Therapeutic Horseback Riding

Therapeutic Horseback Riding is a complementary program to standard treatments with regular client sessions, which marries concepts based in traditional horseback riding with fundamental treatment theories, whose positive attributes can be found at the neuromotor, cognitive and psychosocial levels. Although limited to clinical frameworks that allow for it, this therapy can provide great improvements for all those that can beneficially access it. Although its initial versions date from earlier on, it was in 2001, through the Inclusion Project of the APCB, that the Horseback Riding for therapeutic purposes first started growing into its current present day size.

Therapeutic Horseback Riding Sessions are held in Regimento de Cavalaria, nº 6 (Braga)
The APCB Therapeutic Horseback Riding sessions are staffed by specialist professionals, with the support of a Therapeutic Horseback Riding Auxiliary. These sessions have international recognition and regularly meets with HETI (International Federation of Horsemanship for Therapy) and the FRDI (International Federation of Horsemen with Incapacity). The benefits of equine therapy for Cerebral Palsy have been documented through many studies (American Hippotherapy Association, 2012; Wickert, 1999; Andrada, 1997, 2003).

Why the horse? 
It is theorized that a person’s walk is 95% similar to that of a horse, and that through movement in 3 planes (the vertical, frontal and sagittal) one is afforded physical and sensory input that is at once variable, rhythmic and repetitive. Walking on foot produces around 60 to 75 three dimensional movements per minute, providing the central nervous system with a great source of sensory stimulus. The back provides proper positioning whilst seated such that globally the contact with a horse and all of its surrounding environment improves central nervous system response. Regarding pace, we separate the steady gait (i.e. slower, padlocked, steady, without stoppage) the trot and the gallop (i.e. jumpy movements, faster and with stoppages).

What does Therapeutic Horseback Riding embody?
The term Therapeutic Horseback Riding is embraced by the APCB with a view to include 3 kinds of therapeutic intervention with the horse: hippotherapy, therapeutic horsemanship and adaptive riding.
  • Hippotherapy: in this modality the subject remains passive with regard to riding the horse, given that the objective is to learn to mount, although without benefiting from all of the stimulus a horse can provide. The horse acts as a sensory-perceptive and a kinesthetic therapeutic agent. The intervention adopts backriding as a technique, with the therapist mounted on horseback while supporting the client’s posture throughout the ride;
  • Therapeutic Horsemanship: comparable to Hippotherapy, with Therapeutic Horsemanship the client can be more involved in riding the horse. Above and beyond supporting sensory-perceptive and kinesthetic therapeutic functions, there is a further development in the horse’s motivating, relational and educational role. It becomes possible in this manner to use more equipment and aids that enrich interaction;
  • Adaptive Riding: With this the client actively participates in riding the horse, since the main purpose is assisting with social integration, encouraging client participation. Adaptive Riding allows the developing of the equestrian abilities of the rider, making possible the use of adjustable equipment to improve performance with activity.
Horse selection
Not all horses are fit for Therapeutic Horseback Riding, given the specifics of required conditions. The horse must be calm, gentle and reliable as well as consistent in manner. They are usually horses over 10 years old, with an ideal height of up to 1.5 meters and without much breadth in the posterior or structural adjustment. These attributes will allow for a comfortable, steady and tranquil ride. The horse must also not have a problem with weight and equipment.

Therapeutic Horsemanship riding Program clients have their development evaluated

The main therapeutic goals
Above and beyond all aspects already referred to, Therapeutic Horseback riding offers a variety of benefits to a person with Cerebral Palsy and related neurological conditions, principally improvement with posture, muscular expansion, improved dissociation and quality with movement, modulation of tone, walking pattern, muscle tone, joint stability, control of related reactions, improvement of sensory functions, boosted reasoning, psychomotor factors, improvement with communication, attention span, memory and interaction with others.

Therapeutic Horseback Riding Recipients
Aside from the almost countless benefits, Therapeutic Horseback riding is not fit for all medical conditions. Effectively, some conditions exist for which Therapeutic Horseback riding is contra-indicated, specifically:
  • Severe spinal column lesions, 
  • Hip displacement,
  • Atlanto-occipital instability, 
  • Diminished faculties, 
  • Presence of wounds & ulcers, 
  • Heart disease, 
  • Use of internal prostheses, 
  • Osteoporosis, 
  • Plaster casts, 
  • Allergies, 
  • Spurts of accelerated growth, 
  • Developmental stage of scoliosis, 
  • Edemas, 
  • Gravitation to sores, 
  • Uncontrolled epilepsy, 
  • Aggravated anxiety, 
  • Certain mental conditions, 
  • Other specific conditions.
On the other hand, Therapeutic Horseback riding can be a great stimulus with the following conditions, such as:
  • Cerebral Palsy, 
  • Vascular-encephalic accidents, 
  • Cranial-encephalic traumas, 
  • Sensory integration dysfunction, 
  • Pervasive developmental trouble, 
  • Down’s syndrome, 
  • Chemical dependence, 
  • Stress & depression, 
  • Amputation(s), 
  • Visual change, 
  • Learning difficulties, 
  • Behavioral problems, 
  • Communication problems, 
  • Feeding problems, 
  • Mental deficiency, 
  • Other conditions.
Features of sessions
Usually, a Therapeutic Horseback riding session comprises of the following elements and team: the horse, the client, a specialist who supervises the session, the lead and an attendant. Equipment can vary, depending on whether the session is in an enclosed riding-school, a semi-open riding-school or an open field. With regard to equipment used, this can mean steps, transference accessories and ramps that permit the given client to mount the horse consonant with his own mobility characteristics.

Examples of kinds of steps used to help mount the horse

With regard to the horseman, the equipment used is touch, trousers, boots, comfortable clothing (i.e. no creases, elastic pants being the norm) given that big sports jackets and lacings should be avoided. The horse’s apparel can be adjusted accordingly allowing for the aims of each session, making it possible to use a Portuguese saddle, an English saddle, an adapted saddle or a blanket, quilt and (cushion/pillow). The horse should also be equipped with a side-saddle and might also have an adjustable bridle, in case of specific client need. The equipment materials used are usually balls, hoops, cones, springs, pictures and toys.

Examples of training materials used
The start of a session is never just on top of the horse. There comes everything from the moment arrives at the riding-facilities. Adaption is a stage preparatory to mounting that helps with anticipation and regulating comportment. Touching, greeting, establishing a relationship with the horse is a very rich sensory and communication experience to start off the session.

Sequential progress of a Therapeutic Horseback riding session

Text: The technical information exposed is a result of a compilation based on the data elaborated by the APCB's therapists related to the Therapeutic Horseback Riding program.
ImagesAPCB thanks all its clients, families and workers for kindly allowing their personal image usage for the illustration of the services provided by the organization.
American Hippotherapy Association. (2012). Available in
Andrada, M. G. (1997). Paralisia Cerebral – O estado da arte no diagnóstico e intervenção. Medicina Física e de Reabilitação, 2: 15-20.
Andrada, M. G. (2003). Paralisia Cerebral – etiopatogenia/diagnóstico/intervenção. Arquivos de Fisiatria. 10: 5-16.
Wickert, H. (1999). O cavalo como instrumento cinesioterapêutico. I Congresso Brasileiro de Equoterapia – Coletânea de trabalhos. Associação Nacional de Equoterapia. Brasília, p.101, Nov. 1999.