Therapeutic use of the horse in health care settings

Barbara T. Engel, MEd, OTR

"The rhythmic movement of the horse's back, together with the physical contact and the motivation created through use of a living exercise apparatus, meets all the requirements of modem kinesitherapy techniques: increased flow of impulses from the periphery through proprioceptive, tactile, and vestibular stimulation; and improved activation of the voluntary motor control loop (periphery-cerebellum-parietallobe-frontallobe-periphery" (Riede, 1988, ie.).

As early as the 1500's, physicians found that riding was beneficial to health. The Greeks used horseback riding with people who were found to have incurable problems in order to improve their spirits. In 1750, Francisco Fuller, in the first sports medicine text, mentioned equitation and its implications for maintenance of physical exercise and the effects it has on the mind and body.

Benefits which have been attributed to riding during the 1600-1800's are stimulation of the digestive system, alleviating gout, relieving tuberculosis, influencing body metabolism, increasing strength in weak bodies, helping psychological problems, improving general wellness of body and soul. Riders who were seriously injured were reported as making remarkable recoveries after they began to ride again; also in helping to relieve their psychological stress. The movement of the horse at a walking gait and the resulting swinging motions of its back are transferred to the rider; these actions closely approximate the same movement impulses or sequences that occur when a person walks normally.

The current use of the horse in medical care has developed since the late 1950's, mainly by German physicians and therapists. Renaud began using riding to rehabilitate patients. Clients involved in rehabilitation have included those with such disorders as multiple sclerosis, closed head injuries, orthopedic disorders, cerebral palsy, behavioral disorders and developmental disabilities. In the late 1970's, a few therapists, including physical therapist Barbara Glasow, who studied hippotherapy in Germany, began to spearhead the development of hippotherapy in the United States. International Congresses for Therapeutic Riding began in 1964 in Paris, France; 1976 in Basle, Switzerland; 1979 in Warwick, England; 1982 in Hamburg, Germany; 1985 in Milan, Italy; 1988 in Toronto, Canada; and 1991 in Aarhus, Denmark. These Congresses have been especially helpful in the exchange of information leading toward the development of the treatment applications of the horse.

Heipertz points out that the type, degree and quality of the horse's movement are important since these movements provide the therapeutic effects sought for the rider. In addition, the facilities where activities occur must be appropriate for treatment purposes. A third essential element is a therapy team of qualified specialists. The treatment team consists of a therapist who is well trained in equine-assisted therapeutic methods and in the theory of Hippotherapy, a skilled riding instructor who influences the horse's movements at the first/second level dressage maneuvers, and trained support assistants or helpers. The use of the horse for therapeutic purposes combines the ability to produce specific movement in the horse with traditional therapy techniques used by physical therapists, occupational therapists, speech pathologists, and other health care practitioners.