What is Hippotherapy?!
What is hippotherapy?
According to the American Hippotherapy Association, “The term hippotherapy refers to how occupational therapy, physical therapy and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement as a therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes.”
So what does this mean? Hippotherapy is a tool that therapists (PT, OT, SLP) use in their treatment sessions. It is a way for therapists to help their clients develop functional skills that can be applied to their everyday life. Just like a therapist may use an exercise ball, a swing, bean bags, word searches, an obstacle course- the horse’s movement is the tool to elicit responses from the patient/client. The goal is NOT to become a better rider. This is often a by product of using hippotherapy, but the goals are always functional and applicable to the client’s everyday life. It is still occupational therapy (or physical therapy or speech therapy) and the goals are centered around daily living skills that are meaningful to the patient and family. This tool is incorporated into the patient’s plan of care.
How is it different from other equine activities?
Human horse interactions are incredibly powerful and healing. As such there are many disciplines that utilize this tool. Equine assisted learning, adapted riding, equine therapy and more. All of these areas use a horse. They differ in who is running the session, the purpose/goal of the session and how the horse is incorporated. When hippotherapy is used in sessions, a therapist (OT, COTA, PT, PTA, SLP, SLPA) is present and “in charge” of the client- their goals, the specific activities to be used, safety precautions specific to their diagnosis, etc. The therapist also works closely with the horse handler and other team members when deciding which horse to use, the tack to be used, what supports need to be in place and more. The goal of an OT session utilizing hippotherapy is functional, NOT riding based. Lastly hippotherapy is specific to using the horse’s movement. Grooming, tacking up, leading the horse and other activities may also be utilized however it is the purposeful manipulation of the horse’s movement that is significant about the use of hippotherapy.
Why does hippotherapy work so well?
A horse’s gait (their walking pattern) is very similar to a human’s. When a human is sitting on a horse, their hips, spine, shoulders- their whole body!- moves in a very similar fashion as if the human themselves were walking. This has beneficial effects on the nervous system & sensory systems (vision, hearing, vestibular/balance, proprioceptive/ muscle engagement, tactile/touch and interoception/inner sense). The horse’s movement provides movement in all three planes- vertical (up/down), lateral (side to side) and along the horizontal plane (moving forward through space). All of these elements can be manipulated by choice of horse, tack, and how the handler encourages the horse to move. A horse’s movement is rhythmic, low amplitude, consistent and can be sustained. The therapist and handler can alter a horse’s tempo, speed, direction and even length of stride according to the patient’s needs.
According to AHA, “The average horse walks at a rate of approximately 100 steps per minute. Just 5 minutes on a walking horse represents 500 neuro motor inputs to the patient. In a typical therapy session, 15 to 25 minutes of equine movement may be incorporated by the treating therapist – which represents 1500 to 2500 neuromotor inputs to the patient.” With each step, the patient’s body needs to react and adjust accordingly. Under a therapist’s supervision and direction, this can provide a powerful condition for motor learning.
This tool is also highly motivating for most people- it doesn’t feel like work even though the client’s body is working hard while on the horse. Possible benefits include: reduced tone/spasticity, improved attention, improved range of motion and strength, increase and improvement in speech production, improved self regulation and sensory processing skills, improved balance and others.
Who benefits from using hippotherapy?
There are some contraindications to using hippotherapy in a therapy session. A health history and physician statement should be completed prior to any use of hippotherapy, just like any other therapy tools. Many people can benefit from this treatment tool- various levels of physical, cognitive, emotional, social skills can participate. It is up to the therapist to determine if this is an appropriate tool to add to the patient’s plan of care.
What to look for in a facility/therapist who uses hippotherapy:
Therapists who are certified from the American Hippotherapy Association receive extensive training on a horse’s movement and how this effects the client. They also are well versed in contraindications, healthy horse behavior and evidence based practice using this tool. Therapists then take a certification board exam once completing the coursework. This is a team approach including the client, therapist, horse handler, any sidewalkers and the horse. You can ask who will be involved, how they are trained and who is in charge during the session. Effective communication and clearly delineated roles are crucial for providing a safe and effective session. Lastly, the horse’s well being is equally important not only for their own health but also the safety and efficacy of the client. A horse who is unwell, “ring sour” or abused can be unpredictable and ultimately unsafe for the rider. Ask if you can come out for a barn visit and meet some staff and horses- this will usually give you a good feel for the communication, health and overall integrity of the facility.
Camille France, OTR/L, of Desert Quail Therapy has taken the coursework and passed the AHCB Hippotherapy Certification Exam and is an AHCB Certified Therapist. Please contact Desert Quail Therapy with any questions or if you are interested in adding this powerful tool to your treatment!
