There are a wide range of local and regional needs for Necarne. Most of these relate to physical and mental wellbeing. Most are well understood and accepted, exercise releases endorphins which makes us feel good and our bodies benefit physically in endless ways. A beautiful inspirational environment in which to exercise or relax adds value to the experience. For walkers, horse riders, runners, cyclists, scouts, festival or event goers we generally understand Necarne has a huge value to wellbeing.
However there is another huge potential in Necarne – hidden benefits for our hidden needs….
Medical Evidence that Necarne Facility can Meet a Wide Range of Local Needs.
NICE, National Institute for Health and Care Excellence quotes has many references to evidence of equine therapy including for those with;
learning disabilities, depression, anxiety, chronic psychiatric inpatients, mental Health and behavioural disorders. cerebral palsy, at risk young people, enhance options for social workers, enhancing adolescents’ communication and relationship skills, enhancing children’s and adolescents’ emotional, social and behavioural functioning, equine assisted social work, occupational therapy gross motor function, ADHD, dyspraxia, posture, balance, sensory disorders, multiple sclerosis, hope and depression in at risk adolescence, neurodisablity, rehabilitation of people with alcohol misuse, drugs and drug addiction, and prevention of relapse after depression.
“Animal-assisted therapy has shown evidenced-based efficacy in patients with depression3, anxiety4, attention-deficit/hyperactivity disorder5, conduct disorders6, dissociative disorders7, Alzheimer’s disease8, dementia9, autism10, and other chronic mental illnesses11,12.
In light of research and observational findings, experts suggest that Equine Therapy—a common form of animal-assisted therapy–may yield a variety of psychotherapeutic benefits:
Confidence: The learning and mastery of a new skill—horsemanship–enhances patients’ confidence in their ability to tackle new projects, such as recovery, and leads to improved self-esteem.
Self-Efficacy: Learning to communicate and achieve harmony with a large animal promotes renewed feelings of efficacy. A motivated “I can do it!” replaces feelings of helplessness and amotivation, empowering the person to take on challenges in other areas of recovery.
Self-Concept: Riding helps patients to develop a more realistic view of themselves through awareness of their size in relation to the horse. This is especially important in treating patients with eating disorders as well as those with interpersonal aggression problems.
Communication: Horses’ sensitivity to non-verbal communication assists patients in developing greater awareness of their emotions, the non-verbal cues that they may be communicating, and the important role of non-verbal communication in relationships.
Trust: Learning to trust an animal such as a horse also aides in the development, or restoration, of trust for those whose ability to trust has been violated by difficult life experiences such as physical or sexual abuse, abandonment, neglect, or marital infidelity.
Perspective: Through grooming activities and other types of care for a specific horse, patients are able to put aside the absorbing focus of their mental illness, such as depressive ruminations, and instead to direct their attention and interests outwardly toward safe and caring interactions.
Anxiety Reduction: Many studies of human-animal interaction indicate that contact with animals significantly reduces physiological anxiety levels. Some patients are initially afraid of horses. But horses’ genuineness and affection allay these fears, helping patients to embrace exposure therapy for their anxiety issues.
Decreasing Isolation: For many individuals with mental illness, there is a long-term or recent history of feeling rejected by, and different from, other people. Mental illnesses are intrinsically isolating experiences. The horse’s unconditional acceptance invites patients back into the fellowship of life.
Self-Acceptance: Many patients are initially concerned that they will do something embarrassing while learning about or riding the horses. Yet patients quickly learn that the other participants are engaged in their own equine experiences, and they observe the comfort of the horses in their own skin. Fears of embarrassment in public are thereby often reduced and self-acceptance increased.
Impulse Modulation: Particularly for those whose mental illness involves the experience of lost control over impulses, the need to communicate with a horse calmly and non-reactively promotes the skills of emotional awareness, emotion regulation, self-control, and impulse modulation. Research clearly indicates that animal-assisted therapy reduces patient agitation and aggressiveness and increases cooperativeness and behavioural control.
Social Skills: Many individuals with mental illness are socially isolated or withdrawn. A positive relationship with a horse is often a first, safe step toward practicing the social skills needed to initiate closer relationships with people.
Assertiveness: Communicating effectively with a horse requires the rider to demonstrate assertiveness, direction, and initiative, important skills that enable the patient to express their needs and rights more effectively in other relationships.
