Hippotherapy

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Original Editor - Asma Alshehri

Top Contributors - Asma Alshehri, Dakota Martin, Kim Jackson, Sukhi Dhaliwal, Leana Louw, Brandon Oates, George Prudden, Chelsea Mclene, Carina Therese Magtibay and Katherine Chandler

Definition 

Hippotherapy comes from the Ancient Greek words meaning "horse" (hippos) and "treatment" (therapy). 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.

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

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

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.

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.
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.
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.

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. 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.

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

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

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

• Cerebral Palsy
• Traumatic Brain Injury
• Down Syndrome
• Autism
• Behavioural Disorders
• Muscular Dystrophy
• Amputees
• Cerebrovascular Accidents
• Multiple Sclerosis
• Psychiatric Diseases
• Spinal Cord Injuries
• Rheumatism Joint Diseases
• Developmental Dyspraxia and Delay

Who can provide Hippotherapy

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).

Physiotherapy and Hippotherapy

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

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 as well as greater compliance and enthusiasm from patients in regards to their rehabilitation.

Benefits

• 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