Ten years of major equestrian injury: are we addressing functional outcomes?

A retrospective review of the trauma registry at a level 1 center (1995–2005) was completed in conjunction with a patient survey outlining formal in-hospital therapy. Forty-nine percent of patients underwent in-patient rehabilitation therapy. Injuries predictive of receiving therapy included musculoskeletal and spinal cord trauma. Previous injury while horseback riding was predictive of not receiving therapy. The majority (55%) of respondents had chronic physical difficulties following their accident.Rehabilitation therapy is significantly underutilized following severe equestrian trauma. Increased therapy services should target patients with brain, neck and skull injuries. Improvements in the initial provision, and follow-up of rehabilitation therapy could enhance functional outcomes in the treatment resistant Western equestrian population.Horseback riding, both recreational and work related, are popular activities in Alberta. Over 470,000 people are employed exclusively within the Canadian equestrian industry [1]. In addition, Alberta hosts the largest rodeo in the world and possesses over 50% of the 854,032 horses in the country [1].Unfortunately, horse-related activities are also a significant contributor to major injury. When compared to motorcycle riding, equestrian activity has a higher hospital admission rate of 0.14/1000 hours versus 0.49/1000 hours [2,3]. Consequently, horseback riding is considered more dangerous than motorcycle riding, skiing, automobile racing, football and rugby [3-6]. The riding position itself creates this high-risk situation. Horseback riding elevates the rider's head 3 meters above the ground on an animal that can easily weigh 500 kg or more, kick with a force of nearly 1 ton, and run at speeds of 65–75 km/h. In addition, horses are less predictable than either a motorcycle or a racecar.Patients sustaining major injuries from horseback riding often require rehabilitation therapy. The therapy team may include a physiatrist, occupati