Clinical trial NCT02891421: Therapeutic Horsemanship in Veterans
Official title: Effects of Equine Assisted Activities on PTSD Symptoms, Coping Self-efficacy, Emotion Regulation, and Social Engagement in U.S. Military Veterans
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Post Traumatic Stress Disorder
Traumatic Brain Injury
Lead sponsor: University of Missouri-Columbia
Sponsor class: OTHER
Collaborators: name: Harry S. Truman Memorial Veterans' Hospital
name: Horses and Humans Research Foundation
First posted: 2016-09-07
Enrollment: 38
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: The project partnered with U.S. military veterans with a premier accredited therapeutic riding center for six weeks. The veterans interacted with horses by grooming and learning about them, as well as riding them for one hour per week during which they gained a variety of skills. We hoped the veterans would experience a reduction in Post Traumatic Stress Disorder (PTSD) symptoms, depression, and loneliness, while improving their social and emotional health and self-efficacy.

Detailed description: Large numbers of post-deployed U.S. veterans diagnosed with Post Traumatic Stress Disorder (PTSD) and/or Traumatic Brain Injury make effective interventions urgent, to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. Symptoms expand health care costs for stress-related illnesses making veterans' civilian life difficult.

The proposed study used a randomized experimental design with repeated measures and waitlist control group testing the efficacy of a 6-week human-horse interaction and systematic therapeutic horseback riding program in: decreasing PTSD symptoms, increasing coping self efficacy, emotion regulation, and social engagement. The Riding Group spent one hour weekly interacting with and riding the same horse at one of two PATH-accredited riding centers in Mid-Missouri supervised by an Occupational Therapist, Profession Association of Therapeutic Horsemanship (PATH) International-certified instructor, leader and side walkers as needed. Riding was directed by a systematic lesson plan. Data collection occured at baseline, 3 weeks, and 6 weeks. The Control Group was assessed at the same intervals and again 3 weeks and 6 weeks after joining the Riding Group.

Eligibility criteria: Inclusion Criteria:

* Age 18 years or older
* Veterans, left active military service (not serving in reserve units.)
* Diagnosed with Post Traumatic Stress Disorder/Traumatic Brain Injury or both according to ICD-9 diagnostic codes.
* Weight less than 220 pounds.
* Able to walk at least 25 feet without the assistance of a person (but potentially with assistive devices).
* Willing to interact with and ride a horse.
* Have not ridden a horse in the past year.
* Care Provider assent

Exclusion Criteria:

* Age less than 18 years
* Veterans in active military service (including reserve units).
* No diagnosis of PTSD/TBI or both according to ICD-9 diagnostic codes.
* Weight greater than 221 pounds.
* Unable to walk at least 25 feet without the assistance of a person (but potentially with assistive devices.)
* Unwilling to interact with and ride a horse.
* Have been riding a horse in the past year.
* Care Provider unwilling to provide assent

Primary outcomes:
measure: Change in Coping Self-Efficacy Scale (CSES)
timeFrame: Day 1, 3 weeks and 6 weeks
measure: Change in Post-Traumatic Stress Disorder Checklist-Military Version (PCL-M)
timeFrame: Day 1, 3 weeks and 6 weeks
Secondary outcomes:
measure: Change in Social and Emotional Loneliness Scale for Adults (SELSA) scale
timeFrame: Day 1, 3 weeks and 6 weeks
measure: Change in Difficulties in Emotion Regulation Scale (DERS)
timeFrame: Day 1, 3 weeks and 6 weeks
Other outcomes:
Locations:
Study officials:
affiliation: University of Missouri-Columbia
name: Rebecca A Johnson, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003388. doi: 10.1002/14651858.CD003388.pub3.
citation: Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000 Oct;68(5):748-66. doi: 10.1037//0022-006x.68.5.748.
citation: Hakanson M, Moller M, Lindstrom I, Mattsson B. The horse as the healer-a study of riding in patients with back pain. J Bodyw Mov Ther. 2009 Jan;13(1):43-52. doi: 10.1016/j.jbmt.2007.06.002. Epub 2007 Aug 24.
citation: Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008 Jan 31;358(5):453-63. doi: 10.1056/NEJMoa072972. Epub 2008 Jan 30.