FOR REFERRAL PARTNERS
Since the mid 1980s, the professional organizations for physical therapy (PT), Occupational Therapy (OT), and Speech Language Pathology (SLP) have recognized hippotherapy as a standard therapy tool that can be utilized within the professional scope of practice. The American Hippotherapy Association (AHA) defines hippotherapy as: the use of evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement to engage sensory, neuromotor, and cognitive systems to achieve functional outcomes. In this treatment technique, equine movement (movement of the horse) is used as a treatment tool within PT, OT, or SLP treatment. The term hippotherapy refers to an intervention strategy, not a therapy discipline and it must be utilized within the scope of practice of a PT, OT, or SLP. An individual providing hippotherapy should be licensed in their respective field and have advanced training in hippotherapy. The American Hippotherapy Association recommends that PTs, OTs, and SLPs pursue advanced training that is focused on theory, evidence-based intervention, and safety. Therapists incorporating hippotherapy into a plan of care carefully pair horses with their clients. The horses are selected based on their temperament, movement and confirmation is considered and manipulated to impact the client. Therapists also employ developmental positions, and postures to further enhance the impact of the horse's movements. Hippotherapy is incorporated into a plan of care along with other standard tools/strategies to address the client's treatment needs.
Equine movement provides a dynamic and multidimensional input at a high intensity that can be used to facilitate changes in neuro motor system that support functional outcomes. A client participating in 15-25 minutes of equine movement will experience 1,500 to 2,500 neuromotor inputs. That is easily double the amount of stimulation and opportunity for practice available in a traditional therapy setting. More input causes more stimulation of the body's systems which means greater opportunity for a positive outcome. In 2019, there were 8 systematic reviews, 98 peer reviewed research articles, and 11 peer reviewed case studies published. These are listed on the American Hippotherapy Association's Bibliography and Reference List. These research articles support the use of hippotherapy as a treatment intervention. Use of hippotherapy is supported in across all age ranges including the pediatric population and geriatric populations. Equine movement can be used to improve strength, endurance, and muscular function in a range of musculoskeletal, neurologic, and sensory diagnoses.
Freedom Rehabilitation encourages providers to think of us as typical PT, OT, and SLP providers who happen to specialize in hippotherapy. Clients should be appropriate for PT, OT, or SLP in that they should have a medical condition, or functional deficit that requires skilled intervention to improve functioning, or health. We do not teach clients how to ride horses. If clients are interested in learning how to ride horses as an adaptive sport, we recommend looking for a therapeutic riding center. We would be happy to assist you by referring your clients to an excellent center if this is the case. The caveat to this statement is that if a client needs a particular physical or functional deficit addressed to improve riding performance. Hippotherapy is most frequently utilized in young clients, however, the intervention is appropriate throughout the lifespan with research showing that all age groups can benefit, when the client meets appropriate criteria. The clients most frequently referred for hippotherapy are those with deficits in: sensorimotor regulation, strength, balance, coordination, mobility, communication, speech and language, muscle tone, postural control, postural asymmetry, spinal dysfunction, motor control, oral motor function, and arousal. Or with diagnoses such as: autism spectrum disorder/ASD, sensory processing disorder/SPD, chromosomal abnormalities or deletion, cerebral palsy/CP, developmental delay, functional spinal curvature, multiple sclerosis/MS, neuromuscular dysfunction, brain injury, CVA/Stroke, and spinal cord injury/SCI. Please note that these are not exhaustive lists. If you are not sure that a client is appropriate for hippotherapy intervention, we are more than happy to consult to assist with appropriate referral.
PRECAUTIONS & CONTRAINDICATIONS
For the safety of our clients, staff, and horses, there are certain conditions and diagnoses that we approach with caution, and certain diagnoses and conditions that are not appropriate for hippotherapy.
Referrals can be generated by you, your clients, or us. We request that appropriate staff at the physician's office fill out specific forms. This is to certify that the client is appropriate for hippotherapy and to ensure that the medical history we receive is as accurate as possible to optimize safety. Forms can be e-mailed to us, or faxed.