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
About this trial
This is an interventional treatment trial for Post Traumatic Stress Disorder
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
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
NCT ID
NCT02891421
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
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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