Therapists Saddle Up

Increasing Popularity of Hippotherapy

by Megan Malugani

In stables across the country, health professionals are harnessing the power of horses to treat people with disabilities. Occupational and physical therapists say their faithful four-legged partners motivate disabled patients and help them build strength, function and confidence.

Hippotherapy -- using horses in therapy -- has gained popularity in the past decade because it's so effective, says occupational therapist Barbara Engel of Durango, Colorado, a pioneer in the field. ("Hippo" means horse in Latin.) Children respond particularly well to hippotherapy, she says. "Kids don't look at being on a horse the same way they look at being in the clinic," Engel 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 two I finally put her on a horse [with support] and gave her two reins. In riding, it's pretty natural to use both sides of your body, and the horse balances you," she says. Riding was a breakthrough for the child, who learned to use both reins and is now a senior in high school with only a trace of the original disability. 

Besides improving balance, posture, mobility and function, hippotherapy can also improve patients' cognitive, behavioral and communication capabilities, therapists say. Patients with conditions like cerebral palsy, multiple sclerosis, strokes, developmental delays and congenital neurological disorders are good candidates for hippotherapy, experts say. 

"Any disabled person will benefit from being on a horse," says physical therapist Barbara Heine, director of the National Center for Equine Facilitated Therapy in Woodside, California, and president of the American Hippotherapy Association. Many disabled people ride recreationally with the help of trained volunteers, but those sessions are considered "therapeutic riding" rather than hippotherapy, she says. A licensed PT, OT or speech language pathologist must be present to facilitate a hippotherapy session, Heine says. 

When Heine started offering hippotherapy nine years ago, most of her clients were referred by other clients and their families. Now the bulk of her referrals come from physicians and other therapists. In some cases, insurance companies will reimburse for hippotherapy services, she says. "Hippotherapy is becoming more mainstream than it used to be." 

Most OTs and PTs who are involved in hippotherapy spend only a portion of their time working in the field and the rest of their time in more traditional roles, experts say. 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, Inc., a hippotherapy and therapeutic riding program in Evans, Georgia. 

Hippotherapy is not for every OT or PT, 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 treatment tool [the horse]," Morin says. Matching clients with the proper horses is 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'," said Engel, who recently retired. "It's fun for the therapist as well as the client."