Equine Assisted Activities on PTSD, Quality of Life and Functioning in Veterans With PTSD: An ICF Approach (THRICF)
Condition: Posttraumatic Stress Disorder
MeSH terms: Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      The purpose of the research project was to assess changes in Posttraumatic stress disorder
      [PTSD] symptoms, quality of life and participation of combat veteran who participate in
      equine assisted activities [EAA]. The study used a mixed-methods, waitlist-controlled,
      repeated measures trial of a standardized 8-week therapeutic riding intervention for combat
      veterans with PTSD. Behavioral changes were assessed four times during the study. Veterans
      meeting inclusion criteria were selected to participate in either the intervention group or
      the control/waitlist group.
    

Detailed description: 
      The research design was a quasi-experimental trial using mixed methods. Veterans recruited to
      a treatment group or a waitlist control group. Both qualitative and quantitative data was
      collected to assess changes. Qualitative data was collected post-intervention and
      quantitative data was collected at baseline, mid-intervention, post-intervention and 2-month
      follow-up.

      A total of 125 veterans were recruited for the study. Eighty-nine met inclusion criteria.

      Five therapeutic riding facilities will be utilized for this study: Ride On Center for Kids
      (R.O.C.K.), Georgetown, Texas; Riding Equines to Achieve Confidence and Health (R.E.A.C.H.),
      McGregor, Texas; Texas A&M Systems Courtney Grimshaw Fowler Equine Therapeutic Riding Center
      (Courtney Cares), College Station, Texas; Triple H, Cripple Creek, Texas, and Rainier
      Therapeutic Riding, Yelm, Washington. Two of the sites (R.O.C.K. and Rainier TR) are
      Professional Association of Therapeutic Horsemanship International [PATHIntl] premier
      accredited facilities, one (R.E.A.C.H.) is reaching premier status, and one (Courtney Cares)
      is under the direction of the research director at R.O.C.K. All four sites have existing
      Professional Association of Therapeutic Horsemanship [PATH] Equine for Service Members
      programs and the staff is experienced with the veteran population. Five sites were needed to
      ensure adequate sample size for the study.

      EAA Protocol

      The eight week EAA program followed the same protocol at all five testing sites with riding
      instructors and staff using a standardized curriculum, Rainier Therapeutic Riding's Riding
      Through Recovery. Baseline assessments was conducted for all participants in both the EAA
      group and the wait-list group. The EAA program consisted of eight, 90 minute weekly lessons.
      The first few lessons focused on developing a relationship between the horse and the
      participant without riding. The last two lessons included riding instruction if the
      participant chooses to ride. The PTSD Checklist- Military [PCL-M] and PTSD Checklist-5
      [PCL-5] were administered pre and post as well as 2 months following the program. The Short
      Form Health Survey [SF-36v2], World Health Organization Disability Assessment Schedule 2.0
      [WHODAS-2.0] and the Major Depression Inventory [MDI] were completed before beginning the
      program, at four weeks (mid-treatment), post-treatment and 2 months follow-up. Open-ended
      questions were completed post-treatment. The wait-list group participated in treatment as
      usual (TAU) and was assessed using the same instruments and time sequence with the exception
      of the post-treatment open-ended questions and the 2 month follow-up. After the first eight
      weeks, the wait-list group participated in the EAA intervention.
    

Intervention name(s): Therapeutic Horseback riding
Intervention type(s): Other
Intervention description(s): An 8-week equine-assisted program designed to especially for veterans. The curriculum consists of eight 90-minute sessions designed to teach basic horse care and riding skills along with communication skills.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: PTSD; Equine assisted activities; quality of life