Equestrian Rehabilitation Center – Viterbo

At the Equestrian Rehabilitation Center, equipped with ample functional space and a riding school surrounded by ancient olive trees, Equestrian Rehabilitation is successfully used, which plays a very important role in the activities carried out by the rehabilitation center.

Activities are carried out with the technical support of theAREDA Amateur Sports Association.


Integrated equestrian rehabilitation

La equestrian rehabilitation is practiced in an integrated way: the Center is dedicated to people with disabilities who, thanks to their inclusion in groups of able-bodied young people, with whom there is a deep exchange of work and friendship, achieve excellent results in improving interpersonal relationships, thus facilitating their reintegration into the outside world.

The Equestrian Center has structured itself in compliance with the dictates of the National Guidelines for Animal Assisted Interventions referred to in the new regulations regarding the training and establishment of the list of centers and operators (Decree of the Acting Commissioner March 9, 2016, no. U00070 related to the Transposition of the National Guidelines for Animal-Assisted Interventions (IAA) and approval of regional implementing provisions as established by the State-Regions Conference on March 25, 2015).

On October 30, 2019, it obtained from the relevant health authorities the Nulla Osta for the provision of Animal Assisted Interventions and is listed in the Lazio Region lists as an authorized center.

Operators have attained the necessary qualifications to be registered in the national and regional lists for Animal Assisted Interventions.

Operational procedures for rehabilitative interventions and those for the welfare of the animals involved have been refined.

Thus, the principle of integration is cornerstone of the Center’s philosophy. Patients attending the riding school, throughout the year are featured with the well-known “Carousel of St. Raphael Viterbo,” (formerly Carousel of Villa Buon Respiro) in many equestrian events and demonstrations.

Thus, equestrian rehabilitation provides a concrete basis for possible reintegration of disabled people with the help of horses. The riding stables of the Equestrian Rehabilitation Center are home to docile Haflinger horses living freely, used for therapy and lessons in riding and tack, some miniponies used for younger children, and some donkeys used for onotherapy.

The integrated work

Anyone who has a chance to witness the “St. Raphael Viterbo Carousel” in person or to see a film of it can immediately see that there is an extraordinary fellowship and relationship among the riders based on equality. Together they form a team in which each of them knows that his or her role, like that of the others, is crucial to the perfect execution of each figure. So everyone is important, no one excluded, and that makes them one, a “group.” The purpose of the Center is to keep the group dynamic active and positive at all times.

Today all this happens spontaneously compared to the early days because those who approach the riding school now no longer have prejudices against the boys of St. Raphael Viterbo. Thanks to past experience, they are no longer considered “different” or “weaker,” but simply kids-perhaps a little less fortunate-who are entitled to have the same chance, which all human beings have, to fulfill their potential. Outside learners (children 6 years and older) easily fit into a reassuring situation, and the parents themselves immediately enter into the Center’s integrated philosophy. Everyone is welcomed with affection and helpfulness but also with professionalism and organization, quickly overcoming the discomfort that natural mutual distrust generated instead in the early years.

In the beginning, boys from the city of Viterbo, were invited to attend the center not for equestrian rehabilitation or riding but simply to open the doors to the outside world, thus giving the boys being treated at the rehabilitation center a way to come into contact with “normality.” They all started riding horses together, thus cultivating a common interest. This sharing resulted in the nursing home residents being given new and unfamiliar stimuli, thanks to which, even by virtue of the mere spirit of emulation, they were able to make important progress not only in riding but especially in many aspects of behavior.

Being able to be part of the group of “carousel boys” is for everyone the end point, the goal to be reached. This philosophy characterizes the entire activity of the riding school: the boys who perform and who on the outings represent the work of the Center are only a part of the “group” that is actually formed by the more than 250 boys who attend it. Everyone is part of it and everything is done together: therapy, play, work, horse care form one inseparable path toward integration and autonomy. A basic element is to allow each person to try, to express his or her abilities, and often it is thus possible to discover unsuspected gifts and the right way to intervene. Applying this simple methodology showed significant results.

Equestrian rehabilitation for mentally handicapped individuals

After the International Congress in Hamburg in 1982, three phases through which equestrian rehabilitation activities are divided were defined: Hippotherapy, Re-education through Riding and Vaulting, and Presports Riding.

