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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING

A Kinesiological Assessment of Horseback Riding for Riders who have Cerebral Palsy
Rachel Bradley
William Woods University
Kinesiology
April 2017

A Kinesiological Assessment of Horseback Riding for Riders who have Cerebral Palsy
Introduction
What is cerebral palsy, and can therapeutic horseback riding be used to improve the

overall condition of those who are affected by this condition? According to the Mayo Clinic,

Cerebral Palsy can be defined as being a disorder of movement, muscle tone or posture that is

caused by damage that occurs to the immature, developing brain, most often before birth (Mayo

Clinic Staff). The skill of horseback riding utilizes many different muscles, this helps to

strengthen as well as contributes to better overall balance and coordination. Through an

evaluation of horseback riding and an anatomical description of the effects horseback riding on

the body, a prescription can be made for the treatment of cerebral palsy using therapeutic

horseback riding.
Hippotherapy is becoming a widely-used form of therapy. It is one of the many forms of

therapy, used for treating individuals with cerebral palsy.

Primary Purpose
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
To be able to have a thorough consciousness of how horseback riding effects the body of

an individual with cerebral palsy, one must have an understanding of cerebral palsy. There are

several symptoms associated with cerebral palsy. Some of the symptoms include, but are not

limited to, abnormal reflexes, floppiness or rigidity of the limbs and trunk, abnormal posture,

involuntary movements, unsteady walking, or some variation there of (Mayo Clinic Staff).

Some individuals experience trouble associated with swallowing and or have difficulties

focusing on objects due to an eye muscle eye imbalance (Mayo Clinic Staff, 2017). The effect

of cerebral palsy on a persons abilities varies greatly between individuals (Mayo Clinic Staff).
The primary purpose of horseback riding for an individual with cerebral palsy is improve overall

balance and posture.

Phases of Movement
There are several phases to horseback riding. The phases of horseback riding are not well

established. For the phase of horseback riding, whether it be a person with cerebral palsy or not,

there is a constant state of rebalance, a cyclical skill. Since it is common practice for a person

with cerebral palsy to be led around the arena using a lead line, the hands of the rider will not be

discussed. For this same reason, the discussion of arm placement will be slightly touched upon.
Phase 1: The first phase is the preparatory phase. In this phase, the rider needs to be

sitting in proper head, hip, and heel alignment as described by Lesley Eccles in her book

Successful Riding (Eccles, 1990).

Phase 2: The second phase is a force phase. In Jill Hassler-Scoop and Kathy Kelly

Ph.D.s book, Riding Experience & Beyond: Personal Development for Riders they point out

that in this phase, the horse is now in motion, which in turn causes the rider to move (Hassler-

Scoop & Kelly Ph.D., 2002). The riders movements must follow the motion of the horses

movements to create a harmonious performance (Hassler-Scoop & Kelly Ph.D., 2002).

Phase 3: The third phase simultaneously occurs during phase two. Phase three is the

balance phase. This phase is what the riders body does while the horse is in motion. As
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
described by Naomi Scott in her 2005 book Special Needs, Special Horses: A Guide to the

Benefits of Therapeutic Riding, when the horse moves, its center of motion moves, which

causes the riders center of balance to move. The motion of a horse at a walk is comparable to

the hip movement of human at a walk (Scott, 2005). The motion causes the riders hips to move

in unison with the horses. Charles Harris discloses in his text book for the British Riding School,

Fundamental of Riding: Theory and Practice, the unity of movements between horse and rider

is achieved by the rider using his or her body posture, weight, and limbs in a manner to improve

() stability and balance (Harris, 1986). The legs of the rider slide backward and forward in

contact with the sides of the horse, and can also exert direct/inward pressure against the sides of

the horse (Harris, 1986). While the head, trunk, and arms are kept upright and still, the loins and

the seat can act as two separate coiled compression springs, to absorb, balance, and vary the seat

pressure without ever reducing the seat contact area with the saddle (Harris, 1986). In

addition, the rider will place weight evenly over the seat of the saddle and in his/her heels

