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Kabuk A, Şevgin Ö. Comparison of the effects of mechanical hippotherapy and Cawthorne-Cooksey exercises in patients with multiple sclerosis: Randomized trial. Mult Scler Relat Disord 2024; 87:105697. [PMID: 38833975 DOI: 10.1016/j.msard.2024.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/03/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Patients diagnosed with multiple sclerosis (MS) commonly encounter heightened postural instability and challenges in aligning their eyes, head, and bodily motions while engaging in specific tasks. This study aims to compare the effects of Cawthorne-Cooksey and mechanical hippotherapy exercises on fatigue, balance, gait, dizziness, and life quality in patients with MS. METHODS The MS patients were randomly divided into Cawthorne-Cooksey (n:25) and mechanical hippotherapy exercise (n:25) groups. In addition to the traditional physical therapy program, Cawthorne-Cooksey and hippotherapy exercises were applied to the groups 3 days a week, for 8 weeks. The trial's clinical number is NCT06005909. The Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Dizziness Handicap Inventory, Tinetti Balance and Gait Assessment Scale, and Ferrans&Powers Quality-of-Life Index were used for pre-and post-treatment assessment. RESULTS Both groups exhibited a significant decrease in FSS, FIS, and Dizziness Handicap Inventory scores, as well as an increase in Tinetti Balance and Gait Assessment Scale and Ferrans&Powers Quality-of-Life Index scores following treatment. In the inter-group comparison, the Tinetti balance and gait assessment and the Ferrans&Powers quality of life index scores were higher in the hippotherapy group compared to the Cooksey group. CONCLUSIONS Although both forms of physical activity have demonstrated effectiveness in reducing fatigue among individuals with MS, hippotherapy shows superior efficacy in enhancing balance, gait, and overall quality of life.
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Affiliation(s)
- Alesta Kabuk
- Üsküdar University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Ömer Şevgin
- Üsküdar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
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Fridén L, Hultsjö S, Lydell M, Jormfeldt H. Experiences of a Therapeutic Equine-Assisted Group Intervention for People with Common Mental Disorders on Sick-Leave. Issues Ment Health Nurs 2024; 45:344-351. [PMID: 38301175 DOI: 10.1080/01612840.2023.2301611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Common mental disorders such as anxiety, depression and stress-related disorders are increasing worldwide, resulting in long-term sick leave and lower quality of life. Traditional treatment is often insufficient to facilitate the recovery process, and the need for holistic interventions that enable successful recovery is evident. Equine-assisted interventions have shown promising results in health promotion among people with mental disorders, and further research is needed to implement them within the range of available care. The aim of the study is therefore to describe experiences of a therapeutic equine-assisted group intervention for people with common mental disorders on sick leave. The study has a descriptive qualitative design with an inductive approach. Ten participants with common mental disorders on sick leave were interviewed after participating in a 12-week equine-assisted intervention and the data were analysed with conventional content analysis. The analysis generated the overall theme "The equine-assisted group intervention facilitates recovery," which summons the four categories "The environment of the horses contributes to relaxation and an ability to be in the present," "The presence of the horses facilitates supportive relationships in the group," "Interplay with the horses entails physical activity and bodily improvements" and "Emotional interactions with the horses strengthen inner power." In conclusion, equine-assisted interventions have the potential to facilitate recovery for people with common mental disorders by providing relaxation, promoting the ability to be in the present, cultivating supportive relationships and providing physical activity and bodily improvements as well as emotional interactions that strengthen the participants' inner power.
