Falls are the leading cause of injuries and deaths in adults over the age of 65. The purpose of this case study is to explore the use of Equine Assisted Activities and Therapies (EAAT) to improve the mechanisms of balance, postural sway, fear of falling (FOF), and participation in older adults (OA). The participant (a 76-year-old woman), completed 10 Adaptive riding (AR) sessions over a six-week period, led by a Level II therapist (COTA/L and PATH certified riding instructor). Changes in function were assessed using the Berg Balance Scale (BBS), Activities-Specific Balance Confidence Scale (ABC), Activity Card Sort (ACS), and Video Motion Capture (VMC) system. Results indicated improved static standing balance, postural stability, and greater dynamic head and trunk control. Additionally, the participant expressed decreased FOF, decreased back pain, the ability to recover self after a fall, and an increase in activity participation as indicated in the ACS.