Horses and healing
September/October 2012 California Bountiful magazine
Story by Jennifer Harrison
Photos by Paolo Vescia
Not far from the bustle of the city, agriculture and hope meet to change lives.
Charlie Wonnacott, with his grandmother Donna and father Bruce, beams after a therapy session that includes riding backwards on hands and knees to develop balance.
Charlie Wonnacott likes to ride horses—even backwards on his hands and knees. This is quite a feat for Charlie. Born three and a half months early and weighing only 1 1/2 pounds, his chance for survival was questionable. The 5-year-old beat the odds, but needs extensive physical therapy to develop his neuromuscular system—nerves and muscles that, when working together, move the body.
Charlie's father says that time spent on a horse is one method being employed to help Charlie overcome the obstacles of a premature birth.
"I don't have the scientific evidence, but my intuition tells me this is a good approach," said Bruce Wonnacott as he watched Charlie circle the covered arena on a red quarter horse under the watchful hands of several assistants.
Gari Merendino directs a center where horses offer physical and emotional therapy.
There actually is a science behind the approach, and it's called hippotherapy. Hippo—derived from the Greek hippos, meaning horse—is literally using the horse as a treatment tool. In Charlie's case, the horse is helping him develop his senses, and strengthen and use his muscles.
"It's all about the abdominal muscles, about rhythm and coordinating the body and the brain," his father said.
Charlie is finding his rhythm thanks to the National Center for Equine Facilitated Therapy, an internationally recognized leader in the field of hippotherapy.
Nestled on 12 serene acres in Woodside, not far from the buzz of Silicon Valley, NCEFT has used horses as healing instruments for 41 years. Clients are those with neuromuscular, cognitive or sensory disorders, and range from children with autism, cerebral palsy or Down syndrome to injured veterans or adults with spinal cord injuries or conditions such as multiple sclerosis.
Charlie has been coming to the state-of-the-art facility since he was a toddler.
"We have an age range of 2 to 90 years here," said NCEFT Executive Director Gari Merendino. The center treats about 85 patients a week.
While the idea of hippotherapy was documented by the ancient Greek physician Hippocrates, the concept was not formalized until the 1960s in Germany, Austria and Switzerland, where it was used in addition to physical therapy. Hippotherapy was introduced a decade later in the U.S. and is now recognized as standard practice by organizations including the American Physical Therapy Association.
How does it work? As the horse moves, either walking or cantering, it provides motor and sensory input to the rider.
"As we are sitting astride a horse, our pelvis moves as if we were walking," explained NCEFT Program Director Chris Swan, a physical therapist and hippotherapy specialist.
Physical therapist Chris Swan (in purple) and Jess Draener offer Charlie plenty of hands-on support.
For example, if you have difficulty walking, the horse's movement helps train or retrain your neuromuscular system. Riders are at first seated, but like Charlie are often put in different positions, and the neuromuscular system then must react to the horse's movement.
"Your system has to process it, react to it, fire the correct muscles, put a hand out to protect yourself from falling over," Swan said.
Hippotherapy also helps the brain filter information, which is important for people with autism or cognitive issues.
"Coordinating the balance system with the visual system and the input of the pounding of the horse—this is called the proprioceptive input—helps them focus on what is going on," Swan said.
Jacques Rivet meets Sebastian the horse under the watchful eye of occupational therapist Liz Kallinsky.
Success stories can be dramatic, especially when it comes to injured veterans. In one case, a Marine wounded in Iraq, with no experience on a horse, arrived at NCEFT reluctant and doubtful an animal could help him.
"He wore a knit hat because he had a big scar on his head, he couldn't use the right side of his body and he walked with a three-pronged cane," Merendino recalled.
For veterans with traumatic brain injuries, post-traumatic stress disorder or other injuries, horses are used for treatment, teaching and emotional support. NCEFT's goal? To create independence for them. According to Swan, the experience helps improve many aspects of the veterans' health, including memory, decision-making skills, thought organization and body awareness.
As for the reluctant Marine, one year on the horse changed his life.
"When he left here, he never wore a hat, proud of his scar," Merendino said. "He could shake your hand, walk on his own, actually could drive a car."
Maintaining the horses' health and care is a priority at the center, where photos help identify the proper food and medication for particular animals.
Not every horse has what it takes to make it as a therapeutic animal. NCEFT now has about 15 horses at its facility, and most are donated.
"Only 1 in 50 horses work," Merendino said. Age, temperament, size, gait and breed all are taken into consideration.
Older horses—from 10 to 17 years—fare better than younger animals. And horses that have a relaxed but confident disposition—often draft and quarter horses—are best.
The horse can't be too big or small—handlers and assistants need easy access to horse and rider—and gait must be steady and consistent.
It also takes a special horse that can "tap into the rider" and remain calm, whether that rider is an upset child or a nervous, fidgety adult.
"The horse has to be able to tell exactly how you feel by not talking to you; it needs to understand by how you move around them, how you smell and how you act," Merendino said.
The therapeutic horses at the center are treated like other horses; they're ridden on local trails and have time off from "work" every nine weeks.
Some people don't view the horses' role simply as therapeutic, but closer to miraculous.
Casey Terribilini, 56, sits proud and tall, his cowboy boots dangling, on a majestic quarter horse named Buddy. He rides at the center twice a week and is pushing his instructors for more. In an ironic twist of fate, Terribilini, a 20-year member of the NCEFT board, suffered a spinal cord injury at a riding event and was initially paralyzed from the chest down.
Cole Hetherington enjoys a trail ride at the center near Silicon Valley.
"I've been involved in horsemanship my whole life and just out of a fluke, instead of raising money for this place, now I'm a patient here," he said.
A chiropractor, Terribilini said he is noticing the benefits of hippotherapy firsthand, including core stability, balance and position of body in space.
With the help of the center's staff, Dominic Thomas performs gymnastic-like maneuvers known as vaulting to increase balance.
While he has encountered therapists and surgeons who have told him to get used to the wheelchair, Terribilini thinks otherwise.
"They don't take into mind I'm that 'what the mind perceives, is what the body is going to achieve' kind of person," he said.
His goal? To walk again.
"Normal, or as close to it as I can," he said. "I'll probably end up with an interesting cowboy swagger at some point."
How horses heal
Horses provide physical and occupational therapy for those with special needs. Here are various ways horses are used for healing at the National Center for Equine Facilitated Therapy in San Mateo County.
A chiropractor, Casey Terribilini said he is noticing the benefits of hippotherapy firsthand.
Hippotherapy: A horse's movement is variable, rhythmic and repetitive. This can help improve a person's neurological function (how the nervous system processes stimuli) and sensory processing. The patient adjusts to the horse's movement, which helps improve core strength and control, balance, posture, endurance and more. This therapy is used for people with neuromuscular disorders and other disabilities.
Therapeutic riding: Programs focus on the unique relationship between a person and a horse. Learning about horses—how to ride and care for them—has been found to increase confidence in those with social, emotional and learning challenges.
Interactive vaulting: Vaulting is gymnastics on horseback. Patients participate in a group activity that promotes team spirit, peer activity and sportsmanship.
Therapeutic driving: Patients control the horse while seated in a carriage behind the horse. Used for people who are unable to ride a horse, carriage driving can provide the physical and emotional support that comes with traditional hippotherapy.
Veterans program: Active-duty personnel and veterans learn about horses and horseback riding. This can provide both physical rehabilitation and emotional support to wounded soldiers.