Updated June 08, 2015.

Hippotherapy is the use of a specially trained horse for the treatment of individuals who have disabilities. The treatment term means “treatment with the help of a horse.” Hippotherapy programs have been shown helpful in the treatment of multiple sclerosis, brain trauma, cerebral palsy, stroke, autism, developmental delay, learning disabilities and language disabilities. Children, as well as adults, can benefit from this form of therapy.

What is Hippotherapy

According to the American Hippotherapy Association, the therapy is ”a physical, occupational, and speech-language therapy treatment strategy that utilizes equine movement as part of an integrated intervention program to achieve functional outcomes. Equine movement provides multidimensional movement, which is variable, rhythmic and repetitive. The horse provides a dynamic base of support, making it an excellent tool for increasing trunk strength and control, balance, building overall postural strength and endurance, addressing weight bearing, and motor planning. Equine movement offers well-modulated sensory input to vestibular, proprioceptive, tactile and visual channels.”

Riding a horse requires an individual to use many of their senses, as well as a variety of muscle groups. While some riders may require assistance riding a horse, others may be able to ride a horse by themselves with supervision or with someone leading the horse. A rider does not have to have any experience with horses prior to receiving these therapy sessions, but individuals who are afraid of horses may not be good candidates for this type of treatment program.

What Happens in Hippotherapy Sessions

Depending upon the type of disability, individuals who receive hippotherapy are first introduced to their horse that will be used in a treatment session. The horses are specially trained to be patient and alert to their handlers. Individuals are not left alone with a horse, and a handler is always either leading the horse for those who cannot control one, or close by for those who are able to guide their own horse.

Therapy sessions may include trail rides, riding inside of a large stable that has a riding arena or riding inside of an outdoor ring. Individuals may ride a horse astride either facing forwards or backwards, sitting sidesaddle and lying prone or supine. Some patients ride the horse with the assistance of another individual with them on the horse (such as an adult holding a child). The therapist can adjust the horse’s movements and tempo according to the needs of the patient. For this reason, therapists must have a unique understanding of horses, as well as the physical therapy needs of a patient.

Therapist Certification

Therapists who provide hippotherapy as part of a physical therapy program often have extensive experience riding and working with horses. In the United States, individuals need the following credentials to offer this form of therapy to clients:

• A license or are registered to practice PT, OT, or SLP.
• Training in the principles of Hippotherapy, equine movement and equine psychology. This can be obtained through attending an AHA approved 3-day introductory course.
• Be a NARHA registered instructor (minimum level) and, if not, has a NARHA registered instructor assisting with the horse at all treatment sessions.
• Carry professional and general liability insurance.

Therapy Recommendation

Hippotherapy can be recommended by an individual’s physician or physical therapist. Individuals and caregivers who are interested in this type of therapy should consult with their health insurance company prior to beginning therapy sessions to determine what portion of the cost will be covered. Some insurance companies will only cover a certain number of sessions, while others will provide coverage as long as a patient is making progress as determined by their therapist.

While it is not a new form of therapy, there are a limited number of trained therapists available within the United States. The following are organizations that offer further information on this form of therapy, and provide contact information to locate trained therapists in your area.

• American Hippotherapy Association
• Midwest Council for Children with Disabilities
• PATH International - Professional Association of Therapeutic Horsemanship International
• Stable Possibilities - Occupational Therapy Services in Hippotherapy