Cerebral Palsy
- Jaithra Kakarla
- May 6, 2020
- 5 min read
Updated: Aug 2, 2020
Animal therapy engages children and adults who have a variety of illnesses and disabilities. The animals traditionally include dogs, cats, talking birds, and horses. Hippotherapy, a form of Equine Assisted Therapy, is gaining ground as an effective way to increase the physical and emotional health of children with cerebral palsy (CP). It has the potential to help the child develop physical strength and endurance and increase balance. It can also improve the child’s communication skills as they interact with the horse and the therapist and build their overall sense of confidence and well-being.
This form of therapy involves interacting with a well-trained horse. Sessions may include feeding and petting the animal as well as talking to it. The core of the therapy involves riding on the horse’s back in a safe, controlled environment. It has been used since the 1960s and is increasingly being adopted today. Equine Assisted Therapy can improve cognitive ability, body strength, and endurance. It may also increase broader abilities such as the child’s social skills, confidence, and overall sense of well-being.
This kind of therapy is not usually used alone. It is generally a supplement to the traditional therapy practices recommended by the participant's treatment team. This may include physical therapy, speech therapy, and occupational therapy to meet various goals on the treatment plan. However, these same therapists may be certified to integrate horse therapy into their other teaching methods. Typical goals that the therapy session may address include:
Strengthening the muscles of the child with cerebral palsy
Improving balance and flexibility
Increasing fine motor control skills to help with everyday tasks
Not every horse is a good candidate for this specialized therapy. Only the most well-trained, gentle, and patient horses and ponies are chosen. These animals also undergo training for specific concerns that may occur during therapy. For example, the horses are trained not to startle at a child’s shout of excitement and to stop immediately if they feel the child slipping from their position on the saddle.
How do individuals with Cerebral Palsy benefit?
This therapy introduces physical activity in a safe, carefully monitored, visually interesting environment. During a session, the horse moves with a gentle, repetitive motion, gait, and tempo. The horse may move at 100 steps per minute. Over the course of a half-hour session, this movement will gently challenge the child’s body thousands of times. This stimulates balance and motor control in numerous ways. The children with cerebral palsy may:
Maintain balance, with appropriate assistance, over a period of time
Direct the horse by squeezing his or her knees
Turn the horse by manipulating the reins
Hold his or her head erect
Interact with the therapist and any assistants
Participants may greatly enjoy the visually varied environment, and, of course, interacting with the animals themselves. This can help encourage children to meet the sometimes tiring and frustrating challenges offered by therapy. Children may also meet, build friendships with, and learn from other children who are also taking advantage of the Equine Assisted Therapy program. This can unlock other activities to participate in. A well-implemented therapy session will scale the difficulty to appropriately challenge the child with CP’s physical and mental capabilities. This can improve the child's:
Overall strength
Trunk and core strength
Gross and fine motor control
Balance
Posture
The ability to give and receive visual cues
Sensory issues
Communication skills
Social skills
Confidence and self-esteem
How effective is this therapy?
The various subsets of Equine Assisted Therapy have not been studied as extensively as other, more traditional methods. However, growing evidence and scientific studies show that it can work for many people. Zadnikar and Kastrin analyzed a number of other studies and determined that Equine Assisted Therapy was effective for 76 out of 84 children with cerebral palsy. Most of the children looked at improved posture and stability and walked faster on level surfaces. Half of the children developed a greater forward reach and walked faster on irregular surfaces. The therapy sessions also improved hypertonia. The children with lesser degrees of disability experienced the most gains.
Other benefits were noted by Champagne, Corriveau, and Dugas. They studied 13 children with CP, aged 4 to 12, and saw significant improvement in scores for fine motor precision, balance, and strength. These gains remained, even when the children were retested 10 weeks after the end of the therapy. These studies suggest that many, although not all, of children with cerebral palsy, will see a number of benefits from Equine Assisted Therapy.
When can you start?
There is no set age for starting this kind of therapy. Additionally, there is no upper age limit where the child would stop seeing benefits. Children, ranging from toddlers to older teens, have successfully undergone Equine Assisted Therapy. It is more a question of whether it is the right fit for the child and family. You will need to consider both the child’s well-being and the price of therapy to determine this.
The first step is to discuss your hopes and concerns with your child’s doctor and treatment team. This kind of therapy challenges the child’s body and mind in unique ways. The doctor and other members of the treatment team can determine if your child is in the right place to benefit from Equine Assisted Therapy.
Some concerns to think about and bring up include:
Your child’s physical strength and ability to stay upright and hold his or her head up with the weight of a helmet during the session
His or her overall health, including whether he or she has enough endurance to remain in the saddle for a productive length of time
Whether your child will need specialized equipment that may need to be ordered ahead of time, perhaps including a neck brace or specific kind of saddle
Sensory issues that may make your child reluctant to wear necessary safety gear
Allergies, an often overlooked problem that may halt therapy as allergy medications can make your child drowsy
Any phobias your child may have of large animals
What Can You Expect During the Therapy Sessions?
The therapist will give a baseline assessment before the therapy sessions begin. This will most likely cover the child’s physical abilities and may also include cognitive and emotional assessments. These will be repeated after a number of weeks of Equine Assisted Therapy to see if, and how much, it has helped. The results of the assessment will be discussed with the guardians. The child’s therapist will give their recommendation as to whether this form of therapy is a good fit for the child’s needs. If so, they will discuss their goals for the coming therapy sessions.
The length and frequency of sessions are determined by the therapist as he or she writes the treatment plan, and they can vary wildly. You can generally expect at least one half-hour session a week for perhaps 10 weeks. After that, the therapist will reassess the child to determine progress and decide if more sessions may be beneficial.
Is this the therapy for you?
From anecdotes to professionally designed studies, a number of sources indicate that children who attend Equine Assisted Therapy can make substantial gains along a number of areas to gain physical, cognitive, and emotional well-being. These benefits have been experienced by children of a wide variety of ages, from toddlers to teens. Gains tend to be kept even after therapy ends. There are no guarantees that your child with CP will experience the same results, but if their doctor and treatment team think Equine Assisted Therapy may be helpful, it is worth investigating.
RISKS
I implore any individual considering any form of EAA* or EAT** to consult with their physician or any related doctor before beginning this form of therapy. It is highly important that you are well aware of the risks of participating in this form of therapy, which sometimes may be entirely related to the health issue too. If you have any queries or suggestions please leave a comment below or reach out to me through the Contact Form on the Home page.
*Equine-Assisted Activities
**Equine-Assisted Therapy
Visit the "Current medical use of horses" post to gain more clarity about the interventions for specific modalities: https://www.equineinsight.info/post/current-medical-use-of-horses
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