Frequently Asked Questions
Frequently Asked Questions
1. How does hippotherapy or Equine-Assisted Therapy work?
Hippotherapy has been shown to be one of the most efficient and effective treatments to improve postural control, balance and walking in patients with motor disorders. Children with developmental disabilities such as spasticity, hypotonia (low tone), and attention disorders, as well as traumatic brain injury can benefit from hippotherapy. The horse's movement has a therapeutic effect on the child because it imparts a precise, repetitive pattern of movement very similar to the movement of a person's pelvis during normal walking.
The major aims of hippotherapy include mobilizing the pelvis, lumbar spine and hip joints, normalizing muscle tone, developing head and trunk postural control and equilibrium reactions in the trunk. In fact, these goals of postural control and equilibrium reactions can be achieved more easily on the horse than in the clinic. The horse's rhythmical movements transmit symmetrical sensory input to the child's brain and nervous system in a way that cannot be imitated by a mechanical apparatus or with any degree of consistency in the traditional therapy clinic. Therefore, hippotherapy offers a valuable adjunct or even an alternative to more conventional treatment tools.
2. How does hippotherapy differ from therapeutic riding?
In hippotherapy, the therapist uses the horse as part of an overall treatment plan to achieve specific functional goals, such as improving postural control, balance, sensory integration, and/or walking. The therapist works closely with the family to carry over gains made in therapy into daily routines. The focus is on improving function. The therapist has extensive training in understanding disabilities, and how to improve function as it relates to the disability. The therapist focuses on empowering the family to take part in guiding, leading and transforming disabilities into functional skills.
In therapeutic riding, the instructors use equine activities to achieve cognitive, behavioral, psychological and physical goals while teaching adapted riding skills. The focus is on mastering riding skills.
3. How do I know which type of therapy is right for my child?
Choosing the right type of therapy for your child with special needs is complex because each child has different goals, and each responds to treatment differently. Our therapists are highly qualified to assess your child’s needs and always employ a holistic approach, taking into account your child’s interests and the effects of your family.
4. How can hippotherapy facilitate change in a patient with low muscle
Low muscle tone, also called hypotonus, refers to “decreased postural or muscle tone resulting in difficulty or inability to move, to sustain a posture against gravity, or to support functional movement”. The muscle quality is associated with limpness or a feeling of heaviness when the limb is moved and the head lags when lifted against gravity. There is a lack of joint stability, particularly through the midline, which limits dynamic postural stability and graded movement. Decreased sensory awareness contributes to a high threshold for pain.
Change can be facilitated in the hypotonic patient using the movement of the horse and physical therapy principles: First, head stability and proper alignment of the joints must be maintained at all times; these patients are at risk for injury due to a lack of ligament, muscle and tissue resistance toward the ends of range of motion. Weight bearing or joint compression can be used to increase joint co-contraction and improve proximal stability; rear facing on the horse will provide a broader base of support, where weight bearing can begin on the forearms and progress to extended arms as tone increases in the head, neck and upper trunk. A horse with a lot of lateral sway may not be appropriate for this patient, due to his or her insecure seat; however, a more concussive gait may provide stimulation through the pelvis needed to develop midline and upright control. There is usually difficulty with shifting weight; balance reactions and weight shifting can be facilitated once pelvic and trunk control have been established. Exercise to accomplish this would include reaching outside the base of support and graded movement tasks. External sensory input, including tapping or vibration, may be used to help activate muscles. Exercises such as placing and holding a limb against gravity, overlaid on the rhythmic movement of the horse will promote strength and joint stability. Gentle upward and downward transitions (from halt to walk, or walk to halt) can then be added to challenge the back extensors and abdominal muscles respectively. Finally, circles and schooling figures can be used to enhance lateral trunk balance reactions.
