Hippotherapy: Difference between revisions

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== '''Definition'''&nbsp;  ==
== '''Definition'''&nbsp;  ==
Hippotherapy comes from the Ancient Greek words meaning"Horse"(Hippos) and "treatment"(therapy). <ref name=":1">Tuba Tulay Koca, Hilmi Ataseven. What is Hippotherapy? The indications and effectiveness of Hippotherapy. North Clin Istanbul. 2015;2(3):247-252. Access from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175116/pdf/NCI-2-247.pdf (accessed 19/11/2021).</ref>  It is a medical treatment that utilizes evidence based practice and clinical reasoning to use purposeful movements of the horse to influence and engage sensory, neuromotor and cognitive systems to promote functional outcomes in individuals with mental and physical disabilities.<ref name=":0">American Hippotherapy Association, Inc. What is Hippotherapy. Available from:https://www.americanhippotherapyassociation.org/what-is-hippotherapy (accessed 19/11/2021)</ref>  
Hippotherapy comes from the Ancient Greek words meaning "horse" (hippos) and "treatment" (therapy). <ref name=":1">Tuba Tulay Koca, Hilmi Ataseven. What is Hippotherapy? The indications and effectiveness of Hippotherapy. North Clin Istanbul. 2015;2(3):247-252. Access from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175116/pdf/NCI-2-247.pdf (accessed 19/11/2021).</ref>  It is utilized as a treatment tool in therapy and is derived from evidence based practice and sound clinical reasoning skills. Using intentional movements of the horse, sensory, neuromotor, and cognitive systems are influenced to promote functional outcomes in individuals with physical and psychosocial disabilities.<ref name=":0">American Hippotherapy Association, Inc. What is Hippotherapy. Available from:https://www.americanhippotherapyassociation.org/what-is-hippotherapy (accessed 19/11/2021)</ref>  


Physiotherapists, occupational therapists and speech language pathologists integrate Hippotherapy as part of an integrated treatment plan to address the functional limitations and impairments to improve functional skills.<ref name=":0" />  
Physiotherapists, occupational therapists and speech language pathologists integrate Hippotherapy into a patient's treatment plan to address functional limitations and impairments.<ref name=":0" />  




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==How does it work?==
==How does it work?==
Hippotherapy involves a specially trained therapist who uses the horse as a "live" treatment tool. The movement of the horse is used to achieve long term and short term treatment goals that are individualized to each patient.  
Hippotherapy involves a specially trained therapist who uses the horse as a "live" treatment tool. The movement of the horse is used to achieve long-term and short-term treatment goals that are individualized to each patient.  
# The three-dimensional movement of the horses mimics the normal movements of the human [[pelvis]] when walking. The rhythmic and repetitive and multidirectional movements provided by the horse stimulates the anterior and posterior swinging movements of the patient.<ref name=":1" />
# The three-dimensional movement of the horses mimics the normal movements of the human [[pelvis]] when walking. The rhythmic, repetitive, and multidirectional movements provided by the horse stimulate the anterior and posterior swinging movements of the patient.<ref name=":1" />
# The movement of a walking horse produces put to 100 rhythmic impulses per minute, this encourages the patient to achieve proper balance and posture by repetitively challenging postural reactions to remain sitting on the horse. Thus, improving balance and muscle control of patients. Also helping with the development of paraspinal muscles.<ref name=":1" />
# The movement of a walking horse produces 100 rhythmic impulses per minute. This encourages the patient to maintain  balance and upright posture by repetitively challenging postural reactions to remain sitting on the horse. Thus, improving balance, muscle control, and the development of paraspinal muscles.<ref name=":1" />
# The patient rider receives a large sensory and motor input from not only the horse but from those also around the horse assisting with the session.<ref name=":1" />
# The patient rider receives large sensory and motor input from not only the horse but from those also around the horse who are assisting with the session.<ref name=":1" />




