Considerations & Best Practice: Gait belt use in adaptive/therapeutic riding lessons

This post was prompted by a true/false question posted on the Hoof Falls & Footfalls Facebook page and the resulting answers, comments, and discussions.

A quick note: Thank you to everyone who continues to positively and politely (professionally) engage in the quizzes and content I post here and on social media even when things are relating to a “hot topic” like this! I also want to commend those that venture a guess to questions even if they are not sure if it’s correct or incorrect….this is how we learn and we need to have more open, honest, and professional conversations around important industry topics!!!! Well done everyone….you all are awesome.

Original prompt posted on the Hoof Falls & Footfalls Facebook page:

Uh oh….. does this go against what you have done for years or even what you were taught? Has an uncomfortable feeling set in?

Please don’t stop reading…hear me out and let’s dig into this hot topic together and understand the whys and hows this is false.

First….You’re not alone! I will be the first one to admit that, in the past, I used gait belts during the riding portion of adaptive/therapeutic riding lessons, not just during mounts and dismounts, as this is what I had observed other instructors who had been teaching longer than me doing. They would leave them on during the ride and even using them to “support” the rider.

I continued to do this until this method was challenged to do better, and follow the actual best practices, by other instructors and mentors I respected. Over time I also really researched to understand what the recommended industry best practices were and how using gait belts tied into Precautions & Contraindications and Adaptive Tack Guidelines.

Gait belt industry best (safest) practice, “whys”, and the citations that back this stance.

In adaptive/therapeutic riding lessons, gait belts should only be used during mounts and dismounts as they are an invaluable tool that can help instructors not grab and pull on body parts or clothing during mounts and dismounts. Once a rider is safely mounted and ready to ride the gait belt should be removed. If the gait belt is needed during a dismount, it can then be put on the rider again prior to dismount. ¹

Gait belts should be removed during the riding portion of adaptive/therapeutic lessons for multiple reasons:

1. Even if used “extremely carefully”, using a gait belt (or any other thing with handles) greatly multiples the risk of the sidewalker pulling the rider off the horse if they trip or fall.
2. Even if used “extremely carefully”, using a gait belt (or any other thing with handles) often does not provide even support and makes it much more difficult for the rider to maintain balance….and often times the holds are causing position issues, not resolving them.
3. Leaving a gait belt on the rider during the riding portion of the lesson creates a visual that sidewalkers may want to grab onto in an emergency which could worsen a situation and mentally or physically interfere with a volunteer establishing a correct support hold or performing an emergency dismount.
4. Gait belts can interfere not only with the rider but also the equine’s movement.
5. Holding onto gait belts interferes with allowing the rider to learn how to maintain their own balance and position on the horse, of course with position adjustments as needed from the instructor. If the rider is unable to maintain position without a gait belt then they need to be assessed to make sure ar/tr is the appropriate EAS for them.
6. Riders who cannot be appropriately supported by traditional holds (thigh, thigh and ankle, trunk, etc.) and/or appropriate adaptive tack (anti-cast surcingle, saddle with handle bar, etc.) may not be suitable for adaptive/therapeutic riding and may require direct treatment by a therapist.
7. Gait belts should not be used to try and overcome a contraindication as it relates to adaptive/therapeutic riding.
8. Gait belts are not necessary and should not be used for emergency dismounts If an emergency dismount cannot be performed without a gait belt, then the rider needs to be assessed to determine if adaptive/therapeutic riding is appropriate for them. (see example on PATH Intl. Instructor Education Guide Page 162-163 or THIS VIDEO in the Intuitive Instructor Club).

I promise the above information is not just “personal opinion”. Here’s the proof:

Precautions & Contraindications related to gait belt use:

If an instructor feels that they need to use a gait belt to support a rider during the riding portion of the adaptive/therapeutic riding lesson then they need to go to the Standards and carefully evaluate if adaptive/therapeutic riding is appropriate for the student, if they should have direct treatment by a therapist (this means no more ar/tr but instead PT, OT, or Speech incorporating equines….aka “hippotherapy”), or if mounted services altogether are contraindicated or an unsafe option.

Instructors often feel the need to use gait belts beyond mounting and dismounting and during the riding time for students with hypotonia, hypertonia or spasticity, and/or trunk control issues.

