Spinal Cord Injuries and Stroke (Neurological Modality)
- Jaithra Kakarla
- May 1, 2020
- 5 min read
Updated: Aug 2, 2020
Spinal cord injuries
A spinal cord injury — damage to any part of the spinal cord or nerves at the end of the spinal canal — often causes permanent changes in strength, sensation, and other body functions below the site of the injury. For people who have recently experienced a spinal cord injury, it might seem like every aspect of their life has been affected. They might feel the effects of their injury mentally, emotionally, and socially. Many scientists are optimistic that advances in research will someday make the repair of spinal cord injuries possible. Research studies are ongoing around the world. In the meantime, treatments and rehabilitation allow many people with spinal cord injuries to lead productive, independent lives.
Rehabilitation often includes physical therapy, occupational therapy, and counseling for emotional support. The services may initially be provided while the patient is hospitalized. Following hospitalization, some patients are admitted to a rehabilitation facility. Other patients can continue rehab on an outpatient basis and/or at home.
The ability to control their limbs after a spinal cord injury depends on two factors: the place of the injury along your spinal cord and the severity of injury to the spinal cord. Spinal cord injuries of any kind may result in one or more of the following symptoms:
Loss of movement
Loss or altered sensation, including the ability to feel heat, cold and touch
Loss of bowel or bladder control
Exaggerated reflex activities or spasms
Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
Some of the problems associated with spinal cord injuries can be improved with equine-assisted activities. Due to the fact that Spinal cord injuries affect the spinal cord and nerves of the individual, the most common problems associated with the injury related to motor coordination as a result of lack of feeling, weakness, or paralysis in the lower limbs. Often, individuals with spinal cord injuries have increased muscle tone and some spasticity in their legs. Spasticity is known as an accompanying phenomenon of spinal cord injuries and is defined as an increased reflex activity to passive movement of the limbs and difficulty in initiating and controlling muscular movement. Not every patient suffering from spasticity necessarily requires treatment. However, depending on the severity of spasticity it may interfere with activities of daily life.
For several years hippotherapy has been used in rehabilitation of spinal cord injured patients (SCIs) and positive effects on spasticity have been reported. Unfortunately, only a few studies assessing the effect of hippotherapy on spasticity have been conducted, and most of the existing literature is not in the English language. Studies that aim at explaining the mechanisms underlying the positive effect of hippotherapy on spasticity are even more scarce. Unlike therapeutic horseback riding, which teaches riding skills to individuals with disabilities, hippotherapy is a neurophysiological treatment that uses the movement of the horse.
Hippotherapy causes an immediate reduction of spasticity of the lower extremities of SCI patients. Hippotherapy has an alleviating short-term effect on spasticity of the lower extremities in SCI patients. Hippotherapy is also more efficient than sitting astride a Bobath roll or on a rocking seat in reducing spasticity temporarily. The rhythmical side flexion and extension of the patient's trunk combined with trunk torsion have a beneficial effect on spasticity. The working mechanism of hippotherapy on spasticity may be complex. Furthermore, Hippotherapy has a positive short-term effect on an individual's mental well-being. Contact with a large animal has a profound effect on humans: for instance, a horse may help increase a patient’s confidence and self-esteem through its acceptance of him/her as a rider. However, to my knowledge, the psychological effect on individuals with spinal cord injuries has not been measured before.
Spasticity in persons with SCI has the potential to negatively influence the quality of life, to disturb sleep, to impede the rehabilitation efforts of the patient, and may even contribute to a negative self-image. There is evidence that there is a greater prevalence of anxiety and depression in people with SCI than in people in the general population. Moreover, depressive symptoms and impaired subjective mental well-being have been associated both with fewer functional improvements in SCI rehabilitation and with limitations in participation and motivation.
A complete spinal cord injury is a risk for riding, but would not necessarily prevent a client’s participation in other types of equine programs such as driving and unmounted activities. Many people who have had a spinal cord injury may participate in therapeutic riding lessons, carriage driving, or may choose an equine-assisted therapy program to address challenges with trunk control or coping with their injury.
Stroke
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include paralysis or loss of muscle movement, difficulty talking or swallowing, memory loss or thinking difficulties, emotional problems, and changes in behavior and self-care ability. Experts have discovered that riding can help survivors of strokes to recover. We now know that interacting with animals can help people suffering from a variety of conditions. Most therapies involving animals have been designed to address mental health issues as opposed to physical ones. But riding involves physical activity and interaction with an animal and so potentially offers the best of both worlds.
Stroke patients undertaking therapy with horses show significant improvements in their balance, gait, grip strength, and cognition. Researchers who conduct studies believe that horse riding is so successful in helping the patients because the rocking motion of the horse’s back creates a sensory experience that closely resembles normal human gait. Therefore it reminds patients of the sensation of walking and balancing. The researchers found that this form of therapy may improve survivors’ perception of recovery, gait, balance, grip strength, and cognition even years after their stroke.
Interventions that engage patients in physical, sensory, cognitive, and social activities simultaneously target a range of functions. Researchers said it was this combination of different activities and stimuli, rather than the individual components, that appeared to produce additional beneficial effects for stroke recovery. Riding therapy targets a range of functions and so addresses a variety of issues simultaneously whilst being an enjoyable activity. Participants who engage in enjoyable therapies are more likely to experience improvements, are more likely to perceive that they have improved and are more likely to stick with their therapy.
It may not be for everyone, but a new study suggests that the smooth stride of a gentle horse may help stroke survivors regain lost mobility and balance years after their brain attack. Many of the individuals see improvements outside of what's available in traditional stroke rehabilitation. Examples of activities that they do when they join an equine program are learning to ride or drive with one hand or may use an adapted rein on their weaker side. Riding in a group is a great shared social experience as well as the opportunity to interact with horses.
RISKS
I implore any individual considering any form of EAA* or EAT** to consult with their physician or any related doctor before beginning this form of therapy. It is highly important that you are well aware of the risks of participating in this form of therapy, which sometimes may be entirely related to the health issue too. If you have any queries or suggestions please leave a comment below or reach out to me through the Contact Form on the Home page.
*Equine-Assisted Activities
**Equine-Assisted Therapy
Visit the "Current medical use of horses" post to gain more clarity about the interventions for specific modalities: https://www.equineinsight.info/post/current-medical-use-of-horses
References:
Spinal cord injury:-
Stroke:-
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