Hippotherapy Equipment

January 30, 2010

Hippotherapy Equipment

Recently, when asked the difference between therapeutic riding and hippotherapy by a potential client, I had the chance to reflect upon and discuss the many differences–primarily, that hippotherapy is not to be confused with teaching the sport of riding to the disabled population (therapeutic riding), but rather a therapeutic intervention, using the horse’s movement as a means of eliciting a response in our clients to achieve an objective or goal set at evaluation.  Hippotherapy is conducted by licensed physical, occupational or speech therapists, and not by riding instructors.

Rope Halter vs Web Halter

Rope Halter

Web Halter

That said, there are many types of equipment that we use primarily in hippotherapy, that are generally not used in therapeutic riding.  First, because horse handling is such an integral part of a successful session, we specially train our handlers how to use rope halters vs. webbing halters.  The primary reason behind this, is that rope halters have a smaller surface area on the horses head, making the cues given by the handler much more succinct.  The horses head must be properly fit and the halter adjusted to ensure the nose, poll and chin are not uncomfortable.  Once the rope halter is properly adjusted, the skilled handler has better control and a safer partnership with their horse. (see photo)

Why Front Range Hippotherapy Uses Bareback Saddles

Bareback Pad

In Hippotherapy, saddles are rarely used.  Saddles, while providing riders with stability and support, prevent the client from feeling the movement of the horse directly translated through to their pelvis–because of the large interface between horse and client.

Riding bareback is the best way to achieve direct movement translation.  However, it is still necessary to provide some source of protection to the horse’s spine and soft tissue while a client is astride.  For this purpose, we typically use either a bareback pad (see photo) or a western pad combined with a surcingle. Bareback pads are lightly padded and have an attached girth to hold them into place.  They are used mostly when a client has good balance and can stay upright without the use of his/her upper extremities.

Double Handled Surcingle vs Single Handled Surcingle

Double Handled Surcingle

Single Handled Surcingle

Surcingles are used in the equine world primarily for vaulting patterns.  Vaulting is a series of “tricks” performed on/with the horse at varied gaits and usually the rider is standing, kneeling, circling the barrel or any combination of the above.  While hippotherapy is definitely not vaulting,  we still benefit from the use of surcingles as they help the pad stay firmly in place while the horse is walking, as well as providing one or two handles with which to assist a client’s balance. (see photos)

A one handled surcingle typically allows for more lateral trunk movement (left and right).  A two handled surcingle blocks lateral movement and allows for more anterior/posterior trunk movement (forward and backward).

Other factors, when choosing a surcingle, are physical limitations in our clients.  For example, if a client is hemiplegic (one-sided paralysis or weakness), we would typically use a single handled surcingle to additionally facilitate mid-line awareness and assist with balance and centering.  If a client is requiring more assistance with stability and balance, or is initially frightened of being astride, we may choose a two-handled surcingle to maximize upper extremity use in stabilization.

Other equipment considerations are when to add/use reins (for upper extremity range of motion and intentional mobility) and/or stirrups (for weight bearing through the lower extremities or as additional means of support/balance).  For both of these, we have a variety of options.

Rainbow Reins

Rainbow Reins

Reins can be clipped on to the horses halters at the nose band.  (We hesitate to use bridles in hippotherapy, since most clients aren’t able to grade/control the amount of pressure distributed through bits and onto the horse’s mouths)  If reining, the client’s abilities are assessed and they can either hold rainbow reins–colored at intervals for appropriate cuing and holding with relation to the horse’s face and client’s arm length (see photo) or if the client has abnormal muscle tone, contractures, or weakness, leather bows can be attached to enable them to hold reins without adequate grip strength. (see photo).

Plastic Stirrups

Plastic Stirrups

Stirrups can be attached with stirrup leathers to the surcingle handles, or to loops on the body of the surcingle, designed for long lines.  The stirrup width is dependent on the client’s needs for stability and balance.  Narrower, iron stirrups can be used for light support and minimal balance.  Wider plastic stirrups are used for more support and clients with high tone to assist in keeping their foot and ankle aligned.

Surcingles can be used, additionally, for long lining clients.  This is the purest way to achieve natural horse movement in all gaits.  The lines are threaded from the halter, through specially placed d-rings on the surcingle, to the handler who is driving the horse from his rear–or ‘zone 5’.  This helps the horse to use his entire back and belly as well as engage his hind end in maximizing the movement attained in a collected walk.  Direct to the client, they are treated to the full range of pelvic mobility in all 3 dimensions–anterior/posterior, lateral, and rotational movement.

Many facilities and clinics have come up with a variety of tools and equipment designed to enhance the client’s experience in hippotherapy.  As far as creativity, the sky is the limit!  The important thing to remember, as with all equine-related activities, is safety first!  Whatever is commonly used in a treatment session should not impede natural movement of the horse or human, should be a quick release or safety release when attached (so if there is a spook, or sudden movement, the client is not “caught”) and should not inherently hurt or spook the horse due to it’s use.  Consider fabrics, irritants (such as velcro), complicated hooks and fasteners, and wiggly attachments that may spook a horse without a rider.

Hippotherapy is an enormously rewarding, successful means of meeting therapy goals.  The right equipment, chosen by a trained team, can make the difference in a client’s session.

Walk on!