Hippotherapy

“Hippotherapy” is a term that describes physical, occupational, and speech-language therapy treatments utilizing the movement of the horse as part of an integrated intervention program. In each therapy session a specially trained occupational, physical or speech therapist properly positions the client on the horse, analyzes the client’s response and directs the horse’s movement. Each client is working toward specific goals developed with input from both the client/parent and therapist. Enjoyable and challenging therapy activities are selected to help established a foundation to improve neurological function and sensory processing. This foundation can be generalized to a wide range of daily activities.

The horse’s unique walk transfers variable, repetitive and rhythmic movement to the client, which provides sensory input to the brain and nervous system. The resulting responses in the client are similar to human movement patterns of the pelvis while walking. An average horse takes 120 walking steps per minute, allowing 120 chances each minute for a client to experience this unique movement that cannot be replicated by other apparatus or equipment. During a session the therapist, working along with a specially trained horse handler, can grade or adapt this movement to provide a “just right challenge” for each client. Most clients respond enthusiastically to hippotherapy treatment and thoroughly enjoy the opportunity to engage with the horse in an environment that is much different than the typical therapy clinic.

A wide variety of clients can experience benefits from hippotherapy. Some diagnoses commonly treated by our therapists include:

• Attention Deficit Disorder
• Autism
• Cerebral Palsy
• Closed Head Injury
• Developmental Delay
• Down Syndrome
• Emotional Disorders
• Hearing Impairment
• Multiple Sclerosis
• Muscular Dystrophy
• Paralysis
• Scoliosis
• Spinal Bifida
• Traumatic Brain Injury

Some conditions that may be contraindicated for hippotherapy include:

• Orthopedic:
  • Atlantoaxial Instability-describe neurologic symptoms
  • Coxa Arthrosis
  • Cranial Deficits
  • Heterotropic Ossification/Myositis Ossificans
  • Joint Subluxation/dislocation
  • Osteoporosis
  • Pathologic Fractures
  • Spinal Fusion/Fixation
  • Spinal Instability/Abnormalities
• Neurologic:
  • Hydrocephalus/Shunt
  • Seizure
  • Spina Bifida/Chiari II Malformation/Tethered Cord/Hydromelia
• Medical/Psychological:
  • Allergies
  • Animal Abuse
  • Physical/Sexual/Emotional Abuse
  • Blood Pressure Control
  • Dangerous to self or others
  • Exacerbations of medical conditions
  • Fire Settings
  • Heart Conditions
  • Hemophilia
  • Medical Instability
  • Migraines
  • PVD
  • Respiratory Compromise
  • Recent Surgeries
  • Substance Abuse
  • Thought Control Disorders
  • Weight Control Disorders
  • Age-under 2 years
  • Indwelling Catheters

Hippotherapy sessions must be conducted by a licensed occupational, physical or speech therapist or therapy assistant with additional specialized training in using the movement of the horse. Hippotherapy is a medical treatment, requiring a doctor’s prescription for OT, PT or speech therapy, which aims to achieve functional outcomes. Therapeutic riding lessons are conducted by PATH International registered or advanced riding instructors who are specially trained in working with people with disabilities. While there is an inherent therapeutic value in horseback riding, therapeutic riding lessons focus on teaching riding skills.

Before registering for hippotherapy the therapist will usually meet with the client to determine if he or she is appropriate for our program. While there is no upper age limit for participating in hippotherapy, generally children are not accepted before age 2. Children younger than 2 years old do not yet posses neurological systems that are mature enough to accommodate to the sensory input, which is produced by sitting astride a moving horse. Children must also be able to be fitted with and wear an approved riding helmet for the duration of each hippotherapy session. Some young children lack the neck control necessary to hold up the head with the additional weight of a helmet when on a moving horse. While age 2 is used as a general guideline for inclusion in hippotherapy, this varies from child to child. Some children may be 3 or 4 years old before they are neurologically mature enough to be able to derive maximum benefit from hippotherapy. In some instances it may be determined that hippotherapy is not an appropriate treatment strategy for a specific client in which case the therapist can recommend alternative treatment suggestions.

Hippotherapy sessions at Three Gaits are usually individual sessions that last 30 minutes in duration. There may be times when small groups of clients are working with one therapist when it is determined that this is the best way for each client to meet his or her therapy goals. Hippotherapy at Three Gaits is conducted by a highly trained occupational therapist in collaboration with a hippotherapy horse handler and trained volunteers who act as sidewalkers or in other capacities during the session. The average number of staff and volunteers working with each client during a single hippotherapy session is between 3-5. Since we rely on so many people during each session it is important for hippotherapy clients to come at a regular day and time each week and to arrive on time for the session. We are often not able to accommodate clients who arrive more than 10 minutes late to a scheduled session.