I was surprised to learn that hippotherapy involves physical, occupational and speech therapy all wrapped up into one very large package. I took a tour pf the facility. I learned that hippotherapy in not new. It started as a formalized discipline in the 1960s Germany, Austria and Switzerland where it was used along with traditional therapies. In Germany that therapy was practiced by a physiotherapist, a specially trained horse and horse handler. In the late 1980s a group of Canadian and American therapist traveled to Germany to learn about hippotherapy. They brought the new discipline back. That discipline was formalized in 1992 with the formation of the American Hippotherapy Association (AHA).
Why a horse? The horses pelvis has a similar movement to the human pelvis at a walk. That movement provides physical and sensory input, which is variable, rhythmic and repetitive. The variability of the horses gait allows the therapist to control the amount of movement along with other treatment strategies to reach desired therapy goals or functional outcomes. That movement involves the horse carrying the patient in many different positions, one at a time of course.
Riding is not the only way a patient interacts with a horse. There is occupational therapy where the patient simply grooms the horse. There are several different ways and tools used in what seems at first as a simple procedure. First though is some speech therapy. Speech? The patient, me, had to introduce myself to the horse. That speech was both physical and verbal. My movements where slow and deliberate to approach from the front so I did not surprise the horse. The horse being specially trained was very patient of course. After a sniff of the back of my hand and a soft touch to the horse’s neck we were introduced. The therapist guided every part of my movement as needed and guided me through the proper sequence of events.
Then the grooming tools where introduced. I had been in traditional therapy for many months many years before so I was familiar with standing up to a wall and simply brushing a chalkboard eraser on a wall. That is the best analogy I could apply to a form of occupational therapy that was completely new to me. Then came the difference. The wall did not move when I brushed it. The horse did. It moved closer to or farther from me. It even moved left or right, all depending on my technique used with the brush. Of course I had to keep the brush in my hand, a particular challenge. I still have many challenges on my right side from a stroke I experienced almost 13 years earlier. To keep the therapy balanced, I stroked the brush evenly with my right and left hand. Then came another challenge. That was to stand and walk on the sand floor of the arena where the hippotherapy was practiced.
So, what had been a simple exercise of wiping a wall with a felt eraser that involved standing and balancing while brushing a static wall, was now an exercise that involved moving while standing next to a “wall” that moved in four directions, while I brushed it.
At the same time I talked to the horse in a quiet, even tone to keep him calm. That is important whenever I was close to the horse so the horse knew where I was. Of course I learned to watch and listen to the horse. Call that speech therapy as I learned to watch the ears, the eyes and even the position of the head – if it was tall and alert or lowered and relaxed. All three forms of therapy, occupational, physical and speech were all wrapped up in the simple act of grooming the horse.
It wasn’t long before I learned how to put a halter on the horse’s head and attach an 8 foot lead to the halter in preparation to lead the horse around the arena. That meant walking on the sand floor. I normally use a cane on such an unstable surface but if I am careful I can walk without the cane. Okay, the floor is soft so my 68 old frame will come in for a crash landing with a soft thud rather than solid crash. Needless to say, that the patient has to know how to fall, to participate. My therapist does accompany me as heeded if close hand is needed. In my case I know how to fall and after several months of hippotherapy I have not fallen.
To lead the horse all three forms of therapy are involved simultaneously again. I have to walk and balance myself on the soft, uneven floor, I use my hand on the lead that is attached to the halter to guide the horse and I have to talk to give verbal commands to guide the horse and establish authority over the horse without being loud or sharp, which might make the horse more nervous than obedient. Leading the horse, even grooming, is an art called horsemanship.
After several months of hippotherapy I have learned the answer to my initial question – Hippo what? In the limited space here it is almost impossible to do justice describing the art of hippotherapy. There are several places on the WEB to research, just like I did before my tour. Before I leave though I must add that half of my time with each appointment includes traditional therapy, which is no different from the therapy that I have experience over the years following my stroke.