HIPPOTHERAPY

What on earth is that? 

Hippotherapy : The term hippotherapy refers to how physical therapists, occupational therapists 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.

Physiotherapists, like myself, as well as occupational therapists and speech/language professionals integrate hippotherapy into a patient's plan of care, along with other therapy tools and strategies.

Hippotherapy exists within a medical model of treatment, in which equine movement is a treatment tool applied by the therapist.

The term "hippotherapy" comes from the Greek word for horse - "hippos" and literally means - "treatment with the help of a horse"

So what does that formal definition mean?  When I determine that hippotherapy would be beneficial, I put the patient on a well-chosen therapy horse and lead the horse in various movement patterns.  This works on activating neuromotor input, strengthening postural muscles, balance, core muscle activation, and sensory processing with my patients.   

The patient is NOT "horseback riding".  There is very little tack, no reins or stir-ups.  With the patient on the horse, I utilize various positions, therapeutic  exercises and activities working toward treatment goals. 

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Take a look at this video from the American Hippotherapy Association.  Currently, there is no Canadian Hippotherapy Association, all training is through the AHA..

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WHY THE HORSE?

Mounting a patient upon a horse provides a dynamic surface with movement that is repetitive, symmetrical and predictable.  The multi-dimensional movement of the horse produces pelvic and spinal movement in the patient that is similar in to ratio to the movement required in human gait.  The average walking horse takes approximately 100 steps per minute.  In a typical therapy session, 20-25 minutes of horse movement represents 1500-2500 neuromotor inputs for the patient.  This can never be duplicated in the clinical setting.

Equine/Horse movement:

  • challenges the patient to maintain stability during rhythmic, reciprocal movement.  As the horse changes direction, speed, halts, begins movement, steps over poles, walks up or down inclines - the relationship between body segments must change accordingly

  • challenges the patient visually, through optical righting, and visual flow

  • can be manipulated by the therapist in order to create feed forward/anticipatory and reactive/feedback control.  Transitions of the horse's movement can be done with the patient aware fo the change or without verbal/visual cues, so that the patient must react to the change in movement

  • offers patients who may not have had varied movement opportunities to learn dynamic postural control, particularly with movement through space, with visual flow, and vestibular input in combination with active postural control

  • creates approximation of the joints from force transmission from the ground and through the horse, stimulating skeletal and disc stimulation

  • provides sensory input that stimulates the limbic system, vision, arousal, proprioception, visual and olfactory centres.  

  • can influence respiratory function by facilitating an elongated trunk, trunk rotation, lateral flexion, flexion/extension and in turn mobilizing the pelvis, spine and ribs and facilitating diaphragmatic breathing.  Concussive forces from the ground, with appropriate positioning, can help loosen secretions in the lungs

  • can influence the circulatory system through the concussive and percussive forces enhancing overall oxygenation and blood flow

  • provides highly organized sensory input that can be modified and graded to meet the needs of the patient.  VISION on a moving horse may be one of the only opportunities a patient with impaired mobility may have to experience visual flow while actively engaged. TACTILE stimulation occurs on the horse by feeling different surfaces such as the horse's coat, mane, tail, warmth of the horse.  VESTIBULAR stimulation is provided by the multi-dimensional movement of the horse through space and can be modulated with different surfaces, inclines, and patient positions.  PROPRIOCEPTIVE stimulation is provided by the concussive forces and rhythmic movements transmitted from the horse to the patient.  Kinesthetic information is stimulated by the movement of the body parts facilitated by the horse's movement or active engagement.  AUDITORY stimulation can occur from the horse's gait pattern, whinnying, snorting and can be novel for many patients.  Various OLFACTORY stimulants occur with the multiple smells in a barn and on the horse itself.

  • can provide a new, more interesting and enjoyable way to engage a patient to follow through with a physical therapy program.  Performing activities on a horse can be viewed by a patient as "horseback riding with Sandra".  However, the proper manipulation of the horse's movement and active engagement of the patient creates powerful therapeutic benefits.

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Incorporating hippotherapy as a therapeutic tool into a physiotherapy program isn't for everyone.  There are some cases where mounting a patient onto a horse is not safe, or contraindicated.  I do need a physician's referral and medical "ok" before I start any patient on a horse.  

 

I have developed a partnership with G.R.A.C.E. Therapeutic Riding Centre, located in Springmount, with set arena times and following Covid 19 protocols.

G.R.A.C.E

(Georgian Riding Association for Challenged Equestrians)

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