Hippotherapy - Sdruzeni Ambra . . .

Michaela Burdová - Head of Hippotherapy at Sdruzeni Ambra

'I have worked as a leader of hippotherapeutic centers for 15 years and it´s been often quite difficult to explain how is it possible that the horses really help children with disabilities. People say -  yes, its trendy, chidren simply love horses and they enjoy the riding  –  but there is any other therapeutic benefit.

I can see them every day, in every hippotherapy session when we work with handicapped children  – it maybe small improvement, too small for healthy people, but a big improvement for these children – in various areas according to the type of disability. There are children, who say their first word on horse-back, some who are locked in their spastic muscles and after a 20 minute session, they can sit more upright, they are relaxed, which is often the reason of better communication – and of course they enjoy their rides.

The physical principle of hippotherapy is really simple. The movement of the horse-back is imparted to the patient from the horse's movement, creating a pattern that is similar to normal walking in the patient. This movement cannot be duplicated in traditional clinical settings. As a result of the horse's movement, the patient makes improvements including balance, strength, coordination, and postural symmetry. Improvements in these areas result in increased independence with functional activities such as walking, dressing and communication.

Hippotherapy
Hippotherapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse to provide carefully graded motor and sensory input. A foundation is established to improve neurological function and sensory processing, which can be generalized to a wide range of daily activities. Unlike therapeutic horseback riding (where specific riding skills are taught), the movement of the horse is a means to a treatment goal when utilizing hippotherapy as a treatment strategy.

History
Derived from the Greek hippos(horse), "hippotherapy" literally refers to treatment or therapy aided by a horse. The concept of hippotherapy finds its earliest recorded mention in the ancient Greek writings of Hippocrates. However, hippotherapy as a formalized discipline was not developed until the 1960s, when it began to be used in Germany, Austria, and Switzerland as an adjunct to traditional physical therapy. In Germany hippotherapy was treatment by a physiotherapist, a specially trained horse, and a horse handler. The movement of the horse was carefully modulated to influence neuromuscular changes in the patient.

Modern Hippotherapy
Equine-assisted therapy is an umbrella term for therapy incorporating the equine environment into a treatment session within the scope of a therapist's practice and professional designation. Physical and occupational therapists, physical and occupational therapy assistants, and speech and language pathologists practicing hippotherapy incorporate the horse's movement into the total care plan for their patients.

The Role of the Horse
The horse's pelvis has a similar three-dimensional movement to the human's pelvis at the walk. The horse's movement is carefully graded at the walk in each treatment for the patient. This movement provides physical and sensory input which is variable, rhythmic and repetitive. The variability of the horse's gait enables the therapist to grade the degree of input to the patient and use this movement in combination with other treatment strategies to achieve desired therapy goals or functional outcomes. In addition, the three-dimensional movement of the horse's pelvis leads to a movement response in the patient's pelvis which is similar to the movement patterns of human walking. A foundation is established to improve neurological function and sensory processing, which can be generalized to a wide range of daily activities and address functional outcomes and therapy goals.

Indications
Hippotherapy has been used to treat patients with neurological or other disabilities, such as autism, cerebal palsy, arthritis, multiple sclerosis, head injury, stroke, spinal cord injury, behavioral disorders and psychiatric disorders. The effectiveness of hippotherapy for many of these indications is unclear, and more research has been recommended. There is a lack of scientific evidence regarding the effectiveness of hippotherapy in the treatment of autism. The Argentine Institute for Clinical Effectiveness and Health Policy concluded, in a study of the evidence for the efficacy of hippotherapy, that there were generally significant problems in terms of study design and/or methodology. "The efficacy of this therapy does not seem to have been sufficiently proven for any specific indication. Its recreational role and impact on the quality of life of these patients have not been sufficiently analyzed."

Use in physical, occupational, speech and language therapies
Physical therapists who have had training in hippotherapy may incorporate the multi-dimensional movement of the horse to achieve gait training, balance, postural/core control, strengthening and range of motion goals. Improvement in gross motor skills and functional activities for developing children with disabilities has been reported. Impairments are addressed through the variability of the horse's movement by modifying the rhythm, tempo and cadence of the horses movement.

Occupational therapists providing hippotherapy utilize the movement of the horse to improve motor control, coordination, balance, attention, sensory processing and performance in daily tasks. The reciprocal multi-dimensional movement of the horse helps with the development of fine motor skills, visual motor skills, bilateral control and cognition as well. Sensory processing via hippotherapy simultaneously addresses the vestibular, proprioceptive, tactile, visual and auditory systems. The occupational therapist incorporates the movement of the horse, hippotherapy, to modulate the sensory system in preparation for a therapy or treatment goal that leads to a functional activity.

Hippotherapy has also seen use in speech and language pathology. Hippotherapy uses a horse to accomplish traditional speech, language, cognitive, and swallowing goals. Using hippotherapy, appropriate sensory processing strategies have been integrated into the treatment to facilitate successful communication.

For a video presentation explaining hippotherapy, please have a look at this link on you-tube from an American hippotherapy centre here

For any further information, inquiries or if you would like to help Sdruzeni Ambra then please contact us