LeAnn Smiley

CLEVELAND, Tenn. — Years ago, traditional physical therapists had all but given up on David Richardson.

Before he began therapeutic horse riding five years ago, the 32-year-old used two arm braces to assist his walking, which was stilted and uncontrolled because of brain damage from a bacterial infection.

Physical therapy was a chore, said his mother, Katie Richardson.

“Every physical therapist said, ‘We can’t get him to do anything,’” said Mrs. Richardson, batting away flies on a muggy evening at the Tri-State Therapeutic Riding Center in Cleveland. “David is stubborn as the day is long, but you get him to have a good time and he’ll learn.”

She turned to watch her son grinning broadly as he sat astride a slow-moving horse and lifted his arms wide. After years of therapeutic riding, she said, his strength and balance have vastly improved and now he walks with just the help of a quad cane. Most important, he loves the sessions, she said.

“His whole world has improved,” she said. “I wish it had come earlier in his life.”

Some participants and their family members said they started out skeptical of the therapy offered by the center’s “Reinbow Riders” program. But the improvements — physical, cognitive and emotional — for many participants are impossible to ignore, the riding instructors said.

“We’ve had students who have never walked start walking. We have students that never talk start talking,” said certified riding instructor Jerry Howard, who has been with the program for two years. The Reinbow Riders are part of the nonprofit Tri-State Exhibition Center in Cleveland.

Mounting and riding a horse improves balance, posture, mobility and strength, he said.

“The natural movement of the horse works parts of the body that normal therapy doesn’t get to,” Mr. Howard said.

The instructors and volunteers also play games with the participants, asking them to ride without hands, lift their feet from the stirrups or stand up on the balls of their feet. The games improve balance and strength, as well as cognitive abilities and memory, instructors said.

Therapeutic riding — also known as hippotherapy, from “hippos,” the Greek work for horse — can be effective in treating a range of conditions including muscular dystrophy, cerebral palsy, Down syndrome, autism spectrum disorder, learning disabilities, emotional disabilities and attention deficit disorder.

Participants all must get the therapy approved by their doctor, Mr. Howard said.

The therapeutic value of horseback riding has been known for centuries, but the therapies didn’t make it to North American until the 1960s, said Carol Nickell, who heads up the North American Riding for the Handicapped Association. The Denver, Colo. group certifies therapeutic riding instructors.

Nationally about 3,500 people are NAHRA-certified instructors and about 5,900 horses provide the service, she said.

Benefits come not only from physical movement, but from interacting with the horse and forming relationships with instructors, volunteers and fellow riders, Ms. Nickell said.

“I don’t think there’s a diagnosis that could not benefit from this,” she said.

The riding program started 10 years ago with two horses and two students. Participation has grown in recent months as the center has promoted its program, said LeAnne Smiley, executive director of the Tri-State Therapeutic Riding Center.

The upcoming summer session has 86 participants, she said.

“It’s just snowballed,” she said. “The need is so strong.”

Ms. Smalley noted that many of the new riders have autism spectrum disorder, which affects 1 in 150 children, according to the U.S. Centers for Disease Control and Prevention.

For David Richardson, who is largely nonverbal, riding has improved his walking, his social skills and quality of life, his mother said.

“When you can’t talk, and you can’t get your message across, you get frustrated. The joy of what he’s doing (in therapy) makes that a trivial something,” she said. “He’s so proud of himself.”