Transcript No Slide Title - Brain Injury Alliance of Oregon

www.forwardstride.org
Laurie Schick, PT MSPT & Erin Nolan, PT DPT
Hippotherapy and
Traumatic Brain Injury
Forward Stride Introduction Video
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www.forwardstride.org
Forward Stride Programming
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Premier Accredited center with
NARHA (formally North
American Riding for the
Handicapped Association).
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Largest comprehensive
therapeutic recreational center
in Oregon
Offers Therapeutic Riding,
Hippotherapy, and Vaulting
Programs in Development
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Horses for Heroes
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Therapeutic Riding and Hippotherapy
program for injured veterans
Our staff…
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Therapists: licensed
occupational and
physical therapists are
registered with the
American
Hippotherapy
Association
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Sport Riding
Instructors: certified in
therapeutic riding
through NARHA
What is Hippotherapy?
Historical overview of Hippotherapy
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1952 – Olympian Liz Hartel
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1987 18 American and Canadian therapists
went to Germany
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1992 The American Hippotherapy Association
was founded and became a section of NARHA
1960’s horses used as adjunct to PT in
Germany, Switzerland, and Austria
Definition of Hippotherapy
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Utilizes the three dimensional movement of the horse.
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Part of an integrated treatment program to achieve
functional outcomes
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Hippotherapy vs. Therapeutic Riding
Performed by a PT, OT, or SLP to address impairments,
functional limitations, and disabilities in patients
.
Principles of Hippotherapy
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The horse’s movement
produces an active
response in the patient.
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Variations in the horse’s
movement, as directed
by the therapist,
promote variations in
the patient’s responses
Principles of Hippotherapy (continued)
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Patient responses in
Hippotherapy are
intended to affect
function
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Hippotherapy is used
to achieve physical
goals, but may also
effect psychological,
cognitive and
behavioral and
communication
outcomes.
Equine and Human Movement
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The walk of the horse approximates that of the
human.
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The movement of the horse’s hind legs and pelvis is
transmitted to and produces movement in the pelvis
of the person.
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The rider posturally accommodates to the movement
of the horse.
Benefits of Hippotherapy
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Improved trunk and
postural control
Increased mobility
Normalize tone
Improve balance
Increase strength
Improve midline
orientation
Benefits of Hippotherapy (continued)
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Improve ambulation
Facilitate postural
symmetry
Increase coordination
Improve sensorimotor
function
Improve
communication
Improve social and life
skills
Medical Conditions
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Brain Injury
Cerebral Palsy
Sensory Processing Disorders
Cerebral Vascular Accident
Neuromuscular Dysfunction
Developmental Delay
Multiple Sclerosis
Chromosomal Abnormalities
Postural dysfunctions
Functional spinal curvature
Brain Injury
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Patients with brain injuries often have
deficits in balance, coordination, core
strength, motor planning and sensory
integration
Neurological tone can inhibit gait by
decreasing motor control, isolated
muscle function and dissociation
Hippotherapy offers the opportunity to
engage intricate motor patterns in a
perfectly timed delivery.
Helps with the reciprocal hip movement
required in walking
Contraindications and Precautions
for TBI population
•Seizures
•Skin Breakdown
•Heterotopic Ossification
•Hydrocephalus/Shunt
•Behavior Concerns
•Recent Surgery
Selection of the Therapy Horse
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Match the horse to the needs of the patient.
Postural response varies depending on the size,
confirmation, and movement of the horse
Hippotherapy Evaluation
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A complete PT/OT
evaluation is performed
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Functional short and long
term goals are established
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Patient is matched to the
appropriate horse based on
their individual needs.
Treatment Team
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Therapist
Leader
Sidewalkers
Equine Movement Progressions
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Straight Lines
Turns
Circles
Figure Eights
Serpentines
Walk-Halt
Walk-Trot
Tempo Changes
Forward Sitting
Rear Facing
Side Sitting
Prone Over Barrel
Modified Prone
Quadruped
Tall Kneeling
Standing
Functional Activities
Summary
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The gait of the horse can facilitate corresponding
movement patterns in the human pelvis.
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The horse’s walk provides sensory input that is variable,
rhythmic, and repetitive.
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This dynamic movement, coupled with traditional PT &
OT techniques, can provide heighten functional
outcomes.
“My therapist weighs 900 pounds!”
www.forwardstride.org
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