal confidence, self-esteem, communication skills, leadership and trust.

"The ability to control a horse as well as one's own body inspires self-confidence and responsibility," says Astrid Petracchi, a NARHA (North American Riding for the Handicapped Association) Advanced Therapeutic Riding Instructor at RDAD who has more than 21 years of riding experience. "Abdullah is a case in point.

When he began his riding lessons two years ago, he needed two side-walkers and a trainer alongside in his hourly sessions. But today, with just a little help in mounting the horse, he can command the horse on his own, and this has been a tremendous confidence booster for him.

"Often he is perplexed about his ability to reach the goals I set for him, but when he does so, he is amazed and proud that he can do it. His steady and consistent progress is a clear indication of how much more he can achieve," she says.

Riding off into the sunset

His father, Shahid Khan, is quick to testify to the changes he has noticed in his son since he began therapeutic riding lessons at the RDAD. "His progress has been amazing and I am not talking merely about his riding skills.

Overall, his confidence levels have improved. He now knows that there are things he is capable of doing – things he had never thought possible earlier. For instance, he has acquired a good perception of direction – he can turn right or left when the trainer instructs him to. Today, this subtle difference comes to him right away, but it wasn't always so earlier."

He has improved memory too, says Shahid. "Abdullah is now capable of remembering better. The repetition of patterned movements in his riding class, I believe, has subconsciously led to his memory improvement. He has also begun to trust in his abilities. It may sometimes be difficult for him to understand what he has to do, but when he overcomes that challenge, he becomes more confident."

His close association with the horse has also instilled in him a love for animals, says his father. "Abdullah is extremely possessive about his horse and once objected to mounting another one when Tyke had taken ill! He thoroughly enjoys his riding classes and never forgets that Saturday is the day he has his riding lessons."

Abdullah attends the Rashid Paediatric Therapy Centre at Al Barsha in Dubai and it was through the school that his parents came to know about RDAD.

"Abdullah had undergone major surgery on his knee for patella dislocation, a congenital condition associated with Down's syndrome, and the school suggested that riding lessons could perhaps help in his rehabilitation. When we first came to RDAD and saw the children at the training sessions, it never occurred to us that horse riding would not only hone our son's riding skills but also greatly improve his social and emotional skills," says Shahid.

"Abdullah has received immense support from the team – the trainers and volunteers who assist him, and today his dream is to ride alone, and to be able to come and work here when he grows up!"

Different effects

While for Abdullah the benefits of therapeutic riding have apparently been immense, such progress is neither the exception nor is it the rule, admits Astrid. "Each child that comes to RDAD is different; he has his own set of abilities and skills.

By focusing on their abilities and concentrating on what they can do rather than what they cannot, we chart out individual programmes, set realistic goals and work towards achieving them."

It is not only the physical benefits that are important. There are psychological, social and cognitive skills to be gained too, she adds. "For special needs children, horses offer a powerful medium for restoring a sense of personal control, which significantly improves behaviour. Proper etiquette in their behaviour towards the horses, volunteers and the trainers is stressed. At RDAD we believe that setting the right attitude is very important."

From the beginning, riders learn balance, coordination and self-assurance while receiving therapeutic muscle stimulation.

The aim is to improve poise, posture, strength and flexibility, she says. "As the horse moves, the rider is constantly thrown off-balance, and his muscles contract and relax in an attempt to rebalance."The physical benefits come naturally as riding reaches deep muscles not accessible through conventional physical therapy.

The complex movements of the horse consciously or unconsciously use all of the body's muscles. To a person who cannot walk, therefore, riding feels like walking. It exercises and strengthens weak muscles, relaxes and stretches spastic ones, stiffness is decreased and joints are exercised. "Additionally, horse riding requires a great deal of coordination to get the desired response from the horse.

Repetition of patterned movements required in controlling a horse quickens the reflexes and aids in motor planning. As riding 1is also perceived as an enjoyable experience, the rider has increased tolerance and motivation to lengthen the period of exercise."

