New NAC treatment takes off at a gallop
March 25, 2006
Emi Lorscheider sits backwards on a pony named Rocky. Later in the hour she will balance on all fours on Rocky’s back and even stand up.
She is participating in the National Ability Center’s latest offering: hippotherapy.
Derived from the Greek word hippos, meaning horse, hippotherapy uses a horse’s movement to treat disabilities or functional limitations.
Around the time she was nine months old Emi was diagnosed with hypotonia, a medical condition that causes her to have low muscle tone.
Her mother Ardice said that before beginning treatment Emi was fearful and hesitant when it came to movement because the hypotonia effects her balance and can lead to falls. Since enrolling in hippotherapy, Emi is more eager to crawl and be active.
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In the 1960’s people in Germany, Austria and Switzerland began incorporating horses with physical therapy. Nearly three decades later, 18 therapists from the United States and Canada traveled to Germany where they studied hippotherapy.
Kim Desautels, the occupational therapist who conducts hippotherapy at the NAC, studied in Colorado under one of the original 18 therapists.
Equestrian Program Manager, Jessica Wignall, said the NAC decided to start offering hippotherapy to expand the range of treatments they have available.
"It’s something that we (hope to) develop and grow and offer to more people," Wignall said.
How it works
Hippotherapy can be used to treat a variety of disorders including abnormal reflexes, impaired balance and delayed motor skills. Unlike therapeutic riding, hippotherapy must be conducted by a physical therapist, occupational therapist or speech and language pathologist.
At the foundation of the therapy is sensory integration, which is a term describing the way a person takes cues from sensory information through their environment and uses it to form patterns of behavior.
During Emi’s lesson Desautels led the pony in a series of abrupt transitions, starting and stopping quickly to help Emi learn how catch herself when she is unbalanced. With this sensory information Emi is developing behavior patterns that will be helpful when she crawls and eventually walks.
"We can get these new behavior patterns instilled in her brain, (and) they’ll override the old ones," Desautels said. "Providing her with challenges and changes within her body and in her environment facilitates the integration of new patterns."
The horse also has a gait similar to that of people, and like humans their pelvis has four different rotations, said Desautels. While riding. Emi can experience how correct movement should feel, something her mother said is very beneficial.
Before beginning hippotherapy treatment the NAC requires individuals to get a prescription for evaluation and treatment in occupational, physical, or speech therapy.
Once they receive a prescription, an individual evaluation is performed where the NAC assesses a student’s specific needs are.
Desautels said during the evaluation she determines which exercises will be most beneficial and tries to match the best person with the best horse depending on temperament and other factors.
At the beginning of a session Desautels goes through a warm up and also establishes which elements from the patient’s other therapies she will incorporate. At the start of Emi’s one-hour session she asked what sounds Emi is working on with her speech therapist and proceeded to use those throughout the hour to help reinforce what she has been learning.
"Occupational therapy is a holistic type of therapy. They’re trying to help an individual develop skills for daily living," Wignall explained.
For Emi’s session much of the work focuses on developing muscle tone in her trunk, and upper body and fine motor control.
To accomplish this Desautels has Emi sit in a variety of positions, including backwards and sideways while leading the horse in different patterns. Walking in a tight figure eight focuses on the trunk, while having her balance on all fours while riding the horse helps her body get used to weight bearing activities and balance.
Wignall said the hippotherapy patients work hard but don’t mind because it isn’t in a clinical setting. Many of the children interpret it as play.
"I feel like with all the therapies that she has she doesn’t mind this one as much because she doesn’t know she’s having therapy," Ardice said.
"A lot of our clients are looking for normal muscle tone," Wignall said.
Since starting hippotherapy Emi has gained strength, and the improvements are noticeable.
As Emi got on all fours with her four arms against the pony Desautels remarked, "She couldn’t tolerate this when she first started."
In a press release issued by the NAC Desautels noted the improvement she sees in patients.
"After doing almost 20 years of outpatient neurology, I’ve never seen the functional outcomes and progress as I have seen with hippotherapy and using the horse as a medical treatment modality," Desautels said.
Ardice is particularly pleased with the results she has seen.
"For Emi I think this has made a tremendous impact on where she is right now and where she will continue to go."