Hippotherapy as seen by the riding instructor
Different authors recommend different ways of handling a horse in this kind of work, such as leading by a rein, or driving the horse on a longe line around an assistant, riding at a walk, or a trot. With our child patients, good results are achieved by a method whereby the instructor leads the horse at a walk, from the near (left) side. The rehabilitation worker walks on the off side, so that the patient feels more secure by their presence. The instructor walks the horse about the arena, changing directions according to the rehabilitation worker's suggestions. Walking in circles, spirals or slalom curves. This is supplemented by horseback exercises at standstill and at walk. The lead rein should be long enough for the horse to walk relaxed and move head and neck naturally. This way the patient also relaxes, in tune with the horse, and his muscles are exercised by the motion of the horse's back. At a trot the patient, fearing a fall, might hold on too stiffly and so stress the muscles unevenly. The patient does not hold the reins himself. Up to now we had used a saddled horse, the advantage being that the patient's balance is aided by the stirrups. One disadvantage is the need to move the right leg over the cantle when helping the patient to mount. Another drawback is that the saddle insulates the patient from the horse, thus diminishing the therapeutically most important, irreplaceable effect of the three-dimensional motion of the animal's back. For this reason we are now experimenting with a surcingle with handles, without a saddle.
Advantages include easier mounting and direct contact of the patient with the horse, which brings about distinctly better transfer of the motion and makes use of the animal heat of the horse's back. A disadvantage is the loss of stirrup support, which has to be compensated by holding onto the handles. Of course, some patients hold onto the pommel anyway, when in the saddle.
From a rider's point of view, it would be possible to enhance the effect of transfer of the horse's back's motion to the patient by leading the horse on firmer ground, because soft footing such as sand or sawdust in an arena absorb a lot of the footfall effect. Another plus of harder ground is the fact that the footfall rhythm is clearly audible. At a walk the horse is not harmed by it. What intensity of the therapeutic motions of the horse will be considered optimal and the decision for hard or soft transfer will depend on the physician.
A hippotherapy horse must be used to carry a rider, be calm, trusting, and easily handled. It should be about as tall a a hucul; if taller than 150 cm at the withers, steps are necessary to help the patient on. Preferred is a horse with a steady walk and appropriately high knee action, definitely not one that drags his feet. Of course, a retired riding horse is easiest acquired for our purpose. At our barn in Plzen we have an older, formerly successful dressage horse. He does his job on the health care beat reliably, if somewhat lazily. Given his 17-hand height the mounting steps are essential.
All safety rules must be strictly observed when working with a horse, to prevent any falls, kicks or other dangers to the patients. The best insurance are "horse-savvy" rehabilitation personnel and qualified riding instructors who know the assigned horse and know how to prepare him in a manner that will ensure that, before a patient is mounted, the horse is relaxed and free of stable-friskiness or nervousness. Other important safety measures are a safety helmet, well-kept tack and meticulous tacking-up to prevent slippage or breaking of girth or stirrup leather.
The therapy sessions should only be held in areas well known to the horse, in places to which he used, in order to avoid startling him by anything new and unknown, thus preventing any sudden jumps.
The therapy sessions should only be held in areas well known to the horse, places where he goes to often, in order to avoid startling him by anything new and unknown, thus preventing any sudden jumps.
By no means should these closing words be taken as threatening, rather as suggestion to take good care that unreliable animals or inexperienced people do not cause injury to a patient and damage to the good name of hippotherapy.
Reference: Otto Pech, Ústav sociální péče, Zbůch. Sborník semináře Hipoterapie [Proceedingins of Hippotherapy Seminar], 1988