We also need this subdivision for the purpose of assessing the specific goals of each subject. (from “Practical Principles of Equestrian Rehabilitation” by Professor Massimo Papini and Professor Anna Pasquinelli).


‘Hippotherapy is the stage of the first approach with the horse, but in severe mental handicaps the active participation of the subject is not required. Indeed, it is the horse itself, with its rhythmic and modulable gait and docile but never passive nature, that lends itself to the breaking of pathological patterns: stereotyped movements, isolation, postural rigidity, and aggression. It is used for those who more or less passively, approach and/or agree to ride a horse and during the activity leave an opportunity for the practitioner to enter into a relationship with them. It can be supplemented, where possible, by moments on the ground aimed at caring for the horse.

Equestrian reeducation, practiced as integrated rehabilitation

It requires an active approach to the world of horses and riding, a world that lends itself extraordinarily well to education and/or reeducation of all cognitive, relational and psychomotor areas. It is in fact rich in situations that can be exploited by the operator: think, for example, of harness care and cleaning of the horse for praxis and manual skills in general, but think also of the relationship and communication with the horse itself, made up of such primitive gestures and sensations and yet the basis of normal interpersonal relationships. Since this phase gathers a type of cases with often very different skills and abilities, we felt the need to divide it into two distinct moments: one of approaching riding and the other of learning riding with the ultimate goal of horse control and autonomous riding.


  • Cognitive area: Knowledge of the main anatomical parts of the horse, harnesses, and tools for cleaning and care
  • Relational area: Recognition of the individual “horse,” differentiation of “selves,” respect
  • Motor skills area: Education and control of fine motor skills, through care of the horse and harness, global
  • Language area: Understanding and production of object names and simple commands


  • Cognitive area: Work on body knowledge, figure recognition, complex movements; work and games on the floor to test and fix what has been learned
  • Relational area: Group work (shooting), mate recognition and differentiated work. Active behavior with the horse
  • Motor skills area: Work on muscle tone, balance, rhythm. Work on body acquisition of simple and complex postures and movements
  • Language area: Understanding and production of simple and complex commands


Horsemanship understood as a sports discipline and precisely as preparation for children’s participation in the equestrian carousel. This is the stage in which the individual must develop an awareness of riding as a sporting discipline with all that this entails: performance, competitiveness, but also a special relationship with the horse and full inclusion in shooting and riding work with able-bodied people, contact with the outside world.

Carousel of St. Raphael Viterbo

The inspiring principle of the Center finds its best expression in the simple verses of American poet Douglas Malloch (1877-1938)…

The best
If you cannot be a pine tree on the mountaintop, be a shrub in the valley, but be the best little shrub on the bank of the stream. Be a bush if you cannot be a tree. Be a path if you cannot be a highway. If you cannot be the sun, be a star. Not with mole win or fail.
Be the best of whatever you are.

St. Raphael Viterbo’s Carousel is an equestrian show, of good technical level, unanimously acclaimed nationwide, performed by the Center’s disabled and non-disabled students (16 on horseback and 2 by buggy); the horses are all haflinger breeds bred and trained by the operators themselves. The choreography is designed by Instructor Mauro Perelli, who has followed the birth and development of the riding school and equestrian activity since its inception. The figures are accompanied by music specially written by composer Gabriele Campioni.

From a rehabilitation point of view, it represents the goal achieved and also the beginning of a new path full of possibilities for growth: it is the time when patients can participate in real sports events. In fact, anyone who plays a sport needs a goal. At the St. Raphael Viterbo riding school, the goal that unites everyone is to join the carousel group. Why the Carousel? The method based on integration and equality implies equal opportunities for everyone, no one excluded. The motto of the center is precisely, “on horseback we are all equal.”

Membership in the Carousel group creates a de facto solidarity among its members, as for the perfect success of the figure set, everyone is committed to and helps each other. It is an attitude that naturally arises in each of them since they all arrived at this level by going through the same training process. Patients who are best in terms of equestrian technique but also at a more advanced level in the personal and social autonomy they have achieved, participate in trips throughout Italy as the protagonists of the carousel together with their able-bodied companions. (Fieracavalli Verona, Piazza di Siena, etc.).