(Harris, 1986).
Phase 4: The last phase is the phase of rebalance. It is when not only the rider is in the

original body starting position, but the horse is in its original starting position. Since the two

move as one, it would make sense that they would both be in the starting position at the same

time.
Skill Description
The primary purpose for an individual with cerebral palsy to go horseback riding is to

improve balance, posture, and overall muscle strength. Both accuracy and form play a large role

in reaping the therapeutic benefits of horseback riding. Success in this skill is measured in

appearance and a goniometer. According to a research study, The Effect of Riding as an

Alternative Treatment for Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

by Guoqin Wang, Ruiqin Ma, Guangwei Qiao, Koji Wada, Yoshiharu Aizawa, and Toshihiko
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
Satoh, a riders balance improvement can be measured using a Sitting Assessment Scale that

evaluates sitting balance and postural control (Wang, et al., 2015). In a collection of therapeutic

riding studies, Rehabilitation With the Aid of a Horse: A Collection of Studies, Barbara

Teichmann Engel M.Ed., OTR explains that a goniometer is used to measure hip abduction

(Teichmann Engel M.Ed OTR, 2003).

Underlying Mechanics. The underlying mechanics of horseback riding are as follows for

each phase of movement:

First, for the preparatory phase is proper head, hip, and heel alignment of the rider on the

horse. Proper head, hip, and heel alignment is attained through the use of the entire body. For this

to happen, the trunk needs to be in neutral alignment (Harris, 1986).

Second, the force phase is the effect a horse in motion has on the body. Riding allows

the brain to practice correct walking movement patterns, giving not only the muscles an

opportunity to experience motion, but also the vestibular system (Scott, 2005). In addition, Dr.

Beth Glosten reinforces Scotts claim in the excerpt, Basic Human Anatomy for Riders, when

she explains that the hip joint swings with the movement of the horses back, while () the

pelvis [stays] in a stable position (Glosten MD, 2002). In a Wroclaw University of

Environmental and Life Sciences research study by Anna Mackow, Monika Malachowska-

Sobieska, Ewa Demezuk-Wlodarczyk, Marta Sidorowska, Alicja Szklarska, and Anna Lipowicz

titled, Influence of Neurophysiological Hippotherapy on the Transference of the Center of

Gravity Among Children with Cerebral Palsy, it was discovered that the reflexes of an individual

with cerebral palsy tend to follow a particular motor pattern (Mackow, et al., 2014). The pattern

is as follows, when transferring the body weight, the trunk lengthens on the loaded side and

shortens on the unloaded side (Mackow, et al., 2014). The physiological curvatures of the

spine are not excessively increases or decreased so that the spine can actively respond to the

horses movement and transfer the stimulation to the distal parts of the body (Mackow, et al.,
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
2014). Proper riding position allows the patient to receive all motor stimuli transferred by the

horse and transform them into coordination and joint function training (Mackow, et al., 2014).
Third, phase three is all about balance. In order to retain balance, the body needs to adjust

and stay in alignment. Balance reflexes allow for maintaining the center of gravity over the

subtended area and transferring the body weight when changing positions and during

locomotion (Mackow, et al., 2014). Since the proper alignment of the spine gets altered when

the horse is in motion, it is pertinent for the rider to implement their transverse abdominis,

external oblique, internal oblique, and rectus abdominis muscles to maintain that alignment

(Glosten MD, 2002). Now that sustaining desired trunk alignment has been discussed, the ability

to retain lower extremity position will be discussed, starting with the attachment of the femur and

the pelvis, the hip joint. Since the hips and legs move with the horse, it is important for the rider

to open up the angle of the hips, so that angle of the riders hips and heel continue to line up with

his/her head. An opened hip angle is a result of flexing the psoas muscle on both legs (Glosten

MD, 2002). While the psoas muscles aid in opening up the hip angle, the hamstrings are actively

pulling femur towards the riders posterior (Glosten MD, 2002). Simultaneously, the hip

abductors are aiding in the outward rotation of the leg (Glosten MD, 2002). Meanwhile, the

lower leg is flexes at the knee and the calf is being pulled back towards the horses flank

(Glosten MD, 2002). The toes of the rider should be pointing up and forwards to where the

riders ankle rests slightly lower than his or her toes at all times (Eccles, 1990). This requires

muscle strength to maintain the heels down, toes up position. Not only is important for the rider

to maintain alignment of the lower extremities, but it is also important for the rider to maintain

proper position of the upper extremities while in motion. This requires the rider to open up

his/her chest. The rider opens up their chest by relaxing the shoulders in a depressed manner.

