Experiences therapists united in the Association elaborated a set of basic rules of conduct for hippotherapists – i.e. the Canons of Polish Hippotherapy. This act serves to promote professional, safe and responsible hippotherapy.
Hippotherapy is the oriented therapeutic activity to improve physical, emotional, cognitive and/or social functioning of a human, with a specially trained horse being an integral part of the therapeutic process.
A qualified hippotherapist is responsible for its execution according to the orders of the physician referring the patient to hippotherapy and in cooperation with other specialists who treat him.
1. Physical sphere – the increase of general efficiency, normalization of muscular tension; teaching proper walk standard; improvement of motor coordination capabilities, mainly balance and sense of rhythm; an increase of space orientation and own body pattern; stimulation and normalization of deep and surface sensibility.
2. Emotional and motivational sphere – the increase of motivation and acceptance for the therapeutic process; increased self-esteem; decrease of emotional disorders.
3. Cognitive sphere – stimulation of sensory stimuli reception; improvement of visual and auditory perception; stimulation of attention, memory, reasoning, speech; acquisition and development of new skills.
4. Social sphere – social activation; developing positive social interactions.
Physiotherapy on horseback – therapeutic exercises on horseback in a walk aimed at movement improvement; held by a physiotherapist or under his supervision.
Psycho-pedagogical horse riding and stunt riding – a set of riding, pedagogical and psychological activities, focused on intellectual, cognitive, emotional and physical improvement; held by a psychologist, pedagogue, occupational therapist or under their supervision.
Therapy by a contact with a horse – the aim of this therapy is to make a patient come into contact with an animal, his surrounding and other people, its basis is the patient-horse contact, creating a therapeutic situation, not just sitting on horseback; held by a psychologist, pedagogue, psychiatrist, or under their supervision.
Moreover, there is horse riding for the disabled people (recreational and professional), which in itself is not part of hippotherapy, but is closely related and may have a therapeutic aspect.
Hippotherapy can prove profitable in all areas of human functioning: physical, motivational, emotional, cognitive and social. Every disabled person, suffering from any disease or disorder can benefit individually from hippotherapeutic activities.
People with the following diseases and development disorders are treated with hippotherapy:
1. Poliomyelitis – patient’s own head control and active sitting position necessary.
2. Post cranial and brain injuries conditions.
3. Minor brain demage.
4. Muscular diseases (with muscle strength at least 3 points according to Lovett scale), individual intensity and length of exercises necessary
5. Visually impaired and blind children.
6. Mental diseases and disorders.
1. Abnormal spinal curvature.
2. Scoliosis up to 20° according to Cobb excluding progressive idiopatic scolioses.
3. Post-amputation conditions and developmental anomalies of the limbs.
1. Genetic syndromes, e.g. Down syndrome (necessary x-ray – side and functional – the neck part of a spine).
2. Meningorachidian hernia, depending on how high is the damage, clinical picture, parallel hydrocephalus.
3. Psychological syndromes: emotional disorders, mental defects, poor social adaptation.
4. Mental and motor retardation of unclear etiology.
1. Disseminated sclerosis.
2. Post-stroke condition.
3. Post cranial and brain injuries conditions.
4. Other motor organs diseases with neurological and orthopedic background.
5. Mental diseases and disorders.
6. Adictions.
7. Social pathologies.
CONTRAINDICATIONS
Absolute contraindications:
- Allergy to horse coat, sweat or sent.
- Unhealed wounds.
- No acceptance for this form of therapy, e.g. patient’s panic.
- Separation of the retina, increased intraocular pressure.
- No head control in the motor development and active sitting position.
- Unstable cervical vertebrae in the Down syndrome.
- Clear hip joint dislocation.
- Scoliosis above 20° according to Cobb and progressing idiopatic scoliosis.
- Muscular diseases with the muscles strength below 3 points according to the Lowett scale.
- Deterioration of condition in neurological syndromes, post injury conditions, post cranial and brain injuries conditions, ADHD, muscle diseases.
- Acute illness or psychological disorder.
- High temperature.
- Acute infections.
- Epilepsy.
- Profound mental handicap.
- Bone mineralization disorder.
- Fixed deformations, contractions, limited movement capability of bone and joints system.
- Slipped disk.
- Hemophilia and other hemorrhagic diatheses.
- Ophthalmologist disorders- required medical opinion.
Managing doctor or consulting team
Qualified hippotherapist
Cooperating specialists: physiotherapist, psychologist, special needs teacher, speech therapist, neurologist, orthopedist or other specialist depending on patient’s particular problem.
1. Basic duty of a hippotherapist is to care for the improvement of his patient’s condition.
2. The program and goal of the therapy is set by a hippotherapist according to the indications of the doctor referring the patient to the therapy and according to his individual needs including those verbalized by himself or his parents or minders. Also, he can work on the basis of the program designed by other specialists treating the patient.
3. According to the professional and personal ethics the hippotherapist is obliged to consult his therapeutic decisions with other people with complementary professional competences.
4. Hippotherapist cooperates with other therapists, specialists and medical doctors taking care of his charge.
5. Hippotherapist should consolidate and develop his knowledge and skills in the process of constant training and education.
