This week I will focus on Hippotherapy (horse-riding therapy)
Hippotherapy is a physical, occupational, and speech-language therapy treatment strategy that uses equine movement as part of an integrated intervention program to achieve functional outcomes (AHA 2010). Unlike Therapeutic Riding, hippotherapy is a passive form of riding in which the rider benefits from, but does not control, the movement of the horse.
The rider will typically sit on a sheet rather than a saddle in order to feel and respond to the movement of the horse. The movement of the horse is usually controlled by a specialist handler under direction of the physiotherapist, the rider will not be expected to do so. As the horse walks, it transfers movement patterns to the rider’s lumbar spine and pelvic regions which are similar to those used in normal walking. This in turn gives the rider the opportunity to practice normal movement responses and balance.
Horse riding allows those who have trouble moving independently to experience the sensation of free movement. Disabled riders often report increased confidence and self-esteem, particularly when they work towards and achieve personal goals. Hippotherapy has been shown to improve posture, movement and muscle strength (particularly head and trunk control) and to develop balance reactions. Spending time with a social animal such as a horse is also known to lower blood pressure in humans. It is a relatively new therapy in the UK (having been practiced for around 15 years by a small number of physiotherapists) but is growing in popularity. In Germany, where it originated, it is a mainstream treatment and widely available to children and adults. People with movement and neuro-motor disorders in particular can benefit from hippotherapy, including cerebral palsy, spinal cord injury and stroke. (Tate, 2014) Other conditions that can find Hippotherapy include: · Autism · Multiple Sclerosis · Down Syndrome · Dyspraxia · Paralysis · Head Trauma · Convulsive Disorders · Amputation · Muscular-Dystrophy · Scoliosis · Arthritis
The average cost of a session (30 minutes) is $30-50 dollars.(£20-£40/€25-€45). There are a number of Hippotherapy Associations that are able to provide information regarding practitioners and their costs:
Professional Association of Therapeutic Horsmanship International (http://www.pathintl.org/)
North American Riding for the Handicapped Association (http://narha.org/) American Association for Horsemanship Safety (http://asci.uvm.edu/equine/law) American Medical Equestrian Association (http://ameaonline.org) American Youth Horse Council, Inc. (http://www.ayhc.com/contactus.htm) Bermuda Riding for the Disabled (www.brd.bm)
Ecuador: Fundación AM-EN (www.fundacion-amen.org) Mexico: Asociacion Mexicana de Equitacion Terapeutica (www.gromex.org/amet) Mexico Equestrian Rehabilitarion Centre “Las Aguilas” (Alberto Ziehl: [email protected])
Belgium: Hippodecom New (Genevieve Preat: [email protected]) Czech Republic: Obcanske Sdruzeni Svitani Jablonec Nad Nisou (www.os-svitani.cz) Italy: Aiasport Equestrian Activity (www.imprese.com/aiasport) Associazione Lapo (www.associazione-lapo.it) Centro Nazionale Ricerca – Assistenza e Formazione (www.cnranire.it) Netherlands: Federatie Paardrijden Gehandicapten (www.verenigingfpg.nl) Slovakia: Slovak Hippotherapeutic Association (www.healthnet.sk/sha)
Hippotherapy remains an experimental treatment due to the insufficient scientific evidence for its effectiveness in the treatment of CP, autism, and other conditions characterized by motor dysfunction. More studies are required before it can be widely recommended as a treatment, however there is evidence to support Hippotherapy: • Bass, Duchowny, and Llabre (2009) examined the effects of a twelve week long therapeutic horseback intervention on social functioning in children with autism spectrum disorder. The results showed improved social interaction and increased attention in the autistic children. These findings indicate that hippotherapy may have a place in the treatment of children with autism. • Benda, McGibbon and Grant (2003) examined the effect of hippotherapy on muscle activity in children with cerebral palsy. The results showed a significant improvement in symmetry of muscle activity was noted in muscle groups that had displayed the highest asymmetry prior to hippotherapy. • Sterba MD (2004) examined if hippotherapy improves gross motor function. The study included eleven published studies on instructor-directed, recreational horseback riding therapy and licensed therapist directed hippotherapy. Sterba concluded that hippotherapy is effective for gross motor rehabilitation. • Macauley and Gutierrez (2003) examined the effectiveness of hippotherapy for children with language-learning disabilities. Three boys aged nine, ten and twelve years old took part in this study. The results showed that after both therapies the children improved their speech and language, however, the responses were noticeably higher following hippotherapy.
Despite the support hippotherapy has received, there are several negative factors to hippotherapy: • COST- Each center charges different prices for hippotherapy. In order for hippotherapy to be effective, it must be practiced frequently. This can get very expensive for families. • LACK OF INSURANCE- Unfortunately, most insurance companies do not pay for hippotherapy. Having to pay for every session may not be feasible for some families. • AVAILABILITY TO CHILDREN- There are centres all over the world that practice hippotherapy, however some geographical locations may only have one centre available to them. This could cause difficulty in making arrangements for transportation, adding to the cost of receiving hippotherapy. This could also result in a long waiting list. Any feedback, questions and/or input is greatly appreciated!
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