Hippotherapy - "Do You Use Hippopotamuses?"

"I have often been asked that question," laughs Donna Stoffa, Program Director of Horse And Rider Therapeutic System (HARTS) in Spicewood, Texas. "Years ago, people rarely heard of the word hippotherapy, but now it has become mainstream." HARTS is a non-profit organization formed to provide a safe and enjoyable environment in which to access hippotherapy and therapeutic riding systems for clients with special needs.

This photo shows Gabe Hartramph and his father Allen being greeted by miniature horse Teddy. Gabe rides with our program and has cerebral palsy. In this photo he is seven years old. Photo courtesy of Adaptive Riding Institute

Hippotherapy is literally 'therapy on a horse' derived from 'hippos', the Greek word for horse. Hippotherapy is a medical treatment using the multidimensional movement of the horse as a means of achieving functional outcomes for the rider. With the assistance of specially trained physical, occupational and speech therapists, clients who have movement dysfunction can benefit from this medical treatment.

"Therapeutic riding has been around since the 1960s," says the HARTS physical therapist, "but it was little known for a long time. It has grown tremendously in recent years, though." Several non-profit organizations have been formed to provide this service to people of all ages and sizes. Why the sudden popularity? Donna explains, "After awhile, word got around and more people became interested in it. Also, the economy has been good. But mostly, it is because the treatment really works."

Today, approximately 40,000 riders take part in hippotherapy and therapeutic riding programs in the United States. Is there a difference between Hippotherapy and Therapeutic Riding? "Yes, there is," says Donna. Therapeutic riding is a program to teach riding skills on a horse so the rider can develop physical fitness while enjoying a recreational sport and leisure activity. With hippotherapy, specific riding skills are not taught as they are in therapeutic riding, but exercises and activities while mounted, in a controlled environment, improve neurological function, sensory processing, and movement.

How Does It Work?

This photo shows Gabe riding in a specially made saddle assisted by Sue Rosen. Photo courtesy of Adaptive Riding Institute

The motion of the horse's walk provides rhythmic, variable, and repetitive sensory input. The rider's resulting responses to these movements are similar to human pelvis movement patterns while walking. The movement of the horse can be combined with other clinical treatments to achieve desired therapeutic results. Horseback riding is both stimulating and rewarding - physically, mentally, and emotionally. Clients love the experience and are enthusiastic about going to therapy. Hippotherapy can improve posture, mobility, function, and balance while affecting cognitive, psychological, behavioral, and communicative functions for people of all ages.

The list of conditions for which therapeutic riding and hippotherapy are of benefit is virtually endless. Though specially trained health professionals must evaluate each potential client on an individual basis, this type of therapy has been useful for clientele with a wide range of disabilities. Muscular Dystrophy, Multiple Sclerosis, Cerebral Palsy, Mental Retardation, Down Syndrome, Spina Bifida, brain and spinal cord injuries, stroke, speech and hearing impairments, visual impairments, amputations, cardiovascular conditions, autism, attention deficit disorder (ADD), developmental delay, learning and language disabilities, and emotional disabilities are among the many conditions and diagnoses for which therapeutic riding and hippotherapy have been of value.

Benefits of Hippotherapy and Therapeutic Riding

This photo shows a blind rider on a trail ride in Silver Falls State Park. She is accompanied by a program volunteer. Photo courtesy of Adaptive Riding Institute

How do these therapies help? Horseback riding is an effective means of therapeutic treatment, especially among patients with neuromuscular-related problems or disabilities. The rhythmic, slow, and continuous motion of the gait of the horse helps the rider develop the muscles around his spine. Riding requires balance and muscular control of the trunk, arms, shoulders, head and the rest of the body. It requires that the rider respond with his own smooth and rhythmic natural body movements that often aids and hastens recovery. Riders gain a better range of hip and knee motion, improved sitting balance, and greater ambulatory capacities. Riding enhances strength, flexibility, coordination, balance, and muscle tone.

In addition to the physical benefits, riding as therapy offers psychological benefits as well. Riders feel a sense of achievement, involvement, responsibility, and control. Grooming and being around horses can help one develop self-awareness, self-discipline, and self-esteem while reducing or overcoming fear. Riding improves concentration and lengthens the attention span. The riders have a more positive and cooperative attitude toward this therapy, which often carries over to their regular physical therapy. The interaction with others helps improve social skills, and riding horses teaches communication skills of a non-verbal kind. Riders have claimed they feel confident, brave, normal, free, independent, and like they are no longer limited while on a horse. The horse offers them four strong legs to get to places they otherwise can't. And riding is fun. It exercises the spirit as well as the body.

