What is Hippotherapy

What is Hippotherapy?

The term hippotherapy refers to how occupational therapy, physical therapy and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movement as a therapy tool to engage sensory, neuromotor and cognitive systems to promote functional outcomes.

Best practice dictates that occupational therapy, physical therapy and speech-language pathology professionals integrate hippotherapy into the patient’s plan of care, along with other therapy tools and/or strategies. 

What professionals can provide treatment that incorporates hippotherapy?

Hippotherapy can be utilized in as a treatment tool or strategy by occupational therapy, physical therapy and speech language pathology professionals, while working within their scope of practice.

Why the horse?

The average horse walks at a rate of approximately 100 steps per minute.  Just 5 minutes on a walking horse represents 500 neuro motor inputs to the patient.  In a typical therapy session, 15 to 25 minutes of equine movement may be incorporated by the treating therapist – which represents 1500 to 2500 neuromotor inputs to the patient. 

Incorporating hippotherapy into an occupational therapy, physical therapy or speech language pathology session can serve as a powerful tool for the facilitation of the key neuromotor systems that support function.  Skillfully applied equine movement, under the direction of a therapist, can offer the patient the opportunity for complex motor learning.  Hippotherapy is combined with other standard therapy tools/strategies in an intervention plan designed to address the treatment needs of the client.

Strength, Muscle Coordination and Sensory Processing used for walking, talking, and the use of fine motor skills for activities of daily living and general attention to tasks have all been shown to be positively impacted by equine movement as a facilitation tool/strategy, when under the direction of a therapist, as part of a larger total plan of care. In additional, increased motivation and participation in treatment and social emotional benefits have been reported.

There is a growing body of peer reviewed clinical research that supports the value of including hippotherapy as a therapy tool/strategy in facilitating positive functional outcomes for a broad range of patients who demonstrate neuromotor and cognitive/communication deficits.

Understanding hippotherapy as a treatment tool/strategy:

It is important for families and healthcare professionals alike to recognize that hippotherapy is provided within standard occupational therapy, physical therapy and/or speech-language therapy services.  Hippotherapy is not a separate service or a program.  Further, there is no such service as “equine therapy” or “horse therapy and use of these terms is incorrect (see AHA, Inc. Recommended Terminology document for more information- here).  View a free webinar on terminology.

Hippotherapy has been regarded as a therapy tool/strategy that can be utilized by occupational therapy, physical therapy and speech-language therapy professionals while working within their scope of practice by the American Occupational Therapy Association (AOTA), American Physical Therapy Association (APTA) and American Speech-Language and Hearing Association (ASHA). (Link to each letter).  For more information on coding and billing related to hippotherapy, see the AHA Inc. Position Statement on Coding and Billing Practices When Hippotherapy is part of plan of care here and view “Use of Hippotherapy in Occupational Therapy, Physical Therapy and Speech Therapy” here.

There is no such thing as “hippotherapy service” nor are there “hippotherapy programs”.   Therapists do not “perform hippotherapy”.   Licensed therapy professionals in PT, OT and SLP incorporate equine movement into their plans of care for their patients as a ” therapy tool”.  Please refer to the description of hippotherapy on the AHA, Inc. website.

Incorporating equine movement as a therapy tool is regarded as use of a standard practice tool/strategy by APTA, AOTA and ASHA —    Hippotherapy must not be treated as separate service from PT, OT or ST services.   Even in casual conversation, it is important to describe it accurately.