Hippotherapy, when used under the direction of a trained therapist has been known to show positive impacts in children with neurological disorders who present with a combination of cognitive, motor and social disabilities.<ref>Bass MM, Duchowny CA, Llabre MM. The effect of therapeutic horseback riding on social functioning in children with autism. Journal of autism and developmental disorders. 2009 Sep;39(9):1261-7.</ref> Positive impacts have been shown with strength, muscle coordination and sensory processing used for walking and talking and the use of fine motor skills for activities of daily living and general attention to tasks. <ref name=":0" />
 
When used under the direction of a licensed and trained therapist, Hippotherapy can elicit positive changes in children with neurological disorders who present with a combination of cognitive, motor, and psychosocial disabilities.<ref>Bass MM, Duchowny CA, Llabre MM. The effect of therapeutic horseback riding on social functioning in children with autism. Journal of autism and developmental disorders. 2009 Sep;39(9):1261-7.</ref> Positive impacts have also been demonstrated in a patient's strength, muscle coordination and tone, and sensory processing used in mobility, talking, and the use of fine motor skills for activities of daily living and general attention to tasks. <ref name=":0" />




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|Teaches horsemanship and riding skills to children or adults with special needs
|Teaches horsemanship and riding skills to children or adults with special needs
|-
|-
|Intense treatment technique
|Utilizes specific treatment goals with outcome measures and reassessments
|A form of therapy with possible progression towards competitive or independent riding goals.
|A form of therapy with possible progression toward competitive or independent riding goals
|-
|-
|Specific treatment goals with outcome measures and reassesments
|Evidence-based treatment tool
|Educational, recreational as well as therapeutic
|Educational, recreational, and therapeutic
|-
|-
|Individual session
|Individual sessions
|Group or individual sessions
|Group or individual sessions
|-
|-
|Horse is led or long lined by the therapist
|Horse is led or long lined by a handler
|Horse is led, lunged or ridden independently  
|Horse is led, lunged, or ridden independently
|-
|-
|Sheepskin or flatbeds, occasionally a saddle
|Utilizes sheepskin, flatbeds, or saddle
|Usually exclusively a saddle  
|Utilizes a saddle exclusively
|-
|-
|Horse is chosen for it appropriate gait and conformation  
|Horse is assessed for appropriate gait and conformation
|Chosen for height, width and temperament match with rider.
|Horse is assessed for height, width, and temperament match with rider
|-
|-
|Horse facilitates the movement of the rider who has no control of the horse.
|Handler facilitates the movement of the horse who then influences the rider who has no control of the horse
|The rider or leader influences the horse  
|The rider or leader influences the movement of the horse
|-
|-
|Practised by Physical, Occupational or Speech Therapist with specific training in Hippotherapy through he American Hippotherapy Association.
|Utilized by Physio, Occupational or Speech Therapists with training in Hippotherapy through the American Hippotherapy Association
Each session requires a therapist, a skilled horse handler and a sidewalker to provide stability and insure safety of the patient.
Each session requires a therapist, a skilled horse handler, and a sidewalker to provide stability and insure safety of the patient
|Lead by an instructor and/or therapist
|Led by an instructor and/or therapist
|}
|}


== Who can benefit from Hippotherapy ==
== Who can benefit from Hippotherapy ==
The patient population for Hippotherapy consists of children with varying mental and physical disabilities. This includes but not limited to:
The patient population for Hippotherapy typically consists of children with varying psychosocial and physical disabilities. This includes but is not limited to:


* [[Cerebral Palsy Introduction|Cerebral Palsy]]
* [[Cerebral Palsy Introduction|Cerebral Palsy]]
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* Psychiatric Diseases
* Psychiatric Diseases
* [[Spinal Cord Injury|Spinal Cord Injuries]]
* [[Spinal Cord Injury|Spinal Cord Injuries]]
* [[Rheumatoid Arthritis|Rheumatism Joint Diseases]] Etc.
* [[Rheumatoid Arthritis|Rheumatism Joint Diseases]]
* Developmental Dyspraxia and Delay


<ref name=":1" />
<ref name=":1" />
==Who can provide Hippotherapy==
==Who can provide Hippotherapy==


Hippotherapy requires a specialization in most countries and can be provided by the following therapists once they have achieved the necessary training and certification.   
In most countries, Hippotherapy requires a specialization and can be provided by or supervised by the following healthcare professionals once they have achieved the necessary training and certification.   


