Hippotherapy: Equine therapy
Horses for courses
by Michael Braunstein
||Horses for Courses
Edye Godden, OTR/L, is Executive Director of the Heartland Equine Therapeutic Riding Academy (www.HETRA.org) in Valley, Neb. She is a graduate of Creighton University, and a licensed occupational therapist. Founded in 1989 by Steve and Janet Henthorn, HETRA is a NARHA certified center. There are others listed on the NARHA website. The Cheff Center in Michigan was the first NARHA certified center in the U.S.
HETRA sees dozens of patients a week. They range in all ages, from the youngest to adults. They are mostly persons with physical disabilities but there are some with other issues, too. Some centers focus on the psychological or emotional issues more than others.
Like the 50 or so volunteers involved at HETRA, Godden is no stranger to horses. The center has nine of them that are specially trained for therapy.
"I got my first horse at age seven, so I guess you could say I grew up in the barn," she told us. "When I was a senior at Creighton, I did my project on [hippotherapy] and my career as a therapist just led to it naturally."
HETRA offers regular therapy sessions throughout the week. Scheduling and information is available at the website. The center accepts referrals from physicians and physical therapists. As a stand-alone operation, not affiliated with any hospital or clinic, HETRA operates as a 501(c)(3) non-profit. They present a yearly fundraiser. It’s their opportunity to make some hay. Check out the website if you want to help.
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Therapy with horse sense
Admittedly, it has a funny name. And chances are you thought it had something to do with hippos, right? Well, the "hippo" part of it is only deceptive in modern English. In fact, "hippo-" is the Greek language derivative that means "horse." Most of us think of what the Greeks named the "river horse" or hippopotamus. When it comes to therapy though, the "hippo" in hippotherapy means horse. Another thing to get clear on is that hippotherapy is therapy for people, not for horses.
Hippotherapy is sometimes also called "equine facilitated therapy." It is a form of physical therapy that recognizes the special relationship between animals and humans and utilizes the physical motion associated with riding and caring for horses to improve health. In thousands of centers around the world, professional therapists and volunteers bring horses and humans together for the purpose of healing.
Hippotherapy is not a new therapy. Like most of the traditional healing arts, there are records of its use going back thousands of years. Historians refer to writings by Orbasis around 600 B.C. that mention the healthy virtue of horseback riding in an anecdotal sense. 19th Century physicians wrote in even greater detail about what they observed. With a more contemporary understanding of gross anatomy, they could see how riding had beneficial effects on people. Doctors of that era noted that people with disability, injury or partial paralysis would derive benefit. Riding could restore a lost sense of balance, improve muscular use and provide exercise. They came to the conclusion that riding as therapy could treat certain types of neurological paralysis.
By the 20th Century, quaint though effective modalities like hippotherapy were overshadowed by increased reliance on pharmaceutical and technological medicine. But one fateful event in 1952 is credited with bringing hippotherapy back into public awareness. In the Olympics of that year, a Finnish equestrian named Liz Hartel won the silver medal in dressage. What captured public attention was that Hartel had been wheelchair-bound since a childhood bout with polio. With that incident as a catalyst, interest in hippotherapy stampeded across Europe and by the late 1950s had made its way to the United States.
Initially, the very notion that a person with paralyzed legs could ride a horse was news enough for most. One immediate application became known as Equestrian Therapy, which differs somewhat from hippotherapy in concept if not in reality.
It was apparent that a person accustomed to being wheelchair-bound would benefit tremendously just by the fact that some activity, of any sort, that allowed a somewhat normal interactive experience, could be undertaken. Just to get out and ride became therapy in itself.
A horse is a horse, of course, of course; but…
Eventually, physical therapists and doctors realized that there were specific and factual physiological benefits derived from riding (much like pre-20th Century practitioners had known). When a disabled person rides on a horse trained for use in hippotherapy, the motion and the gait of the animal actually exercises the pelvic girdle of the patient. Muscles that are ordinarily involved with walking are passively exercised and the result can be increased flexibility of the joints and improved circulation.
The sensory feedback loop provided by the amount of balance required for the patient to remain stable in the saddle improves the natural function of equilibrium that is lost when a person's walking ability is compromised. Even if a patient has lost complete use of the legs, the simulation of the action necessary for walking that is provided by the horse's movement mimics the physical activity of walking to the rest of the body. Hippotherapists use a specific grading technique to ascertain the degree of physical improvement that a patient makes over time.
The gentle, rhythmic motion of a horse, when guided by a skilled volunteer or therapist, provides a form of sensory input that interacts physically with the body and mind. The horse becomes a therapy tool to improve neuromuscular function. And not only are there physiological benefits, but patients respond to the opportunity to do something active and connected with nature.
A hippotherapy session is done in a controlled environment under the guidance and care of a therapist or trained technician. The horses are special too. An ideal horse is one with a comfortable and easy gait, well-broken in. A gentle demeanor is also important and while a lively horse is okay in some cases, it must be one that has no tendency to buck or become rambunctious. The horse must be accustomed to variations in riders, flexible hours and must not startle easily.
A patient of any age can benefit from hippotherapy. Nearly any impairment of neuromuscular function can be helped with hippotherapy. Patients with brain or head injuries, balance issues from diseases like multiple sclerosis or walking problems, cerebral palsy, even Alzheimer's or Parkinson's disease, can benefit. Down syndrome, learning or language disabilities, developmental delay, spinal curvatures or posture problems are other reasons a doctor may recommend hippotherapy.
Because therapeutic riding also builds self-awareness, self-control, confidence, trust and independence, an individual benefits both physically and emotionally from the experience of riding a horse. In addition to providing physical benefits, hippotherapy has become a recognized tool that is now used to help people with specific emotional, behavioral, social, mental, physical and/or spiritual needs.
Horses for courses.
Hippotherapy has been extremely common in Europe since the 1950s. It is an important tool in physical and psychotherapy and is often covered by medical insurance. In the United States, hippotherapy is becoming nearly as popular. In 1970, a group of physicians and therapists founded the North American Riding for the Handicapped Association, known as NARHA. NARHA is a non-profit organization that has grown to include over 600 riding centers across America. Member centers must meet certain qualifications to be certified, including an onsite inspection by NARHA observers.