Finding A Program

Training begins moments after birth. Bonding to humans is a critical factor in the development of a horse destined to work with disabled riders. This photo shows six year old volunteer, Micah Knaus welcoming baby quarter horse, Dusko, to his new world. Photo courtesy of Adaptive Riding Institute


North American Riding for the Handicapped Association (NARHA) is a large, non-profit organization that has been promoting and supporting therapeutic horseback riding programs throughout the United States and Canada since its inception in 1969. By bringing together the horse and the individual with the disability, NARHA promotes the strengths that lie within both horse and rider.

NARHA helps both children and adults start and maintain successful riding programs.

The association provides guidelines for selecting riders who are suitable and appropriate for therapeutic riding activities. Before participating in any therapeutic horseback riding activities, individuals must consult with their physicians. NARHA riding centers require each potential rider to present a complete medical history and a physician's statement signed by their physician prior to a therapeutic riding session.

In 1969, NARHA consisted of four member centers and 60 individual members. Today, the number of NARHA-affiliated centers and members has grown to more than 550 centers and 3,200 individual members. There are more than 35,000 riders who take part in NARHA programs with the help of 1,100 instructors, 25,000 volunteers, 600 licensed therapists, 4,000 therapy horses, and thousands of contributors from all over the world. NARHA certifies therapeutic riding instructors and even organizes an annual Ride-A-Thon for its member centers. Visit NARHA on the web at www.narha.org to find a member center near you.


The American Hippotherapy Association (AHA) is a special interest section of NARHA formed in 1993 to promote research, education, and communication among physical and occupational therapists and others using the horse in a treatment approach based on principles of classic hippotherapy. Registered therapists in hippotherapy are located throughout the United States and Canada. The American Hippotherapy Certification Board certifies therapists to promote excellence in the practice of hippotherapy.


People with disabilities and their able bodied companions enjoy the rugged Oregon scenery during a 4 day wilderness pack trip. Note: Once on horseback it impossible to destinguise which riders have disabilities and which are ablebodied. Being able to "Leave your disability behind" is one of the magical moments provided by the Adaptive Riding Institute. Photo courtesy of Adaptive Riding Institute

Riding Instruction for Special Equestrians (RISE) is a program offered by the Easter Seal Society of Northeastern Pennsylvania. The mission of the Easter Seal Society is to provide programs and services that enable people with disabilities to live life with equality, dignity, and independence. RISE, a member of NARHA, is divided into two different tracks: a Therapeutic Riding Education Track for children 4 to 18 years of age with developmental delays and/or disabilities, and a Hippotherapy Medical Track for children from 2 to 18 years of age who have developmental delays or disabilities, and older individuals whose disabling conditions require the hands-on involvement of the physical therapist.

ARI offers variety

Not all centers are alike. Some offer opportunities to expand one's horizons beyond the arena. The Adaptive Riding Institute (ARI) is a non-profit organization in Oregon started in 1987. Upon discovering that there was no organization in any country that offered recreational riding to people with any degree of disability, the founders developed their own organization, Horseback Outdoor Recreation Scenic Experiences and Services (HORSES), later to become ARI (see For the Rider, this issue of NHM).

ARI provides riding lessons and pleasure riding for people with disabilities inside a covered arena at their Scotts Mills, Oregon facility from October through May of each year. These skill-building sessions help riders develop the skills needed to ride independently in outdoor and wilderness settings. Family members and significant others are invited to participate in winter riding lessons as well. The goals of these sessions are to prepare for summer riding adventures by training the rider's mind, body, and horse to work in harmony, to develop and perfect any adaptive equipment needed by the rider, and to keep horses and riders physically and mentally fit.

ARI offers trail riding and camping trips to a variety of locations. The rider who chooses to work toward the goal of participating in the out-of-the-ordinary, rewarding adventures can further expand his education and awareness. ARI offers horse camping trips to various locations according to environmental factors including snow levels, road conditions, availability of sites, and other factors.