*Physiotherapists (PT)
*Physiotherapists (PT)
*Occupational therapists (OT)
*Occupational Therapists (OT)
*Speech-language pathologists (SLP)
*Speech-Language Pathologists (SLP)


In North American, The American Hippotherapy Association has a licensing program to become a titled Hippotherapy Clinical Specialist (HPSC).<ref name=":0" />
 
In North America, The American Hippotherapy Association has a licensing program to become a titled Hippotherapy Clinical Specialist (HPSC).<ref name=":0" />


==Physiotherapy and Hippotherapy==
==Physiotherapy and Hippotherapy==


A Physiotherapist with specialized training in Hippotherapy is able to provide the patient with a treatment plan tailored to each individual patients physical needs and ability to ride. The therapist will manipulate the horse's movements as well as the riders position to attain functional outcomes such as:   
A Physiotherapist with specialized training in Hippotherapy is able to provide treatment plans tailored to patients' physical needs and ability to ride. The therapist will manipulate the horse's movements as well as the riders position to attain functional outcomes in the areas of:   


* Gait training   
* Gait training   
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* Postural control   
* Postural control   
* Strengthening   
* Strengthening   
* Increasing Range of Motion 
* Range of motion
* Normalization of muscle tone
* Proprioception
* Vestibular input


<ref name=":1" />   
<ref name=":1" />   


In many studies, therapist lead Hippotherapy sessions have been shown to positively influence the functional mobility of children with movement disorders, such as [[Cerebral Palsy Introduction|Cerebral Palsy]]. Improvements with improved overall gross motor function, dynamic balance, and trunk postural coordination were demonstrated. <ref>Lightsey, P., Lee, Y., Krenek, N. ''et al.'' Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. ''J NeuroEngineering Rehabil'' 2021;18:132. <nowiki>https://doi.org/10.1186/s12984-021-00929-w</nowiki></ref> As well as greater compliance and enthusiasm from patients in regards to their rehabilitation.<ref name=":1" />     
In many studies, therapist-lead Hippotherapy has been shown to positively influence the functional mobility of children with movement disorders, such as [[Cerebral Palsy Introduction|Cerebral Palsy]]. Improvements with improved overall gross motor function, dynamic balance, and trunk postural coordination were demonstrated<ref>Lightsey, P., Lee, Y., Krenek, N. ''et al.'' Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. ''J NeuroEngineering Rehabil'' 2021;18:132. <nowiki>https://doi.org/10.1186/s12984-021-00929-w</nowiki></ref> as well as greater compliance and enthusiasm from patients in regards to their rehabilitation.<ref name=":1" />     


==Benefits==
==Benefits==
* Improvement in:  
* Improvements in:  
** Muscle tone and strength
** Muscle tone and strength
** Gross motor skills
** Gross motor skills
** Fine motor skills
** Range of motion
** Range of motion
** Coordination  
** Coordination
** Endurance
** Endurance
 