At this stage, practitioners can test the skills achieved by patients and, if difficulties are evidenced, focus on the transfer and generalization of the skills achieved. The main purposes are: to popularize equestrian rehabilitation and its effectiveness through participation in equestrian events and shows; to bring the disabled boy into contact with the outside world for his reintegration; to enhance the philosophy of integration characteristic of the Center’s method; and to stimulate the interest and participation of C.R.E. users.”


Attacks, activities for toddlers

In order to meet the many different needs and to address in an increasingly specific and individualized way each patients’ needs, normal stature horses, mini ponies and donkeys are also used, as well as differentiated activities

In addition to horseback riding, the discipline of “bindings” aimed at all those who do not have the opportunity to ride horses and to bring younger children closer is also conducted at the center. Two small gigs are used, one of which is adapted to facilitate access for people with motor impairments, pulled by schetland ponies, and a buggy regularly attached to one of the Haflingers. In the carousel, an attachment, an elegant wooden buggy, referred to in the English term “gig,” has also been included in recent years, as this discipline is also enthusiastically practiced by many of the center’s children.

For the little ones

For the past several years, an activity has been started at C.R.E., aimed exclusively at younger patients, of approaching horses through play, in the company of shetland miniponies, which are more suitable due to their size. This allows the children to go through a course of preparation for learning about the horse, its handling and riding, which will make them excellent amazons and excellent riders.


A very important aspect of equestrian rehabilitation activity that often takes a back seat is that related to the preparation work of the horse being used. In the experience of St. Raphael Viterbo, a major contribution to the achievement of the goals is undoubtedly made by the use of the Haflinger or Haflinger horse and the care devoted to its training. The first specimen arrived by chance, but over time the adoption of this breed became a definite and thoughtful choice. Its physical characteristics such as height, morphology, colors, endurance, and character characteristics such as helpfulness, docility, versatility, friendliness, cold-bloodedness, and others are decisive working tools.

In addition, there is a belief that in order to perform at their best, horses also need to be well both physically and mentally. The horse is an animal that was born to be free, needs space, and living in a way that indulges its natural needs is more serene than a horse living in a box in a stable; this seems to us to be a key factor. It has been found that, given the chance, it is preferable to leave them in herds and grazing.

Observing herd dynamics, hierarchies, friendships and impatience simplifies the work in shooting: six, eight horses in a class can stay together without problems. The formation of the carousel is also designed precisely according to the friendships among the horses in the herd.

For all these reasons, it was decided to go the breeding route so that foals can be born, grow up and be trained according to the Center’s principles from birth: horses should not know violence and abandonment but rather see in humans a reliable and grateful friend for all that these “therapists extraordinaire” do for them.

Haflinger horses


Perhaps not everyone knows that.

…at San Raffaele Viterbo during the school break, children can attend the riding school all week Monday through Friday from 8 a.m. to 6 p.m. This project, which is named “Riding Life.” aims to offer children ages 8 and up a full immersion aimed at getting to know up close and actively participate in the life that takes place at the stables, from caring for the animals to cleaning the environments in which they live, from riding lessons to hitching lessons, from grooming the manes and tails to seeing the work of the farrier, from playing with the ponies to the moment when the horses returned to their paddocks slowly head out to pasture.
Today’s children living in a super-technological world thus have the opportunity to confront a completely different and authentic reality.

…at St. Raphael Viterbo animals live on pasture and have about 20 hectares of olive grove at their disposal. The plants, about 1,300, of various breeds and ages, some centuries old others younger, are pruned and kept tidy but never polluted by any chemical or even biological treatment. Fertilizer is provided and distributed directly spontaneously by the guests living under their canopies, namely horses and donkeys. The olives are harvested in November and a natural, exquisite extra virgin olive oil with a unique flavor is produced. On those days there is a week-long oil festival, and all St. Raphael Viterbo children are invited to participate for a day in the harvest and then to taste the freshly pressed oil on fresh bread.
Proceeds from the oil sold are used to purchase harnesses and equipment used for equestrian rehabilitation.

