1. The document summarizes a study that examined the effects of 12 months of therapeutic horseback riding and exercise on strength, postural control, and cognitive function in a veteran with anoxic brain injury. 2. One male veteran participated in the study, receiving therapeutic horseback riding sessions once per week for one hour and therapeutic exercise sessions twice per week for one hour over the course of three years. 3. Results showed improvements in the participant's muscular endurance, strength, postural control, cognitive function, and circumference of various body parts, as well as positive reports from caregivers on his mobility and engagement in community activities.

1. Acknowledgements
Results and ConclusionsPurpose
Therapeutic Horseback Riding
Discussion – Quality of Life in Community
Methods
Participant
The Effects of 12-months of Therapeutic Exercise and
Horseback Riding on Strength, Postural Control, and
Cognitive Function in Anoxic Brain Injury
Louisa A. M. Summers¹, Ph.D. and Maria Sebastiani. B.S.2
¹Department of Exercise and Sports Science,
2 Department of Occupational Therapy
Eastern Kentucky University, Richmond, KY
We would like to acknowledge the following for
their help in making this research possible:
Ms. Nancy Adamson, Mr. Christopher Perry
Mr. Codie Monhollen, & Ms. Kaitlyn Krizman
College of Health Sciences
Provost’s Office for Academic Affairs and
Students Success Office
EKU Department of Veteran Affairs
To Examine The Effects of
Therapeutic Horseback Riding
(THR) and Therapeutic Exercise
on Muscular Strength,
Endurance, Postural Control, and
Cognitive Function in One
Veteran with Anoxic Brain Injury
One male participant, aged 28
• Active duty Army January 2005 – until injury
November 22, 2008
• 14 months in Iraq – Oct 2006-November 2007
• Specialist 11 Bravo (509th infantry - Ft. Richardson
Alaska)
Injury – Aspiration Pneumonia
• 4 hours later in the ER went into cardiac arrest
• Intubated: first 2 attempts failed, 3rd successful
• Loss of oxygen to brain caused Anoxic Brain Injury
• Two years post injury at start of THR
• Inpatient – Dec 2008-April 2009- Shepherd Center (GA)
• Inpatient - April 2009 – May 2010- Tampa Bay (FL) VA Hospital
• Home PT/OT/Speech therapy – June 2010-June 2011
• Outpatient PT/OT– July 2011-Sept. 2012- Cardinal Hill (KY)
Rehabilitation
1. Muscular Endurance
• Time on Horse
• Postural Support Needed on Horse
2. Muscular Strength
• Number of lateral steps taken with support
• Sitting time
3. Anthropometric Measures
• Forearm, Arm, Thigh circumference
4. Cognitive Function – Mini-Mental State Exam
(Copeland, Abou-Saleh, & Blazer, 2002).
Year Beginning of the season End of the season
2010 7-17-2010 11-19-2010
6 sessions 30 minute ride 45 minute ride
Needed full trunk support – 14”
peanut ball
More erect over ball
2011 6-22-2011 11-16-2011
8 sessions 20 minute ride 45 minutes
Hands on 3” PVC pipe over the
horn of Western Saddle
Hands on 3” PVC pipe
fitted over the horn
Moderate support with side
walkers on both sides
Minimal assist with side
walkers
Stood in stirrups 3 times Not Standing – tremors
on/off
Commands “Whoa” and “Walk on”
2012 2-17-2012 10-19-2012
10 sessions 45 minute ride 50 minute ride
Hands on 3” PVC pipe over the
horn of Western Saddle
Hands on 3” PVC pipe
over the horn of Western
Saddle
Added Riding Vest for trunk
stability
Ability to sit up straight
Moderate support with side
walkers
Moderate support with
side walkers
Clonus and tremors Stood in saddle 4 times
Reaching and grasp for objects Lateral movements
Commands “Walk, Whoa, Walk”
Year Beginning of the season End of the Season
2013 3-08-2013 10-13-2013
11 sessions 25 minutes 60 minute ride
Hands on 3” PVC pipe
fitted over the horn of
Western Saddle
Erect
Two Side walkers with
minimal support
No support on Needed
on Left side;
Minimal support on
Right side
Reach and Return
without support
Legs stiff Stand in saddle 7 times
Twice per week
(2 sets , 5-12 repetitions)
Once per week
(2 sets , 5-12 repetitions)
Standing Squats (with
support)
Bridges (on mat table)
Back Extension (in
wheelchair)
Crunches (on mat table)
Shoulder Flexion (front
raises)
Prone press up (on mat
table)
Shoulder Abduction (side
raises)
Reverse Flys
Shoulder Press (with object
in hand)
Wrist Extension
Hip Flexion (standing) Hamstring Stretch (on mat
table)
Crunches (in chair) Butterfly stretch (on mat
table)
• Therapeutic Exercise at a local University with
Professor – 2/week for 1 hour with Professor
• October 2012 - May 2013
• Home based Therapeutic Exercise
• May 2013 – Present
• Therapeutic Horseback Riding – 1/week for 1
hour; March – November
1. Increased total sitting time from 2 minutes (with
minimal support) to 16 minutes without support.
2. Increased number of lateral steps taken from 2 to 10.
3. Mini-Mental State Exam – 14.0 in July & October 2013. .
Therapeutic Horseback Riding - Outcomes
• Increased Time on Horse
• Increased Postural Control
• Increased Ability to Stand in Stir-ups
• Increased Ability to Reach and Grasp Objects
Methods-Outcome Measures
1. “Easier to transfer”
2. “He has better control of his
movements”
3. “More alert, laughing, very
attentive on the horse”
4. Improved postural control and
stamina has allowed the veteran to
take part in community events such
as: golf, bowling, baseball games,
and climbing.
Therapeutic Exercise Circumference (cm) June 7, 2013 October 7, 2013
L Bicep 30.5 31.0
R Bicep 30.5 32.0
L Forearm 25.5 26.6
R Forearm 25.5 27.2
L Quad 46.0 47.5
R Quad 46.0 48.0
Anthropometric Measures
Other Comments