Ukraine Hippotherapy

Hippotherapy: Utilizing Equine Motion in Medical Practice

Hippotherapy: Utilizing Equine Motion in Medical Practice
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Incredible Hippotherapy: Using Equine Movement in Clinical Practice // Chapter 4, Therapy Sessions


therapy sessions by discipline

hippotherapy includes many techniques

for a therapist treatment toolbox it is

not a standalone therapy patients should

be evaluated and functional goals set

like any other treatment setting

assessment will be similar to those used

in the clinic they may be more

functional in order to adapt to the

equine environment assessments are not

necessarily discipline dependent but are

chosen based on client needs assessments

include but are not limited to body

structure tests such as range of motion

manual muscle tests and observational

gait analysis to assess temporal

distance factors tests of function such

as sitting and standing balance using

time as a measure are quick and reliable

measures the five times sit to stand as

well as the sensory profile are easily

applied within the equine environment

activity measures include the activity

scale for kids functional gait measures

such as timed up and go timed up and

down stairs and activity tests such as

timed walk test and the vineland

adaptive behavior scale which can be

used in this environment without

modification participation measures

frequently used in this practice setting

include the Canadian occupational

performance measure as well as

standardized questionnaires such as the

pediatric quality of life general and

disease specific versions these next

videos provide examples of treatments

incorporating hippotherapy

for the disciplines of physical

occupational and speech therapy physical

therapy physical therapists may

incorporate activities to improve range

of motion of the lower extremities

examples include stretch on the

adductors to straddle the width of the

horse gravity assisting with lengthening

of hamstrings along with manual

stretching of the lower extremities

while on the horse supine position on

the moving horse opens the entire chest

wall along with improving scapular

retraction and lengthening pectoral

muscles if the lower extremities are

allowed to straddle the back

of the horse this provides a stretch on

the hip flexers strengthening activities

include the use of weights for upper

extremities with varying lever arms

tossing balls sit-to-stand transition

using stirrups and standing in stirrups

the movement through space in and of

itself provides facilitation of core

musculature this can be enhanced with

stop and starts of the horse encouraging

agonist and antagonist coupling the

horse provides one of the best mediums

for enhancing postural control by

developing sensory motor function

therapists can manipulate environmental

cues by asking the client to close their

eyes promoting the use of vestibular and

somatosensory systems by having the

client sit sideways or backward the

therapist provides a typical visual cues

allowing the patient to practice

filtering sensory information for

postural control additional

developmental positions on the moving

horse promotes further somatosensory

mapping to promote body awareness and

assist in motor planning getting on and

off the horse as well as transitional

position changes on the moving horse

supplement motor planning activities the

equine environment offers multiple

challenges and motivators not available

in a traditional clinic

these include walking steep inclines

that lead to a horse or maintaining

balance while providing the horse with

the treat taking advantage of the

sensory motor input of the horse the

therapist may then work on functional

skills that further enhanced permanent

motor learning all of these activities

either on the horse or in the

environment are structured to meet the

patient’s therapy goals occupational

therapy occupational therapy is client

centered and depends greatly on what

each client needs for functioning in his

or her daily life occupations may

include ordinary activities a dressing

eating a snack reading the paper driving

a car and telling a story occupational

therapy folk

on those tasks that may be difficult to

do because of a myriad of problems with

the horse and horse environment an OT

may focus on sensory processing through

sequencing tasks various tactile

surfaces visual motor integration or

listening and responding to graded

directions because being on the horse or

in the horse environment is sensation

rich many clients benefit from this

integration of visual motor olfactory

auditory and tactile senses and ot may

also work on cognitive tasks such as

planning and activity following the

steps and cleaning up the area often

fine motor activities such as reaching

for a ring or tossing a ball into a

basket from the horse can develop

coordination and challenge balance as

well as focus attention on the task at


grooming activities with the horse may

facilitate self-care and motor

development as well as learning the body

parts colors and numbers which transfers

directly to school related tasks for

people with physical impairments that

make everyday functional tasks difficult

mounted sessions provide a movement