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Affiliation(s)
- Linda Fridén
- School of Health and Welfare, University of Halmstad, Halmstad, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Region Jönköping County, Sweden and Department of Health, Medicine and Caring Sciences. Division of Nursing and Reproductive Health, University of Linköping, Linköping, Sweden
| | - Marie Lydell
- School of Health and Welfare, University of Halmstad, Halmstad, Sweden
| | - Henrika Jormfeldt
- School of Health and Welfare, University of Halmstad, Halmstad, Sweden
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Marchand WR, Smith J, Nazarenko E, Joubert K, Black H, Osborne M, Andersen S, Bell K, Baldwin S, Klinger W, Connelly H, Sheppard S, Hoopes K. A Pilot Replication Study of Implementing an Equine-Assisted Services Program Within a VA Residential Substance Use Disorder Treatment Program. Mil Med 2024; 189:e220-e226. [PMID: 37522743 DOI: 10.1093/milmed/usad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION Veterans have high rates of substance use disorders and other mental health conditions including post-traumatic stress disorder. Effective treatments for these conditions exist; however, high attrition rates and residual symptoms after completing treatment are common. Complementary treatment approaches could enhance treatment engagement and/or response among this population. We previously reported a study of one such intervention, an equine-assisted learning, and psychotherapy incorporating horses intervention provided to veterans admitted to a Veterans Health Care Administration residential substance abuse treatment program. The first aim of this study was to replicate the previous study assessing the safety, feasibility, and preliminary outcomes of this intervention. The second aim was to examine the effect of participants attending multiple intervention sessions. MATERIALS AND METHODS Participants were 94 veterans who participated in one to six sessions of a 3-4-hour program consisting of both equine-assisted learning and psychotherapy incorporating horses. Pre- and post-session administration of the Positive and Negative Affect Scale, State-Trait Anxiety Inventory, and Craving Experience Questionnaire was utilized to assess changes in affect, anxiety, and craving. Wilcoxon signed-rank or paired two-tailed t-tests were utilized for pre- to post-session comparisons of the outcome measures for sessions 1-4. Generalized linear mixed-effects (GLME) models were constructed to determine the impact of dosage. GLME models were constructed to determine the impact of dosage. RESULTS As with our previous study, the intervention was safe and feasible to utilize for this population. There were statistically significant pre- to post-session improvements, with medium-to-large effect sizes, for sessions 1-3 for negative affect and sessions 1 and 2 for positive affect, anxiety, and craving. The GLME models revealed no statistical significance for any of the predictors. CONCLUSIONS Taken together, this study and our previous investigation of this equine-assisted services intervention suggest that it is safe and feasible to utilize for veterans admitted to a residential substance abuse treatment program and we have now found short-term benefits in two separate studies. Thus, a randomized controlled trial of this intervention is warranted to demonstrate cause and effect and determine whether longer-term benefits are associated with the intervention. The finding that there was no additional benefit from attendance at more than two intervention sessions suggests that dose-response relationship studies of equine-assisted services interventions for veterans are needed.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Judy Smith
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Katryna Joubert
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Heather Black
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Makenna Osborne
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Sarah Andersen
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Kylie Bell
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Shannon Baldwin
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - William Klinger
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Heather Connelly
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Stephen Sheppard
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84108, USA
| | - Karl Hoopes
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
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Machová K, Juríčková V, Kasparová A, Petrová K, Sládková B, Svobodová I. An evaluation of the effect of equine-facilitated psychotherapy on patients with substance use disorders. PLoS One 2023; 18:e0286867. [PMID: 37379304 DOI: 10.1371/journal.pone.0286867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 05/24/2023] [Indexed: 06/30/2023] Open
Abstract
Equine Facilitated Psychiatry and Psychology (EFPP) is a supportive non-pharmacological treatment program used in the treatment of patients with substance use disorder. The aim of this study was to evaluate a possible change in patient's health and health-related quality of life between the first and fourth session of the EFPP program using the Assessment of Quality of Life (AQoL) and the Health of the Nation Outcome Scales (HoNOS). The Human-Animal Interaction Scale (HAIS) and a 5-point Likert-type scale was used for an assessment of patient's mood in the experimental group. The study sample included 57 patients (39 in experimental group with EFPP and 18 without EFPP program) with substance use disorders hospitalized in the psychiatric hospital. Comparing the initial and final patients scores in the experimental group, there was a significant positive shift in three of the four domains of the HoNOS scale and in seven of the eight dimensions of the AQoL scale. HAIS significantly increased (p <0.001) in time as well as patient´s mood after every session and in long time perspective. Based on these results, we can assume that the EFPP might be one of the successful programs which may improve patient´s mood and social interactions in substance use disorders.
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Affiliation(s)
- Kristýna Machová
- Department of Ethology and Companion Animal Science, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - Veronika Juríčková
- Center for Advanced Studies of Brain and Consciousness, National Institute of Mental Health, Klecany, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anna Kasparová
- Department of Ethology and Companion Animal Science, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - Kamila Petrová
- Center of Equine Assisted Therapy of Psychiatric Hospital Kosmonosy, Psychiatric Hospital Kosmonosy, Kosmonosy, Czech Republic
| | - Barbora Sládková
- Center of Equine Assisted Therapy of Psychiatric Hospital Kosmonosy, Psychiatric Hospital Kosmonosy, Kosmonosy, Czech Republic
| | - Ivona Svobodová
- Department of Ethology and Companion Animal Science, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
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Diaz L, Gormley MA, Coleman A, Sepanski A, Corley H, Perez A, Litwin AH. Equine-assisted services for individuals with substance use disorders: a scoping review. Subst Abuse Treat Prev Policy 2022; 17:81. [PMID: 36517823 PMCID: PMC9749232 DOI: 10.1186/s13011-022-00506-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
The implementation of equine-assisted services (EAS) during treatment for psychological disorders has been frequently documented; however, little is known about the effect of EAS on outcomes for populations with substance use disorder (SUD). The purpose of this scoping review was to synthesize existing literature reporting the effects of EAS when incorporated into SUD treatment. This review followed guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for scoping reviews. A search of four databases (MEDLINE/PubMed, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Academic OneFile) identified studies reporting quantitative and/or qualitative data for an EAS intervention that was implemented among a population receiving treatment for and/or diagnosed with SUD. Of 188 titles, 71 underwent full-text assessment and six met inclusion criteria. Three additional articles were identified through other sources. Quantitative data suggested a potential positive effect of EAS on SUD treatment retention and completion as well as participants' mental health; however, studies were limited by small sample sizes. Qualitative data indicated that in addition to participants developing bonds with the horses and perceiving EAS as welcomed breaks from traditional treatment, they experienced increased self-efficacy, positive emotional affect, and SUD treatment motivation. Due to methodological limitations and an overall dearth of available studies, the effectiveness of EAS as adjuncts to SUD treatment is inconclusive. Additional research is necessary before supporting broad implementation of EAS as adjuncts to SUD treatment.