Six-year-old volunteer, Micah Knaus, helps socialize baby quarter horse, Dusko, as Dusko's mother patiently stands near. Dusko's mother is Miss Littletown, a registered quarter horse and brood mare for the Adaptive Riding Institute, which now has a small breeding program designed to breed, raise and train horses for this unique field. Photo courtesy of Adaptive Riding Institute

For example, the Central Oregon Ranch Trip provides activities that include trail rides, camping, fishing, outdoor cooking, and exploring natural history and local plant life. A stocked pond offers wheelchair-accessible fishing for guests. Trail rides tour the original homestead with its surrounding farmland and the ranch irrigation routes. Participants also explore ancient lava beds and the sagebrush-studded, high desert landscape common to much of central and eastern Oregon - country out of a western movie, complete with tumbleweeds, lizards, and junipers. This trip may include a scenic float trip on the nearby Deschutes River, located in the high desert country of North Central Oregon, and it offers everything one could want on a scenic float trip - fresh green water, basalt cliffs, and wild life.

Other adventures include Forest Camp Trip, Wilderness Pack Trip, Beach Camping Trip, and Make Your Own Adventure. Oregonians are blessed with one of the most beautiful coastlines in the world, where rugged rocky cliffs break up stretches of smooth sandy beach. Horse camping takes the rider to the spectacular and unspoiled providing activities which focus on the limitless, not the limitation. Specially trained horses, skilled volunteers, and custom saddles and other adaptive equipment make horse camping possible for many who were previously believed to be unable to ride. Guided scenic trail rides are offered to the general public as well.

ARI is the leading pioneer in the field of adaptive riding equipment. State of the art designs include custom support systems and safety devices, working in combination to achieve the greatest possible comfort for both the rider and horse. Custom-made saddles and other adaptive equipment are an essential part of making trail riding adventures not only possible, but also safer for people with disabilities. Careful thought and planning are essential to the development of adaptive equipment to prevent disastrous results in the event of an accident. All equipment should include safety features that consider the laws of physics including, weight, speed, motion, and impact.

A helmet is another essential component of safety equipment. ARI recommends helmets for all riders whether or not they have a disability, although there are some instances when the rider is unable to wear a helmet such as when a neck brace may interfere.

ARI offers custom horse training for the therapy horse. Training is available for privately owned horses, ponies, and mules belonging to riders who have special needs and also to the general public. Each animal is evaluated prior to training to determine if it possesses the intelligence and temperament needed to perform the desired tasks safely and consistently.

A young man and his horse enjoy the afternoon sun during a wilderness pack trip in Central Oregon. This photo shows how horses must be trusting and relaxed even in unfamiliar settings. Photo courtesy of Adaptive Riding Institute

Volunteer opportunities abound at ARI. ARI is staffed almost entirely by volunteers who perform many vital activities. Anyone who enjoys helping people, working with animals, trail riding, camping and other outdoor activities may volunteer. There are many positions: stable hand, yard hand, handler, riding assistant, coach, paper jockey, transporter, scout, adventurer, photographer, roustabout, and host. For some duties, enthusiasm is the only prerequisite; others require extensive related experience and satisfactory completion of special training. All volunteers are encouraged to complete first aid training and C.P.R.

ARI believes that people labeled "disabled" are only so in the physical sense. Their programs offer riders the opportunity to go to places that they never before could, making their dreams come true. Visit ARI on the web at www.open.org/~horses88/comments.html .

Mobility International USA

Mobility International USA (MIUSA) is a U.S.-based, national, non-profit organization whose mission is to empower people with disabilities around the world through international exchange, information sharing, technical assistance and training, and to ensure the inclusion of people with disabilities in international exchange and development programs. MIUSA provides educational exchanges between Oregon and other countries for people with disabilities by sending teams of disabled delegates from Oregon to nearly every other country in an effort to empower people with special needs to make positive changes in their own lives as well as political changes that will help improve the lives of all disabled people in their country. MIUSA also sends teams of disabled delegates from foreign countries to ARI in Oregon as an inspirational activity and to learn from ARI's services. MIUSA opens its delegates to the idea that anything is possible with hard work and dedication; it encourages them to practice achieving things that they may have considered impossible. Visit their website at www.miusa.org .


 Horses as an advantage

Advantage Ranch Center for Equine Interactive Concepts (CEIC), located in the scenic Blue Ridge mountains near Blacksburg, Virginia, offers an innovative way to utilize horses and rural life experiences to help children. Any child who feels he or she has lived 'without an advantage' can go there and find one. That is the cornerstone of the ranch - to see the ability in every child and help them see it in themselves.

The Equine Interactive Counseling™ method involves a teamwork approach using horses, parents, the community and CEIC certified coaches to help youngsters develop a variety of skills. Children learn to set goals and work toward them, solve the problems that arise along the way, and evaluate their own progress. Through this process they authentically experience achievement and increased self worth.

