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

Assisted kneeling and sitting position

The assisted kneeling and sitting position provides the opportunity to set the hip joints to exterior rotation and abduction, allows for direct influence on the pelvis as a result of the movement of the horse’s back and thus education/re-eduction of muscle coordination of the trunk, whilst excluding the legs. In this position, the therapist sits behind the client and directly adjusts his/her position, kneeling on the heels or sitting. It is a good idea to begin on children with significant lower limb spasticity in a kneeling position. The therapist thus has the chance to avoid any unwanted holding of the legs which would prevent the required coordination of the pelvis and the movement of the horse’s back, which would in turn result in the generation of pathological movement patterns.

Support from the arms can be generated by using different aids and thus movement coordination functionally influenced. This position is generally prescribed for older children and children with cerebral palsy if they do not sit of their own accord. Their weight (around 40 kg) and height (not higher than the sitting therapist on the horse behind the client) are the limiting factors in providing quality therapy and making sure the horse does not suffer any damage to health.

Assisted kneeling and sitting position (drawings T. and R. Lizna, photographs from the Caballinus archive)

Key: the drawing shows an overall perspective of the chosen position with regard to the positioning of the client on the horse, while the photographs show the details of the position on the horse – assisted kneeling at the top, assisted sitting at the bottom.