** Symmetry
* Advances in:
** Body awareness
** Balance  
** Mobilization of pelvis, lumbar region, and hip joints
** Balance
** Head and trunk control
** Head and trunk control
** Body awareness
** Body awareness
** Posture  
** Posture
** Mobility
** Mobility
* Positive effects on:
** Hand-eye coordination
** Hand-eye coordination
** Limbic system function related to arousal, motivation and attention
** Limbic system function related to arousal, motivation, and attention span
** Sensorimotor function, &nbsp;
** Sensorimotor function
** Oral motor, voice quality and vocal accocommunication &nbsp;
** Oral motor ability, voice quality, and vocal communication
** Emotional and cognitive well-being
** Self-esteem
** Confidence
** Didactic and group interaction
** Concentration
<ref name="TherAplay">Children's Theraplay. Hippotherapy. https://www.childrenstheraplay.org/hippotherapy (accessed 10 December 2016).</ref>
<ref name="TherAplay">Children's Theraplay. Hippotherapy. https://www.childrenstheraplay.org/hippotherapy (accessed 10 December 2016).</ref>


Revision as of 01:46, 31 March 2023

Welcome to  Arkansas Colleges of Health Education School of Physical Therapy Musculoskeletal 1 Project.  This space was created by and for the students at Arkansas Colleges of Health Education School in the United States. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editor - Asma Alshehri

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Definition [edit | edit source]

Hippotherapy comes from the Ancient Greek words meaning "horse" (hippos) and "treatment" (therapy). [1] It is utilized as a treatment tool in therapy and is derived from evidence based practice and sound clinical reasoning skills. Using intentional movements of the horse, sensory, neuromotor, and cognitive systems are influenced to promote functional outcomes in individuals with physical and psychosocial disabilities.[2]

Physiotherapists, occupational therapists and speech language pathologists integrate Hippotherapy into a patient's treatment plan to address functional limitations and impairments.[2]


American Hippotherapy Association. What is Hippotherapy? Available from: https://youtu.be/RzcUTg-VKsM [last accessed 22/22/2021]</ref>


How does it work?[edit | edit source]

Hippotherapy involves a specially trained therapist who uses the horse as a "live" treatment tool. The movement of the horse is used to achieve long-term and short-term treatment goals that are individualized to each patient.

  1. The three-dimensional movement of the horses mimics the normal movements of the human pelvis when walking. The rhythmic, repetitive, and multidirectional movements provided by the horse stimulate the anterior and posterior swinging movements of the patient.[1]
  2. The movement of a walking horse produces 100 rhythmic impulses per minute. This encourages the patient to maintain balance and upright posture by repetitively challenging postural reactions to remain sitting on the horse. Thus, improving balance, muscle control, and the development of paraspinal muscles.[1]
  3. The patient rider receives large sensory and motor input from not only the horse but from those also around the horse who are assisting with the session.[1]


When used under the direction of a licensed and trained therapist, Hippotherapy can elicit positive changes in children with neurological disorders who present with a combination of cognitive, motor, and psychosocial disabilities.[3] Positive impacts have also been demonstrated in a patient's strength, muscle coordination and tone, and sensory processing used in mobility, talking, and the use of fine motor skills for activities of daily living and general attention to tasks. [2]


TheSheaCenter. Hippotherapy Ride Along:Visualizing How Equine Movement Benefits Clients. Available from: https://youtu.be/J_MvYAvYQkk [Last Accessed 22/22/2021]</ref>


Differentiation between Hippotherapy and Therapeutic Riding[edit | edit source]

[2][4][5]
Hippotherapy Therapeutic Riding
Medical treatment mainly for children with neuromotor dysfunction Teaches horsemanship and riding skills to children or adults with special needs
Utilizes specific treatment goals with outcome measures and reassessments A form of therapy with possible progression toward competitive or independent riding goals
Evidence-based treatment tool Educational, recreational, and therapeutic
Individual sessions Group or individual sessions
Horse is led or long lined by a handler Horse is led, lunged, or ridden independently
Utilizes sheepskin, flatbeds, or saddle Utilizes a saddle exclusively
Horse is assessed for appropriate gait and conformation Horse is assessed for height, width, and temperament match with rider
Handler facilitates the movement of the horse who then influences the rider who has no control of the horse The rider or leader influences the movement of the horse
Utilized by Physio, Occupational or Speech Therapists with training in Hippotherapy through the American Hippotherapy Association

Each session requires a therapist, a skilled horse handler, and a sidewalker to provide stability and insure safety of the patient

Led by an instructor and/or therapist

Who can benefit from Hippotherapy[edit | edit source]

The patient population for Hippotherapy typically consists of children with varying psychosocial and physical disabilities. This includes but is not limited to:

[1]

Who can provide Hippotherapy[edit | edit source]

In most countries, Hippotherapy requires a specialization and can be provided by or supervised by the following healthcare professionals once they have achieved the necessary training and certification.

