The symbolism of horses in many instances is that of power and freedom. Horsed in most cases is a symbol of independence and strength. For instance, in the Chinese Zodiac the horse, which is the 7th element, represents freedom or living without restraint. A horse is a sign of enthusiasm and energy as well as independence and integrity. The symbolism of the horse is one that triggers freedom from aspects that bind any individual. Perhaps this symbolism is the reason horses are the preferable animals in the equine-assisted therapy. The symbolism of horses in various mythologies and cultural traditions allude to the effectiveness of the use of horses for therapy. Horses are particularly used to treat neurological disorders due to its freeing allusion. However, the effectiveness if using horse therapy in treating neurological disorders such as cerebral palsy, stroke, autism, and psychiatric and behavioral disorders is an area that elicits divided opinions from various practitioners since there still exists a gap for evidence to prove its effectiveness (Bachi 370). Some studies suggest that the effectiveness of horse therapy is in the fact that it stimulates the cognition, gait parameters as well as the mood (Benda et al. 820). In this regard, it is essential to review the existing studies in regards to the effectiveness of horse therapy by considering several existing factors including the age of the patient as well as other pre-existing conditions.
The benefits of the horse for therapeutic purposes date as far back as 460 BC. The Greeks are credited for having the earliest recordings of the use of horseback riding for therapy especially in treating illnesses that were considered incurable. Hippocrates alludes to the therapy in his recordings and writings in which he underscores the values of horseback riding. Writings from as early as the 1600s reference the emotional and physical benefits of horseback riding. However, it is prudent to note that the benefits of the equine-assisted therapy in modern days only seemed to have come to the limelight in the early 1950s. This was prompted by Liz Hartel from Denmark who despite suffering from paralysis caused by polio was able to win a silver medal in 1952 for dressage at the Helsinki Olympic Games. The victory aroused interest among medics and clinicians. Horse therapy was thus adopted for rehabilitation in Germany before it spread out to England and finally in North America. Nevertheless, it is prudent to note that Scandinavians also used horseback therapy for treating poliomyelitis and an important part of physical therapy for other forms of physiotherapy (Burgon 32). The United States began operation for horse therapy in the 60s before it was finally mainstreamed into treating neurological disorders in 1969 when North America Riding for the Handicapped Association (NARHA) was formed professionally. The association, which is currently known as the Professional Association of Therapeutic Horsemanship (PATH) now runs several centers around the world with several members and instructors with horses for therapeutic purposes. The main objective of the organization is to promote safety and get the most optimal outcomes in equine-aided activities and therapies for people with special needs. It is, therefore, obvious that the priority of the organization is to ensure effectiveness and the efficiency of the equine assisted therapy. Through trainer certification and the training of the horses for therapy, it is quite ostensible that PATH seeks to ensure that the entire process is not only safe but also gets the optimum results.
The essential aspect of this therapy process is perhaps the question as to why the horse is the preferred animal for animal-assisted therapy. Besides the symbolism of horses in mythologies, there are other traits of horses that make it the most preferred animal for equine assisted therapy. The reasons for the preferences may be answered by understanding the movement of the horses about the human movement patterns. The natural gait of horses often provides a variety of repetitive and rhythmic movements that can be compared to human movement patterns (Benda et al. 819). Horse's gait, therefore, enhances the sensory input as the individual experiences patterns that are similar to the pelvis while walking. With the natural gaits in walking, trotting, galloping, cantering, and pacing, it is prudent to state that the animal often seeks to create a balance while moving and swaying the client. The horse, in this case, offers both a dynamic and solid support base for the client. In this case, the client can experience stability and confidence, as well as exhilaration as important aspects of the therapy. Notably, during the transitions between the gaits from walking to pacing the client is required to make adjustments to align the pelvis and the rhythmic patterns between their movements and that of the horse. In this dynamism of movements, the client is allowed to strengthen their postures while their postural control is increased to increase their balance, addressing their motor skills, and build endurance and ultimately their strength. The dynamism in movement and definite correspondence with the human movement patterns are why hypnotherapists prefer the horse as it provides both a therapeutic and enjoyable moment.
