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Hippotherapy:How does it Affect Children with Mental and Physical Impairments?Sabrina HrabeOctober 27th, 2011EDEC 420IntroductionHer legs involuntarily cross at her shins. Her feet and toes curl as her shoes come off. Her arms contract as if stuck in imaginary elbow casts. Yet, sixteen year old Jazzy still waits patiently in her wheelchair as I fasten her shimmery, metallic blue helmet. While her care giver pushes her up the ramp to the mounting block, I sneak a quick glimpse of what could be a smile as she anticipates Stormy’s arrival. Jazzy suffers from spastic cerebral palsy, and for the past thirteen years, has received hippotherapy treatment with the infallible Stormy—an 1100 pound black Missouri Fox-Trotter. Horses have long been known as the “helper and healer of humans” (Meregillano). It dates back to the 5th century to the days of Hippocrates. He was the first to propose the healing power of horses and described it as “a universal exercise with a ‘healing rhythm’” (Granados). Even though the horse has been represented as a “healer” for several centuries, the use of horses in a therapeutic setting did not emerge in the United States until recent decades (Lane). It was not until the 1970’s that physical therapists in the U.S. started using horses for treatment, and finally, in 1987 an actual program was established (Benjamin). This form of therapy is known as hippotherapy: “treatment with the help of the horse” (Meregillano). This paper will focus on the effects of this modern therapy in children with mental and physical impairments. It will present studies that will provide a better insight into the recent success of hippotherapy. Discussion of ResearchToday, hippotherapy is being used on a global scale with 650 centers in the United States to treat children with an array of disabilities (Lane). Through every rhythmic stride the 1100 pound animal takes, the horse proves its medicinal benefits in more ways than one. Hippotherapy has shown improvements in every area of physical functions such as balance, coordination, strength, and posture. However, the physical advantages aren’t the only benefit children reap. Emotional, social, and cognitive improvements have also been observed with increased self-esteem, confidence, and communication. It “is multifaceted and has extraordinary effects on all body systems” (Meregillano). Many may confuse hippotherapy with therapeutic riding; although, these two concepts differ greatly. Unlike therapeutic riding, hippotherapy focuses on skills to improve the patients sensory processing and neuro-motor functions in daily life rather than teaching horsemanship skills (Meregillano). Therapeutic riding takes a group of people that may or may not have physical or mental disabilities and takes a more adaptive approach. However, the biggest distinction between the two is that therapeutic riding doesn’t require a medical professional. Hippotherapy, on the other hand, must have a certified physical, occupational, or speech therapist that specializes in this field to run treatment sessions. The therapist must exhibit knowledge of the horse’s movement, responses, and attitude to gain the best results as well as for the safety of patients. Horses used in hippotherapy are simply the tools to achieve success while the patient rides passively. Sitting astride a horse engages just about every muscle group in the body. The passive riding style of modern hippotherapy requires the horse to move the rider, which promotes its many advantages (Granados). The environment of hippotherapy activates each one of the child’s senses.It allows for all kinds of sensory integration such as tactile, vestibular, visual, olfactory, and proprioceptive stimulation, as well as developing a stronger fine and gross motor system (Smith). Each minute astride a horse stimulates the child’s brain with up to 1,000 nerve impulses, which clearly can’t be duplicated in a clinical setting according to occupational therapist, Tricia Coates (Doucette). There are many different ways that therapists achieve the desired results. The sitting positions and exercises are designed for each child depending on their capabilities and/or disabilities. Different positions and activities on the horse encourage different sensory input. But the key element that separates hippotherapy from others is the rhythmic factor. While atop a horse, the rhythmic, swaying gait mimics that of the human walk (Benda). It essentially exercises the muscles used in gross motor functions, such as walking, without posing a struggle for the child as it may in a clinical setting. This is just one of the phenomena’s of hippotherapy treatment.Over the 40 years hippotherapy has been in practice, most of the research and studies have been done on children with cerebral palsy (Meregillano). This neurological disorder develops in the fetus or infant when there is damage to the central nervous system. Cerebral Palsy (CP) affects 1 to 3 children for every 1000 live births (Benda). Because this disorder inhibits the proper development of the motor cortex, motor, postural, and cognitive abnormalities hinder these individuals their entire life (Zadnikar). CP differs in degrees of severity depending on how much and what part of the brain is damaged. Hippotherapy proves to be especially effective for these children because it “focuses on trunk stability, posture, and pelvic mobility impairments to improve gait and balance” (Meregillano). A meta-analysis was done in 2010 that looked at children with CP and the effects ofhippotherapy on their posture and balance. The final analysis includes eight studies and 173 total children ranging from 2 to 13 years of age. This group of children was split into an intervention group containing 84 children with CP and a comparison group with 89 children, 39 children with CP while the other 50 were non-disabled. The eight studies all had different types of hippotherapy sessions and duration. The intervention group received hippotherapy treatment, while the children with CP in the comparative group sat astride a barrel instead of a horse. Some sessions were 60 minutes long and others as little as 8 minutes. These studies also varied from 12 week treatment sessions once or twice a week to just a single intervention. The results were measured either as a positive or negative outcome. Of the 84 children in the intervention group, 76 experienced a positive


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