Boundaries: Many patients have experienced prior relationships as controlling or abusive. Healing takes place as patients discover that riding occurs within the context of a respectful relationship between a rider and a horse, and that, although physically
powerful, each horse typically operates within the boundaries of this mutually respectful relationship.
Creative Freedom: Many persons with mental illness have been emotionally inhibited or over-controlled, and have lost some measure of spontaneity. The playful aspects of riding and team equine activities can help restore spontaneity and an ability for healthy recreation and play.
Spiritual Growth: Through Equine Therapy trail rides, patients have a unique opportunity to encounter the outdoors from a new perspective. Feelings of joy and spiritual connection are often discovered or revived as patients experience the earth’s beauty in a renewed way”
“Equine therapy is used to help victims of domestic violence, at-risk youth, people with addictions or eating disorders, and more. “Almost every mental health condition is being helped by equine therapy somewhere now,”
“The North American Riding for the Handicapped Association (NARHA) certifies close to 750 equine therapy programs nationwide. Children with ADHD are among those who can benefit from these programs”
“Evidence shows that equine therapy helps people with anxiety, depression and other emotional challenges to build trust and confidence, improve physical wellbeing, and enhance social skills. The bond between horse and rider has proven highly therapeutic for many people who may otherwise find it difficult to communicate with others”.
“The equine is a critically important partner in the work of EFP. The equine’s prey nature and intense sensitivity to subtle changes in their environment make them perfect partners for professionals who teach a wide range of life and coping skills”
Health professionals say horses can reflect our emotions to bring relief from addiction and stress
Not just horsing around … psychologists put their faith in equine therapies
There are many references to evidence the role of Equine Assisted Therapy in Suicide Prevention such as this report. There is a wide range of reports showing how Equine therapy is a successful intervention with ‘at risk’ young people and those experiencing PTSD.
There are endless references to solid evidence of effective positive outcomes from Equine therapy for many and varied issues. Apart from those above there is also potential for much needed interventions for others, such as those affected by domestic violence, eating disorders and bereavement – many of the unmet needs in Fermanagh area.
There is clear evidence ( samples above and in Appendix A) from experts across the world of the benefits of equine therapy and there is also solid evidence of extensive local needs in both young people and adults in Fermanagh to justify that priority should be given for Necarne to be opened as an equine centre that can meet needs of our most vulnerable adults and children. There is clear potential for Necarne to develop for health and well being tourism which would provide both for local needs and attract visitors seeking wellbeing in a beautiful environment, if the council open up to the health and wellbeing needs and professionals who should be involved in the future of Necarne.
There are many local people who use the area to walk their dogs and important health and recreation for the local community which would be detrimental for them and their health and wellbeing to lose it.
There are many other groups which could be accommodated , if the process were opened up and a scoping exercise of local needs undertaken. The first priority should be meeting local needs of vulnerable children and adults and those with challenging health issues and disabilities.
Other local and regional gaps which Necarne as an equestrian facility could address:
There is no special olympics riding club facility in Fermanagh, there are many young people with disabilities in Fermanagh who would love to take part in this training and opportunity but there is no facility which can cater for this – the nearest is in Omagh but this is too far for the young people and their families or carers to be able to attend regularly.
There is no access to BHS (British Horse Society) training facilities in entire region – only Belfast or Dublin provide training and examination bases. The BHS provides the best and most internationally recognised exams in the world. These popular courses and exams greatly assist rider development and the industry, but neither training nor exams are provided in this region. However there were at one time in the past, provided at Necarne.
We have an Equine college locally and Necarne is a top facility but there is little opportunity to develop equine employment opportunities locally so we are losing all young people trained at CAFRE in equine management to other areas or abroad. Necarne must be developed and retained as an equestrian facility and elected representatives must now represent the needs of the community to ensure, after millions spent creating this top equestrian facility, it remains as an equestrian facility that the community can avail off.
Understanding Hippotherapy by Lauren Tate
Hippotherapy (‘hippo’ from the Greek, meaning horse) is a physiotherapy treatment using the movements of a horse to achieve the desired responses in a client, depending upon their disability. They can be placed upon the horse in a variety of positions, and they accept the movement of the horse passively. The horse acts as a dynamic base of support on which the client can coordinate and control their movements.
