Marsha Berger Grant PT, DPT
Deb Saffren OTR/L
Hippotherapy is a physical, occupational or
speech-language therapy treatment strategy that
utilizes equine movement as part of an integrated
intervention program to achieve functional
outcomes. The horses movements provide
carefully graded motor and sensory input. It has
been practiced in North America since the 1970s
and is practiced in many countries throughout the
world.
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Misnomer
Any PT, OT or SLP who uses a horse as a
modality can do hippotherapy, but there are no
hippotherapists.
Special Equestrian's
Mission
To improve the
physical, mental,
and emotional
well being of
individuals with
disabilities
through the
equine
experience.
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32 years of nonprofit service to the community
249 riders in 2013
60 different diagnoses
3,900 lessons in 2013
100+ volunteers per week (+ corporate groups)
14 therapy horses
3 full-time, 14 part-time staff, 2 vocational workers
Participants in research in the field
Fees charged to all riders only 50% of cost to SE
30% of riders receive additional tuition assistance
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Three dimensional movement of the horse
This 3 D movement leads to an adaptive
response in the rider’s pelvis which is similar to
the movement patterns of human walking
which in turn affects core control and posture.
It is the only therapeutic treatment strategy in
which we can provide patients with sustained
3 dimensional movement.
Changing the gait allows for degree of input
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Looking at the whole experience of the rider to
make it a safe, fun and successful interaction
with the horse and environment to promote
increased self esteem and self efficacy.
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PTs- promote functional outcomes in skill areas related
to gross motor ability such as sitting, standing, and
walking.
OTs -fine motor control, sensory integration, feeding
skills, attentional skills, visual perception and
functional daily living skills in a progressively
challenging manner.
SLP - generate effective remediation of communication
disorders and promote functional communication
outcomes.
Overlap of all three disciplines in each lesson.
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Ages 2+
Weight restrictions
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Autism
Cerebral Palsy
Developmental Delay
Arthritis
Adults with gait
dysfunction = MS, PD
TBI
CVA
Chromosomal
Disorders
Sensory Processing
Disorders
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In dwelling catheter
Scoliosis greater than 30 degrees
Poor Unsupported Sitting Posture
Uncontrolled Grand Mal seizure
Combative behavior
Unstable hip
SIDE WALKERS
HORSE LEADERS
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For the horse
Therapy saddle
Rainbow reins
Ladder reins
Black Handle Reins
Devonshire stirrups
Wedges
Boppy pillow
For the rider
 Safety belt
 Sensory balls
 Flash cards
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Improve posture
Increase balance/core control
Increase ROM
Increase attention span
Decrease anxiety
Improve behavior
Increase safety awareness
Normalize tone
Improve speech
Increase attention, sensory processing
Improve functional grasp, crossing midline
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Parental response
Changes in
 Posture
 Coordination
 Behavior
 Communication skills
 Fine and gross motor abilities
To be promoted to therapeutic riding which
allows for a lifelong program to maintain gains
and to offer a recreational activity for lifelong
enjoyment.
Noodle Toss
Carwash
S: rider’s parent reports rider was sick this week
O: 30 minute hippotherapy session on Bear.
Required mod assist of 2 to mount at ramp.
Worked on balance with quick stops and starts,
reaching across midline with noodle toss and
grasping activities with ball drop.
A: Weakness noted with increased assistance to
mount and postural assist needed at trunk rather
than hips. As expected due to illness.
P: Continue w/ same horse/tack. Attempt mount
with less assist as able
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Does horseback riding therapy or therapistdirected hippotherapy rehabilitate children
with cerebral palsy?
Dev Med Child Neurol. 2007 Jan;49(1):68-73
Reviewed 11 quantitative studies – 6 for
recreational horseback riding therapy and 5 for
hippotherapy
Methodological quality was moderate to good
for all studies
Hippotherapy improved gross motor function
in all studies
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Video: Ride On St Louis Participates in
Hippotherapy & Cerebral Palsy Study at
Washington University
Tim Shurtleff OTR/L
Measured stability in head and trunk via
computer assisted analysis
Riders on mechanical horse, then lessons, then
retest
Positive improvements immediately and 6
months post.
SE- The happiest
Place on Earth
“There is something
about the outside of
a horse that is good
for the inside of a
man.”
Winston Churchill