The Benefits of Hippotherapy
"Hippotherapy offers the potential for improvement in the following areas: arousal and attention,
balance strategies, belief in one's functional capabilities, bilateral integration, body awareness,
circulation, dynamic postural stability, endurance, expressive or receptive speech and language,
midline orientation, mobility of pelvis, spine and hip joints, modification of muscle tonus, motivation,
muscle strength, musculoskeletal alignment, neurogenic bladder, neuromotor function, oral-motor
function, posture, problem-solving movement strategies in different environments, respiratory
function, self confidence, sensorimotor integration, symmetry and alignment, and timing and
coordination of motor strategies." (American Hippotherapy Association, 2000) The therapist is able to
utilize the movement of the horse to assist during therapy just as a home therapist may utilize the use
of a specific toy or therapy ball. This movement is unique and cannot be imitated by any other available
therapy equipment.

Diagnoses that may be appropriate for therapy:
A recent survey of American Hippotherapy Association (AHA) registered therapists determined that a
great variety of patients are receiving hippotherapy as part of their treatment. (McGibbons, 2003)
McGibbons reports that the results of the survey showed these patient diagnoses to be cerebral palsy
45%, developmental delay 12%, sensory integration dysfunction 3%, traumatic brain injury 3%, Down
syndrome 3%, autism 2%, multiple sclerosis 2%, and other diagnoses 30%. The other diagnoses
indicated in this study were not specified but may include microcephaly, fetal alcohol syndrome, PDD,
hypotonia, in addition to many others.

Is Hippotherapy appropriate for everyone?
Hippotherapy is not appropriate for all people with special needs. Each patient must be individually
evaluated to determine eligibility. There are definite contraindications to Hippotherapy, which may
cause more harm then good to the patient or put the horse, therapist or volunteers at risk of injury.
Some of these contraindications include but are not limited to Down syndrome under the age of three,
unstable spine, uncontrolled Grand Mal seizures, atlantoaxial instability, and hemophilia. Hippotherapy
is not recommended for children under the age of two. It is vital that the treating therapist, referring
physician, the patient and the patient's parent or guardian all be in consensus with the treatment plan
and be comfortable with the decision to participate in a Hippotherapy program.
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Why does it work for so many?
Hippotherapy is a multi dimensional therapy in that it allows therapists to address numerous skills at
one time. While the patient is riding the horse, they receive constant sensory input from the horse
including vestibular, proprioceptive, tactile, auditory, olfactory and visual. The vestibular system, the
system that controls balance and equilibrium, is stimulated because the patient is on a dynamic surface.
The therapist also enhances this input by having the patient change positions on the horse. These
positions cause movement in the inner ear, the part of the body that controls balance. By stimulating
this area, the ability to process vestibular input improves. Proprioception is the body's ability to know
where it is in space. The body receives proprioceptive input when the nerve endings In the muscles
and skin are stimulated, which happens when a part of the body is touched or moved, even by gravity
or air. Normal functioning systems allow a person to close their eyes and still know where their arm
ends, for example. When a person rides a horse the lower extremities receive proprioceptive input
from touch the horse. When you add in movement, which causes bouncing the entire body receives
this input. The therapist can also enhance this input by having the patient change positions on the
horse, having more or less of the body touching the horse. Both of these systems and also the tactile
system, work closely together and are all stimulated when a patient is simply trying to maintain balance
on the horse in order to not fall off. The touch, sights, sounds and smells of the horse and the barn
contribute to stimulating the other sensory systems. During therapy, most of these systems are
stimulated on a subcortical level because the patient is focusing on the activity, such as throwing the
ball, and not consciously processing the sensory input. Because of this, carryover frequently occurs
and integration is more common.