Let’s take a look at what the PATH Intl. Precautions & Contraindications say about these diagnoses:

• Trunk Control
  • “….Independent sitting balance is defined as the ability to sit on the edge of a mat without back support, use of the arms, help of an assistant and without weight bearing through the feet. Standing balance requires the ability to maintain alignment and balance without stepping or moving in any direction²“
  • Precaution:
    • Adults who are unable to sit on a flat surface without back support assistance for three to five minutes without assistance
    • Children who are unable to sit unassisted may require direct treatment by a therapist
  • Contraindication:
    • Adults who are unable to sit unassisted on a flat surface with a back rest
• Hypotonia
  • Precaution:
    • Laxity in weight-bearing joints
    • Inability to maintain upright sitting posture without assistance
    • At risk for hip subluxation
  • Contraindication:
    • Unable to attain upright sitting posture may require direct treatment by a therapist.³

How does this apply to you as an instructor?

If you feel that you are unable to keep the student safe without using something like a gait belt or another item with handles, the student likely has a contraindication for adaptive/therapeutic riding and should be receiving therapy OR reach out to a mentor/coach for guidance in assessing student and/or improving implementation of standard support holds.

If you feel that you are unable to do an emergency dismount without using a gait belt or another item with handles reach out to a mentor/coach for guidance on how to improve your emergency dismount mechanics OR the student should be assessed if mounted activities are appropriate for them.

If you feel that you are unable to do position adjustments during the riding portion of the lesson without using a gait belt or another item with handles each out to a mentor/coach for guidance on how to improve your position adjustment techniques and mechanics OR the student should be assessed if mounted activities are appropriate for them and/or should be receiving therapy services instead of adaptive/therapeutic riding.

Adaptive Tack & Equipment Guidelines as it relates to gait belt usage:

Gait belts, which are considered adaptive equipment, should also not be used to try and overcome contraindications (see above).

“The participant should be evaluated for the presence of contraindications prior to considering the
use of adaptive equipment if a contraindication is present, mounted activities are contraindicated,
regardless of equipment used. The use of adaptive tack does not override a contraindication. Pre-
cautions and contraindications that may apply include, but are not limited to, issues with poor head
and trunk control, severe scoliosis, a high level of paralysis and complications of cerebral palsy,
including lack of range of motion of the hip”. ⁴

In conclusion….and encouragement:

I encourage adaptive/therapeutic riding instructors and barns/programs/centers to:

• Thoroughly read and research all standards, precautions, contraindications relating to the situation and know that you often have to piece together several things to get a best answer and see the big picture.
• Understand the different mounted services that can be provided within the Equine Assisted Services Industry, who they are provided by, and how that impacts you as an adaptive/therapeutic riding instructor.
• Continue to stay updated on industry standards and best practices
• Don’t let your emotions rule your final decision
• Don’t feel guilty if you have been doing things a certain way but now have learned a different way. Just change moving forward.

I understand that this is a hot topic and can sometimes get emotions going because when instructors do use gait belts to support riders is out of the desire to help and be a “fixer”. BUT we have to be careful that we don’t let our “fixer” hearts overrule safety and industry best practices….especially if we don’t like what the best practices are.

Please know that if you used or currently use gait belts during the riding portion of adaptive/therapeutic riding lessons, I’m not judging you but urging you to do your thorough research. Remember…I’ve used them before as well before I knew better!

• Don’t do something just because you heard/see other instructors pr centers doing it.
• Don’t do it because you think you are “more careful” than most or “rarely use it”
• Don’t do it just because you are afraid of saying “no”.

Research, prove, and document why your decision is the best choice but also know that during that discovery phase sometimes the answer or wisest decision is not always the one we want.

If you made it this far in reading…congratulations! Let me know your thoughts in the comments below.

Note: Information above relates to ar/tr instructors in the USA and Canada following guidelines set by the main organizations that are involved with ar/tr instructor certification. Other RDA organizations that are in countries beyond the USA and Canada may have other guidelines for Gait belt use and instructors certified/trained/etc. through those organizations should thoroughly research local rules, regulations, and best practices regarding adaptive equipment.

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Want to learn more about topics mentioned in this post? Check out the Intuitive Instructor Content below:

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1. Professional Association of Therapeutic Horsemanship International. (2019) Instructor Education Guide (2019 ed.). Pages 36-38. ↩︎
2. Professional Association of Therapeutic Horsemanship International. (2021). Standards for certification & accreditation (2021 ed.). Professional Association of Therapeutic Horsemanship International. ↩︎
3. Professional Association of Therapeutic Horsemanship International. (2021). Standards for certification & accreditation (2021 ed.). Professional Association of Therapeutic Horsemanship International. ↩︎
4. Professional Association of Therapeutic Horsemanship International. (2021). Standards for certification & accreditation (2021 ed.). Professional Association of Therapeutic Horsemanship International. ↩︎