I became interested in learning about this funny word because I grew up with horses and have seen some of the benefits they provide to people. It wasn’t until recently that I discovered physical therapists can use horses as a type of treatment. I began volunteering at a local farm outside of Pittsburgh where I have learned more about this type of therapy.
Hippotherapy can also be described as Equine Assisted Therapy, or therapy with the help of the horse. The professions of occupational therapy, speech-language pathology, and physical therapy can use evidence-based practice and clinical reasoning to manipulate the movement of the horse in order to achieve a functional outcome for patients. It is most commonly used for children with disabilities, but others who have suffered from a stroke or spinal cord injury may benefit as well. This is usually done with one person leading the horse, and two people walking on either side (one of which is the therapist), next to the patient. Typically, only a saddle pad and surcingle are used instead of an actual saddle so that the patient is not separated from the horse’s movement.
This works because the horse’s pelvis moves in the same three planes as the human pelvis. In other words, sitting on a walking horse sends your brain the same signal as when you are walking. This reciprocal movement activates the central pattern generators of the brainstem; for some, this is the first time the patient’s brain has received the sensory input of walking. This type of therapy is not done in isolation, it is in addition to the patient’s plan of care.
There are numerous movements you can do with a horse to reach a certain outcome with a patient. There is a huge benefit simply of walking in long straight lines on the horse because of the reciprocal movement. If the patient requires more sensory input, the horse can increase its speed or the patient can be placed on the horse facing backward. If a patient has a right sided hemiparesis, the horse could walk in tight circles to the right to increase activation of the right neuromuscular system. The stopping and starting movements of the horse work the patient’s flexors and extensors which can greatly improve trunk control.
I believe having a basic understanding of this type of treatment is important as students of physical therapy. The horse can facilitate neuromuscular movement that our own modalities and treatments cannot, and it may serve a future patient of yours well to remember.
-Mallory Weiss, SPT