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Tina Schuh works with Bandit during a session with physical therapist Brent Applegate (not shown), certified riding instructor Donna Peterson (left) and volunteer Flo Scarfone (right) at Chastain Horse Park in Atlanta.
Photos courtesy of Brent Applegate
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Horse power

Risks and fears

Marilyn McDowell practices her balance on an Equicizer, which mimics the movements of a horse.

Marilyn McDowell practices her balance on an Equicizer, which mimics the movements of a horse.

Hippotherapy is no riskier than therapy in a traditional setting, says Jacqueline Tiley, executive director of the American Hippotherapy Association (AHA), pointing to a nearly non-existent incident rate reported in a five-year, industry-wide safety survey. The horses are trained and the rider is surrounded by experienced professionals and volunteers.

At some centers, the riskiest part of hippotherapy—mounting and dismounting—is made even safer with the use of a SureHands Lift, a crane-like machine that hoists the rider from the ground or wheelchair up, over and onto the horse’s back. If people are worried about their ability to sit on a horse, therapists may start them on a device called an Equicizer, a kind of mechanical horse that simulates a real horse’s movements.

Promising research

So far, research on the benefits of hippotherapy has been extremely limited but promising, particularly when it comes to improving balance.

In a small 2005 Swedish study by Ann Hammer and her colleagues at the department of rehabilitation medicine at Orebro University Hospital, 10 of 11 people showed gains—primarily in balance—after weekly hippotherapy sessions conducted over 10 weeks. Some participants also demonstrated improvements in pain relief, muscle tension and ability to perform activities of daily living.

Silkwood-Sherer directed a small 2012 pilot study conducted over 14 weeks in which three people with MS participated in weekly hippotherapy sessions and two with MS received no treatment. Those who rode showed significant improvement when tested in balance and mobility. Research she conducted in 2007 showed that among 15 adults with MS, the nine who underwent weekly hippotherapy treatment for 14 weeks demonstrated a significant improvement in balance versus the control group. She hopes the positive results from these studies will lead to grants for a larger study, which will be important to confirm the findings.

Is it covered?

While physical, occupational and speech-language therapists trained in hippotherapy can be found in nearly every state in the country, one of the larger barriers to accessing hippotherapy is the cost.  Not all insurance companies cover hippotherapy, and many deny claims on the grounds that hippotherapy is “recreational” or “experimental,” decisions that stem from common confusion between hippotherapy and therapeutic riding, Tiley says. AHA’s insurance task force is working with the American Physical Therapy Association and the American Occupational Therapy Association to develop strategies for therapists and people with MS to deal effectively with denials. As insurance companies and the public begin to understand the definition of hippotherapy, the quest for coverage is slowly getting easier.

Financial assistance may be found through scholarships at hippotherapy centers or through local community foundations, says Tiley. The National MS Society may be able to help locate additional financial resources.

Kirkham’s insurance covers her therapy with My Heroes. And if it didn’t, she says, she’d find another way to pay for it. “Somebody once said that the outside of a horse is good for the insides of a man,” she says. “That is so true. It really, really is. I know that it’s truly improved my quality  of life.”

 Shara Rutberg is a freelance writer based in Boulder, Colo.
Spring 2014
Find certified therapists who practice hippotherapy through the American Hippotherapy Association.
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