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Therapeutic Horsemanship in Veterans

Primary Purpose

Post Traumatic Stress Disorder, Traumatic Brain Injury

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Therapeutic Horseback Riding
Standard Care
Sponsored by
University of Missouri-Columbia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Post Traumatic Stress Disorder

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Other

    Other

    Arm Label

    Therapeutic Horseback Riding

    Standard Care

    Arm Description

    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

    Participants received standard care.

    Outcomes

    Primary Outcome Measures

    Change in Coping Self-Efficacy Scale (CSES)
    26 item, 11 point analog scale
    Change in Post-Traumatic Stress Disorder Checklist-Military Version (PCL-M)
    17 item, 5 point scale

    Secondary Outcome Measures

    Change in Social and Emotional Loneliness Scale for Adults (SELSA) scale
    15 item, 7 point Likert-type scale.
    Change in Difficulties in Emotion Regulation Scale (DERS)
    36 item, 5 point Likert-type scale

    Full Information

    First Posted
    September 1, 2016
    Last Updated
    September 1, 2016
    Sponsor
    University of Missouri-Columbia
    Collaborators
    Harry S. Truman Memorial Veterans' Hospital, Horses and Humans Research Foundation
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02891421
    Brief Title
    Therapeutic Horsemanship in Veterans
    Official Title
    Effects of Equine Assisted Activities on PTSD Symptoms, Coping Self-efficacy, Emotion Regulation, and Social Engagement in U.S. Military Veterans
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2016
    Overall Recruitment Status
    Completed
    Study Start Date
    May 2013 (undefined)
    Primary Completion Date
    February 2015 (Actual)
    Study Completion Date
    February 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of Missouri-Columbia
    Collaborators
    Harry S. Truman Memorial Veterans' Hospital, Horses and Humans Research Foundation

    4. Oversight

    5. Study Description

    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.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Post Traumatic Stress Disorder, Traumatic Brain Injury

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    38 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Therapeutic Horseback Riding
    Arm Type
    Other
    Arm Description
    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
    Arm Title
    Standard Care
    Arm Type
    Other
    Arm Description
    Participants received standard care.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Therapeutic Horseback Riding
    Intervention Description
    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.
    Intervention Type
    Other
    Intervention Name(s)
    Standard Care
    Intervention Description
    Standard Care: Participants received standard care
    Primary Outcome Measure Information:
    Title
    Change in Coping Self-Efficacy Scale (CSES)
    Description
    26 item, 11 point analog scale
    Time Frame
    Day 1, 3 weeks and 6 weeks
    Title
    Change in Post-Traumatic Stress Disorder Checklist-Military Version (PCL-M)
    Description
    17 item, 5 point scale
    Time Frame
    Day 1, 3 weeks and 6 weeks
    Secondary Outcome Measure Information:
    Title
    Change in Social and Emotional Loneliness Scale for Adults (SELSA) scale
    Description
    15 item, 7 point Likert-type scale.
    Time Frame
    Day 1, 3 weeks and 6 weeks
    Title
    Change in Difficulties in Emotion Regulation Scale (DERS)
    Description
    36 item, 5 point Likert-type scale
    Time Frame
    Day 1, 3 weeks and 6 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    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
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Rebecca A Johnson, PhD
    Organizational Affiliation
    University of Missouri-Columbia
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    17636720
    Citation
    Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003388. doi: 10.1002/14651858.CD003388.pub3.
    Results Reference
    background
    PubMed Identifier
    11068961
    Citation
    Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000 Oct;68(5):748-66. doi: 10.1037//0022-006x.68.5.748.
    Results Reference
    background
    PubMed Identifier
    19118792
    Citation
    Hakanson M, Moller M, Lindstrom I, Mattsson B. The horse as the healer-a study of riding in patients with back pain. J Bodyw Mov Ther. 2009 Jan;13(1):43-52. doi: 10.1016/j.jbmt.2007.06.002. Epub 2007 Aug 24.
    Results Reference
    background
    PubMed Identifier
    18234750
    Citation
    Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008 Jan 31;358(5):453-63. doi: 10.1056/NEJMoa072972. Epub 2008 Jan 30.
    Results Reference
    background

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    Therapeutic Horsemanship in Veterans

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