…at San Raffaele Viterbo live donkeys of endangered breeds: the Amiata donkey, native to Mount Amiata, height at withers cm 120 – 140 and the Sardinian donkey, height cm 80 – 100. In the center they are both used foronotherapy (onos in Greek means donkey). The donkey is a quiet, calm animal, curious and attentive to his surroundings and those around him. He does not convey anxiety; in fact, his calmness is contagious, and he never makes sudden movements that may frighten those who approach him. It is very independent, and in its relationship with humans its management does not present any particular difficulties; in fact, it tends to interact spontaneously, leaving the therapist to act as a mediator rather than as the animal’s handler. The domestic donkey is a frugal, robust and intelligent animal, excellent for companionship, adapts to a wide variety of environmental conditions and is undemanding in feeding. It is all over the world used as a pack, draft and saddle animal, it learns the way and can retrace it on its own. Physical characteristics are its large ears, high hooves and short, straight mane. The tail is shaped like a brush. The coat is gray with a light abdominal coat and a crisscrossed mulina stripe on the back. Very hardy in stride and trot, gallops less frequently. Its cry is the braying used as an expression of greeting and call. It can live as long as 40 years.

… at San Raffaele Viterbo animals live as much as possible according to their natural inclinations and habits so that their mental and physical well-being is guaranteed. This is good for them but also good for the operators, who not only have balanced and well-disposed horses but also many educational insights to share with the Center’s visitors. The welfare of animals is held in high regard in respecting their way of life in nature. Elderly animals, who have worked willingly for so many years, end their days in the pasture, pampered by people who have grown with them, improved with them, who have had them by their side in their work.

The riding hall and riding school

Created to accommodate the patients of St. Raphael Viterbo, the riding school is a real “department” of the nursing home. Since 1988, it has also been open to outside users who attend it as students for riding and working side by side with disabled companions. The aim was to achieve a non-medicalized but protected environment in which pietistic and marginalizing behaviors and attitudes that make the disabled person unsuitable for integration itself are banned.

All users with disabilities, are initially supervised individually by an operator-instructor, and then, each at their own pace, are placed in a small integrated group of 4 to 6 learners. Since 2005, the AREDA Amateur Sports Association , formerly “Friends of St. Raphael,” has been affiliated with the Italian Equestrian Sports Federation for equestrian rehabilitation and integrated equestrian sports.

The Equestrian Center offers several opportunities for children who can enroll in winter classes that run from mid-September to mid-June like the school year or weekly summer classes. The students are distributed in classes of various levels that will take the most enthusiastic ones to the Carousel boys’ group.

There is also the possibility of attending summer classes, during the school break, in which children are offered a week of “riding school life,” a full immersion aimed at getting to know up close and actively participate in all the sports and other activities that take place at the riding school.

Instead, adults can purchase a package of classes to be booked on a case-by-case basis.
The riding stables are equipped with 5 sand courts of various sizes, 3 saddleries and a bindings shed, a clubhouse, a small bar, a multi-purpose indoor area, and country trails for riding.

Here is a roundup of pictures of the Riding School:

Onotherapy: rehabilitation with donkeys

L’onotherapy at St. Raphael Viterbo has been practicing since 2005: in that year the Equestrian Rehabilitation Center has initiated, with the collaboration of Dr. Patrizia Reinger of the Fatebenefratelli Institute in Genzano di Roma, an experimental project of rehabilitation with a donkey (onotherapy), friendly and generous equine endowed with great communication potential and equally good qualities such as affection, stimulating curiosity, and seeking interaction, which was proposed to our patients.

The project was born of the need to offer a new rehabilitative activity to those patients at St. Raphael Viterbo who presented difficulties with relationships, attention, aggression and excitability and who due to their pathology could not work with horses. Due to the positive results that have been recorded, onotherapy is now regularly available to patients and included in many rehabilitation projects.

Like the rehabilitation intervention with the horse, the rehabilitation intervention with the donkey, albeit through a different path, is also aimed at the recovery and/or development of:

  • simple and complex interpersonal relationship skills that involve at their core motivation, openness to experience and control of emotional functions;
  • Technical skills regarding memory, psychomotor, cognitive, language, and muscle functions.

Based on past experience, it could be verified that onotherapy is indicated for patients with excessive impulse control regardless of the severity of cognitive or motor impairment. In these cases it constitutes the assisted therapy of choice as well as in patients with severe sensory deficits or major affective-relational difficulties. In fact, it addresses a clientele that often expresses discomfort or malaise on the level of adaptation, socialization, behavior, and affectivity. Patients with disorders involving the affective and relational spheres are those who can most benefit from working with donkeys, which, by their nature, require contact and are empathetic, characteristics that make an affective interaction easier by facilitating the recovery of spontaneous communication.

