SRU study shows therapeutic riding reduces stress levels of adolescents with autism


Two women with a therapy horse

From left, Betsy Kemeny, Slippery Rock University assistant professor of parks, conservation and recreational therapy, and Courtney Gramlich, manager of Storm Harbor Equestrian Center, completed a study that shows therapeutic horseback riding reduces stress levels of adolescents with autism.

Feb. 20, 2019

SLIPPERY ROCK, Pa. - Anyone who's been to the Storm Harbor Equestrian Center at Slippery Rock University can see the benefits horseback riding has for children and young adults on the autism spectrum. Until recently, the evidence was based on the smiles on their faces, improved moods and other immeasurable indicators of reduced stress. But a recent study by a research team at SRU is helping assign empirical evidence to the value of therapeutic riding and equine-assisted activities.

"There is recognition that therapeutic riding is beneficial, but what we are trying to do is put some numbers to it," said Betsy Kemeny, SRU assistant professor or parks, conservation and recreational therapy, who is the principal investigator of an elaborate study of the effectiveness of therapeutic horseback riding on adolescents with autism spectrum disorder. "On the face of it, the results say that therapeutic riding does benefit youth with autism, especially in the area of those who have a lot of social anxiety and have some issues with stress."

A scarcity of existing research indicates that stress and a lack of coping mechanisms for youth with ASD become barriers to health and wellness as they enter adulthood.

The SRU study involved 27 people ages 13-22 with ASD participating in three, 10-week phases from March 2017 to April 2018 that compared therapeutic riding with a proven stress management protocol and a control group. The study was administered weekly at Storm Harbor, an on-campus facility that provides equine-assisted activities and equine-assisted therapies for children and adults with disabilities, serving individual clients and larger groups through a variety of outreach programs.

Researchers collected saliva samples from participants and tested for levels of cortisol, a stress-response hormone, before and after therapeutic riding, a protocol that included everything from horse grooming to steering and trotting. The groups of participants rotated every 10 weeks to or from a control group, which abstained from treatment, or a stress management protocol called HeartMath, a program that is already proven to regulate stress and heart rate variability through breathing and mindfulness techniques.

The results of the study showed that the therapeutic riding protocol and the HeartMath protocol are equally effective in decreasing salivary cortisol. The mean differences in the therapeutic riding protocol showed sharper changes in cortisol levels than HeartMath, but there was not a statistically significant difference between the two phases.

"They are both viable and both better than the control group," said Kemeny, who conducted smaller pilot studies during the past five years to establish the ideal protocol and to attract interest from funding sources before launching the recent study. "After doing three or four smaller studies it was very satisfying to have the funding to be able to do a larger project that has broader implications. When you do smaller projects, sometimes they can't be generalized, and I feel like this one was very well done."

"We are thrilled with the results of this study," said Pam Cusick, board president of Horses and Humans Research Foundation, a nonprofit, non-endowed foundation that awarded the SRU research team $88,000 to conduct the study. "Adolescents with autism spectrum disorder report high stress and anxiety levels that impact functioning in the community. We are pleased to see confirmation that therapeutic riding has a positive impact on stress levels and hope that this research will encourage more adolescents with autism to consider therapeutic riding as an option."

Also making the study possible were contributions from the research team that included three coinvestigators, Deborah Hutchins, associate professor of parks, conservation and recreational therapy; Courtney Gramlich, manager of the Storm Harbor Equestrian Center; and Steffanie Burk, an equine scientist at Otterbein University. In addition to collecting saliva and heart rate results from humans in the study, samples and data from horses were also collected to detect correlations.

"The research is important to see the true effects that therapeutic riding can have," Gramlich said. "This could help programs like ours across the country. We've been getting phone calls from people reading about the benefits that we saw from the research and they are asking questions and wanting to do similar things. We say riding gives you so many great benefits but until we have measurable results that we can document, (people) won't 100-percent believe it."

Dil Singhabahu, SRU assistant professor of mathematics and statistics, provided statistical consultation. Anthony Rock, a graduate student majoring in clinical mental health counseling from Hermitage, administered the HeartMath protocol, and Jess Lowry, a 2010 SRU graduate with a degree in therapeutic recreation and a former Storm Harbor staff member, assisted with the therapeutic riding protocol.

Students research assistants included Emily Jones, a junior recreational therapy major from Mason, Ohio; Kristen Laird, a 2018 SRU graduate with a degree in interdisciplinary studies; Allison Kronyak, a senior recreational therapy major from Wood Ridge, New Jersey; and Jessica Dietrich, a senior recreational therapy major from Eastlake, Ohio.

"This was an invaluable experience," said Jones, who spent about 10 hours a week collecting saliva and entering data. "I learned a lot about the research process and being able to present the findings at conferences. That all the hard work we put in will be recognized and published is amazing, and to see this help people with autism is even better."

The research team already won the Best Research Poster Award at the Recreational Therapy Institute at the American Therapeutic Recreation Association's annual conference last fall and in April they will present at the International Association of Human-Animal Interaction Organizations' triennial conference in Brewster, New York. Additionally, Kemeny will be presenting at the International Society of Autism Research Conference in Montreal in May.

"Working with the students is great because it gives them hands-on experience, not only working with people with disabilities but getting the component of working with horses," Gramlich said.

"I couldn't have done this study without the whole team," Kemeny said. "I was just the person steering it. People put in a lot of time into this and made sacrifices."

In addition to expanding the research scope, Kemeny is hopeful that the SRU study will be used to encourage people to consider therapeutic riding as a non-pharmacological treatment.

"This is helpful because you can now have a physician or health provider say this would help your stress level," said Kemeny, who hasn't published the research in a journal yet but is already thinking about how increasing the treatment frequency from weekly to twice a week would impact results. "Every time you do research there's always more questions you can ask."

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