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Integrity: to always act with
principle
Excellence: to always strive
for improvement
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and our environment
Equality: to recognize the
best in everyone
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and each other
~ Heated indoor areana
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Frequently Asked Questions
3. How can hippotherapy facilitate change in a patient with low muscle tone?
Low muscle tone, also called hypotonus, refers to “decreased postural or muscle tone resulting in difficulty or inability to move, to sustain a posture against gravity, or to support functional movement”. The muscle quality is associated with limpness or a feeling of heaviness when the limb is moved and the head lags when lifted against gravity. There is a lack of joint stability, particularly through the midline, which limits dynamic postural stability and graded movement. Decreased sensory awareness contributes to a high threshold for pain.
Change can be facilitated in the hypotonic patient using the movement of the horse and physical therapy principles: First, head stability and proper alignment of the joints must be maintained at all times; these patients are at risk for injury due to a lack of ligament, muscle and tissue resistance toward the ends of range of motion. Weight bearing or joint compression can be used to increase joint co-contraction and improve proximal stability; rear facing on the horse will provide a broader base of support, where weight bearing can begin on the forearms and progress to extended arms as tone increases in the head, neck and upper trunk. A horse with a lot of lateral sway may not be appropriate for this patient, due to his or her insecure seat; however, a more concussive gait may provide stimulation through the pelvis needed to develop midline and upright control. There is usually difficulty with shifting weight; balance reactions and weight shifting can be facilitated once pelvic and trunk control have been established. Exercise to accomplish this would include reaching outside the base of support and graded movement tasks. External sensory input, including tapping or vibration, may be used to help activate muscles. Exercises such as placing and holding a limb against gravity, overlaid on the rhythmic movement of the horse will promote strength and joint stability. Gentle upward and downward transitions (from halt to walk, or walk to halt) can then be added to challenge the back extensors and abdominal muscles respectively. Finally, circles and schooling figures can be used to enhance lateral trunk balance reactions.
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