About RDAD

Set up in 1998 under the patronage of Shaikha Hassa Bint Mohammad Bin Rashid Al Maktoum, the RDAD is dedicated to improving the lives of people with disabilities by providing opportunities for riding.

Currently, on a weekly basis, RDAD teaches horseback riding to 65 special needs students from 15 countries with assistance from 45 volunteers and two certified therapeutic riding instructors.

The RDAD programme caters to children with varied disabilities including cerebral palsy, Down's syndrome, epilepsy, muscular dystrophy and Asperger's syndrome.

"RDAD's volunteers, instructors and riders may not speak the same language," says Astrid, "but our communication is universal as our common goal is to encourage our riders to be the best they can be. In addition, we also have the support of 12 horses on our ‘team'."

Cardigan Bay

Cardigan Bay is one of the horses on the RDAD team. At 20 years of age, many would consider him well past his best riding years.

At the stables, "he seemed a bit of a loner" when 14-year-old Charlotte Hoonhout, a Grade 9 student at Wellington International School, Dubai, first noticed him.

"My heart went out to him," she says. "Spending some time with him at the stables made me realise that he wanted to ride again." Thus, after more than 18 months of riding another horse, Charlotte explains how she switched her loyalties to Cardigan Bay. She now rides him twice a week.

As a child with cerebral palsy, horse riding facilitates and improves her posture, muscle strength and movement while aiding in circulation, promoting relaxation and helping achieve more normal balance.

Riding since the age of seven at her hometown in New Zealand, Charlotte's love of horses has helped her take to riding lessons "like a natural". But unlike her classes at New Zealand, what is different at RDAD is the ample freedom she enjoys while riding.

"I was independent from the start," she says, "and being given this sense of independence made me realise what I am capable of. I am a lot more relaxed mentally, my legs seem stronger and my confidence has grown."

While she continues to improve her riding skills, Charlotte finds that leading her horse is not as easy as it looks. "At turnings or when the horse leans forward even slightly, I can feel the full weight of the animal and then, besides having to supporting his weight, I also have to ensure that
I maintain proper balance."

Currently, Charlotte is learning to mount a horse on her own. "When you watch others do it, you think it's easy," she says. "But it is only when I do it, I realise the challenges involved."

A great workout

"Lifting the leg up is a challenge for Charlotte because of her difficulty with gross motor skills," explains Astrid. "Even when she leads the horse, my concern is about getting the horse to move alongside with her without it causing her to lose her balance."

Simple things that riders take for granted like kicking the animal as an indication to move or stop poses a huge challenge for a child like Charlotte who has poor muscle function and impaired muscle coordination, she says. "She has to concentrate hard on which muscle to move to get her leg to do what she wants it to. For us, it is almost like a reflex, but for Charlotte, it certainly calls for a lot of effort."

However, the rhythmic motion and warmth of the horse may aid in relaxation, especially of the legs and what is encouraging about horse riding is that the benefits occur without the rider being aware of it, says Astrid.

Though Charlotte undergoes regular physiotherapy sessions, she says that with physiotherapy, "I have to work hard. I am forced to concentrate on which muscles to move and I am also aware of how long I need to keep moving those muscles. I also swim to exercise my muscles, but the difference I notice in my strength is subtle.

But riding a horse exercises all my muscles without making me conscious of it and at the end of a riding lesson, I can tell the difference it makes to my body."

According to her father, John Hoonhout, "Personally, I've noticed immense improvement in Charlotte in the past two years. It is a meaningful and constructive activity that improves overall body fitness and contributes to better mental well-being.

Horse riding is not only helping her with physical fitness but is also boosting her confidence levels."

A boost of confidence

Many a time, not having to be in a wheelchair or on crutches increases the child's sense of independence and freedom, says Astrid. "It allows the child to go to places that are otherwise inaccessible because of the disability. Just like any of us, for a special needs child too, exercising the spirit is as important as exercising the body, for it raises their self-esteem and motivation.

