Hippotherapy and Cerebral Palsy

October 21, 2009

Cerebral palsy (CP) is a neurological disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way). Cerebral palsy can also lead to other health issues, including vision, hearing, and speech problems, and learning disabilities.
CP is usually caused by brain damage that occurs before or during a child’s birth, or during the first 3 to 5 years of a child’s life. There is no cure for CP, but treatment, therapy, special equipment, and, in some cases, surgery can help a child who is living with the condition.
About Cerebral Palsy
Cerebral palsy is one of the most common congenital (existing before birth or at birth) disorders of childhood. About 500,000 children and adults of all ages in the United States have the condition.
The three types of CP are:
1.    spastic cerebral palsy — causes stiffness and movement difficulties
2.    athetoid cerebral palsy — leads to involuntary and uncontrolled movements
3.    ataxic cerebral palsy — causes a disturbed sense of balance and depth perception
Cerebral palsy affects muscle control and coordination, so even simple movements — like standing still — are difficult. Other vital functions that also involve motor skills and muscles — such as breathing, bladder and bowel control, eating, and learning — may also be affected when a child has CP. Cerebral palsy does not get worse over time.
There are a variety of therapies available for cerebral palsy. An increasingly popular one being prescribed by physicians is hippotherapy.   There are many benefits of hippotherapy to patients with cerebral palsy, including increased balance, posture, speech and coordination, not to mention fun, increased confidence and a sense of accomplishment.

In hippotherapy, a trained physical therapist, usually with a team of horse handler and sidewalker, walks alongside the patient, providing support as needed. The therapist may place the patient in a variety of positions on the horse, such as sideways and backwards, and have her reach for toys or other items. The therapist has a trained view of horse movement and knows when to ask the horse for an upward transition ( halt—walk;walk-trot or walk—fast walk) or a downward transition (trot—walk; fast walk –walk or walk-halt) The idea behind hippotherapy is that the rhythmic movement of the horse provides a sense of rhythm to the patient with cerebral palsy, and through developing and normalizing muscle tone in the trunk and extremities, encourages the patient to align his head, torso and hips correctly, which aids in sitting, and eventually standing and walking.

The rhythmic, three dimensional movements of the horses’ pelvis and footfalls help to reduce abnormal muscle tone.  Children with hypertonic (spastic) CP benefit from rocking/rhythmic movement to help relax their muscles and bring their extremities into a position where they can begin to use them functionally and with intention.  The warmth of the horse, coupled with this movement, helps to reduce unwanted high tone as well.  For riders with low tone, their Central Nervous System (CNS) is stimulated by this 3-D movement.  These clients do better when paired with horses that have an inherently shorter stride, a “higher” energy and a faster cadence.  All types of clients benefit from a staff that is diverse in its ability to read the client, their body, and what they need from us in terms of energy level and interaction.

Hippotherapy has many benefits for children and adults with cerebral palsy. Physically, it helps improve posture and balance, coordination, muscle strength, core strength, trunk control, and gross motor skills such as walking, sitting and standing.

Cognitively, hippotherapy helps to enhance expressive language skills (speech) as well as receptive language skills (comprehension) through the dynamic communication with their team of therapist, volunteers and mostly—their horse. The client begins to anticipate the horse’s movements as well. In addition, a patient learns better focus, concentration and attention.

There are substantive emotional and psychological benefits as well.  Hippotherapy can help to boost the self-confidence of patients of all ages.  They begin to feel empowered, as well as supported by the notion that they are ABLE bodied while astride.  The feelings of partnership with the team boosts a client’s chance of success–and they feel that tenfold while connecting with their horse, spending time outdoors and away from conventional clinical settings. The bond between humans and horses lasts a lifetime and can be the key to eliciting participation in therapy.  Because even while WE all know the client is in therapy, often THEY do not.   They only perceive it as a fun activity.

In all, hippotherapy is an excellent addition to the therapeutic interventions offered to patients with CP.