How Can I Adapt The Therapeutic Riding Lesson Plan For A Child With Severe Cerebral Palsy And Limited Upper Body Mobility To Incorporate The Use Of A Customized Adaptive Saddle And Reins, While Also Addressing Their Specific Goals For Improving Balance And Core Strength, And Taking Into Account The Child's Recent Hip Replacement Surgery And Subsequent Need For Gentle Mobilization Of The Affected Joint?

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Adapting a therapeutic riding lesson plan for a child with severe cerebral palsy, limited upper body mobility, and recent hip replacement surgery requires a comprehensive and gentle approach. Here's a structured plan to address the child's needs effectively:

Adaptive Equipment

  • Customized Saddle: Use a saddle that provides support for the hips and lower back, ensuring proper alignment and preventing strain on the hips post-surgery.
  • Adaptive Reins: Utilize reins designed for ease of grip, possibly with extra support or a special design that minimizes the need for hand movement.

Lesson Structure

  1. Warm-Up (5-10 minutes):

    • Gentle walking on a smooth-gaited horse to avoid jolting.
    • Consider sitting without stirrups to engage core muscles, with support as needed.

  2. Exercises for Balance and Core Strength:

    • Sitting Without Stirrups: Short periods to engage core, ensuring comfort and safety.
    • Gentle Weight Shifts: Minimal movements to challenge balance without overexertion.
    • Heel Taps: To encourage lower body engagement while minimizing hip movement.

  3. Cool Down and Stretching (5-10 minutes):

    • Gentle stretches while mounted to aid hip mobility without strain.
    • Careful unmounting to avoid hip stress, possibly with assistance.

Team Collaboration

  • Involve a physical therapist, riding instructor, and spotter for safety and support.
  • Monitor the child's comfort and pain levels, allowing regular breaks.

Session Considerations

  • Duration: Start with shorter sessions (20-30 minutes), increasing as the child's endurance improves.
  • Horse Selection: Use a calm, well-trained horse for smooth movement.

Progression and Goals

  • Set specific, measurable goals, such as increasing unsupported sitting time or core engagement duration.
  • Gradually introduce more challenging exercises as the child heals and strengthens.

Documentation and Flexibility

  • Maintain detailed records of each session to track progress and adjust the plan as needed.
  • Remain flexible to adapt to the child's daily condition and progress.

Additional Considerations

  • Consult with a physical therapist specializing in hippotherapy for tailored exercises.
  • Ensure support staff, like sidewalkers, are present to assist with balance and comfort.

This plan prioritizes safety, comfort, and gradual progress, ensuring a beneficial and enjoyable experience for the child.