Kerrill Knaus-Hardy gives pre-ride instructions to a group of Japanese visitors from Mobility International USA, a disability international exchange organization. Photo courtesy of Adaptive Riding Institute

Advantage Ranch believes the horse is nature's perfect partner for a child. The body of the horse has natural physical linkages to that of the rider and the mind of the horse has natural linkages to that of the child; thus, the horse can read the child, is sensitive to the child's fears and feelings, and is responsive to the child's attitude and direction, and the horse is caring and observant of the child. When the child learns to be caring and observant of the horse, magic happens, and the Equine Interactive Counseling™ Coaches are trained to bring this magic alive. Advantage Ranch helps children turn their present reality into the dreams that become their future.

Advantage Ranch offers ongoing Equine Interactive Counseling™ services for children residing on the campus, and has also cleverly designed its programs to be available in any community. Parents do not have to go far from home to get help for their child. Advantage Ranch CEIC offers a comprehensive Equine Interactive Counseling™ training program for adults, which enables them to staff the community-based centers. The training program can be completed in two weeks and qualifies as an internship or independent study at many colleges. Coaches are CEIC certified to provide Equine Interactive Counseling™ services at the community level. CEIC support of the community-based centers includes standardized business and program resources to provide top quality service. Advantage Resource furnishes books, tapes, planning guides, public relations activities and consulting services to assure uniformity of Equine Interactive Counseling™ services from one community to another. If relocated, a child is assured of a consistent program. The materials are the same as those used at Advantage Ranch, where they have been developed and tested.

CEIC is unique in the therapeutic riding industry regarding its research as well. Though its services are customized to meet each child's needs, CEIC coaches use standardized measurement tools that help them track each child's progress. Standardized measurement tools yield valid and reliable results, which are sent to the central research office, the only significant database in the country for horses used as therapy. This provides valuable information for the promotion of community based centers, fund raising, and grant writing.

Advantage Foundation, Inc., an educational charity backed by an endowment fund, will offer grants and scholarships for children, student loans for participants in the Advantage Ranch Center for Equine Interactive Concepts coaches training program, and start up funds for the community based centers.

Their goal is to help open 120 new community based centers each year. Visit Advantage Ranch at www.advantageranch.com .

More organizations and centers

I Saw A Child

I saw a child who couldn't walk,

sit on a horse, laugh and talk,

Then ride it through a field of daisies

and yet he could not walk unaided.

I saw a child, no legs below,

sit on a horse and make it go

through woods of green

and places he had never been

to sit and stare

except from a chair.

I saw a child who could only crawl

mount a horse and sit up tall.

Put it through degrees of paces

and laugh at the wonder on our faces.

I saw a child born into strife,

Take up and hold the reins of life

and that same child, I heard him say,

Thank God for showing me the way.

John Anthony Davies

(Poem reproduced courtesy of Normandy Farm Therapeutic Riding)

Most centers are non-profit, and you can help their rapidly-growing programs by donating your time, money, horses, tack, or horse supplies. Donations are welcome, and are usually tax deductible.

Normandy Farm Therapeutic Riding (member of Maryland Council of Equestrian Therapies, Inc.) was formed in 1992 because of the difficulties that people with disabilities were having finding appropriate recreational opportunities. Normandy Farm provides therapeutic riding from April through October for individuals who are physically, emotionally and developmentally challenged. The riders may play games on horseback, perform gymnastic movements on the horse's back, and learn dressage or jumping; each rider has individual goals to work toward. Most of the sessions are held in an enclosed outdoor ring, however an occasional stroll across the countryside can be experienced through picturesque, rural Hartford County in Maryland.

The Maryland Council for Special Equestrians (MCSE) is located at Patapsco Horse Center in Catonsville, Maryland. MCSE offers a Hippotherapy Program that uses horses as an integral part of the rehabilitation process. The non-profit center treats patients of all ages with cerebral palsy, developmental delay, multiple sclerosis, hypotonia and balance disorders. A Registered Physical Therapist works directly with the person on a specially trained horse, with the assistance of two or three trained aids.

The Frederick County (Maryland) 4H Therapeutic Riding Program (FC 4H TRP), affiliated with NARHA, is located at Silverado Stables in Thurmont, Maryland. FC 4H TRP began in April, 1984 as a special project under the Frederick County 4H Horse and Pony Club. A seven-week session of riding instruction is offered each spring and fall at no charge to students. The students, ages 2 to 80, represent all areas of Frederick County and many various types of disabilities.

