An exploration of German and British physiotherapists' views on the effects of hippotherapy and their measurement

Abstract

Hippotherapy (Greek hippos = horse) is a specialised physiotherapy treatment that makes use of the horses' unique three-dimensional movement impulses at a walk to facilitate movement responses in patients sitting on the horse's back (Strauss, 2000). Despite a substantial body of anecdotal and clinical evidence for its benefits, research evidence for hippotherapy is sparse. This questionnaire survey was the first study in a series of investigations exploring the views of physiotherapists and people with cerebral palsy who use hippotherapy. These investigations, in turn, form the basis from which the authors will recommend outcome measures for individuals with cerebral palsy in a hippotherapy environment. This study aimed to: (a) establish the pattern of hippotherapy practice in Germany and the U.K.; (b) examine the perceived main effects of hippotherapy on people with cerebral palsy in Germany and the U.K.; and (c) investigate how these effects are being measured in both countries. The results highlighted considerable differences in how hippotherapy is practised in the U.K. compared with in Germany. In spite of this, the study revealed agreement among respondents on the overall perceived effects of hippotherapy on individuals with cerebral palsy, namely, the regulation of muscle tone, improvement of postural control and psychological benefits. The results also indicate scant use of outcome measures to evaluate these effects. The impact of these findings is discussed in the light of published research, and suggestions for further research are made.

Effects of hippotherapy on posture in individuals with Down Syndrome

“…A study that evaluated the trunk alignment in sitting position, using hippotherapy as treatment, showed symmetry in the pelvis weight transfer, further dissociation of pelvic girdle and cervical alignment (20). Other investigations report that the sensorimotor stimuli applied to the individual sitting on the horse generate greater muscle activation of the extensor muscle groups of the spine and muscle tone normalization for triggering biomechanical adjustments, facilitating postural control (21,22,23). These data corroborate our indings, which demonstrated that the stimuli provided by hippotherapy contribute to a better alignment of biomechanical structures, especially in shoulder and hip alignment and thoracic kyphosis.…”

Use of hippotherapy in gait training for hemiparetic post-stroke

“…Would, apud Debuse et al 22 , found evidence in his study that the walking ability of the subjects investigated had improved after a period of therapeutic riding, compared with the same period in the control group. The aspects of walking ability investigated were specific object and included the transfer of weight, ability to stand without support, ability to walk without the use of a walking aid, and the ability to stop and turn successfully.…”

“…In one study, Would, apud Debuse et al 22 was able to demonstrate statistically significant improvement in weight shifting and balance in eight children who underwent therapeutic riding program. In this survey, the balance of both groups did not obtain significant improvements, although there was a trend to significance in the difference between the groups (p=0.056).…”

Efectos de las terapias ecuestres en personas con parálisis cerebral

“…Los resultados demostraron mejoras significativas entre las medidas pre-test y post-test lo que sugiere que la hipoterapia tiene efectos positivos en el desarrollo de las habilidades motoras de niños con PC. Debuse et al (2005) diseñaron y pasaron un cuestionario en el que evaluaban los efectos principales percibidos por los fisioterapeutas de personas con parálisis cerebral que realizaban sesiones de hipoterapia en Alemania y el Reino Unido y cómo dichas sesiones de hipoterapia eran llevadas a cabo. Dichos autores observaron diferencias considerables en cómo la hipoterapia era practicada en Reino Unido y Alemania.…”