What does a hippotherapist do?

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What is a Hippotherapist?

The word hippotherapy comes from the Greek hippos meaning horse or equine and therapy meaning care. The term refers to the use of horse movement as a therapy tool to engage sensory, neuromotor (of or relating to the effects of nerve impulses on muscles), and cognitive systems to improve patient outcomes for conditions such as developmental delays, autism, cerebral palsy, multiple sclerosis, stroke, and various traumatic injuries to name a few. In hippotherapy, the horse influences the rider / patient rather than the rider / patient controlling the horse. The patient is positioned on the horse and actively responds to its movement. The therapist directs the movement of the horse, analyzes the patient’s response, and adjusts treatment accordingly.

Hippotherapy is not a separate service or a program. It is a strategy applied across three therapeutic disciplines. The word hippotherapist, therefore, is a misnomer. There really is no such thing. People who conduct hippotherapy sessions are physical, occupational, or speech therapists. These practitioners utilize hippotherapy as a strategy to achieve functional – physical, occupational, or speech and language – outcomes.

What does a Hippotherapist do?

Further to the information presented above in the What is a hippotherapist? section, what a hippotherapist does depends on the therapeutic discipline in which they are trained. But before we zero in on precisely how different kinds of therapists apply hippotherapy to their practice, let’s take a look at the components of horse movement and how it can be part of an integrated intervention program.

Hippotherapy being used for a young patient.

Equine movement is multidimensional movement. It is variable, rhythmic, and repetitive. The horse provides a dynamic base of support, making it an excellent tool for increasing trunk strength and control, improving balance, building overall posture strength and endurance, addressing weight bearing, and motor planning (the skill that allows us to remember and perform steps to make a movement happen).

Equine movement facilitates well-modulated sensory input into vestibular (relating to the sense of balance and spatial orientation), proprioceptive (relating to the body’s ability to sense movement, action, and position or location), tactile (connected with the sense of touch), and visual (connected with the sense of sight) channels.

During gait (manner of walking) transitions, a patient must perform subtle adjustments in the trunk to maintain a stable position. When a patient is sitting forward astride the horse, the horse’s walking gait imparts movement responses remarkably similar to a normal human gait. The effects of equine movement on postural control, sensory systems, and motor planning can aid coordination and timing, grading of responses, respiratory control, sensory integration (the process by which we receive information through our senses, organize this information, and use it to participate in everyday activities), and attention. Equine movement can be used to facilitate the neurophysiologic systems that support all of our functional daily living skills.

Now, with this basic understanding of horse movement, let’s summarize how therapists in the three therapeutic specialties use hippotherapy to treat their patients:

Physical therapists can overlay a variety of motor tasks on the horse’s movement to address the motor needs of each patient and promote improved function in areas related to gross motor ability such as sitting, standing, and walking.

Occupational therapists combine the effects of equine movement with other standard intervention strategies for working on fine motor control, sensory integration, feeding skills, attentional skills, and functional daily living skills in a progressively challenging way.

Speech-language pathologists use horse movement to faciliate the physiologic systems that support speech and language. In humans, there are four main body systems involved in the production of speech. The respiratory system, laryngeal system, and articulatory systems are responsible for the physical manifestations of speech, and the nervous system regulates these systems on both the conscious and unconscious levels. When combining hippotherapy with other standard speech-language intervention strategies, the speech-language pathologist is able to remediate communicative disorders and promote functional communication outcomes.

These specially trained therapy professionals evaluate each potential patient on an individual basis to determine the appropriateness of including hippotherapy as a treatment strategy. If they determine that a patient can benefit from the therapy, they work closely with horse trainers and other horse experts to manipulate various aspects of the horse’s movement and position, and to determine the equipment and activities best suited to the patient’s specific needs.

Regardless of whether they are focused on shortening a patient’s recovery time from an injury or improving a patient’s balance, posture, and muscle control; bone strength and regeneration; verbal and communication skills; or confidence and overall mental health, all of these therapists are dedicated to using every treatment tool at their disposal to help their patients live better lives. They often find that hippotherapy is an especially valuable tool – because many patients respond to working with horses and therefore have quicker positive outcomes.

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What is the workplace of a Hippotherapist like?

When physical therapists, occupational therapists, and speech language pathologists integrate hippotherapy into their patient treatment plans, they work away from their offices or clinics, outdoors or in barns. When doing so in winter, they may have to endure uncomfortable temperatures, depending on their location. A significant part of their role is to liaise with other therapists, doctors, and family members of their patients. Practitioners who use hippotherapy must be prepared to work some evenings and weekends, to accommodate the schedules of their patients and patient support teams.