While it is quite apparent that the use of horses for hippotherapy buys a lot into the dynamism of the horses and their changes in gait, it is quite apparent to note that it requires more than just instinct to ensure the effectiveness of the animal in the therapy process (Hofman 400). As earlier mentioned, it is rather obvious that PATH also offers training sessions for the horses to be used for the therapy. The optima of the process not only depend on the instincts of the animal as well as the certification of the medic to offer the therapy but also the training offered to the animal. Training a therapy horse is not quite the same technique that is used to train the average riding horse. The horses for therapy should be able to cope with the different angles in which they are handled as well as the likelihood to come around crowded spaces. The horses not only need to be trained for calmness but on behavioral matters in regards to the environment in which they will be used for therapy. There is a requirement that a horse to interpret the synergy between them and human beings is an assumption that would not ensure the effectiveness of the horse for therapy. In this light, when training, it is essential to keep the horse emotionally and mentally stable and to let the animal express himself confidently around humans. Likewise, it is important to interpret the synergy between the horse and humans as well as understanding each horse individually and its nuances of body language, equine characters and herd dynamics (Bass 1265). Interpreting synergy would in turn help in understanding the distinctions between its projection of humanistic emotions and traits and the horse's actual behavior to effectively interpret what the horse is doing in any particular session. Essentially, the horse may be trained for basic indoor hospital practice. Besides the animal training, it is significant to consider the training and accreditation of the handler of the horses in the entire therapy session.
Several aspects go into optimal and effective horse-assisted therapy. However, it is rather prudent to understand the various areas in which equine assisted therapy is applied. In most cases, pathologists apply the use of horse therapy in physical therapy sessions. Physical therapy involves the involvement of horse movements to address the various motor needs for the client to promote the functional outcomes in the areas of skills related to the entire motor ability such as standing, sitting, and walking. These are in regards to the postural outcomes achieved in the gait movement and dynamism of the horse (Hofman 300). Occupational therapy, on the other hand, involves the inclusion of the effects of the equine movement in other intervention processed to work on fine motor control as well as sensory integration, attention skills, feeding skills, and other functional skills for daily living through a series of progressively challenging ways (Trotter 152). Point to note is that hippotherapy may also be applied in speech-language pathology through the using horses in facilitating basic physiological systems that support language acquisition and speech. By combining equine therapy with other standard strategies and interventions for speech and language, there is likelihood to generate effective remedies for communication disorders and ultimately promote functional communication.
Equine-assisted therapy is a lot about biophysics and neurology and the way the brain and the body constantly communicate. The manner in which the brain always assesses the surrounding and the immediate environment of an individual and making adjustments as well as compensating aids in equine assisted therapy. For instance, when one is ill or injured, the neurological pathways in the brain are impaired as well and changed to register a disability or injury (Trotter 260). In this regard, the pathways are in need of strengthening and rehabilitation. Hippotherapy as a physical therapy utilizes the multi-directional movements of the horse for gait training, postural control, balance, strengthening and increasing the range of motion. The process buys into the plasticity of the brain to maintain a particular neurological pattern towards achieving an effective recovery for the patient. Many studies have reported an increase in functional activities and gross motor skills in disabled children. In occupational therapy, hippotherapy is utilized with the intention to increase coordination, attention, balance, sensory process, motor control, and general performance of daily activities. As a part of speech therapy, it is often utilized to increase cognitive, speech, language, and masticator functions. The aspect of hippotherapy in these forms of therapy is put into practice about the ability of the brain to adjust to the new surroundings and the ability to adjust to new sensory aspects. In autistic children, for instance, equine-assisted therapy not only helps in postural control but also coordination the cognitive and sensory process (Lee 424). While it is quite obvious that there are different needs for the patients regarding therapy, some neurological disorders may require a combination of the three therapies, i.e., occupational, speech and physical to report a complete treatment method.
