Mapping equestrian injuries and injury incidence in Sweden using insurance registry data

Horse-riding hazards: an observational cohort study mapping equestrian related injuries at a Scandinavian trauma centre

INTRODUCTION

Horse-riding is practiced on a regular basis by 500,000 people in Sweden. It is reputed to be one of the most dangerous sports. On average, there were 1756 acute injuries and three fatalities each year between 1997 and 2014 in Sweden related to horses. The primary aim of this study was to outline the injury spectrum related to equestrian activities cared for at a large Swedish trauma centre. The secondary aim was to identify trends in clinical outcomes and to investigate the association between age and such outcomes.

MATERIAL AND METHODS

The electronic medical records system at Karolinska University Hospital was queried for patients cared for due to equestrian related trauma between July 2010 and July 2020. Complementary data were gathered using the hospital's Trauma Registry. No exclusion criteria were applied. Descriptive statistics were used to outline the injury spectrum. Age was split into four categories which were compared using the Kruskal-Wallis H test or the Chi-squared test. Logistic regression was used to analyse correlations between age and outcomes.

RESULTS

A total of 3036 patients were included with 3325 injuries identified as equestrian related. The hospital admission rate was 24.9%. The cohort had one death. Regression analysis showed significant associations between decreasing risk of upper extremity injury (p < 0.001), increasing risk of vertebral fractures (p = 0.001) and increasing risk of thoracic injury (p < 0.001) with increasing age.

CONCLUSIONS

Equestrian activities are not without risks. The morbidity is high, and injuries are taken seriously by the medical profession, reflected by the high admission rate. There are age-related variations in the injury spectrum. Older age appears to predispose to vertebral fractures and thoracic injuries. Other factors than age appear more important in determining the need for surgery or admission to ICU.

An initial survey of volunteer perceptions of horses in Equine-Assisted Services: Volunteer experiences, training, and educational needs

Equine-Assisted Services (EAS) gained a foothold in the healthcare industry as a unique modality addressing the physical, cognitive, and psychological health issues for people across the lifespan. These services require a team approach, with volunteer support playing a prominent role in service delivery. Volunteers are a precious resource for EAS programs and step into a variety of support roles, including preparation and handling. However, little is known about the horse-volunteer relationship or factors that influence their working relationships. Therefore, the purpose of this web-based survey was to characterize the volunteer experience and explore factors that may impact volunteers' ability to accurately identify equine behavior. A total of 240 volunteers from 25 Professional Association for Therapeutic Horsemanship, International (PATH, Intl.) Premier Accredited Centers participated in this survey. The results of the correlational analyses and a general linear model suggested certain volunteer characteristics can be linked to accurate identification of horse behaviors. Horse leaders (p < 0.001) and volunteers who help with adaptive riding (p = 0.048) or therapeutic driving (p = 0.031) sessions more accurately recognized behaviors than those who held other roles. Volunteers who had any amount of horse experience prior to volunteering correctly identified more behaviors than those who came with none. A qualitative content analysis showed that volunteers felt most unprepared when a horse exhibited a behavior they were not trained to handle, and volunteers indicated their preparation to assist in EAS could be improved with more general training and education related to equine behavior.