Onotherapy involves a pathway consisting of several steps:

Approach and contact: begins with individual work focused purely on contact with the animal and the practitioner;
Interaction with the donkey: we also gradually incorporate simple exercises that teach the patient how to handle the donkey (cleaning, leading with the lunger, etc.);
Ability to get response to one’s requests: collective games, courses of various types and difficulties with ground barriers, skittles, hurdles, leading with long reins are finally proposed. At this point we work as a group to expand the three-way relationship to include peers and operators as well.

Both The work with the horse and the work with the donkey make it possible to achieve similar goals with people who manifest different frailties: any rehabilitation intervention in fact tends toward the achievement of the greatest possible social and personal autonomy, the improvement of one’s self-esteem, and the enhancement of communication and contact with the other than oneself.

A bit of history

The Equestrian Rehabilitation Center was founded in the late 1980s almost by accident. Someone donates a horse to St. Raphael Viterbo, which arouses such enthusiasm that they decide to start a real equestrian business.

The city within the institute.
The facility’s first director Franco Di Marco, convinced of the need for the social reintegration of the boy-patients of St. Raphael Viterbo, tries to take them out of the “Institute,” but the outside world greets them with extreme distrust. With a brilliant insight, he decided to do the opposite: let the city into the institution. To do this he uses horses. Opens the riding school to young people in Viterbo and allows them to attend it for free to learn to ride horses: their presence and friendship for the patients of St. Raphael Viterbo in exchange for riding lessons. At first with the usual distrust, then with confidence, then with enthusiasm. The results were evident right away. Soon outside and inside boys formed a close-knit group that shared not only work and friendship but also a common, noncompetitive goal: to run the carousel.

St. Raphael Viterbo boys in the outside world.
And that is the magic: his idea is a winner. By participating in carousel trips, the boys of St. Raphael Viterbo are invited outside into everyone’s world and finally accepted and admired as expert protagonists for what they can do. In fact, those who join the Carousel group have reached a good level both in terms of riding technique but also in terms of personal autonomy.
The boys of St. Raphael Viterbo made their debut with the first Carousel at the International Tuscia Cavalli Fair in Viterbo in July 1990 with the figures accompanied by the music “The power of love.” It was so successful that since then the youngsters have been invited to participate in many other horse and disability-related events throughout Italy.

San Raffaele Viterbo and San Raffaele S.p.A.
In 2003, San Raffaele Viterbo (formerly Villa Buon Respiro) became part of the San Raffaele S.p.A. Health Company, which sensed the ethical and scientific value of Equestrian Rehabilitation and dedicated itself to its development and dissemination. Activities, number of horses, staff and riding school facilities are implemented. In 2004, the Amateur Sports Association “Friends of St. Raphael” was founded and affiliated with the Italian Equestrian Sports Federation as a Federal Equestrian Rehabilitation Center.
In 2005, other activities such as attachments and onotherapy were introduced. Approach horse activities for younger children are organized during the same period. In 2007, the first experimental research project on the effects of Equestrian Rehabilitation and Onotherapy on people with intellectual disabilities started, which was concluded in 2011 with its publication in the international journal Disability and Rehabilitation. The Center participates in numerous conferences, courses and studies on equestrian rehabilitation and onotherapy. Since 2009, it has been opening its doors during the months of school break to school children in Viterbo and province by offering weekly summer riding classes and knowledge of “Riding Life” to families.
The riding school today is attended by a lot of kids, about 250 in a week between outdoor and indoor.

Equestrian rehabilitation…explained to children

It is often difficult to explain to children what they are going to do with the horse…hence the idea of producing a “visual trail” that could be helpful.

The drawings on this page and the attached poster were made by the Equestrian Rehabilitation Center for the FIEROBECCO project – Multicenter Study on the Application of Equestrian Rehabilitation in a Group of Children with Autism – proposed and organized by the Italian Equestrian Sports Federation – Equestrian Rehabilitation Department, the Istituto Superiore di Sanità, the University Institute of Motor Sciences of Rome – Foro Italico and the National Reference Center for Animal Assisted Interventions – Ministry of Health.

In Handling: Work Program

Here to download the poster on equestrian rehabilitation