Hippotherapy
Hippotherapy is specialized physical therapy that takes advantage of the three dimensional movement of a horse during walking to facilitate movement responses in children with cerebral palsy riding the horse. The name is from the Greek word “hippos,” which means horse. There have been several studies looking at the effect on children with cerebral palsy and either recreational horseback riding therapy or therapist-directed hippotherapy. Both have been shown to increase gross motor function. Some small studies have shown improvement in some ADLs as well.
It has been theorized that riding a horse while it is walking mimics classic pelvic movement during walking in a person without any disability. One study compared riding a horse to sitting on a barrel to show that the symmetry of movement obtained was not just from stretching muscles that would be found when riding a horse. They found improved symmetry of muscle activity after riding. There has been some suggestion of more efficient energy expenditure in walking after hippotherapy, as well. There are a number of therapy programs around the country for hippotherapy, and children who participate have a broader smile in describing this than in any other therapy visit I have seen.
Aquatic Therapy
Another area of therapy generally described with a huge smile by children is aquatic therapy. Any therapy in a swimming pool offers many potential benefits and is a logical choice for children with cerebral palsy. The buoyancy of water supports their body so that they can more easily stay upright and move. It also protects their joints. With the resistive forces offered by water, one can get a great strengthening program. Moving an arm or leg, particularly with a paddle or kick board or something else to increase resistance, is a great strengthening activity. A key concern is to avoid fatigue. Aerobic programs in the water are excellent.
Programs can be facilitated by use of many floating objects, including kick boards, pool noodles, life jackets or other floating devices. By holding onto the wall or having a therapist or a volunteer assist in having individual exercise programs, one can work on technique in walking or other movements. In a group program, there is increased motivation and social benefit by using games and races to work on cooperation and/or competition.
An aquatic exercise program allows working on fitness even for a child with significant mobility limitations who cannot do land-based activities. Aquatic programs have been shown to increase the lung capacity in children participating in long-term exercise programs. In choosing a program for one’s child, it is important to make sure that it is a safe aquatic environment with experienced personnel. The combination of aerobic exercise, strengthening exercise, social interaction and fun is a wonderful combination.
Pet Therapy
Pet therapy is thought to have been developed in 1976 by a nurse named Elaine Smith who noticed how well patients responded to a golden retriever. She then developed a program for training dogs to visit institutions with their patients. There are several companies now that specialize in certifying dogs as therapists and dogs must be registered with them prior to visiting health care facilities. Dogs have been shown to relieve stress, lower blood pressure and raise spirits.