  • Physiotherapists (PT)
  • Occupational Therapists (OT)
  • Speech-Language Pathologists (SLP)


In North America, The American Hippotherapy Association has a licensing program to become a titled Hippotherapy Clinical Specialist (HPSC).[2]

Physiotherapy and Hippotherapy[edit | edit source]

A Physiotherapist with specialized training in Hippotherapy is able to provide treatment plans tailored to patients' physical needs and ability to ride. The therapist will manipulate the horse's movements as well as the riders position to attain functional outcomes in the areas of:

  • Gait training
  • Balance
  • Postural control
  • Strengthening
  • Range of motion
  • Normalization of muscle tone
  • Proprioception
  • Vestibular input

[1]

In many studies, therapist-lead Hippotherapy has been shown to positively influence the functional mobility of children with movement disorders, such as Cerebral Palsy. Improvements with improved overall gross motor function, dynamic balance, and trunk postural coordination were demonstrated[6] as well as greater compliance and enthusiasm from patients in regards to their rehabilitation.[1]

Benefits[edit | edit source]

  • Improvements in:
    • Muscle tone and strength
    • Gross motor skills
    • Fine motor skills
    • Range of motion
    • Coordination
    • Endurance
    • Symmetry
    • Body awareness
    • Mobilization of pelvis, lumbar region, and hip joints
    • Balance
    • Head and trunk control
    • Body awareness
    • Posture
    • Mobility
    • Hand-eye coordination
    • Limbic system function related to arousal, motivation, and attention span
    • Sensorimotor function
    • Oral motor ability, voice quality, and vocal communication
    • Emotional and cognitive well-being
    • Self-esteem
    • Confidence
    • Didactic and group interaction
    • Concentration

[7]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Tuba Tulay Koca, Hilmi Ataseven. What is Hippotherapy? The indications and effectiveness of Hippotherapy. North Clin Istanbul. 2015;2(3):247-252. Access from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175116/pdf/NCI-2-247.pdf (accessed 19/11/2021).
  2. ↑ 2.0 2.1 2.2 2.3 2.4 American Hippotherapy Association, Inc. What is Hippotherapy. Available from:https://www.americanhippotherapyassociation.org/what-is-hippotherapy (accessed 19/11/2021)
  3. ↑ Bass MM, Duchowny CA, Llabre MM. The effect of therapeutic horseback riding on social functioning in children with autism. Journal of autism and developmental disorders. 2009 Sep;39(9):1261-7.
  4. ↑ Canadian Therapeutic Riding Association (CanTRA). Hippotherapy. Available from: https://www.cantra.ca/en/our-services/hippotherapy (accessed 22/11/2021)
  5. ↑ Eun Sook Park1, Dong-Wook Rha1, Jung Soon Shin2, Soohyeon Kim3, Soojin Jung1. Effects of Hippotherapy on Gross Motor Function and Functional Performance of Children with Cerebral Palsy. Yonsei Medical Journal 2014; 55(6): 1736-1742.
  6. ↑ Lightsey, P., Lee, Y., Krenek, N. et al. Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse. J NeuroEngineering Rehabil 2021;18:132. https://doi.org/10.1186/s12984-021-00929-w
  7. ↑ Children's Theraplay. Hippotherapy. https://www.childrenstheraplay.org/hippotherapy (accessed 10 December 2016).

 

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