Thursday, July 23, 2015

Hippotherapy?? What in the world is that?

When Alaina was a baby, every time we went to the clinic for check-ups I would see a couple rows of brochures in the waiting room. One brochure always stood out to me, but didn't really give it a second thought then since she was so little. Once she turned 3 and wasn't getting services at home, which meant she didn't get services during the summer anymore, I was interested in finding something else to stimulate and help her progress while she wasn't in school. I have never shied away from anything that had the potential to do her some good.

So I made a call 3 summers ago to the therapy department at the Pipestone hospital and was directed to Lori, the occupational therapist. After an evaluation, we got on the schedule for her hippotherapy program. She runs the program during the summer months in the 4-H arena in Pipestone. 

Most people (including me!) are quite thrown by the name! No....we don't have an abundance of hippos in southwest Minnesota! Hippo is the Greek word for horse. The therapy is really cool actually. From what Lori has told me over the years, riding a horse most closely mimics the human gait when we walk, so for those who have difficulty walking, or can't walk, riding a horse will allow you to use the muscles a person typically does when walking - especially core muscles. People with Down syndrome have low muscle tone, so strengthening exercises have always been at the top of the agenda. Finding ways to stimulate and strengthen core muscles benefits just about everything Alaina does. From just sitting straighter to how she stands and her balance, just about every muscles is stimulated and worked when riding a horse. And it is an overall sensory experience too, so not only are muscles worked, but there are mental and sensory components to it as well. It's a true full body therapy! 
Clearly not enjoying herself! ;)
Lori uses different horses for different purposes for each patient. She has some horses that are wider and slower which is better for those who have weaker muscles and can't handle as much stimulation and input. She also uses horses that are smaller - more narrow - and have a much faster gait to them. These are the horses she typically chooses for Alaina. First of all, she is so small that it isn't necessarily good to have her hips so far apart on a larger, wider horse - we have tried to cue her hips in her whole life so riding a wider horse was a disadvantage for her. And she is strong enough to handle all the input for a smaller, faster horse. It gives her more bang for her buck in her weekly 45 minute session. 

For each session, individuals are to put on their helmet and the safety belt - which definitely works her OT skills with the fine motor tasks needed to do that. Once they have the proper safety equipment on, they pick out a brush, and brush and pet one of the horses that is tied up in the arena. It's a good chance to bond with the animals and calm some apprehension they may have about getting close to these big animals. Alaina is tiny compared to the horse - I would be scared too! After brushing, they bring some steps over and Alaina will climb on and they begin!

Typically, they start just walking circles or figure 8's around the arena to get her core muscles warmed up and working. When they do any activities, there is always someone leading the horse and a walker on each side of her. The belt she wears has loops on it that the walkers can hold on to if she were to start to slip too far off to one side or another. This summer the walkers have gotten to the point that they really only lay their farm across her leg and don't even hold her - she has gotten much more comfortable riding the horses and gotten stronger. After a few minutes, Lori (or one of her OT students) will start doing activities with Alaina. When she first started 3 summers ago, they were primarily working on strength, so they would have her reach for objects on both sides of her while the horse was moving. It takes a lot of strength and work to reach and lean forward and side to side on a horse while it's moving for someone so little and with low tone. It was always a good workout for her and helps with coordination.  Another way to incorporate that is also doing things like reaching to put rings or hula hoops on poles as the horse is walking by. They incorporate colors, shapes, numbers, directions like right or left into actives too. Every week she has done something slightly different for activities.
This girl needs a few steps to help her get up on that horse!
Walking laps around the arena
At times they will also have her turn around and ride backwards or side ways, as that is a whole new realm of input into her little body. The muscles needed to balance and do activities is very different when riding in a different direction. Another fun thing they do is let the kids lead a horse around the arena or the grass area outside. This can take a little strength to keep the horse moving and keep it's head up at times. Usually they ask her to lead the horse through a specific course or path, so there is still the cognitive aspect of it also. Alaina loves this part more than anything it seems! And they finish each session by giving the horse treats! She has to get her bucket, open the treats, count out the correct number and give them to the horse in the bucket. That may not sound like a big deal, but to little Alaina the power of a horses head is mighty!! She has to fight pretty hard to hold that little bucket up when a horse is pushing down and side to side on it to get the treats out! It is truly a workout in and of itself! She always looks like she's going to be pulled right over face first, but that girl holds her own! :)

We have seen many benefits for Alaina with only 3-4 months of therapy a year. She definitely becomes stronger, but more than anything she gains so much confidence! With her low tone, any time she gets in a place where she is higher up and unsteady, she has the tendency to become very nervous. As the summer goes on, I find she becomes stronger and more confident in situations like that. It's so cool to see! She certainly gains confidence and develops a comfort level with the animals too. They are so much bigger than her, so it's nice to see her not be afraid to approach the horses and pet, brush, ride and lead them. It wasn't that way when she first started! We see her confidence come out in different ways too with how verbal she is while riding the horse. When she gets on they will not move the horse until Alaina gives the command. This summer she is riding George. So if she wants to ride, she has to say "Go George!" We used to barely be able to hear her whisper the command. Yesterday you could hear her shout it out across the arena! Her favorite is to be able to tell the horse to trot! She's a little dare devil and loves when the horse trots around the arena - nothing but smiles and laughs from her! 

Well, that was a lot of words and I don't think I even covered all the benefits or reasons for hippotherapy - there is SO much to it, so much more than just riding a horse than I ever imagined. I have to give a huge personal thank you to Lori for her efforts in making this program happen. It's a lot of work! And an even bigger thanks to those to help her make it happen! It is all possible through people's generous donations of time and resources. The horses are voluntarily brought in by their owners every week and all the walkers and helpers are volunteers as well. These people donate a lot  to make this possible for our kids. THANK YOU! We are so fortunate to live in such a rural area and have such an amazing program near us to take advantage of! It really has been one of the neatest and best things we have done for Alaina. I think most people know how valuable animals are to our souls and for our well being - therapy with animals is no exception! 

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