The lower part of the trapezius muscle pulls the shoulder and scapula back and down (Glosten
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
MD, 2002). This aids in maintaining overall upper body posture and balance. A combination of

the latissimus dorsi, the rhomboid major and minor, and the lower trapezius stabilize the arms

which ease control (Glosten MD, 2002). As described by Carol Foster in the 1991 book, Basic

Riding, as soon as the rider is no longer in perfect alignment, the rider losses his/her balance

(Foster, 1991).
Fourth, the final phase is the rebalance phase. In this phase, the rider goes back to the

starting/proper riding position where the pelvis of the patient sitting in simple position on the

horse is in an intermediate position between forward and backward tilt and is loaded

symmetrically and perpendicularly to the direction of movement (Mackow, et al., 2014). Over

time, the proprioceptive stimulation achieved in a correct riding position allows for the learning

and consolidation of optimal motor patterns while regulating muscle tone (Mackow, et al.,

2014).

(Dareau, 2011)
The two images above, by Gabrielle

Dareau illustrate the movement/force of the horse, and how the rider is in a constant state of

rebalance.

Anatomic Analysis
Anatomic Analysis Chart
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
Name of Joint Starting Observed Segment Force for Specific Muscles Kind of

Position Joint Being Movement Active Contractio

of Action Moved n

someone

with

Cerebral

Palsy
Cervical Head Extension, Head and Muscle Trapezius, Eccentric

down elevation cervical force splenius capitus,

spine splenius cervicle,

external

intercostals, and

serratus posterior
Lumbar Slouched Extension Lumbar Inertia Transverse Concentric

vertebrae / from the abdominis, and

spine, horse in external oblique, eccentric

abdominal motion internal oblique,

wall, pelvis and and rectus

stabilization muscle abdominis

, pelvic tilt force

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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
Hip Sitting on Flexion, Hips The Iliopsoas, rectus Eccentric

the horse extension, movement femoris, tensor and

abduction, of the fasciae latae, concentric

and horse, the pectineus,

glueteus
adduction width of
maximus,
the horse,
glueteus medius,
muscle
glueteus
force, and
minimus, tensor
gravity
fascia latae,

biceps femoris,

Knee Neutral Flexion Knee Muscle Biceps femoris Concentric

position force and

gastrocnemius

Ankle Extension Dorsi Ankle Muscle Tibialis anterior, Concentric

flexion force extensor hallucis

longus, peroneous

tertius, and

extensor

digitorum longus
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
Scapulothoracic Neutral Depressio Scapula Gravity Pectoralis minor Concentric

position n and and trapezius

muscle

force
Glenohumeral Relaxed Adduction Arm Gravity Rhomboid and Isometric

at the side and lower and middle

of the muscle trapezius

body force
(Golsten MD, 2002; Temcharoensuk, Lekskulchai, Akamanon, Ritruechai, & Sutcharitpongsa,

2014; Champagne, Corriveau, & Dugas, 2017; Teichmann Engel M.Ed OTR, 2003)
Neuromuscular Considerations
Proper Technique and Error Identification
Proper Technique. In the USDF (United States Dressage Federation) glossary of terms,

the riders seat is defined as The riders trunk, which includes the pelvis, spine, and rib cage,

with supporting musculature [and goes on to say, the] control of the seat determines the dynamic

influence and balance of the rider and harmony with the horses movement within each gait and

exercise (United States Dressage Federation, 2015). Proper technique can be described as a

rider who is physically centered. In Dr. Beth Golstens book The Riding Doctor: A Prescription

for Healthy, Balanced, Beautiful Riding Now and for Years to Come, she describes physically

centered as riding with the middle of your body base of support [which is] riding with correct

posture and postural support, and with movement controlled from the area around your center of

gravity (Golsten MD, 2014).

