Physiotherapist Lesley Furnell from Revive MS Support writes about how using horseriding to create movement can be helpful for people with multiple sclerosis.
Hippotherapy literally means treatment using the horse, from the Greek word 'hippos', meaning horse. It uses the three dimensional movement of the horse's hips, pelvis and shoulders at the walk to provide a movement challenge to the rider.
Sessions are under the direction of a physiotherapist specifically trained in this method of treatment. The rider sits on a sheepskin astride a horse, led by an experienced horse person and accompanied by two side walkers. Perhaps one of the reasons for the success of hippotherapy is this team approach. The client makes no attempt to ride the horse but plays their part by actively responding to and interacting with the horse's movement.
The motion of the horse transfers movement patterns to the rider's lumbar (lower) spine and pelvic regions. This movement is very similar to the movement produced in 'normal walking'; per minute a full sized adult horse at walk transfers 110 multidimensional swinging motions to the rider.
Hippotherapy is a unique treatment, which cannot be rivalled or reproduced by any other therapeutic method or piece of equipment. The horse becomes the tool that the therapist uses to improve the client's neuromotor function. Once the client has accommodated to the movement of the horse, changes in gait, stride and pace, transitions to halt, corners and circles are introduced to further challenge the client and encourage alterations in balance and a need for reaction. Sitting backwards, side sitting or lying along the spine of a horse may also be used to achieve the desired outcome.
The hippotherapy offered at Revive uses the principles of Centered Riding, which combine to create a stabilising sensation of connection with the ground. This helps to develop and increase awareness of specific areas of the body and can have quite a dramatic effect, not only in the riding arena but also in every area of daily life.
Why the horse?
- The horse demands movement!
- The movement stimulates postural responses, ie it encourages one to sit up.
- Sitting astride a horse increases the base area of support.
- The rhythm of the horse at walk, especially on straight lines, affects muscle tone and helps to reduce muscle spasm.
- The warmth of the horse, higher than that of a human, is very relaxing and helps to increase blood supply and release tight tissues.
- There is a unique relationship between man and horse not found in the gymnasium or therapy unit.
- It is enjoyable and a new learning experience, which can lead to improved function off the horse.
- Joy creates motivation and increases self-esteem.
Perhaps the comments from the clients will more ably convey the benefits.
L who walks with a rollater
"Absolutely astounding sensations; I felt movement in my hips again. Something I really miss is going for a good walk or climb, I always enjoyed the feeling afterwards that I had had a brilliant workout as well as enjoying the physical activity. Hippotherapy is not only a great physical exercise, it is also great fun. It is hard work doing so much balance and core stability exercise. It is also for me the one activity where I am 100% there in the moment, concentration is on, not distracted by everyday thoughts and concerns. It is a brilliant joyful challenge for me, great for lifting me out of the doldrums, as well as being beneficial physiotherapy."
E who is over 60 and was very fearful when she started
"I was absolutely terrified at first but as the lesson progressed, I relaxed more and more into the horse and allowed my body to be moved by him. I liked being up high, I felt brave and I loved the feel of the strength of the horse underneath me. It was fantastic. My confidence improved, my posture improved and I was proud of myself for being brave enough to try it. Most of all I enjoyed it. My walking was much improved after each session and I hope that I can hold on to that improvement and not return to holding my body in a very fixed way."
M who walks with two sticks
"Uncertainty soon disappears. Riding without a saddle allows you to feel the movement of the horse. I do some tai-chi movements and this really helps me to relax. Hippotherapy has provided me with a sense of achievement and boosts my confidence. If only all therapies were as pleasant."
F who works and walks either unaided or with high sticks
"Not only did I enjoy hippotherapy but I learned a lot about myself and managing my MS in the process. Accepting yourself the way you are and focusing on what you have to do is all about managing MS in my experience. On the horse you are concentrating on what you are doing, relaxing to the rhythm, letting go of the worry and letting others take the strain and support you. Trust is the major element in all of this. By letting go you are strengthened. I know it is ironic and a bit daft but that's life!
When I first got off the horse it was sore for a little while but then it was energising. I remember years ago a veteran with MS telling me that exercise was the answer to MS management. At the time I was in a bad way and this was the last thing on my mind, but I know now that exercise is good for me on my terms. I found hippotherapy liberating and energy giving. With independence in mind it should be available on the Health Service."
The first group of clients have been an outstanding success. They have been brave, accepting the challenge and conquering their fear. Hippotherapy truly is a powerful therapy, producing not only the expected physical results but also deep and different psychological benefits to each individual.
Revive MS Support is very grateful to the Glasgow Group of Riding for the Disabled for the use of their wonderful premises, horses and volunteer helpers.
Written by Lesley Furnell, physiotherapist, Revive MS Support, Glasgow for Open Door - May 2006
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