When you’re the parent or caregiver of a child with cerebral palsy, you are always on the lookout for new and effective ways to spur their development. In many respects, there has never been a better time than now to be a kid with cerebral palsy. The assumed limitations and quick dismissal of past eras has given way to a widespread recognition within the medical community that every case of this neuromuscular disorder is unique. In addition, a wide spectrum of creative, innovative therapies is being developed to assist each child in strengthening their muscles and minds.
Nowhere is this innovation more apparent than in the recent introduction of hippotherapy.
Treatment Table on Horseback
Hippotherapy actually has nothing to do with the famous hippopotamus of Africa, but on something much more familiar: horses. Sometimes known as equine-assisted therapy (or EAT), this approach is founded on the concept that the neuromuscular development of an individual can be optimized over time by adapting synchronously to the form and movement of a horse.
Within a hippotherapy session, a child will be placed astride a horse and learn to not only ride, direct and interact with it. The body’s instincts to maintain equilibrium will gradually override the impulses and spasms associated with cerebral palsy, as the child’s muscles build up strength and coordination in the process of adjusting to the horse’s gait.
All of this happens practically by osmosis, as the body’s foundational instincts are encouraged to take over and the muscles learn to obey. In effect, the horse’s back becomes a “treatment table” where the patient undergoes highly individualized therapy.
Where Does Hippotherapy Come From?
A vast majority of cerebral palsy patients are involved in some form of occupational therapy. Occupational therapy is founded on the principle that occupation—whether it be play, self-care, sports, music or art—is a seminal technique for addressing obstacles in physical and mental development.
No matter what the root cause might be of these obstacles, the result is the same: the brain’s neural pathways adopt a different route than the norm. But neuroscience has shown us that the brain has a remarkable ability to “reroute,” as it were, given the right stimuli and plenty of repetitive practice. This is known as neuroplasticity, and the medical community’s growing insight into its power has amazing implications for cerebral palsy patients.
Hippotherapist Susan E. Grant explains it this way:
“When tasks are engaged at a sub-cortical level—specifically, when you become engaged in a meaningful and enjoyable activity—your brain assimilates this information, efficiently and effectively enhancing neuroplasticity.”
Animal-based therapy has long been a go-to resource in the arsenal of knowledgeable occupational therapists.
An animal’s soft fur, rhythmic breathing and physical warmth are comforting to children, especially those with spastic cerebral palsy or those prone to anxiety or emotional disorder. The proof of this is more than anecdotal: using brain imaging, doctors have definitively documented how the human brain and body respond to interaction with animals—specifically, that the human brain is wired to pay more attention to animals than to other external stimuli.
Hippotherapy takes animal-based therapy one step further, involving not only the tangible connection but also a purposeful physical interaction that benefits the patient’s body, mind, and sense of autonomy. Challenged by different movements of the horse, the patient learns to respond with different postures, movements and directions.
Naturally, the horses used in hippotherapy are carefully trained so that the patient’s safety is never compromised. The patient is never fully in control of the animal; instead, the horse is guided by a trainer at the direction of the hippotherapist, who simultaneously coaches the rider in various actions that encourage specific motor and sensory inputs.
History of Hippotherapy
Many who are just learning of hippotherapy are surprised to find that it has been around since the time of ancient Greece. Hippocrates, the father of modern medicine, wrote about the therapeutic value of horseback riding; he especially recommended it for patients with incurable illnesses. Records from as far back as the 1600s show European physicians recommending it for several conditions, including neurological disorders.
But it was not until the 1960s when the practice began to hit its stride. Starting in Germany and Austria, the good reports about hippotherapy brought it into practice in the United States. By 1992, the practice had been standardized and a governing board, the American Hippotherapy Association, was formed to maintain standards of practice and a formalized education process for therapists.
The Results Are Plain to See
Parents of children with cerebral palsy are often shocked at the wide spectrum of improvements brought on by hippotherapy. Along with physical benefits such as trunk core strength, respiratory control and improved motor skills, this form of therapy brings cognitive and psychological benefits including improved attention span, enhanced verbal self-expression, and a new ability to measure and control responses to sensory input.
Naturally, it doesn’t happen all at once. Hippotherapy sessions may start with the patient simply learning how to approach a horse safely, how to mount it or sit upright on it. Depending on the child’s age, ability and severity of cerebral palsy symptoms, the hippotherapist will put together a plan that provides positive stimulus and targets specific areas for growth.
The crucial point that hippotherapy develops is the connection between physical cues and the brain’s response. By strengthening the body’s ability to send and receive signals from the brain, and connecting that ability to the living presence of an animal, hippotherapy provides enhanced equilibrium not only to the patient’s mind and muscles, but to their emotions, as well.
The key, says Susan E. Grant, is that patients have very little idea that they are in a therapy session at all.
“Changing equine gaits, movement figures and rider position, provides unlimited treatment opportunities that the patient is completely unaware of…because they’re having FUN!”