Here, at the Desert Palm where we conduct our classes, there is lush greenery all around and there are plenty of birds and animals, which is so unlike the ambience of a clinic or therapy room. All this certainly helps to promote a sense of well-being."

Mastering a skill, generally performed by able-bodied people, is a great confidence builder as it instils
a sense of achievement and makes the child aware of his or her own abilities. "Just being able to control an animal that is much larger and stronger than oneself is seen as a highly positive experience. Horse riding also involves risk-taking, again an added beneficial aspect."

But most important, Astrid believes that the excitement and experience of riding stimulates the rider, encouraging the child to speak and communicate. "We had a completely non-verbal child who, at the end of two years, could say the name of his horse, and give it monosyllable instructions as well.

"For those confined by a disability, the world tends to shrink in size. But riding opens a new vista, and allows them to explore a whole new world. It increases interest in what is happening around the rider and creates an increased awareness of oneself."

Taking riding lessons also offers the scope for making new friends as children get the opportunity to interact with other children as well as with the volunteers and trainers. "Off the horse, children are also taught various aspects of horsemanship such as grooming and tacking up their own pony before and after riding," she says.

"Horse riding fosters a deep emotional bond between the rider and the animal, inculcating respect and love for animals in general. By caring for their own horse, they also learn to put the needs of the horse first and to take responsibility for the animal.

Besides the fun part of riding a horse, understanding the nature of the animal, as well as learning to be a considerate rider, goes a long way in helping build a positive self-image, sense of responsibility and increased self-confidence. And these are all qualities, says Astrid, which will serve them well as they meet their challenges in life.

As Charlotte explains, "Horses do not discriminate just because you have a disability. You can be very free with a horse; they allow you to be your natural self. All horses are different, and each has a different personality.

My horse knows when I need him to do something like trot, stop or move. And I believe that I've found another friend in him."

Educational aspect

Although she trained specially at the North American Riding for the Handicapped Association (NARHA), Astrid Petracchi's riding history began at the tender age of six in her hometown in Austria. "The riding lessons created by the instructors are specifically drawn up to help each individual child," she says.

"Horse riding is not only therapeutic but also recreational. Our primary objective is to make a difference in the daily lives of the children who come here by giving them an opportunity to ride and enjoy activities connected with horse riding. Mastering a skill or learning something new is coincidental to the fun they have during riding sessions.

"The kinesthetic nature of this programme wherein children learn by actually carrying out a physical activity, rather than being taught via lecture or demonstration engages children more quickly and will hold their attention long after the session is over.

"Besides the pure pleasure of riding, we also develop activities to enhance the child's experience when riding, combining it with an educational approach. Our lessons are specifically designed for each child. They are tailored based on his or her abilities, and are intended to boost additional skills.

For instance, throwing and catching ball helps with balance while riding and attempting to catch at the same time improves coordination skills.

Children are also taught to pick up rings from T-bars and then hang them on to other objects, which is an excellent mode of stretching and reaching forward. It is a fun way of exercising your muscles without consciously being aware of it."

Another favourite with the children, she says, is steering games that improve left and right coordination. Here, children need to use their reins in order to go left or right and also to stop a horse. Visual sequential memory skills are developed by playing memory games and teaching the riders to follow a particular course, which they need to remember and later ride on their own.

Musical games encourage the kids to both listen and
follow the rhythm to do various activities. Teaching children to
recognise the differences in shapes, sizes and even colours becomes easier when taught on horseback as part of games and activities.

Says Astrid, "Such activities aid in improving visual spatial perception. Children tend to imbibe the concepts easily as there is less resistance to learning when it becomes part of a riding lesson.

The children are sometimes encouraged to search for the hidden grooming tools of the horse. This technique naturally arouses curiosity and directs the thoughts to the specific uses of these tools."

Children are also encouraged to come up with their own games. Anything that would benefit them in their daily lives is stressed upon, she says. "The challenge, ultimately,
is to get them to become independent riders."