Move the horse faster,” urges Manish Rana, juggling the reins of his mount as he watches his younger sibling Anish trot around the park in Bangalore. Manish, 13, is undergoing an equine therapy session under the watchful eyes of his trainer Pushpa Bopaiah, India’s only certified instructor in therapeutic riding. Once astride the big brown horse, Manish, who was born with cerebral palsy, assumes a straight-backed posture, his head steady and eyes smiling. In the 18 months since he began this therapeutic course, the youngster, who earlier walked with a stoop and a shuffling gait, has made steady progress moving about now with greater assurance. “There has been a tremendous reduction in Manish’s spasticity,” says his father Major Jagdish Rana, who ensures that his younger son, Anish, a junior national silver-medallist in equestrian sport, accompanies Manish for these sessions.
Fifteen-year-old Varsha Rao, too, is excited by her 10-minute routine. Also born with cerebral palsy, she mounts the horse with help and rides around the park—her hands on the reins and posture upright. “The course has a lot of ups and downs and she has to be steady. All this has improved her posture and focus,” says her mother Rekha Rao.
Both Manish and Varsha have enrolled at Bangalore’s Healing Horses, a centre for equine therapy set up by Bopaiah, a therapist who trained at Sert, the Special Equestrian Riding Therapy Centre in California.
Bopaiah trains children from age 3 onwards, but only after certifying that the child is fit for the therapy. “Because riding a horse involves moving the body gently and rhythmically in a manner similar to human gait, children with disabilities gain a lot in improved flexibility, muscle strength and balance,” says Bopaiah, who has trained more than 350 children from across the country.
She begins her therapy by encouraging the child to touch and mount a horse. A regular warm–up routine includes stretching exercises such as reaching out to touch the horse’s head or bending backwards, with the child trained to sit upright and independent of a trainer. During each 40-minute module that Bopaiah offers at a choice of two riding institutes in the city, the children loop rings on a long pole while astride a horse, to improve coordination, or play games with coloured balls in a group, among other things.
“I have been using equine therapy for the past seven years, mainly for children with cerebral palsy and other neuro-motor disorders who undergo a surgical procedure,” says Deepak Sharan, a Bangalore-based orthopaedic consultant who specializes in rehabilitation and ergonomics. Children who have undergone a specialist procedure called the “single event multi-level lever arm restoration and anti-spasticity surgery”, devised by Dr Sharan, are offered equine therapy as a post–operative rehabilitation option at Healing Horses. “The excitement of working with a horse creates the enthusiasm and motivation needed for the child to be an active participant in therapy. This improves the outcome of the surgery,” says Dr Sharan, who has treated more than 100 children with this combination of surgery and therapy.
Typically, equine therapy benefits patients with a wide range of disabilities, such as multiple sclerosis, Down’s syndrome, spinal cord injury, attention deficiency, autism and cerebral palsy. However, it should be prescribed by a physician familiar with its risks and benefits. For instance, special care is needed in the cases of children whose conditions lead to tightness in the hips and knees, or those who have suffered hip dislocations.
To ensure that the therapy is well-directed, Bopaiah insists on a recent medical evaluation of the children. For instance, in the cases of children with Down’s syndrome, she insists on an evaluation as recent as 30 days before the start of the session. “Some children with Down syndrome wear a shunt and cannot ride. It is the same for people with scoliosis or arthritis,” says Bopaiah. Healing Horses also does not take children who have had a history of epileptic seizures.
“Equine therapy offers more sensory–motor stimulation and a bond between rider and horse that cannot be simulated artificially in a clinic or with an inanimate horse,” says Dr Sharan.
At present, it is children who are largely benefiting from this therapeutic sport at Healing Horses. The therapy, though, could benefit adults as well, particularly those who suffer from multiple sclerosis, have a spinal cord injury or cerebral palsy. “This is not just sport. There is a human and social need that it fulfils, something that children with special needs benefit the most from,” says Bopaiah.
CURE IN A NUTSHELL
• Therapeutic riding benefits people with muscular dystrophy, cerebral palsy, visual impairment, Down’s syndrome, mental retardation, autism, multiple sclerosis, emotional disabilities, brain injuries, spinal cord injuries, amputations, learning disabilities, attention deficit disorder, deafness, cardiovascular accident/stroke.
• A therapeutic riding course must be preceded by a medical evaluation, in some cases as recent as 30 days before the start of a riding session.
• Therapy is customized for specific disorders. This includes choosing the right horse; for instance, those with rigid muscle tone must ride a horse with a fast gait, while those with lower muscle tone are encouraged to ride a horse with a short stride.
“Organized equine therapy is a 40-year-old concept that began in the West,” says Pushpa Bopaiah, a keen rider who trained as a teacher for children with special needs. A chance introduction to equine therapy during an online surfing session piqued her interest and led her to the website of Narha (North American Riding for the Handicapped Association).
With her credentials she was awarded a scholarship to train at Sert, the Special Equestrian Riding Therapy centre in California that is certified by Narha. At Sert, the training was rigorous with even a skilled rider such as Bopaiah expected to start from scratch.
First off are the lessons in horsemanship that involve caring for and choosing the right mount for each disability.
Once adept at handling horses, students graduate to working with children with special needs. “For instance, if I worked with a child with cerebral palsy in the morning, the noon session would be with an autistic child and the evening session with a Down’s syndrome child,” says Bopaiah.
Riding was first used as a therapy during Word War I, when injured soldiers were prescribed riding sessions. It gained prominence when Liz Hartel, a Danish Olympic medallist, stricken with polio and confined to a wheelchair, overcame her handicap to win a silver medal for Grand Prix Dressage at the Helsinki Olympics in 1952. She went on to repeat her feat in 1956 and motivated medical professionals and equine specialists to set up therapeutic riding centres across Europe.
Since then, such schools have proliferated with Narha setting up more-than-800-member centres across the US and Canada. Narha also has been certifying instructors outside the US for many years, and in 2006 the first Narha accredited centre outside North America was set up in Barcelona, Spain.
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