Hippotherapy is performed by a qualified Physiotherapist who has undertaken approved training, and can apply musculoskeletal, neuro-developmental and sensory integration techniques to help develop balance and postural reactions.
To ensure the client is safe and comfortable at all times the Physiotherapist will work as part of a team with a horse handler – who either leads or long reins the horse and on instruction from the Physiotherapist, will control the pace and movements of the horse to suit the clients personal needs. A side walker may assist the Physiotherapist, walking alongside the client on the moving horse.
Who Can Benefit From Hippotherapy?
Hippotherapy will not suit everyone, as with all other therapies
the individual needs of the person, and which elements would be the most beneficial. As always there should be in-depth discussions with a health care provider, as well as a qualified physiotherapist before beginning.
Hippotherapy can benefit people with both physical and cognitive disabilities, below are only some examples of the medical conditions and disabilities that Hippotherapy can help:
Autism spectrum disorders
Cerebral vascular accident (a stroke)
Learning or Language Disabilities
Personal Injury (e.g. damage to the body/mind after an accident)
How Does It Work?
Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. The horse has a unique gait
when walking, and this is used to influence a passive
rider sitting generally on its back without a saddle. The gait of the walking horse is three dimensional and when translated through the riders’ pelvis sitting on the horse, resembles the pattern of gait that humans have, very closely. The horse walks with a 4 beat rhythm, with a sequence of 8 steps where the 3 leg stand alternates with a 2 leg stand, on alternate sides of the horse.
The rider experiences movements of posterior/anterior
pelvic tilts (frontal-transversal plane), rotational pelvic movements (frontal-sagittal plane) and side-flexion (coronal-transversal plane) of the pelvis. As the horse moves its legs under its belly the horse back rises and lowers through a flexion/extension pattern of the horse’s spine. This moves the rider up/down (longitudinal axis) and forward /backward within the previously described movements.
The movements of the pelvis are translated upwards along the spine including the head, but they also affect the rider’s hip joints and legs with movements of adduction/abduction, internal/external rotation, as well flexion/extension.
Another benefit of riding the horse is its barrel shaped belly, stretching the often tight hips and legs as well as the horse’s warmth, adding to increased circulation and thus reducing pain often involved with stretching.
Essentially what this means is that although the person may be unable to walk alone, their body is going through physical motions that
are extremely close to those that happen when walking naturally, from the movement of the horse.
Dr. Med Ingrid Strauss from Germany, who has been involved with Hippotherapy for more than 35 years, says:
“Hippotherapy is a physiotherapy treatment for people with upper motor neuron disorders with and on the horse, a child or adult that is unable to walk will be walked without the need of their legs” – (Strauss 2008). Methods that can be used:
Backriding can be performed by a qualified physiotherapist. If the client has poor postural and head control, then the physiotherapist may decide that backriding is a more appropriate intervention.
The physiotherapist sits behind the client on the horse and combines the movement of the horse with facilitation techniques to encourage postural control. The physiotherapist requires both neuro-developmental experience and a high level of horse riding skills.
The Physiotherapist requires a team to back ride – a leader and two side walkers are the minimum requirement. The number of team members required may vary from work place to work place.
Vaulting can be defined as ‘gymnastics upon a moving horse’. By adapting traditional vaulting principles and making client specific goals, therapeutic vaulting can be used within physiotherapy treatment programmes. Vaulting is a multi-sensory activity and provides many opportunities for a client to experience observe and react. Vaulting can be either ground work (rhythm work, warm up) or mounted (barrel and horse).
Therapeutic Riding :
Often undertaken under the auspices of the Charity ‘Riding for the Disabled Association’ (RDA), Therapeutic Riding is mainly conducted in a group setting, led by a Riding Coach and assisted by a Physiotherapist, when necessary.
Working closely together they will use the equines movement with the active riding component of the lesson to stimulate the desired responses in a rider. Having initially assessed the rider, the Physiotherapist can further assist with the riding sessions by advising on manual handling issues, optimal mounting/dismounting techniques and riding session content (such as individually tailored exercises and stretches). Different school movements (e.g. straight lines, circles, serpentines) and changes of pace (e.g. walk, halt, and trot) can be incorporated into a session to further challenge a rider, and get the desired results.