6. Hippotherapist is obliged to observe the hippotherapist-patient privilege.
7. Hippotherapist must have the permission of his charge and/or his parents/minders before he takes and uses photos, audiovisual recordings, etc.
8. Hippotherapist evokes the respectful attitude towards animal in his charge and teaches to show this respect.
9. Hippotherapist remembers to obey the safety rules while working with a horse and to guarantee the security of his/her charges.
THE WORKING CONDITIONS OF A HIPPOTHERAPIST
1. Optimal amount of the hippotherapist’s working hours allowing for effective and safe work is 7, including 4 hours of direct work with a patient, with at least one half an hour break.
2. Hippotherapist should be provided with a rest area for the break.
3. Hippotherapist is allowed to disagree to hold exercises in case he/she:
- doubts about the doctor’s orders or he believes there are important contraindications for submitting the particular patient to hippotherapy,
- the patient’s documentation is incomplete,
- he feels incompetent to hold exercises with particular patient,
- there appears the incompatibility of characters with him/her and his charge.
DOCUMENTATION
Should include:
- the doctor’s order to hippotherapy including full medical diagnosis,
- periodical control examinations – at least once a year – with detailed description of the patient’s condition,
- descriptive evaluation of the progress of therapeutic exercises.
EXERCISES AND POSITIONS
should be chosen depending on therapeutic needs and patient’s capabilities, preferably after they are consulted with other specialists who treat the patient.
EQUIPMENT AND AIDS
Zmodyfikowany sprzęt jeździecki i sprzęt rehabilitacyjny dostosowany do potrzeb pacjenta.
DURATION OF EXERCISES
Depending on the patients needs (average 30 minutes).
SAFETY MEASURES
1. Hippotherapeutic exercises are always individual (1 hippotherapist = 1 patient).
2. Precautionary measures are chosen depending on the patient’s needs. The patient may be backed up from upwards, downwards and from ground level on both sides. In case of psycho-pedagogical horse riding and stunt riding the safety measures are appropriate for these.
3. During the therapeutic exercises the horse must be led by a trained and experienced person.
HORSES IN HIPPOTHERAPY
The optimal parameters, not excluding other solutions:
- gelding,
- over 5 years old,
- trained to work in hippotherapy,
- the height making the successful backup possible, compatible with the patient’s height,
- rhythmical, elastic, springy, efficient walk
- desirable such a shape of particular body parts as more or less corresponds to a sort model (among others : appearance, rectangular framework, proportional head of average size, straight neck, well muscled, well developed withers, wide, not too high, longish and oval log, straight back, wide and long enough, wit well developed muscles, not perceptible spinous processes of vertebra, long and oblique scapula, wide well bound loins, long, horizontal croup with strong muscles, proper position of the legs).
- psychological qualities that make a horse useful in solving therapeutic problems in the broad sense and minimizing the probability of unexpected reactions (well balanced character, intelligence, mild temper, friendliness, trust, gentleness, patience, eagerness and precision in carrying out commands, tolerance for sudden and unexpected visual, auditory or tactile stimuli without defensive reaction, no bad habits or addictions).
- having in mind that the above conditions are directly related to the patient’s maximum security, it seems desirable to know in detail the horse’s story and particularly the traumatic events or finding him in professional, trustworthy horse farm and training centre.
- although it is inappropriate to divide breeds into „adequate” and „inadequate” for hippotherapy, in some breeds more traits recommended for horse-patient relationship have been observed. In Poland such an opinion has been appointed to the Hucul breed horses. However, this does not mean that all horses of this breed suit our needs. Similarly, engaging carefully selected Polish horses, Silesian breed, Fording, Shetland, Phelinian pony, various cross breeds offspring with ponies, small horses and representatives of other available breeds in previous generation.
- Breeding and using in the conditions adapted as much as possible to the physical and psychological needs of a horse as a herbivorous and herd animal.
- The amount of work with a patient - 4 hours a day.
- Therapeutic exercises take place in the area familiar to the horse and accepted by him.
- If the type of ground and the structure of the hooves allow the exercises are performed on the horse without horseshoes.
- The field should be surrounded by a fence, preferably high hedge as a natural screen isolating the work area from the outside visual and acoustic signals, disturbing and distracting attention of the horse and patient; also protecting against the wind.
- The outsiders, people and animals, especially unleashed dogs, should keep off the area of work of the therapeutic team.
- The width of the gate in a fence should allow for safe passing of two horse riders.
- Accessibility of a pasture and spacious pens is valuable.
- The schedule of therapeutic exercises cannot coincide with fixed hours of horse feeding.
- Engaging without the veterinary’s consent a horse suspected of health problems is absolutely prohibited.
- A description of generally known zootechnics activities, care, veterinary control, feeding, stable and field conditions are not described here as nonspecific for therapeutic actions.
- Obligatory liability insurance for a hippotherapist and accident insurance for a patient.
- Suggested accident insurance for a hippotherapist and a horse escort.
1. Hippotherapeutic centre – particularly these under Polish Hippotherapy Society auspices.
2. Rehabilitation course away-from-home – organized by a reliable subject.
3. The centres with a hippotherapeutic team or a qualified hippotherapist.