Equine assisted therapy for neurological disorders provides sensory outcomes by utilizing the movements of the horse as opposed to the thrill of the horseback riding offered in a normal horse riding session. Studies comparing hippotherapy with traditional therapy indicated more improvements and performance-focused mobility assessment scores. Studies carried out concluded that including hippotherapy in other therapy sessions would improve not only the postural balance of the patient but also improves the aspect of fatigue and the quality of life. In a study carried out by Lee CW et al. to investigate the difference between the effects of hippotherapy and other forms of physical therapy, it is apparent that hippotherapy for patients who have multiple sclerosis indicated an improved static balance and gait in the older population (Lee 425). Hippotherapy among autistic children shows an increase in social, physical, and sensory functions for the children. It also has a positive effect on the behavior of the children as seen on the Vineland adaptive scale II and activity Card Measurements as compared before and after the therapy. Likewise, equine assisted therapy led to less postural swing and increased adaptive behavior, light activities, self-care, and social interaction. Hippotherapy provides an all-around form of treatment for children with neurological illnesses. Whereas exercise-based therapies have often been used for children with cerebral palsy especially in regards to improving the postural control, studies have shown better results in instances where hippotherapy has been applied. Research on the effectiveness of hippotherapy in comparison to traditional exercise-based strategies applied for children with cerebral palsy indicates that there are predominant improvements in equine-assisted therapy (Lee 423). These findings are measured by the Motor Function Measurement Scale and the Pediatric Functional Skill Scale to determine the comparable differences before and after the exercises. While using hippotherapy as an alternative treatment for neurological disorders, it is rather obvious that the method manipulates the movements of the individual in line with those of the horse.
Being that equine-assisted therapy is based on the manipulative ability of the therapists on the movements of the individual, this form of therapy is listed under the manipulative and body-based practices (Koca et al. 247). These are practices of treatments that are intended to manipulate the movements of the body and are often used for children with neurological disorders such as cerebral palsy and autism. Traditionally, most of the treatments prescribed for people with such disorders were physical treatments that are closely related to the exercise-related treatments such as hydrotherapy, martial arts, and even equine-assisted therapy. However, in the contemporary world, the complementary use of hippotherapy alongside other forms of physical therapy treatments has not been explored. The implication of this is that the field of equine assisted therapy is still scanty based on the need to establish the definite gaps between the responses between humans and animals.
The benefits of equine therapy are based on the positive reviews that the therapy has had on patients with neurological disorders. The most obvious of the downside of the therapy is the animal reflexes and instincts associated with the horse (Coman 300). Despite the fact that special horses are used for the therapy with strict supervision from trained handlers, it is rather obvious that the animal instinct does not escape the animal. In this light, there is a danger of a fall that may lead to increased injuries to an already disabled individual. It is also prudent to note that there are limited insurance options for individuals taking up equine assisted therapy as a treatment option. In most cases, insurance policies do not cover this form of treatment, and perhaps this may be blamed on the fact that there is minimal understanding of the effectiveness of hippotherapy. In this regards, it is ostensible that the injuries and losses incurred during the sessions may not be covered by the various insurance policies available in the United States. Despite the fact that the session may be rather affordable, as it requires two sessions in a single week, insurance cover does not cater for the costs of the therapy. The implication of this is that the individual essentially covers the costs of the sessions in an out-of-pocket plan which may be costly at the end of the therapy that may last for several months. It is also specious that the therapy may not be advisable for children who are afraid of animals. For instance, horses are large animals and may instill fear in the child. In such a case, hippotherapy may fail to make the intended impact on the child and would require more sessions to get the child adapted to the new form of therapy.
In conclusion, traditional forms of therapy that were often exercise-based seem to be giving way to a new kind of therapy that involves the use of animals for treatment. Equine-assisted therapy is a form of therapy that requires the use of animals to improve the functional, cognitive, and sensory actions of the patient. The use of horses in therapy is a form of treatment that takes into consideration the ability to manipulate the movements of the body by aligning them to the movements of the horse. Often used in treating neurological disorders, hippotherapy may be taken from various angles including occupational therapy, physical therapy, and speech therapy. The science behind hippotherapy is in the neurological and physical aspects of an individual that buys into the ability of the brain to convert the cues of the environment and react to them. In this case, hippotherapy is used to realign the brain patterns to achieve better postural swing, static balance and improve the sensory activities such as communication and language acquisition. In comparison to traditional methods of therapy that were more physical-oriented, hippotherapy has been found to have better results as it considers both the physical and cognitive skills of the person. Hippotherapy has been found to be hugely effective in treating neurological disorders but it is not covered by many medical insurance policies. Nevertheless, the effectiveness of horse therapy makes it an essential part of the treatment that should not only be used as an alternative but as complementary to traditional forms of therapy.
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