Whilst there are undoubted physical benefits to be had from Therapeutic Riding, it also has strong and positive recreational and psychological elements.
“The therapist makes use of the horses’ unique three-dimensional movement impulses at a walk to facilitate movement responses in patients positioned on the horse” (Strauss, 2000).
‘The simple pleasure of working with horses is the cornerstone of all RDA’s activities. From that starting point everything else flows – be that freedom of movement, gaining confidence, building relationships, receiving life- enhancing physiotherapy or achieving individual goals.
Medical professionals recognise that there are significant therapeutic benefits for the rider. The warmth and three dimensional movement of the horse is transmitted through the rider’s body, gradually making it more relaxed and supple, strengthening core stability, reducing spasms and improving balance, posture and co-ordination.
Riding offers an element of risk, often denied to many people, especially those who have been affected by an accident or serious illness and offers them the chance to regain mobility and a sense of achievement. People with congenital disabilities discover a new freedom in movement. Those with progressive diseases can retain mobility and remain active for longer.’
Denise Robertson is the Head of Therapy at RDA.
She says, “RDA provides opportunities for therapy, achievement and fun and it has multiple benefits for children & adults who participate in activities. There is certainly a huge demand for Hippotherapy.
Therapy at RDA is disguised as fun and achievement. And what’s more fun? Going to a therapy session in a hospital or interacting with a horse?
Therapy is integral to our activities, and we’re very interested to evidence the therapeutic outcomes.”
40% of participants are referred to RDA by a physio or medical specialist, and adults and children with either physical or learning disabilities can take part.
Main activities at the RDA include, but aren’t limited to:
“In a term went from being very unbalanced and needing lots of support to ch
There are various tests, exams and opportunities to compete at the RDA and every year they have their own RDA National Championships, which is the biggest event of its kind in the world. No matter what level – there is always room to improve and compete for everyone that wishes to. They offer a diverse riding experience, every member of the Paralympic team has a relationship with the RDA and they even have Blind show jumpers that compete, which gives out a brilliant message to the young people who attend. This really puts emphasis on their slogan – “It’s what you can do that counts!”
Denise also said, “We would like very much to be in a position to offer more hippotherapy and access to other therapies.
As Head of Therapy I have a back-up panel of experts to help me including the RDA Medical Officer, a clinical psychologist, an OT, a speech and language therapist, a physiotherapist who is also a hippotherapist, an educational psychologist and I represent social work and psychotherapy.
Our aim is to increase the therapists we have within RDA, encourage therapeutic research, train volunteers about therapeutic issues and various disabilities – how to create the optimum learning environment, what language to use to motivate our participants etc. We want to build bridges with other professional therapeutic bodies such as the British Association of Occupational Therapists”.
A unique element of riding at the RDA is the Tracker that has been created by Denise and the Therapy through Horses Expert Panel to assess the therapeutic benefits to RDA participants. Denise said: “RDA needs to demonstrate that it is much more than a leisure club providing pony rides to kiddies, to evidence that we deliver therapeutic and other benefits so that people will understand that RDA provides a service with the potential to transform the lives of people with disabilities”.
The Tracker assesses change in six main areas where many coaches and volunteers thought RDA participation has the greatest useful outcomes:
Relating to others
Two assessments are made, one before riding and the other as sessions are about to close, and the results are plotted on six scales that are imposed over a large and attractive riding rosette. At a glance it is possible to see that the gap between the two assessments represents the amount of change observed in the individual participant, and in what areas they have changed the most.
The Tracker collects observations made by RDA volunteers as well as things that the participant, their parents, teachers or school physiotherapist have noticed.
For instance, a parent of one of the children participating in therapy wrote: ‘Since RDA, whenever my son and husband play together, daddy has to get down on all fours to be the horse.’
Anna Will is a Specialist Physiotherapist with Interest in Child and Adult Neurology; she is also the Chair of the Association of Chartered
Physiotherapists in Therapeutic Riding (ACPTR) and works
closely with the RDA.
About the ACPTR
It is a small professional network group of Chartered Society members, which are keen to develop and support each other in their interest in using the horse in Physiotherapy sessions.
ACPTR has a role in encouraging members who are interested in Hippotherapy and Therapeutic Riding. They aim to support and develop skills for members through training, research and networking opportunities.