Error Identification. A common mistake with horseback riding is when the rider uses the

reins for support and balance. First, as reviewed by Charles Harris in his text book, this happens

when the riders abdominal muscles and muscles of shoulder girdle become slack and loose
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
(Harris, 1986). Any time a rider is sitting in a position than the proper riding position, it increases

the chance of injury and contributes to back pain (Glosten MD, 2002).
Another common error with rider position is when the hip joints and thighs. If any

muscle of the thigh becomes locked up, supple movement of the hip joint is impossible, thus the

rider ends up bouncing out of the saddle (Glosten MD, 2002).

Prescription for Performance Improvement
A prescription for the treatment for cerebral palsy through the use of therapeutic

horseback riding. The prescription for treatment can be broken down into three segments. These

segments are safety, efficiency, and effectiveness.

Safety. Safety is crucial when doing any type of activity. It is especially important when

the activity involves variable elements. When it comes to therapeutic riding, the variable is the

horse. In a co-operative study by Thai researchers Peeraya Temcharoensuk, Raweewan

Lekskulchai, Chanut Akamanon, Pattama Ritruechai and Sureelak Sutcharitpongsa for the

Mahidol Unversity, it was found that in order to maintain [the riders] center of gravity (COG)

within that base of support while riding, children have to anticipate and compensate for their

postural adjustments by reducing COG displacement to remain safely on a moving surface

(Temcharoensuk, Lekskulchai, Akamanon, Ritruechai, & Sutcharitpongsa, 2014).

Efficiency. Efficiency is the ability to use the least amount of effort necessary to perform

a task. Through the use of shifting body weight in response to rhythmic movement, multiple

sensory inputs and efferent motor outputs from the [central nervous system] (CNS) are

constantly stimulated throughout a riding session in order to secure balance and posture,

eventually leading to an improvement in postural stability, equilibrium reaction, and correction

of upright alignment (Temcharoensuk, Lekskulchai, Akamanon, Ritruechai, & Sutcharitpongsa,

2014).
Effectiveness. It has been found that hippotherapy aids in the regulation of muscle tone,

decreases spasticity and may contribute to improve movement effectiveness (Mackow, et al.,
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
2014). The overall effectiveness of the riders movements is due to the rider being better able to

control the parts of the body. This prescription for effectiveness is reinforced by Danielle

Champagne, Helene Corriveau and Claude Dugas article Effect of Hippotherapy on Motor

Proficiency and Function in Children with Cerebral Palsy Who Walk, in the section that reads

Trunk stability is recognized as an important factor to improve the quality and precision is

dependent of the trunk musculature to maintain verticality and allow orientation within the limits

of the pelvis, and that control and stabilization of the trunk can positively influence the control

of upper limb movements (Champagne, Corriveau, & Dugas, 2017).

Summary
To conclude, hippotherapy is quite beneficial to a person who has cerebral palsy. The four

phase of motion to horseback riding. These phases are the preparatory, force, balance, and

rebalance phases. The four phases are cyclical in nature and are for the most part pretty

simultaneous, so it is not always easy to see each step broken down. It has been found that

better body stabilization as the larger subtended area, the larger the force which must act to

disturb the body balance (Mackow, et al., 2014). In a nutshell, the better a person is able to

stabilize the parts of his/her body, the better the improvement will be to the persons overall

balance. When it comes to a person with cerebral palsy, the time spent on a horse helps to

stimulate the nervous system which can lead to better overall body stability and muscle control.

Bibliography
Champagne, D., Corriveau, H., & Dugas, C. (2017). Effect of Hippotherapy on Motor
Proficiency and Function in Children with Cerebral Palsy Who Walk. Physical &
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Dareau, G. (2011). Rider Biomechanics: The Key to Unlocking the Horse. Gascony,
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Eccles, L. (1990). Successful Riding. Suffolk: Sackville Books Ltd.
Foster, C. (1991). Basic Riding. Ramsbury: The Crowood Press Ltd.
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A KINESIOLOGICAL ASSESSMENT OF HORSEBACK RIDING
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