Hippotherapy module 2 EN

1. SpecialisedVET training on Hippotherapy for
professionals working with children with
intellectual, emotional, physical and psychomotor
disabilities
2019-1-TR01-KA202-074547

3. • 2.1. Definition, characteristics, classification, terminology
• 2.1.1.Definitions and terminology of elements used in hippotherapy while
working with people with special needs
• 2.1.2.Characteristics of hippotherapy
• 2.1.3.Classification of equine activities for people with special needs
• 2.1.3.1.Therapeutic activity
• 2.1.3.2. Sport/equine activity
• 2.1.4. Description and terminology
• Bibliography

4. • Hippotherapy is the name of a therapeutic approach that uses the walking pace of
the horse which is, in a large degree, similar to the human walking
• Hippotherapy uses terms from other four different fields: medicine, psychology,
pedagogics and sport.
• Hippotherapy is a therapeutic approach in which the horse is used as a mediator
and teacher. It is aimed to increase the quality of life for people with disabilities,
persons with mental illness and individuals dealing with social issues.

5. • Horse Assisted Therapy - HAT means the approach that uses the horse in
recovering people with psychomotor disabilities.
• According to the American Hippotherapy Association, the term hippotherapy
refers to how occupational therapy, physical therapy and speech language
pathology professionals use evidence-based practice and clinical reasoning in the
purposeful manipulation of equine movement as a therapy tool to engage sensory,
neuromotor and cognitive systems to promote functional outcomes.

6. • The horse is a member of the therapy group and a therapy tool.
• he is part of the therapeutic team, plays an important role in motivating the rider and in
the time frames needed for the different working stations during the therapeutic session
• he uses the walk pace and the impulses send while doing so
• The multidimensional movement of the horse has an impact on the neuropsychic
system of the rider.

7. • The horse is able to adapt to the rider’s needs
• As hippotherapy is multidimensional there are also more elements needed for it to
be a practice:
• dynamic system
• learning the movement
• sensory integration

8. • Interaction between horse and rider, interaction between inner and outer systems
influence the horse as well as the rider.
• This interaction leads to changes in the system and finally to a change in the way
the system of the rider is functioning.
• In hippotherapy, the movement of the horse is used as a tool.

9. • The therapist has to know this instrument very well: what pace of the horse to use,
what equipment to choose according to specific needs.
• The therapist needs at least 2 years of experience in working with people with
special needs.
• Each therapy program needs to follow a therapeutic objective, chosen according to
the individual needs of each patient.

10. • Hippotherapy means rules and limitations for the horse
• The horse as well as the leader needs to specialize in this type of therapy
• The training means using special elements
• The aim is to enhance specific behaviours
• The equine movement can be modified in various ways in order to stimulate the
body of the rider to produce functional abilities.

11. • The main objective is to support the person with special needs to achieve the
highest degree of independent life possible and to acquire as many as possible
adaptation abilities needed for life.
• The choice and method chosen can often change the therapeutic path.

12. • For children with special needs, introducing a new therapy item means disturbing
a pattern of behaviour. In doing this, the child will have to adapt to a new pattern.
• It is thus expected that any therapeutic intervention, which is seen as a behaviour
change, will be seen as a distress of established patterns and even may be
rejected.
• This can be managed through an authentic therapeutic relationship with the rider.

13. • The ability to adapt of a child with special needs is very different than that of a
neurotypical child.
• This has to be taken into account in order to balance the therapeutic requirements
with the existing ability of the child.
• The therapeutic contact is facilitated in hippotherapy by the horse.
• The therapeutic relationship is a triangular relationship between the therapist, the
horse and the rider. It has a strong emotional and motivational impact.

14. Therapeutic
intervention
Child needs
Contact
Relationship
Resistance
Adapting
capacity
The therapeutic intervention has at its
core the need of the child in order to
increase his ability to adapt to life.

15. Horse assisted therapy contains:
• Contact
• Relationship
• Authenticity
• Creativity
• Motivation
• Balance
• Impulse
• Coordination

16. • The classification of the equine activities in relation to people with special needs is
different according to the internal regulation of each country and the way they are
used.
• Thus, in Europe, it is a form of therapy practiced mainly in the private field, in
special establishments.
• In the US, the horse assisted therapy is taking place in recovery clinics, and is
refunded by the insurance companies. It has also proven being effective and has
been included as a method in recovering people with special needs.

17. • In Switzerland, Portugal and Spain horse assisted therapy is practiced in private
practices and has thus a limited number of working personnel.
• In Romania for example, the classification of psychological activities is different
than in Europe and the USA. We thus have: therapy, sport and education as main
categories when it comes to horse assisted therapy.