They have annual workshops and a biannual international conference. ACPTR has participated in Leonardo projects and is led by a team of volunteer executives, which are
currently all Physiotherapists.
Anna says, “RDA uses the Tracker, an outcome measuring tool of various possible benefits (therapeutic effects) for the riding clients. RDA lessons undoubtedly provide physical and psychological benefits to their clients, which can then be monitored with the Tracker.
The Therapist will use her/his analytical and therapeutic skills to assess the clients’ movements on and off the horse, and provides a specific movement therapy considering the speed, pace and directions of the horse’s gait – whilst changing the clients’ position and posture on the horse.
I work a lot with post-surgery cerebral palsy children, and often parents ask me if their children would benefit from Personal Trainer Fitness sessions instead of Physiotherapy. This is a similar situation; some clients do well with additional gym/RDA sessions, whereas some will benefit greatly from specialist therapeutic Hippotherapy sessions!
I am highly specialised in Cerebral Palsy and use NDT and Hippotherapy with most of my children. From my point of view as a Physiotherapist I gain a lot of “mobile trunk control” through Hippotherapy using additionally my NDT skills”.
One of the parents of a child that Anna has helped through the use of Hippotherapy said:
“Her hands are more open and all movements are gentler. She has fewer spasms around her hands and arms. When supported around her shoulders she plays more gently with her hands in midline. She was able to lift her stacking cups, and her head is generally more up throughout the day and for longer periods at a time. Her legs and generally her whole body are more relaxed. She has less spasms when excited, or in less supportive seating.”
Hippotherapy and How It Can Help.
Hippotherapy can help both congenital (born with) and acquired (gained during life) disabilities. This includes things like head trauma, and paralysis – that can be acquired through personal injury, and it can also help musculoskeletal conditions and spinal cord injury.
Other Disabilities Hippotherapy can also help are:
Sensory Processing Disorders
†Traumatic Brain Injury
Global Development Delay
Lynne Munro is the Shropshire County Physiotherapist for RDA and RDA Regional Physiotherapist for West Mercia, North and South Wales RDA Regions. She is also Research Officer for the Association of Chartered Physiotherapists in Therapeutic
Riding (ACPTR) and was previously the Chair, as well as the ACPTR representative on the RDA Coaching Committee. She is self-employed and works closely with the RDA, practicing Hippotherapy with children at Perry RDA and Clwyd Special Riding Centre.
She mostly works with children, although she works with adults and older people too, but the majority of her clients are children with disabilities – the majority of which have Cerebral Palsy.
She said, “This kind of physiotherapy is unique because when the children come to ride a horse, they don’t think or feel like they are going to physiotherapy, opposed to attending a session within a hospital or clinic for example. For children this is a ‘normal activity’ and most people who have tried hippotherapy want to carry on with it
The main difference is the size difference, you can assist people with various positions on the horse which sometimes in adults can be difficult – with children there is a greater versatility in terms of what you can help them achieve on the horse.
One of my main aims is to promote independent trunk control, which leads to them having free hands to enjoy playing (as opposed to feeling unsteady on a chair, for example, and using their hands to hold on); this in turn gives them a better quality of life and allows them to enjoy it more”.
After doing a survey, the main things the parents said they had seen improvements in were:
†More willing to try new activities
Balance when walking
Sitting up themselves
Boost in their child’s self esteem
As well as many more physical and emotional differences, that would not have occurred without the practice of Hippotherapy.
Scientific Evidence Hippotherapy is Effective
Although there are various ways of proving that Hippotherapy has been very beneficial to a variety of people with a diverse range of disabilities, there have been systematic reviews carried out to find scientific evidence that this form of therapy can be effective on those suffering with Cerebral Palsy.
This is a systematic review incorporating both meta-analysis and meta-synthesis to examine the effectiveness of Hippotherapy, and therapeutic horse riding on Cerebral Palsy. This review was carried out as part fulfilment of the MSc (pre-registration) Physiotherapy course at Robert Gordon University by Hannah Neve and supervised by Valerie Cooper.
There has also been a very similar systematic review done on the effects of Hippotherapy on those suffering with Multiple Sclerosis: Does Hippotherapy improve balance in persons with multiple sclerosis: a systematic review.
