Hippotherapy

Original Editor - Asma Alshehri

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

Definition 

Hippotherapy comes from the Ancient Greek words meaning"Horse"(Hippos) and "treatment"(therapy). 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.

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.

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 and repetitive and multidirectional movements provided by the horse stimulates the anterior and posterior swinging movements of the patient.
2. 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.
3. 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.

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. 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.

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
Intense treatment technique	A form of therapy with possible progression towards competitive or independent riding goals.
Specific treatment goals with outcome measures and reassesments	Educational, recreational as well as therapeutic
Individual session	Group or individual sessions
Horse is led or long lined by the therapist	Horse is led, lunged or ridden independently
Sheepskin or flatbeds, occasionally a saddle	Usually exclusively a saddle
Horse is chosen for it appropriate gait and conformation	Chosen for height, width and temperament match with rider.
Horse facilitates the movement of the rider who has no control of the horse.	The rider or leader influences the horse
Practised by Physical, Occupational or Speech Therapist with specific training in Hippotherapy through he American Hippotherapy Association. 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

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:

• Cerebral Palsy
• Traumatic Brain Injury
• Down Syndrome
• Autism
• Behavioural Disorders
• Muscular Dystrophy
• Amputees
• Cerebrovascular disease
• Multiple Sclerosis
• Psychiatric Diseases
• Spinal Cord Injuries
• Rheumatism Joint Diseases Etc.

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.

• Physiotherapists (PT)
• Occupational therapists (OT)
• Speech-language pathologists (SLP)

In North American, 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 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:

• Gait training
• Balance
• Postural control
• Strengthening
• Increasing Range of Motion

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. 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

• Improvement in:
  • Muscle tone and strength
  • Gross motor skills
  • Range of motion
  • Coordination
  • Endurance

• Advances in:
  • Balance
  • Head and trunk control
  • Body awareness
  • Posture
  • Mobility

• Positive effects on:
  • Hand-eye coordination
  • Limbic system function related to arousal, motivation and attention
  • Sensorimotor function,  
  • Oral motor, voice quality and vocal accocommunication