Hipotherapy
"You always have to remember the fact that horse is the transmitter and client is the receiver. The goal is to tune the receiver in to trouble-free reception." (Zelenka, 1992)
Hipotherapy is one of the facilitation methods. The facilitation is caused by the activity of proprioceptive receptors and it forms the basis of today's modern resuscitation procedures. It is a re-educative procedure that is used to lower irritability threshold for motoneurons with subsequent increase of irritability for nerve structures, thus making movement easier. Facilitation methods use facilitation impulses in excessive amounts – tactile and visual from periphery – which purposefully influence the affected functions and clear the way for their correct use.
Hipotherapy effects
In its effects, hipotherapy is a very complex method. It can offer the following to your child:
Tactile skin stimulation. For maximal effect of this hipotherapy factor it is important to use only a thin blanket instead of a saddle; at the same time the patient should only wear light clothing in the contact area.
Heat impact. Horses have a body temperature of 38 °C, which has substantial impact on muscle activity, easing spasticity as well.
Exercise against resistance. In hipotherapy, this exercise based on the weight of the given segment and is enhanced by horse's back instability.
Supportive reactions. Thanks to stirrups, extensors of lower limbs can be facilitated, which is one of the lesser used elements in hipotherapy.
Defense reactions against falling. Horse's back instability results in activation of postural muscles based on patient's center of gravity tilting during the ride. It is the same principle expressed by Janda (1992) on sensomotorical stimulation about two types of motor learning. The first level is characterized by mastering a new motor skill and by creation of functional connections, the second level by coding the motor skill to a lower subcortical regulation due to lesser difficulty and greater speed. The disadvantage is that the skill gets fixed and is very difficult to change.
Labyrinth reflexes. They are employed in the crosswise position that produces rocking and swaying, thus relaxing the patient greatly.
Irritation irradiation. During hipotherapy, the horse riding stereotype becomes a movement pattern while the weight of segments and gravity impact create a resistance force.
Limbic system activation. Limbic system activates during every movement; it influences the intensity of movement reactions through emotions and creates memory traces in order to fixate movement programs in memory. So it can be said that "the limbic system is an initiator of every movement" (Véle, 2006). Impulses from both inner and outer environment that come to the CNS from receptors and that hipotherapy abounds with initiate both mental and motor activity. Moreover, regular movement rhythm with a harmonic frequency (in this case given by the horse's pace) is accompanied by an emotional experience and influences the psyche and therefore also the personal movement behavior.
In his theory, Pribram has formulated the importance of the limbic system for movement. According to Program’s holographic theory on memory fixation, two activities interfere in brain – sensory projection into the cerebral cortex and activation of the limbic system. Information is stored in several places of the memory at once through interference of those two activities – similarly to a hologram. That means that when a part of the record keeping surface is damaged, the information as a whole is not destroyed; only its details disappear. Moreover, Véle (2006) adds that when activated through intensive stimulation from periphery, high plasticity of the CNS enables the creation of new synapses and most likely also regeneration or even neogenesis of certain neurons. The activation of sensational brain is therefore necessary for creation of memory imprints and it is one of the most important factors of successful hipotherapy when compared to other physiotherapeutic approaches.
Affecting the deep stabilizing system. During hipotherapy, especially the monosegmental muscles Multifidi et semispinales etc. that are of key importance during segmental stabilizing of the spine, are stimulated and purposefully strengthened as the patient's pelvis regularly drops into lateroflection. This way movement segments are mobilized and joint hypomobility is removed as well. The movement of the horse's back tilts the client's pelvis to the side while the spine rotates to the contra-lateral side of the stressed tuber ossis ischi, which results in muscle stabilizing of the spine in the straightened position and to purposeful training of short rotators.
Stimulation of the global postural-locomotion pattern. Based on current opinions, statics malfunctions are not caused only by overstressing a previously optimal posture, but they can also be caused by inadequate development of the base of support, mostly by the end of the first trimenon.
The horse's pace and related movement and rhythm are a specific element that is offered by hipotherapy, unlike other rehabilitation methods. Thanks to the proximity of horse's and person's pace conditioned by the crossed movement pattern, hipotherapy is the only rehabilitation method that re-educates walking from the top. By sitting the client on the horse we "eliminate" the movement of the disturbing lower limbs from his or her walking. By merging the movement of the pelvis with the movement of the horse's back we activate all reflex mechanisms necessary for walking and open the possibility of simultaneous physiological movements of the body, nape, head and upper limbs. This developing movement dialogue between the horse and the patient disrupts the remaining pathological movement stereotypes, at the same time facilitating the image of the physiological walk from periphery to the center.
Another specific factor is rhythm. Rhythm disruption leads to asymmetry, malfunctions, exhaustion and diseases. "In many regards, our body is a rhythmical machine, in which everything pulses synchronously – from the bowel movements to neuron connections in our brain." (Hart, 2008). Even today, rhythm is the only healing method for some peoples – for example for Siberian tribes and for Australian Aborinenes. There is a theoretical explanation, which is still more of a surmise, that when the human body is exposed to regular and steady rhythm, similar reaction is also triggered in the natural rhythms of our body which regain their balance.
Hipotherapy in early treatment is a special field of hipotherapy. In it, we perceive the influence of a horse from another point of view.
In order to verticalize a child, muscle coordination that is required is already present in reflex locomotion models. Children with delayed psychomotor development or children unable to verticalize are missing some muscle coordination. Nevertheless, their sensomotor department is fully functional and in these cases it simply "uses what's available". It results in so-called pathological erection, as the child is "obsessed with movement" and the great motivation to move results in bipedal walk in any form. That means that the coordination complex of reflexive crawling in the vertical position is activated through optical erection mechanisms.
Those newborns therefore have to be offered physiologic patters for permanent use in an apherent way. However, the children consider the therapy an external intervention into their inner lives and they are forced to perform activities they did not choose themselves. That means that the success of the treatment lies in maximal summation of apherent inputs ("apherent set") in combination with strong motivation to move – this combination creates so-called password for CNS that is necessary to launch the given movement program. The success is preconditioned by finding a reason for learning.
In hipotherapy we assume that the horse offers us the required muscle coordination present in the reflexive locomotion models through its quadrupedal locomotion. Based on current opinions, statics malfunctions are not caused only by overstressing a previously optimal posture, but also by inadequate development of base of support, mostly by the end of the first trimenon. Facilitation of the global pattern is preconditioned by sensoric, especially proprioceptive facilitation. The apherent set is very broad thanks to the fact that even not so common receptors are addressed (sight, smell, hearing). Proprioceptive facilitation is accented by co-activation of muscle groups through movement synergies of the closed chain type, in which acri are punctum fixum and the body is punctum mobile. Activation of the limbic system is very important. Also when performing hipotherapy with infants, we cannot talk about external intervention, only about "the child's own adaptation to a different movement". "Today, hipotherapy is considered one of the leading rehabilitation procedures, which teaches individuals trough play." (Hollý, Hornáček, 2002).