Equine Science graduate Sarah Rainford also won Equine Dissertation of the Year, with her winning thesis entitled: “Can a Thirty Minute Hippotherapy Session Significantly Increase the Range of Motion of Four Joints in Five Physically Disabled Children over an Eight week period?”
A main association to know when considering Hippotherapy is
The Federation of Horses in Education and Therapy International (HETI).
‘The Federation of Horses in Education and Therapy International AISBL was founded in 1980 and is registered in Belgium as a non-profit organization. Our mission is to facilitate the worldwide collaboration between organizations and individuals whose objectives are philanthropic, scientific and educational in the field of equine assisted activities.
Physical disabilities – ranging from cerebral palsy to accidental injury, cognitive difficulties and disabilities, mental illness, autism, developmental delay and emotional disorders have all responded positively to equine facilitated activity. The bond that develops between human and horse also opens up many new opportunities, such as independence and responsibility’
Improvement in joint mobility,
Balance and coordination
Changes in muscle tone
Increased self-confidence through improved self-image
Improved learning, concentration, spatial awareness
An incentive and opportunity to take responsibility and control
The transfer of learning outcomes in an equine environment to daily living skills
Motivation to set and achieve goals
Improvement in joint mobility, balance and coordination Changes in muscle tone
Increased self-confidence through improved self-image Improved learning, concentration, spatial awareness
An incentive and opportunity to take responsibility and control
The transfer of learning outcomes in an equine environment to daily living skills
Motivation to set and achieve goals
Their Vice President, Jennifer Dixon-Clegg, is also the Director of The Fortune Centre of Riding Therapy (FCRT)
‘The Fortune Centre of Riding Therapy’s mission is to enable
horse-motivated students with special needs to relate more
successfully to others and to have greater and more
appropriate control over their own lives. This use of horses, to
enable young people to learn and develop, is the core of our work. It is the reason for The Fortune Centre of Riding Therapy’s existence and has been the mission since the foundation of the work in 1976.
Jennifer said, “We predominantly use Equine Facilitated Education and Therapy. More and more physiotherapists are looking into Hippotherapy, and the RDA works closely with professionals to give people the physical benefit of movement of the horse on the rider’s body.
The RDA is run largely by volunteers due to limited funding, and they work very closely with the ACPTR to train physiotherapists to carry out this kind of therapy”.
Dr Valerie Cooper (ACPTR) is the RDA’s Grampian & Highland Regional Physiotherapist.
She mainly treats people with poor trunk and head control, and posture or balance issues, and helps a lot of children with Cerebral Palsy – one of the main disabilities Hippotherapy can help. The RDA ask her to come in and help them to assess the riders from a therapeutic point of view, she helps them by advising them on the best way to go forward by assessing the patients individual needs.
However, Valerie also has experience of using Hippotherapy to help rehabilitate adults that have suffered injuries;
“I also help people with personal injuries; I worked with an adult woman who had a bad pelvic injury from running, she was a rider and I helped her get back into it. We also help former riders that have suffered injuries through accidents, and we help to give them the skills and confidence they need to get back on the horse.
I also worked with an adult lady with a traumatic brain injury – so now she has postural instability. She took part in RDA lessons and I helped with the practice of Hippotherapy. We worked together to build up an appropriate programme of activities for her needs, and by also getting therapeutic help it maximises the therapeutic element as well as the riding element.”
One issue that has arisen regarding the practice of Hippotherapy is the limited funding available in order to train physiotherapists in this field.
Valerie said, “We are working really hard to train more people in Hippotherapy, although as there is no NHS funding at the minute it’s really difficult. A few ACPTR qualified physiotherapists have managed to make a case for including hippotherapy in their NHS job plan, however funding cuts mean that these posts are now going. The Brae Centre for Riding for The Disabled has the first ever salaried physiotherapist for riding therapy in Scotland, and we’re trying to get more people qualified to give Hippotherapy to people who would benefit from it”.
Lauren Tate, email@example.com
With thanks to: Dr Valerie Cooper, Jennifer Dixon-Clegg, Lynne Munro, Denise Robertson, Anna Will
FOR THE MORE GENERAL ABLE BODIED NEUROTYPICAL USERS HORSE RIDING HAS MANY BENEFITS as illustrated in the report by the British Horse Society linked here health-benefits-of-riding-in-the-uk-full-report-2