Hippotherapy for Children, A Guide for Parents

Hippotherapy for Children, A Guide for Parents

Delane Frutiger Clark, PT

Introduction

For children who have neurological and musculoskeletal conditions, hippotherapy (HPOT) is an intervention used by pediatric physical, occupational and speech therapists to improve functional outcomes. Hippotherapy literally means “treatment with the help of the horse” but has been more formally defined as “the use of equine movement as part of an integrated intervention program to achieve functional outcomes.¹

Hippotherapy has been recommended for children with a variety of conditions including autism, cerebral palsy, developmental delay, Down syndrome and other genetic conditions, spina bifida, spinal cord injury, and traumatic brain injury.¹ Furthermore, HPOT has been proposed to have positive effects on physical and psychosocial function.² In HPOT, the horse’s movement is directed to influence the sensory and motor responses of the child positioned atop the horse. While the child is atop the moving horse, other tasks can be incorporated to work on functional goals related to attention, cognition, communication, and fine and gross motor skills.

Since 2006, I have used HPOT as an intervention in my pediatric physical therapy practice at Shining Hope Farms in Mount Holly, North Carolina. Shining Hope Farms has gone to great lengths to train its staff, to provide quality evidence-based interventions and to educate parents whose children are receiving therapy services. The staff at Shining Hope Farms expressed the need for parent education materials that go beyond positive claims and anecdotal evidence for HPOT. The staff and I agreed that the purpose of the materials should be to educate parents about: 1) the use of the horse’s movement as an intervention, 2) the differences between HPOT and other horse-related activities for children with disabilities, 3) the research evidence supporting HPOT, and 4) what to expect from intervention.

To accomplish the task of developing education materials, last semester in Evidence Based Practice II (PHYT 752) I began researching the HPOT literature and used the following PICO question to focus my efforts, “For children with neuromotor impairments, is hippotherapy more effective than conventional physical therapy in improving physical and psychosocial function?” This question led to the creation of an evidence table, a research paper and ultimately, my work in the Capstone course (PHYT 854). In PHYT 854, I expanded my literature review to include additional studies examining the effectiveness of HPOT on function in children and created a second evidence table.

Evidence Table I 

Research Paper 

Evidence Table II

Products

Based on feedback from Shining Hope Farms staff, I determined that a brochure and a PowerPoint presentation were the most practical and needed forms of parent education materials. The brochure and PowerPoint are entitled, Hippotherapy for Children, A Guide for Parents. The brochure will be available at Shining Hope Farms and through their website. Brochures will also be taken to community events. The PowerPoint presentation will be posted on the Shining Hope Farms website but will also be used for in-person presentations. Below, you will find the health literacy assessment for my written materials, the brochure, a PowerPoint that includes a script in the “note” section under each slide, and finally, a VoiceThread. To be honest, the VoiceThread was a bit of an after-thought. Out of concern for my PowerPoint presentation’s literacy level (9^th grade), I felt narration was in order.

Health Literacy Assessment

Brochure

PowerPoint

VoiceThread

Evaluation

To evaluate the Power Point presentation, I created a parent survey. Next month, my goal is to have parents of children who are on Shining Hope Farms’ wait list to receive HPOT view the presentation and afterwards, complete the survey. The survey will provide valuable feedback regarding parents’ needs and how to improve the education materials.

Parent Survey

Videos

Transfer to Horse from Ramp

Transfer to Horse from Block/Step

UE Task at Halt

UE Task at Walk

Forward Sitting at Walk

Transfer Off Horse

Thank You

I would like to thank Karen McCulloch and Mary Beth Osborne for their guidance and support over the last four semesters (and a summer session!). I also want to thank Jeff Hinton. As the father of child who has received hippotherapy, his parent perspective has been invaluable. Last, thanks to my husband, Walter, who over the course of my tDPT program has gone the extra mile with carpooling, chaperoning field trips, building parade floats, feeding hungry kids, and the list goes on! 

References

1. American Hippotherapy Association. Accessed 04/21/14 from   http://www.americanhippotherapyassociation.org/

2. Grenados AC, Agis IF. Why Children with Special Needs Feel Better with Hippotherapy Sessions: A Conceptual Review. The Journal of Alternative and Complimentary Medicine. 2011; 17(3):191-197.