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Hippotherapy is a form of therapy that uses equine (horse) movement – horse riding in other words - to develop and enhance neurological and physical functioning in disabled people, especially those with neuromuscular problems. It has been used with some success with children with cerebral palsy for example.  Hippotherapy is built on the concept that the individual’s neuromuscular development is enhanced when their body makes adjustments to the gait, tempo, rhythm, repetition and cadence of a horse’s movement.

As a therapy, it not only helps patients with neuromuscular dysfunction increase physical strength and cognitive ability, but also offers the individual a chance to take advantage of an enjoyable activity that contributes to a positive therapeutic experience.

Interacting with the animal can lift a child’s spirits emotionally and psychologically while also providing valuable physical exercise as the child learns how to ride the horse properly. A horse’s gait has three-dimensional movement—equine movement–similar to a human that helps a child plan physical responses to the horse’s movement. Horseback riding requires subtle adjustments and positioning to maintain proper balance and posture.

Hippotherapy was devised and developed in the 1960s and used primarily in Germany, Austria, and Switzerland as a companion to more established treatments. It was eventually recognized in the United States in the 1980s.


The objectives of Hippotherapy, are to help improve the following through equine movement:

  • Strength
  • Control
  • Balance
  • Posture
  • Endurance
  • Coordination
  • Sensory integration
  • Understanding of visual cues


Some of the noted physical benefits have included:

  • Improved gross motor skills
  • Better trunk core strength
  • Improved control of extremities
  • Improved postural symmetry
  • Reduced abnormal muscle tone
  • Improved respiratory control

Cognitive benefits have included:

  • Improved attention
  • Improved visual coordination
  • Better sensory input
  • More tactile response
  • Improved timing and grading of responses
  • Improved ability to express thoughts, needs


There is no specific age, or point in a child’s therapy, that dictates when or if a child would benefit from hippotherapy. Children as young as two years old, and teens, have benefitted significantly from hippotherapy.

Thus it is less to do with the age and more to do with how the child feels about horses.  A tiny pony is just as good as a larger horse and as tiny ponies are rather cute, most children are not frightened by them, but clearly if they are, then the therapy won’t work and should never be forced on them

How is hippotherapy performed?

Therapy should always be geared to the child, as such the therapist should begin any course of treatment with an assessment of the child’s physical, cognitive and psychological abilities to gage first whether hippotherapy is appropriate for a child, and then what sorts of adjustments and equipment is needed to help the child, for example, if they cannot sit on the horse in a conventional manner.

Children should be given appropriate safety equipment, such as helmets and safety padding during all sessions.

After a child mounts or is helped onto the horse, it is the therapist’s job to strictly monitor and control the horse while the child is riding horseback. The therapist will walk alongside the horse to direct equine movement and modify movement in a way that is safe for the child. As the therapist monitors the horse, he or she is also monitoring the child to watch for changing physical reactions such as balance, control, strength and range of motion skills.

Changes in physical reactions from the child are considered positive because when a child responds naturally to shifts in gait from the horse, it not only builds physical strength, but also vital connectivity in the brain.

Other information

Most western nations have an accreditation scheme for ensuring that the organisations offering this form of therapy have the right qualifications. 

The American Hippotherapy Association offers a multi-level educational program that aims to educate aspiring practitioners with a foundation of knowledge regarding how to work with both patients and horses.”

In general people offering this therapy need to already be qualified in physical, occupational and speech therapy.  In the USA they also have to have practiced for three years in their field, and have had 100 hours of practical hippotherapy, through the AHA to be certified. There is also an exam – the HPCS examination.




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