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Affiliation(s)
- Liam Diaz
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Mirinda Ann Gormley
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Emergency Medicine, Prisma Health, 701 Grove Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Department of Public Health Sciences, Clemson University College of Behavioral, Social, and Health Science, 503 Edwards Hall, Clemson, SC 29631 USA ,grid.254567.70000 0000 9075 106XDepartment of Emergency Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA
| | - Ashley Coleman
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | - Abby Sepanski
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
| | | | - Angelica Perez
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA
| | - Alain H. Litwin
- grid.413319.d0000 0004 0406 7499Addiction Medicine Center, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA ,grid.26090.3d0000 0001 0665 0280Clemson University School of Health Research, 605 Grove Rd., Suite 301, Greenville, SC 29605 USA ,grid.254567.70000 0000 9075 106XDepartment of Medicine, University of South Carolina School of Medicine- Greenville, 701 Grove Rd, Greenville, SC 29605 USA ,grid.413319.d0000 0004 0406 7499Department of Internal Medicine, Prisma Health, 876 W Faris Rd, Greenville, SC 29605 USA
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Marchand WR, Joubert K, Smith J, Nazarenko E, Klinger W, Sheppard S, Hoopes KH. A Pilot Observational Study of Implementing an Equine-A ssisted Services Program Within a VA Medical Center Residential Substance Use Disorder Treatment Program. Mil Med 2022; 188:usac028. [PMID: 35231128 DOI: 10.1093/milmed/usac028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, more rigorous studies. The overarching goal was to complete the necessary work to prepare for a large randomized controlled trial of this intervention for Veterans with addictive disorders. MATERIALS AND METHODS Participants were 33 Veterans, 29 males and 4 females, who participated in one 4-hour session of combined equine-assisted learning and equine-assisted psychotherapy during an admission to a residential substance abuse treatment program. Preintervention and postintervention instruments were utilized to assess changes in affect, anxiety, and craving. Demographic and diagnostic variables were evaluated for the potential to predict outcomes. RESULTS The intervention was safe and feasible to utilize as there were no adverse outcomes to patients, staff, or equines. The State-Trait Anxiety Inventory, Craving Experience Questionnaire, and Positive and Negative Affect Scale revealed preliminary findings of significant preintervention to postintervention decreases in anxiety, negative affect, and craving, as well as increased positive affect. Lastly, the presence or absence of a history of suicide attempts and/or suicidal ideation were predictive of some postintervention scores. CONCLUSION While more rigorous studies are needed, these results indicate that the intervention evaluated in this study is safe and feasible to utilize for Veterans admitted to a residential substance abuse treatment program. Furthermore, preliminary outcomes suggest that this intervention, and perhaps other equine-assisted interventions, has the potential to be beneficial to Veterans with addictive disorders as well as those at risk of suicide. The psychological instruments used in this intervention appear to be appropriate for use in future investigations. Additionally, more rigorous studies are warranted, and this work provides the necessary first steps needed to proceed with those investigations.
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Affiliation(s)
- William R Marchand
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Katryna Joubert
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Judy Smith
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
| | - Elena Nazarenko
- VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - William Klinger
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Stephen Sheppard
- Mental Health Service, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
| | - Karl H Hoopes
- Department of Animal, Dairy and Veterinary Sciences, Utah State University, Logan, UT 84322, USA
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Hoopes KH, Osborne M, Marchand WR, Joubert K, Nazarenko E, Black H, Klinger W, Sheppard S. A pilot observational study of recreational trail riding for Veterans with addictive disorders. Complement Ther Med 2022; 65:102813. [DOI: 10.1016/j.ctim.2022.102813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/03/2022] Open
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