Hippotherapy techniques (3) – choosing therapy positions (A)

Svitani_hippotherapy (14)The therapy positions used in hippotherapy and the terminology used for these have been applied in practice for several years, drawing on Czech and foreign literature and practical experience.

The therapist uses the horse’s back as a balance area, which he/she can use to achieve the targeted therapeutic effect. The positions of the client on the horse are chosen by the therapist based on his/her knowledge of other physiotherapeutic methods and approaches. The four most commonly-chosen basic positions are described here. We will describe four positions, in this chapter we will focus on prone position.

The prone position facing backward

We choose this position for clients whose motor skills are not of a quality corresponding to the level of psychomotor development at the end of the 1st trimester (trimester = three-month period). Alongside infants with developmental coordination disorder, this is also used for older children and even adults who do not have good posture, who do not have sufficient control over supporting their own head and who are most commonly clinically classed as having spastic quadriplegia cerebral palsy. For adults, the limiting factor is the type of horse and the size of hip joints in abduction with regard for the type of horse which we have chosen for therapy.

The aim of the position is to activate the postural mechanisms. This is a position that uses the horse’s back, in particular the shoulder part of the spine and rear. The client is placed in a position on his/her belly along the back of the horse according to the pattern at the end of the 1st trimester of physiological psychomotor development. He/she rests his/her forearms on the rear of the horse, arms open. Depending on the level of development and motivation, the arms are extended to the elbows for greater support. The client therefore gradually moves into the position of spontaneous activity as corresponding to the end of the 2nd trimester.

This position also offers relaxation and inhibition stimulation, when the client does not actively sit upright, instead mainly using the acting heat of the horse and regular motion stimulus.

Key: The drawing shows an overall perspective of the chosen position with regard to the body of the horse, while the photographs show the details of the position – on the left support on the forearms, on the right support on extended arms.

Hippotherapy- choosing a therapy position

Upright position – support on forearms and support on extended arms (drawing T. Liznová, photographs from Caballinus and OS Svítání)

 

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