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What is Hippotheraphy?

by Bailey Crook, PT Student

Hippotherapy is a form of evidence based practice used by Physical Therapists, Occupational Therapists, and Speech Language Pathologists to purposefully manipulate equine movement to promote the sensory, motor, and cognitive systems to help reach functional goals of patients. This is a type of therapy that would be integrated into the patient’s plan of care.

There are some very big differences between hippotherapy and therapeutic riding. Hippotherapy is a one on one medical treatment with a therapist to work on land-based functional and individualized goals. It’s paid by insurance companies. Progress of the patient is reassessed throughout the plan of care to determine the need for services to continue. Contrarily, therapeutic riding is horseback riding lessons for those with special needs given by a certified adaptive riding instructor to improve horse riding skills. The lessons are paid for by the family, and are either individual, semi-private, or a group activity. The lessons can be for a lifetime.

There are several reasons why to consider hippotherapy as an integral part of a patient’s plan of care. Therapeutic advantages can be seen in physical therapy, occupational therapy, and speech therapy.

In occupational therapy, the limbic system is stimulated while riding a horse through the emotions connecting the patient to the horse. Also, the visual, proprioceptive, vestibular, and olfactory systems are all engaged during hippotherapy sessions. The activation of the postural control system throughout the session can also effect the arousal of the patient.

In physical therapy, a lot of exercises can be done on the horse to help improve core strength and postural control. Maintaining a midline position while riding the horse is a difficult core engaging activity for patients due to the dynamic surface they are sitting on. Due to the rhythmical and symmetrical movements of the horse, the patient can take advantage of those movements to improve pelvic and spine motion. Different positions on the horse, like prone, supine, front-riding, rear-riding, and side sitting, can be a unique way to address range of motion deficits, postural control limitations, and skeletal misalignments.

The improved postural alignment can cross over to improve coordination and timing of respiratory support for speech production and vocal control in speech therapy.

There are many different roles that play important parts during one hippotherapy session with a patient. The horse leader is engaged in the horse’s body language and responds to the horse’s emotions. They lead the horse according to the therapist’s cues, prepare the horse for treatment sessions, and take care of the horse after sessions. There are two side walkers whose main job is safety of the patient. They obey the therapist’s commands with regards to position of the patient on the horse. If an emergency evacuation is necessary, a predetermined planned would be executed by the side walkers. The therapist has the main job of purposefully manipulating equine movement by use of the horse leader to achieve functional goals of the patient while giving cues to side walkers to keep the patient safe. The patient’s job is to try their best, and have fun on the horse! Lastly, the family is there for support, but it’s important that they watch from outside of the arena as to not spook the horse with loud noises, abnormal lights, or movements as this could be very dangerous for all involved.

There are many other aspects to take into consideration with hippotherapy like the environment. It’s a new setting for the patient to have therapy in, which can engage them in new sensory and motor experiences. The horse provides the patient a social interaction and a sense of responsibility to take care of their horse.

Overall, hippotherapy is a very unique way to improve a wide variety of functional goals in the physical therapy, occupational therapy, and speech language pathology realms. For more information on hippotherapy, please visit http://www.americanhippotherapyassociation.org/.