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Equine-related eye injury: a case report of globe rupture and vision loss in a post-stroke hippotherapy patient.
Abstract: Hippotherapy has recently emerged as a horse-based rehabilitative therapy to improve balance, coordination, and strength in patients with a wide range of medical conditions. Although several studies have demonstrated its effectiveness in restoring balance and gait in patients who have suffered cerebrovascular accidents (CVA), few studies have reported on adverse events associated with the treatment. Methods: This case report describes a female post-stroke patient who fell from a horse during a hippotherapy session. She suffered a closed right zygomaticomaxillary complex fracture and ruptured globe injury. The patient's orbital injuries were surgically repaired, yet ultimately left her with no light perception in the affected eye and required enucleation. Conclusions: Ocular and orbital injuries following hippotherapy are potentially blinding yet preventable. As such, practitioners should weigh the risks and benefits of hippotherapy, particularly in patients with unstable gait, and advise that additional safety precautions are taken to avoid these devastating injuries.
Publication Date: 2019-02-12 PubMed ID: 30740519PubMed Central: PMC6366632DOI: 10.1016/j.ajo.2008.10.017Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research article reports on a severe eye injury suffered as a result of a fall during a hippotherapy session by a post-stroke patient. The article advises practitioners to consider the risks versus benefits of hippotherapy, particularly in patients with unstable gait, and to implement extra safety precautions.
Overview of the Research Article
- The primary focus of this article is on the risks associated with hippotherapy, which uses horse riding as a rehabilitative therapy method for individuals with various health conditions, specifically those who have suffered cerebrovascular accidents (CVA) or strokes.
- The therapy has shown effectiveness in improving balance, coordination, and strength. However, the article highlights a case of severe ocular and orbital injury, leading to a loss of light perception in the eye, that occurred during a hippotherapy session.
Case Report and Analysis
- The case report describes a female post-stroke patient who fell off a horse during a hippotherapy session and sustained a closed right zygomaticomaxillary complex fracture and a globe rupture (a severe eye injury).
- The patient’s eye injuries were treated surgically, but the damage led to the eventual removal of the eye (enucleation) due to the loss of light perception.
- The researchers analyze this incident to bring awareness to the potential for serious accidents and injuries during hippotherapy sessions and further discuss measures to prevent such incidents.
Conclusions and Recommendations
- The authors conclude that while hippotherapy can be effective for certain health conditions, practitioners need to consider the risks carefully. Specifically, there are potential dangers for patients with an unstable gait who are more likely to fall.
- The paper emphasizes the essentiality of additional safety measures during therapy sessions to prevent severe injuries.
- They underscore the importance of conducting a thorough risk-benefit analysis before recommending hippotherapy to patients, taking into consideration an individual’s specific health condition and physical abilities.
Cite This Article
APA
Chang LY, Chang SM, Andrews L, Saeedi O.
(2019).
Equine-related eye injury: a case report of globe rupture and vision loss in a post-stroke hippotherapy patient.
Am Med Stud Res J, 5(1), 110-113.
https://doi.org/10.1016/j.ajo.2008.10.017 Publication
Researcher Affiliations
- University of Maryland School of Medicine, Baltimore, Maryland.
- University of Maryland School of Medicine, Baltimore, Maryland.
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
Grant Funding
- K23 EY025014 / NEI NIH HHS
Conflict of Interest Statement
Conflicts of Interest: Mr. Chang reports no sources of financial support or relevant conflicts of interest for the present work. Ms. Chang reports no sources of financial support or relevant conflicts of interest for the present work. Dr. Andrews reports no sources of financial support or relevant conflicts of interest for the present work. Dr. Saeedi reports no relevant conflicts of interest for the present work. This case report has not previously been presented in any other scientific meeting or publication.
References
This article includes 11 references
- Lee CW, Kim SG, Yong MS. Effects of hippotherapy on recovery of gait and balance ability in patients with stroke.. J Phys Ther Sci 2014 Feb;26(2):309-11.
- Bronson C, Brewerton K, Ong J, Palanca C, Sullivan SJ. Does hippotherapy improve balance in persons with multiple sclerosis: a systematic review.. Eur J Phys Rehabil Med 2010 Sep;46(3):347-53.
- Sunwoo H, Chang WH, Kwon JY, Kim TW, Lee JY, Kim YH. Hippotherapy in adult patients with chronic brain disorders: a pilot study.. Ann Rehabil Med 2012 Dec;36(6):756-61.
- Loder RT. The demographics of equestrian-related injuries in the United States: injury patterns, orthopedic specific injuries, and avenues for injury prevention.. J Trauma 2008 Aug;65(2):447-60.
- Ueeck BA, Dierks EJ, Homer LD, Potter B. Patterns of maxillofacial injuries related to interaction with horses.. J Oral Maxillofac Surg 2004 Jun;62(6):693-6.
- Margo JA, Feldman S, Addis H, Bodanapally UK, Ellish N, Saeedi O. Open Globe Injuries Presenting With Normal or High Intraocular Pressure.. Eye Contact Lens 2016 Jul;42(4):256-61.
- Savar A, Andreoli MT, Kloek CE, Andreoli CM. Enucleation for open globe injury.. Am J Ophthalmol 2009 Apr;147(4):595-600.e1.
- Jalayondeja C, Sullivan PE, Pichaiyongwongdee S. Six-month prospective study of fall risk factors identification in patients post-stroke.. Geriatr Gerontol Int 2014 Oct;14(4):778-85.
- Inness EL, Mansfield A, Lakhani B, Bayley M, McIlroy WE. Impaired reactive stepping among patients ready for discharge from inpatient stroke rehabilitation.. Phys Ther 2014 Dec;94(12):1755-64.
- Mansfield A, Inness EL, Komar J, Biasin L, Brunton K, Lakhani B, McIlroy WE. Training rapid stepping responses in an individual with stroke.. Phys Ther 2011 Jun;91(6):958-69.
- Cook R. Low injury rate in hippotherapy practice.. Hippotherapy 2013;Summer Issue:19–20.
Citations
This article has been cited 2 times.- Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. Int J Environ Res Public Health 2023 Jul 16;20(14).
- Marchand WR, Andersen SJ, Smith JE, Hoopes KH, Carlson JK. Equine-Assisted Activities and Therapies for Veterans With Posttraumatic Stress Disorder: Current State, Challenges and Future Directions. Chronic Stress (Thousand Oaks) 2021 Jan-Dec;5:2470547021991556.
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