18. • HAT as therapy is a therapeutic intervention, adapted to each rider. It can be
practiced only by a trained specialist. They must have at least 2 years of
experience in working with special needs people and must be trained in HAT as
well as in working with horses.
• They can be: psychologist, psychotherapist, kinetotherapist or doctors specialized
in therapeutic intervention.They must be accredited in HAT.
• Educational field: this has as main objective building educational programs aimed
for vulnerable people and people with special needs using horses and special
activities.

19. • It can be practiced by educational psychologists, therapists, social workers which
have finished a course in the field of working with horses in recovering persons
with special needs and which have enough knowledge about horses.
• As sport, it includes the equine activities that are sport activities practiced by
people with special needs and which include horses.
• The sport side can practiced by a trainer specialised in horse riding and working
with people with special needs.

20. Rehabilitation
with the aid of
horses
Therapy
Sport
Education

21.  Horse Assisted Therapy is a term used for all activities in which horses and people
with special needs are involved in a therapeutical process.
 Each of the previous named components of Horse Assisted Therapy are different in
their purpose and they use different tools to achieve their objective.Using a horse
is the common denominator.

22. 2.1.2. Special equine activities are divided in two parts:
• 2.1.2.1.Therapeutic activities assisted by the horse:
• hippotherapy,
• horse assisted therapy (psychotherapy using the aid of horses)
• 2.1.2.2. Special equine activities:
• special equine activities
• adapted horse riding and specific competitions

23. • Hippotherapy
• Horse Assisted Therapy
• Psychotherapy using the aid of horses
Horse Assisted
Therapy HAT
Hippotherapy
Psychotherapy
using the aid of
horses

24. • Represents an approach with an individual curriculum.
• Therapists need a specific training.
• Aims to fulfil previous established therapeutic milestones.
• It needs to be evaluated and monitored.

25. Aims of HAT are:
• A better physical condition
• A better mental health status
• An increase in motivation
• Emotional balance

26. • Horse Assisted Therapy is used for all the equine activities that involves people with
special needs and that have a therapeutic aim. Its components have common traits
but also differ a lot from the point of view of what they intend, and who is involved.
• When mentioning Horse Assisted Therapy we are talking about all therapeutic
actions which use the horse as a therapy tool. And we also acknowledge that it
includes activities taking place off the horse. It is also to be understood that we refer
also to elements concerning emotional therapy, therapy for specific phobia and
depression.

27. • Horse Assisted Therapy has as its main purpose to obtain functional results,
following an evaluation of a psychologist, occupational therapist or speech
therapist.
• The therapist has to be present.
• It is mandatory that the therapist is trained to work with people with special needs
and a psychologist/psychotherapist.

28.  When the therapist uses the movement of the horse as a treatment strategy and
her/his purpose is to obtain a better neuromuscular function, you have to always
use the term hippotherapy.
 According to the American Hippotherapy Associations, the term hippotherapy
refers to how occupational therapy, physical therapy and speech language
pathology professionals use evidence-based practice and clinical reasoning in the
purposeful manipulation of equine movement as a therapy tool to engage sensory,
neuromotor and cognitive systems to promote functional outcomes.

29. • Hippotherapy is performed by professionals working in the rehabilitation field and
it means an individual planning according to specific needs.
• Individualisation of intervention plan allows the therapist to work more efficiently
according to every child’s specific needs. It also allows to use specific strategies
and set personal objectives.

30. • Hippotherapy allows the therapist to develop a personalised intervention plan in
which the relationship between horse, child and therapist facilitates a more in
depth therapeutical process, being also a fun and enjoyable activity.
• This activity has as main goal to develop and correct what needs improvement.

31. • In hippotherapy the movement of the horse is used as a tool.
• The therapist must know this tool very well: which pace of the horse to use and
which equipment to use according to the individual needs of each patient
• Hippotherapy is a therapy method used by specialised therapists.
• The therapist must have an experience of at least three years in working with
children with disabilities.
• The therapist is the one responsible for the therapy session. The horse and the rest
of the team are tools for the therapist to use in the process.

32. • Hippotherapy is one of the most efficient therapy methods used in order to
improve the balance, posture, mobility and other functional imbalance in people
with motoric dysfunctions.
• The intervention plan is established according to the specific diagnostic and
individual needs.
• In certain cases, hippotherapy can only be practiced with a note from the medical
team. Following situation requires mandatory medical approval, thus not limited to
these: any problems of the spine, hip dislocation or after any surgical intervention.