5. How can hippotherapy be used for improving postural control, balance,
Hippotherapy is the preferred tool for improving postural control, balance, and walking because it offers distinct advantages not found in other therapies. Considering stability, the horse provides a broad, stable base of support, while at the same time, challenging the patient's stability with its rhythmic, reciprocal motion. Orientation is challenged each time the horse changes direction, or has an upward or downward transition, requiring the realignment of body segments in response to inertial forces. Hippotherapy improves integration and interpretation of movement information by a variety of opportunities to learn dynamic postural control, including movement through space and gradability of movement. Adaptive capabilities are enhanced by the variability of the hippotherapy experience, engaging the patient in active problem solving. The coordination and timing of motor strategies are refined by the consistent and repetitive nature of the horse's motion, providing thousands of opportunities to practice solutions to postural challenges within one therapy session. Anticipatory and feedback postural control is enhanced as the patient learns to use cues from the therapist, the horse, and the environment to anticipate postural adjustments. Finally, hippotherapy facilitates postural tone, since antigravity muscles must support the trunk and limbs in the upright position; this is attributed to the strong somatosensory, visual, and vestibular input transmitted to the patient.
6. How can hippotherapy influence attention and arousal?
Before attention can occur, a person must first be aroused. Arousal, referred to as alertness, occurs on a physical and mental level and prepares a person for some form of action. Hippotherapy provides an opportunity to manipulate arousal through the movement of the horse. The integration of sensory and motor systems requires a level of brain activation that is sufficiently aroused so as to make processing more efficient. The movement of the horse can be used for this purpose: too little movement can mean a less efficient system, while too much movement may agitate or overload the patient. It is important to know that either increasing or decreasing certain stimuli can facilitate attention. For example, long slow strides may have a calming effect, while the concussive impact of a horse with straight pasterns and a choppy gait may have an arousing effect. Similarly, increasing the cadence, or varying the pattern can arouse a patient, as can a series of upward and downward transitions; conversely, decreasing the pace or lack of variation may allow the patient's attention to wander.
The multidimensional movement of the horse appears to have an organizing effect on the central nervous system, thus making sensory processing more efficient, at the same time it is a strong sensory input in the context of a meaningful activity. Motor planning is thereby enhanced by this variety of sensory stimulation while moving forward through space and requiring constant adjustments of posture.
The movement of the horse is not the only variable in hippotherapy that affects arousal: the level of activity in the clinic could be a factor, where other riders or loud music could be over stimulating. The patient's level of participation can affect arousal, where a patient is merely a passive participant, alertness may be low compared to a patient who is actively involved in an exercise such as ball skills or steering the horse through an obstacle course.
7. What, if any, are the benefits of receiving therapy in a non-clinical
Studies have shown that children respond best to therapy in a natural, non-threatening setting. The recreational nature of our programs allows children with special needs to enjoy a sense of independence they never thought was available to them. Whether in the comfort of their home or school, in our playful facility or on our green pastures, children feel liberated from their disabilities as they interact with our caring staff.
8. At what age can my child begin therapy at Quest Therapeutic?
Our Early Intervention Program provides one-on-one supports in the home and community for families with children birth to 3 years. Our Hippotherapy Program is offered from the age of 2 years to young adult. Therapeutic Riding is for children over 12 years.
9. How long and how often will my child receive therapy services?
The frequency and duration of treatment is contingent upon the initial evaluation performed by our therapist and authorized by your pediatrician or specialist. Our certified therapists will estimate the proper course of treatment for your child. Typically, therapy services are provided 1 time per week for 45 minutes at a time.
10. How much does therapy cost and who pays for it?
We are committed to providing affordable high-quality treatment to children with special needs. Fees vary depending on the services provided, but in most cases can be partially or fully funded by insurance. We also accept all forms of private payment that cover a portion of operating costs. One third of our funding comes from fundraising, including special events, individual and corporate donations, and general grants.
11. Does Quest Therapeutic operate year-round?
Yes, we are a full-time treatment facility. We have a heated indoor facility, which enables us to work with your children year-round, regardless of the weather.
12. What qualifications does Quest Therapeutic have to provide pediatric
All of our therapists are licensed and certified, and many have doctorate-level training in specialized areas that exceed the national standards for pediatric therapy. Not only does your child get excellent care, but he or she also benefits from our clinical affiliations with Widener University and A.I. duPont Hospital for Children. Furthermore, through our Board of Directors and Advisory Board we have direct access to the expertise of some of the most distinguished professionals in the industry.
13. How do I begin services for my child?
Your child may be referred for therapy services at Quest Therapeutic by the family, pediatrician, specialist, or qualified child services agency. We will ask you to complete the proper application forms and schedule an initial appointment with us, followed by an assessment of your child by our certified therapists. We strongly encourage parents, caregivers, and case managers to take an active role in all therapy sessions.