Bright Vision Therapeutic Riding (BVTR) located in Westminster, Maryland provides therapeutic services utilizing the horse as a facilitator. The horse is an ideal instrument for strengthening and healing the body. Riding simultaneously stimulates many muscle groups and the horse provides positive motivation to achieve personal goals. BVTR focuses on the physical and spiritual bond that naturally develops between horse and rider for individual development and enrichment. BVTR uniquely combines the fields of sport, recreation, education and medicine to serve many populations; a disability is not required to participate. The program is open to anyone who wishes to benefit from the results that can be achieved.

Thorncroft Therapeutic Horseback Riding, Inc., a program that has worked wonders with physical and emotional therapy through riding, is one of the oldest and largest therapeutic riding facilities in the nation. Thorncroft helps the disabled to improve balance, circulation, muscle tone and concentration while enhancing self-esteem. Thorncroft, located in Malvern, PA offers instruction in Balanced Seat Equitation, Driving, Combined Training and Trail.

How you can help

There are many, many therapeutic riding centers which offer opportunities for people to learn more about therapeutic riding. By joining a center near you and telling your friends about therapeutic riding, you can expand your knowledge while networking with others in this growing industry.

None of the centers could exist without the help of volunteers. Volunteers assist in a variety of ways; some offer their horsemanship skills while others who aren't experienced with horses perform other duties that ultimately benefit the center's riders. Volunteer your time, in whatever way you like. No experience is necessary to become a volunteer. To learn more about volunteering, call a center near you.

Make a donation to a center. Nearly all of the centers depend on donations of tack, horse supplies, and financial support from kind, caring individuals who help them carry out their mission. Donations are tax deductible.

Therapy horses are often donated, volunteered or leased out by local horse owners. Centers are in need of horses suitable for the therapeutic riding environment and will evaluate a prospective horse on its conformation, health, age, gaits, way of going, manners, attitude, reliability and adaptability. Any breed will be considered; different breeds offer different builds needed for a wide range of disabilities. Consider donating or sharing a horse with a center.

There is an ever-increasing demand for therapeutic riding services. At many centers, individuals must be placed on a waiting list. Consider opening a therapeutic riding center at your farm or in your area. NARHA offers educational and networking assistance for those interested in starting up a therapeutic riding center. For more information on starting a center, NARHA has created a Start-Up Packet for Operating Centers, which includes information on budgets, personnel, facilities, insurance, funding, equipment, and samples of required federal, state and NARHA forms. To order a copy, call NARHA at 800-369-RIDE (7433).

There are many heart-warming stories of disabled riders that begin with despair and disability and end up with ability and accomplishment. A great potential exists between horses and all kinds of people, and the benefits of getting them together are endless. Therapeutic riding experiences open the door to a wonderful world, leaving behind the limitations. Getting involved with a therapeutic riding center is a way to be a part of this miraculous and enjoyable adventure that is as rewarding for the staff and volunteers as it is for the riders. There are many, many centers from which to choose!


Natural Horse Magazine thanks Donna Stoffa and Kerrill Hardy for their kind contributions to this article.

For further information (to mention just a few):

Horse And Rider Therapeutic Systems (HARTS)

3915-B Crawford Road

Spicewood, TX 78669 USA


E-mail: dstoffa@yahoo.com

North American Riding for the Handicapped Association (NARHA)

PO Box 33150

Denver, CO 80233 USA

800-369-RIDE (7433), 303-452-1212


E-mail: narha@narha.org

Riding Instruction for Special Equestrians (RISE)

Easter Seals

109 Seven Bridge Road

East Stroudsburg, PA 18301 USA


The Adaptive Riding Institute (ARI)

PO Box 280

Scotts Mills, Oregon 97375 USA



E-mail: horses88@open.org

Mobility International USA

PO Box 10767

Eugene, Oregon 97440 USA


Fax: 541-343-6812


E-mail: info@miusa.org

Advantage Ranch

Center for Equine Interactive Concepts

2182 Mount Tabor Road

Blacksburg, Virginia 24060 USA



Email: resource@advantageranch.com

Normandy Farm Therapeutic Riding

3153 Ady Road

Street, MD 21154 USA


Maryland Council for Special Equestrians, Inc.

2501 Frederick Road

Catonsville, MD 21228 USA


Frederick County 4H Therapeutic Riding Program

Silverado Stables

11515 Angleberger Road

Thurmont, MD 21788



Bright Vision Therapeutic Riding

P.O. Box 114

Westminster, MD 21158


E-mail bvtr@cct.infi.net

Thorncroft Therapeutic Horseback Riding, Inc.

190 Line Road

Malvern, PA 19355