33. • The therapist will seat the rider in the correct position on the horse. Once the horse
is moving, the rider will adjust as much as possible to the correct posture.
• The therapist has to closely observe the rider and to adjust the pace of the horse
and the position of the rider according to each person’s specific needs.
• In hippotherapy, teamwork is important. The therapeutic team should involve
doctors, therapists and trainers.

34. • Main objectives:
• To obtain a balanced position while seated.
• This can be realised through proprioceptive and tactile kinetic integration.
• Obtaining a balanced position will help to optimize the energy consumption
involved while trying to achieve balance.
• The hip area will be strengthened by:
• obtaining a better posture in the lumbar and hip area through strengthening
the specific muscles,
• constantly training the dysfunctional area towards the correct position,
• using rhythmic motor sequences,
• when an area is malfunctioning the nearby muscles will try to compensate,
which will activate more areas and will, eventually, lead to a strengthening in
all muscles.

35. • Addresses those with an emotional imbalance or other issues such as:
• anxiety, depression, panic attacks, phobia, low self esteem, low capacity to take decisions.
• Spending time with horses, grooming them and taking care of them have in itself a
positive influence on the human psychic, besides the influence of the movement.
• Being in the open air, changing environment is considered a bridge between the
restrictive world of a patient with limited options and the life of a non-patient.

36. • Adapted horse riding
• Special sport activity
• Competitions
Adapted
horse
riding
Special
sport
activity
Competition

37. • Adapted horse riding refers to actions that are supposed to support people with
special needs to learn to ride. These may include, but are not limited to: riding
lessons, grooming, horse training. They are mainly recommended to people with
special psychomotor needs.
• It is usual a group activity.Two or more riders are taking adapted riding lessons.
• The trainers are specialised in evaluating and creating individual intervention plans
according to each rider’s specific need.
• Adapted horse riding has two main advantages: emotional connection, a pleasant pastime
for people with special needs.

38.  Special Sport Activity includes learning to ride a horse or any other activity that
means sport (wagon competition, horse gymnastics, dressage)
 Participants are people with cognitive and physical disabilities.
 Harnesses are adapted to individual needs.
 Represents more a pastime activity than an actual therapy.

39. • Competitions are represented by those equine activities that are structured as
competitions and are part of special sports events (events for people with special
needs, e.g. Special Olympics).
• All these activities are performed using an adapted harness.
• Equine competitions are organised. Special rules and regulations are being applied.
• People with special needs take part in mainstream equine competition, obeying general
regulations.

40. • “Hippotherapy” is the term worldwide used to name the therapeutic method using
the aid of the horse.
• The correct term should be Horse Assisted Therapy which includes hippotherapy.
• Those practicing HAT should not be named “hippotherapist”.
• The correct naming is “therapist assisted by the horse” or “therapist using the
horse as a therapy tool”.

41. • Recently the horse has been used in therapy mainly for:
• Hippotherapy
• Horse assisted therapy
• It has to be taken into consideration it is difficult to look to these two forms of
therapy separately because a therapy session will have elements of both.

42. • As it uses the action of the horse as well as that of the therapist, we can conclude
that the horse as well as the therapist will influence the therapeutic process.
• The difference is made by the tools used according to special needs of each
patient.This is the starting point for a classification of the methods used.
• Horse Assisted Therapy includes hippotherapy. Hippotherapy is not including any
other features than the influence of the movement of the horse on the human being.

43.  Silkwood-Sherer, D.,Warmbier, H., (2007). Effects of Hippotherapy on Postural Stability
In persons with Multiple Sclerosis.Journal of Neurologic Physical Therapy, 31(2), pp. 77-
84
 Quint C.,Toomey, M., (1998). Powered saddle and pelvic mobility: an investigation into
the effects on pelvic mobility of children with CP of a powered saddle which imitates
the movements of a walking horse.Physiotherapy , vol 84. no 8, pp.376-384
 Riede, D., (1988). Physiotherapy on the Horse, Riderwood, MD:Therapeutic Riding
Services
 Silkwood-Sherer,D.,Killian, C., Long,T., Martin, K., (2012). Hippotherapy: habilitating
balance deficits in children with movement disorders. Physical Therapy, 92 (5), 707-717
 Sutherland, D.H., Kaufman, K.R., Moitoza, J.R., (1994). Kinematics of normal human
walking, in J. Rose, J.G. Gamble, Human walking, 2nd Edition. Baltimore:Williams &
Wilkins, 1994

44. The European Commission's support for the production of this publication does not
constitute an endorsement of the contents, which reflect the views only of the
authors, and the Commission cannot be held responsible for any use which may be
made of the information contained therein.
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