challenge which builds core strength

stability and balance as a foundation

for occupational performance the OT may

also focus on functional skills which

address specific upper extremity

impairments and integrate them with the

rhythmic postural challenge afforded by

horse movement manual tasks similar to

those the client needs to perform at

home at work at school or on the

playground are employed in the therapy

session on the horse to facilitate

practice of fundamental skills the

rhythmic movement of the horse at the

walk facilitates occupational

performance of many different skill sets

occupational therapists may also engage

clients in appropriate social and

emotional behaviors in the equine

environment by having expectations and

rules to follow facilitating team skills

and setting up situational role place to

develop proper social engage

after a mounted session in which equine

movement has challenged and enhanced the

clients ability to perform functional

tasks in a movement context every day

functional tasks can be added into the

session on the ground this creates an

immediate link back to the performance

needs of daily life these tasks could be

removing the helmet which requires a

pinch grip on the clasp the client could

brush the saddle area calm the mane or

brush their own hair in an effort to

carry over skills learned in this

environment to more functional

activities of daily living even changing

to clean clothes to go to dinner or

putting on a coat will require fastening

buttons or zipper using the skills

practiced while mounted helping the

therapist to collect treatment equipment

and putting everything away and even

remembering to do it all in a planned

sequence can reinforce skills that were

learned while engaged in equine movement

this translates to enhance life skills

that improve performance in the clients

everyday life and home environment for

some clients with ADHD for example

planning an activity and then focusing

on and executing their plan

can be quite difficult interfering with

their daily lives tasks that are left

unfinished or messes that are not

cleaned up frustrate many parents and

teachers the environment in the barn

provides many opportunities for planning

and executing activities related to the

horse and the therapy session like Todd

this is just like Tommy oh isn’t it

occupational therapists will engage

advanced clients in preparatory

activities to plan and sequence their

treatment session or assist impaired

clients to remember and execute two to

three step directions while on the horse


the treatment sessions on the horse or

in the equine environment can be very

complex treatments where clients will

improve their executive function skills

speech-language therapy session equine

movement can be used to facilitate the


motor systems that support speech and

language function prior to targeting

specific speech articulation tasks or

receptive expressive language use the

speech-language pathologists can use a

period of measured equine movement to

promote improved postural control and

overall stability

this in turn facilitates oral motor jaw

stability respiratory support for speech

sound production and enhanced sensory

motor performance throughout the

articulator ‘s equal movement has also

been shown to positively impact arousal

and general information processing such

that decoding and encoding of language

can be positively influenced standard

speech and language therapy strategies

are then overlaid on the movement of the

horse either dynamically or statically

to address the client’s communication

needs the setting is rich in

naturalistic conversational context and

communication opportunities which then

provide the speech-language pathologist

with both naturally occurring

communicative interactions and the

opportunity to create specific speech

and language tasks both on the horse and

off the horse evaluation and treatment

planning are no different when

hippotherapy is part of the treatment

plan the speech-language pathologist

conducts a formal speech and language

evaluation using standardized

assessments appropriate to the client

examples include the Arizona

articulation test the preschool language

scale and the comprehensive assessment

of spoken language as well as functional

communication probes and speech language

sampling within the therapy sessions

treatment goals will be consistent with

goals written in any other clinical

application of speech-language therapy

in reality the speech-language

pathologist is simply harnessing dynamic

movement to promote a positive systems

wide neuromotor influence on human

communication performance the

pragmatically loaded environment

inherent in hippotherapy offer

added opportunities for the treating

therapists to incorporate real-world

speech and language tasks and training

interdisciplinary interaction

occupational and physical therapy and

speech-language disciplines often

incorporate similar activities to

provide opportunities for specific

emphasis on functional goals unique to

the client the functional goals of the

client become an interdisciplinary focus

where teamwork and Co treatment allow a

more integrated and comprehensive plan

of care

Source …

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