In stables across the country, health professionals are harnessing the power of horses to treat people with disabilities. Occupational therapists (OTs) and physical therapists (PTs) say their faithful, four-legged partners motivate patients with disabilities and help them build strength, function and confidence.
Over the past decade or so, hippotherapy -- using horses in therapy -- has gained popularity because of its effectiveness, says occupational therapist Barbara Engel of Durango, Colorado, a pioneer in the field. ("Hippo" means horse in Latin.)
Besides improving balance, posture, mobility and function, hippotherapy can also improve patients' cognitive, behavioral and communication capabilities, therapists say. Patients with conditions such as cerebral palsy, multiple sclerosis, strokes, developmental delays and congenital neurological disorders are good candidates for hippotherapy.
"Any disabled person will benefit from being on a horse," says physical therapist Barbara Heine, president of the American Hippotherapy Association. Many people with disabilities ride recreationally with the help of trained volunteers, but those sessions are considered "therapeutic riding" rather than hippotherapy, she says. A licensed physical therapist, occupational therapist or speech-language pathologist must be present to facilitate a hippotherapy session, says Heine, former director of the National Center for Equine Facilitated Therapy who now serves on its advisory board.
Kids Take to It
Engel says children respond particularly well to hippotherapy. "Kids don't look at being on a horse the same way they look at being in the clinic," she says. "You can adapt it so it becomes fun."
One of Engel's early hippotherapy clients was a toddler who suffered a shoulder injury at birth, severely limiting the function of one of her arms.
"When she was 2, I finally put her on a horse [with support] and gave her two reins," she says. "In riding, it's pretty natural to use both sides of your body, and the horse balances you." Riding was a breakthrough for the child, who learned to use both reins and is now a young adult with only a trace of the original disability.
Hitting the Mainstream Therapy Trail
When Heine started offering hippotherapy, most of her clients were referred by other clients and their families. Now most of her referrals come from physicians and other therapists. In some cases, insurance companies cover hippotherapy services. "Hippotherapy is becoming more mainstream than it used to be," she says.
Most physical and occupational therapists involved in hippotherapy spend only a portion of their time working in the field and the rest of their time in more traditional roles. OTs and PTs who are interested in hippotherapy should attend classes offered through the North American Riding for the Handicapped Association, says occupational therapist Claudia Morin, who has developed hippotherapy coursework and runs Blue Ribbon Riders, a hippotherapy and therapeutic riding program in Grovetown, Georgia.
Hippotherapy is not for every occupational or physical therapist, Morin cautions. "It's easier to teach therapists about it if they have a knowledge of riding and they understand the safety issues," she says. "You can be dangerous to yourself, the horse and the rider if you don't understand [the horse as a] treatment tool."
Matching clients with the proper horses is also a big challenge, Heine adds.
For therapists who have the skills and training they need to succeed, hippotherapy is rewarding and enriching. "Sometimes when I was out there with clients, I would think, 'I'm not even working,'" says Engel, who has since retired. "It's fun for the therapist as well as the client."