Throughout the centuries, the horse and human relationship has evolved from one of sustenance to one of partnership. Historically, the idea of horses being partnered with humans in a therapeutic capacity is evident from writings of the ancient Greeks to documentation by European physicians and therapists from the 1500s through the 1800s. The impetus for the development of modern day equine-assisted activities and therapies (EAAT) is credited to a Danish dressage rider named Lis Hartel, who won an equestrian silver medal at the 1952 Olympic Games despite being partially paralyzed by polio. Her international accomplishments on the back of a horse demonstrated the potential healing power of riding
In 1870, Chassaigne published the first known study testing the effects riding had on individuals with disabilities. He concluded positive benefits on balance, posture, and muscle control. Research on EAAT was limited until the Scandinavian polio outbreak in in the 1940s. Since that time, numerous publications on the benefits of EAAT have been documented, echoing outcomes of early investigators; however, many publications lack the rigor necessary for credibility in the US medical community. Small sample sizes, heterogeneity of study groups, lack of control groups or randomized treatment assignment, and lack of codified interventions, are all cited as criticisms for peer-reviewed studies.
The physical effects of EAAT on individuals with cerebral palsy remain the most documented area of research. Meta-analyses and systematic reviews of the literature incorporating well-designed research trials investigating the effects of mounted EAAT on individuals with cerebral palsy show conflicting results regarding improvements in gross motor function; however, significant improvements in balance and postural control were found. Randomized clinical trials determining the appropriate type, dose and frequency of EAAT, assignment of horse to participant, and sorting out the true effect of the horse is necessary for the EAAT industry to gain credibility.
Demonstrated efficacy of EAAT is essential for parents, guardians, and participants to know whether EAAT is beneficial and what evidence exists to support this type of monetary and personal investment. In addition, quality research is important for granting agencies to support EAAT programs. Finally, increasing the number of randomized clinical trials testing the efficacy of EAAT will be essential for the field to earn legitimacy in the medical community, support insurance reimbursement, and be viewed as a viable therapeutic option for identified populations.
Although limited, several funding opportunities exist specifically for research in the area of animal-assisted interventions. The Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Horses and Humans Research Foundation are two examples of agencies that support high quality research investigating horse and human interactions. Continued support is essential to provide funding opportunities for research that will further legitimize the EAAT field and move the industry forward.