Hippotherapy is a physical, occupational, and speech therapy that utilizes the natural gait and movement of a horse to provide motor, and sensory input. It is based on improvement of neurologic functions, and sensory processes, and used for patients with physical, and mental disorders. Especially, in paralyzed individuals it contributes to physical rehabilitation programs.

Herein, we wanted to provide information about hippotherapy whose effectiveness has been demonstrated in scientific studies, and so prevalently used in many countries in the fields of physical, and mental disabilities. In our study, recognition of the importance of this new method for our country will provide benefit for many patient groups.

Diagnosis

Hippotherapy means treatment with the aid of a horse. Despite long-term use in history, only a few studies have been performed on its theoretical basis. Only scarce information are available on its psychological, physical, social, and educational effects in specially trained children. Hippotherapy is a treatment method with concurrently favourable psychological, social, and educational effects on many organ systems including sensory, musculoskeletal, limbic, vestibular, and ocular systems

History, and hippotherapy in the world

Hippotherapy consists of the words meaning “horse” “hippos”, and “treatment” “therapy” in ancient Greek. It is defined as equine-assisted treatment. Firstly, it was mentioned in the works of Hippocrates. However, it has not become a discipline with an established protocol up to 1960s. During 1960s, it is used as an adjunct to traditional physical therapy in Germany, Austria, and Sweeden. In countries as Germany, Austria, and Sweeden which used the horse in physical therapy the term “hippotherapy” was introduced into medical literature. During 1970s in the United States of America (USA), hippotherapy was started to be standardized.

It was standardized by a group of Canadian, and American therapists who traveled to Germany in order to learn hippotherapy near the end of 1980s. American Hippotherapy Association (AHA) was founded in the year 1992, and established an official, and international protocol. In the year 1994 certification document, and standards for certified hippotherapy clinical specialist (HPSC) were established, and in 1999 the first certification examination was realized. This certification program consists of three steps, and encompasses a training period of 3 years.

Mechanism of action of hippotherapy

Physical, and educational therapists have used the movements of the horse for the cure of the patient, while psychologists, and mental health therapists benefit from the horse’s mobility so as to achieve or increase compliance of the patients. Horse pelvis, just like the human pelvis displays a 3-axial movement pattern while walking. Horse gait has been carefully graded at every step of the patient’s treatment. These variable rhytmic, and repetitive movements provides physical, and sensory feedback to the patient. Favourable physical effects of equine-assisted therapy on coordination, muscle tonus, postural balance, stiffness, flexibility, endurance, strength, correction of abnormal movement pattern, and improvement of gait, and balance have been demonstrated in many studies.

Mechanism of action of hypotherapy can be divided into four main groups. The first one is core connection. As we know, during daily living performance, balance, lying supine, and walking, postural control, and core connection are very important. Besides, one of the many beneficial effects of hippotherapy is its favourable effect on postural control, and core body connection. During hippotherapy sessions, during horse riding direct contact with patient’s pelvis, and spine is ensured. Movements of the horse provide sensory input, and induce motor responses in pelvis, and trunk. Other mechanisms of action of hippotherapy can be enumerated as sensory connection, communication connection, and neuroconnection.

Hippotherapy has favourable effects on different domains as physical, social, cognitive, psychologic fields, learning, and adaptive behaviours.

Hippotherapy team

Hippotherapy team consists of a therapist, horse trainer, and riding instructors walking on both sides of the horse. Hippotherapy is applied in the presence of an experienced physiotherapist, horse, and horse carer. Physiotherapist controls the horse gait, gait velocity, and orients the horse into various directions, and all these movements induce neuromuscular, and sensory reactions in the patient.

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