barb and lacrameThis information is provided for educational
purposes by Barbara A. Smith M.S.,
Certified Level II therapist in hippotherapy.
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website at:

 What is hippotherapy?
Historically, the horse began being used in Europe in the 1960’s
as an adjunct to physical therapy and what came to be known as
“hippotherapy” was brought to the
United States in the 1970’s as
a physical therapy tool to address postural and motor responses.

How does hippotherapy differ from therapeutic riding?
Occupational, physical and speech and language therapists utilize
the motor and sensory benefits of riding to work toward specific
therapeutic goals. Hippotherapy is a neuro-physiologically based
medical treatment strategy. Therapeutic riding instructors, on the
other hand, teach riding skills to individuals with disabilities.

How does hippotherapy work?
As the horse transmits movement, the patient integrates
postural reflexes, developing balance and equilibrium
reactions. Sitting on the horse maximizes range of motion.
Movement and weight bearing impact muscle tone. Assuming and
holding various positions during static and dynamic movement
strengthens the trunk muscles. Standing with feet in the stirrups
(the 2 point stand) strengthens legs and reaching activities
strengthen the arms. Sensory stimulation and emotional connections
often promote language, focus and motivation.

How is treatment different when performed
by an occupational therapist?

lacing board

Although all three disciplines address motor
and sensory issues, occupational therapists
are trained to employ activities as the core
principle of the profession. The equestrian
environment provides many tasks and activities
both on and off the horse that are meaningful
 and purposeful. The profession supports a holistic treatment strategy
 that can address physical, cognitive and social skills development. 


Possible occupational therapy objectives:

        To tolerate touching and grasping a variety of textures and
objects. The tactile defensive child will be encouraged to
grasp the handle, reins, a toy or pat the pony’s mane.

·        To sequence 2-3 step tasks (developing memory and following
directions as well as motor planning). I might ask the child to:
pull the reins to stop at the sign, turn around to face the pony’s
tail, then do ten arm circles.  

·        To improve motor planning skills and attention to engage in
self-care activities- Here is where a therapist might work with
a child off the horse. I ask one child on the autism spectrum
to routinely unbuckle the neck strap, pull it off, then hang it
up on a hook.

·        To improve fine-motor skills- This might involve reaching out
of the base of support to place a ring on a stack, bat at bubbles
or focus on more complex manipulation skills such as squeezing
a clothespin to attach it to the mane, circling pictures of what
the child saw on the trail that day or lacing a board that has a
picture of a horse on it. Oftentimes children are more focused
and ready to perform a fine-motor task after 20 minutes of riding
sensory stimulation.

·        To improve visual discrimination skills- A child might be asked to
choose a picture from a photo album or communication board and
then find that same object either on the trail or in the arena.

·        To demonstrate improved  motor planning and communication skills-
by pulling the reins and saying “whoa” when the child wants to or
is told to stop the horse.

The American Hippotherapy Association’s (AHA) (888) 8514592

Engel, Barbara, Enhancing Human Occupation Through Hippotherapy,
AOTA Press, MD, 2007.

Engel, Barbara, Therapeutic Riding I: Strategies for Instruction
(2 volume set), Barbara Engel Therapy Services, 10 Town Plaza,
Suite 238, Durango, CO 81301, 1998.

Engel, Barbara, Therapeutic Riding II: Strategies for Rehabilitation,
Barbara Engel Therapy Services, 10 Town Plaza, Suite 238,
Durango, CO, 81301, 1997. 

©2008 Barbara Smith OTR/L  HORSEOT.COM