by Bailey Crook, SPT
During my clinical rotation with Mia Thomas PT, DPT I’ve had the wonderful experience to shadow Kirsta Malone, OTR at her horse stables in Union Springs on Wednesday afternoons. Kirsta currently runs a nonprofit organization that offers hippotherapy sessions, as well as horseback riding lessons, called Green Goose Acres. She’s in the process of building an indoor facility that will be under the new name of Healing H’Arts Equestrian Center.
I’ve had the great opportunity to observe the various interactions that go on throughout a hippotherapy session. Kirsta is thoroughly and constantly checking in on the patient and making sure they are in optimal alignment and safe on the horse. As the lead therapist, Kirsta also checks in with the horse leader throughout the session to see how the horse is feeling and reacting to the session. Since I’m a side walker, my arm is sometimes resting up on the patients thigh or down on their heel. The patient’s independence level on the horse will determine which type of hold the side walkers need to have. A thigh hold is more taxing on the side walkers arm since you are supporting some of the patient’s weight with your arm. When I first started Kirsta was really aware about switching in and out with me to give me a rest, and now she is checking in 2-3 times per session to make sure her side walkers aren’t getting too tired. It’s very important that the lead therapist is checking in on all of her team members throughout the session in order to ensure safety of the patient and everyone involved.
A hippotherapy session usually isn’t just riding on the horse. Most of the patients are little kids so you need to still engage them like you would on land. I’ve observed many games Kirsta has come up with where the child has to look around the arena and find a word written on the fence or a colored basket with toys hidden inside. Although, it needs to be in mind that any new toy to the horse needs to be introduced to the horse before the session with the patient begins. You need to be sure the horse has approved of the toy beforehand in order to avoid any unforeseen circumstances while the child is riding.
There are different ways to ride the horse in order to challenge the patient. There are the simple changes like changing direction or changing speed. There are also patterns like figures 8s, small and large circles, and sharp and wide turns. It’s important to change up the pattern of riding to engage the patient and challenge their postural system while on the horse.
If the child doesn’t seem to be engaged on the horse, even after changing speed direction, and pattern, there are others way to engage them. If a patient isn’t as social, then adding music is a great way for them to sing along and stay engaged in the session. You can promote talking during the session by asking the child to tell the horse to stop by saying “woah” or to move again by saying “walk on.” This ensures the patient is paying attention during the session.
The hippotherapy session isn’t over when the patient has gotten off the horse. I’ve realized that each patient has their own unique routine after they dismount the horse. Some patients go around and pet other horses, and some patients take care of the horse they just rode. There is responsibility being instilled by asking the child to take the saddle off their horse and brush them after they ride them. This allows the patient to form a bond with their horse, which is very important during hippotherapy sessions. Plus, most horses get a treat after each session given to them by the patient.