Science of Hippotherapy

What makes hippotherapy effective is the combination of many factors about the human and horse:

Shape of the horse – A horse has a therapeutic shape; the barrel of the horse provides a wide base of support for balance while also promoting stretching of the legs. This position of the patient also promotes a more upright sitting posture. This shape allows a rider to assume different positions that affects the human body in positive ways.
Movement of the horse – Now that we understand the unique shape of the horse, we can apply movement to the horse’s unique shape. The horse’s gait (walk) introduces three dimensional movement that forces the rider to balance themselves. This can improve coordination, endurance and strength, as well as positively impact the patient's vestibular and proprioceptive systems. The movement of the horse simulates the normal motion of a human pelvis when walking. This teaches muscle memory for patient's that are in pre-gait (learning to crawl and walk) and gait (ambulating) phases.
Positions of the rider on the horse – By positioning the rider in different ways on the horse, and applying the horse’s unique shape and movements, we can use the tactile inputs to achieve a variety of therapy goals.
Activities done while on the horse – Now that the rider is moving in a variety of therapeutic ways on the horse, we can begin introducing activities the patient will participate in. Placing "mail" in a mailbox, throwing beanbags, placing rings on a hook…all of these activities that can improve various sensory, motor, and cognitive functions in our patients.
Proximity of the human to the horse – Finally, just being near a horse can have a variety of therapeutic benefits to a person with special needs. The connection between the horse and a human can lower heart rates, calm anxiety, and create a special emotional connection that can help place a patient in an emotional state where therapy can be most effective.

Positions on the Horse

Patient sitting

Patient standing in stirrups

Patient laying on back

In this position, the patient is sitting facing forward on the horse. This position stretches the legs around the barrel of the horse, and is the first position to establish balance. This position generally promotes a more upright posture. This is also the position required for the patient to particpate in steering (driving) the horse, using the reins.

Patient laying on back

Patient standing in stirrups

Patient laying on back

In this position, the patient leans back on the horse while facing forward. Laying back helps stretches hip flexors, which can get very tight for patients that spend most of their day in a seated position, such as in a wheelchair/adaptive stroller. Laying back causes shoulders to go back and the chest to open up, promoting improved breathing, stretch to the back, chest, and shoulder muscles, and generally seems to calm the patients.

Patient standing in stirrups

In this position, the patient will be facing forward on the horse, and stand up by pushing against the stirrups. This position allows gravity to assist in pushing the heels down, which is especially beneficial for those patients that are "toe walkers", which is a condition usually due to abnormal muscle tone and weakness. This improves strength in core, legs, and helps with balance, and improves range of motion.

Patient sitting backwards

Patient laying over barrel of horse (prone)

Patient standing in stirrups

In this position, the patient sits facing the rear of the horse. This position pushes the pelvis forward due to the build of the horse (where the neck is higher than the back), which promotes a more upright posture, especially for those patients that tend to sit in a posterior pelvic tilt (where the pelvis is tilted back and shoulders are rounded forward); this is a common posture for patients that sit in a wheelchair throughout the day. When sitting backwards on a horse, the legs are stretched over the largest part of the barrel of the horse, which further enhances both posture and leg stretching.

Many of our patients experience sensory processing disorders. Sitting backwards on the horse while the horse walks forwards introduces many challenges to the senses…everything you see is moving away from you. Normally everything in our world moves towards us as we walk and is how our brain processes things. This forces the client to recalibrate and re-wire their normal perceptions as the brain is being challenged in different way.

Patient laying over barrel of horse (prone)

In this position, the patient lays on their stomach over the horse with their head on one side and the legs and feet on the other side of the horse. This position stretches out the spine via traction of the natural weight of the body. We can use this position to ask the client to try to use their core back strength to look up, resulting in them using their spinal muscles and encourages them to weight bear on their arms (hands or elbows).

Patient in quadruped (on all 4's)

Patient laying over barrel of horse (prone)

In this position, the patient is facing forward on the horse, and is balancing on both arms and both legs in an “all-4’s” position. Many of our patients struggle with moving their arms and legs in a coordinated way. When moving on the horse, all four extremities are feeling the three dimensional movement of the horse. It helps create muscle memory for developmental milestones such as army crawling, crawling, and eventually walking.

Activities and problem solving

Patients may perform a variety of activities throughout the treatment session, depending on the treatment plan and goals. In addition to the obvious physical challenges that are worked on, these activities also benefit many other areas that these patients have challenges with; some examples are as follows:

Cognitive

Different activites challenge patient's thinking skills, from basic one step commands to higher executive function skills, such as problem solving, time management, planning, memory, self control and organization.

Sensory

Movement in any way on the horse forces the patient's body and brain to take in sensory input. This sensory input from the horse can result in a calming or self regulation that some parents rarely see in their kids.

Coordination

Patient's coordination is challenged, from coordinating overall muscles to walk, talk, move, and breathe. Gross motor and fine motor skills are worked on in a variety of ways through different activities.

Science of Hippotherapy

Positions on the Horse

Patient sitting

Patient standing in stirrups

Patient laying on back

Patient laying on back

Patient standing in stirrups

Patient laying on back

Patient standing in stirrups

Patient standing in stirrups

Patient standing in stirrups

Patient sitting backwards

Patient laying over barrel of horse (prone)

Patient standing in stirrups

Patient laying over barrel of horse (prone)

Patient laying over barrel of horse (prone)

Patient laying over barrel of horse (prone)

Patient in quadruped (on all 4's)

Patient laying over barrel of horse (prone)

Patient laying over barrel of horse (prone)

Activities and problem solving

Cognitive

Sensory

Coordination

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