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THERAPEUTIC USE OF THE HORSE IN HEALTH CARE SETTINGS

Barbara T. Engel, MEd, OTR

 

"The rhythmic movement of the horse's back, together with the physical contact and the motivation created through use of a living exercise apparatus, meets all the requirements of modem kinesitherapy techniques: increased flow of impulses from the periphery through proprioceptive, tactile, and vestibular stimulation; and improved activation of the voluntary motor control loop (periphery-cerebellum-parietallobe-frontallobe-periphery" (Riede, 1988, ie.).

 

As early as the 1500's, physicians found that riding was beneficial to health. The Greeks used horseback riding with people who were found to have incurable problems in order to improve their spirits. In 1750, Francisco Fuller, in the first sports medicine text, mentioned equitation and its implications for maintenance of physical exercise and the effects it has on the mind and body.

Benefits which have been attributed to riding during the 1600-1800's are stimulation of the digestive system, alleviating gout, relieving tuberculosis, influencing body metabolism, increasing strength in weak bodies, helping psychological problems, improving general wellness of body and soul. Riders who were seriously injured were reported as making remarkable recoveries after they began to ride again; also in helping to relieve their psychological stress. The movement of the horse at a walking gait and the resulting swinging motions of its back are transferred to the rider; these actions closely approximate the same movement impulses or sequences that occur when a person walks normally.

The current use of the horse in medical care has developed since the late 1950's, mainly by German physicians and therapists. Renaud began using riding to rehabilitate patients. Clients involved in rehabilitation have included those with such disorders as multiple sclerosis, closed head injuries, orthopedic disorders, cerebral palsy, behavioral disorders and developmental disabilities. In the late 1970's, a few therapists, including physical therapist Barbara Glasow, who studied hippotherapy in Germany, began to spearhead the development of hippotherapy in the United States. International Congresses for Therapeutic Riding began in 1964 in Paris, France; 1976 in Basle, Switzerland; 1979 in Warwick, England; 1982 in Hamburg, Germany; 1985 in Milan, Italy; 1988 in Toronto, Canada; and 1991 in Aarhus, Denmark. These Congresses have been especially helpful in the exchange of information leading toward the development of the treatment applications of the horse.

Heipertz points out that the type, degree and quality of the horse's movement are important since these movements provide the therapeutic effects sought for the rider. In addition, the facilities where activities occur must be appropriate for treatment purposes. A third essential element is a therapy team of qualified specialists. The treatment team consists of a therapist who is well trained in equine-assisted therapeutic methods and in the theory of Hippotherapy, a skilled riding instructor who influences the horse's movements at the first/second level dressage maneuvers, and trained support assistants or helpers. The use of the horse for therapeutic purposes combines the ability to produce specific movement in the horse with traditional therapy techniques used by physical therapists, occupational therapists, speech pathologists, and other health care practitioners.

 

Vocabulary notes

 

kinesitherapy techniques –методика кинезитерапии

(двигательной терапии)

voluntary –добровольный

beneficial –благотворный, благожелательный, целебный,

целительный, выгодный, полезный,

прибыльный

incurable –неискоренимый, неизлечимый, безнадежный

equitation –верховая езда, искусство верховой езды

maintenance –поддержание, сохранение

digestive system –пищеварительная система

alleviate –облегчать (боль, страдания),

gout –подагра

injure –ранить, ушибить, повредить; рана

recovery –восстановление, выздоровление, исправление,

перерождение

relieve –облегчать, уменьшать (боль), освобождать,

успокаивать

swinging motions –покачивающиеся (раскачивающиеся)

движения

sequence –последовательность, ряд, очередность, порядок

spearhead –возглавлять

dressage – объездка лошадей; выездка (дрессаж)

 

11.4 Comprehension questions:

1. When did the Greeks use horseback riding with people having incurable problems.

2. When was the horse first used in medical care?

3. Who should the treatment team consist of?

4. What are the methods of treating in the theory of Hippotherapy?

 

11.5 Use the expressions in the sentences of your own on the base of the text and use them in the retelling of the text:

Incurable problems; point out; multiple sclerosis; approximate; closed head injuries, orthopedic disorders, cerebral palsy, behavioral disorders and developmental disabilities; provide the therapeutic effects; essential element; trained helpers.

Make a summary of Text 1 in English of 250-300 words in written form.

Text 2

DEFINING STRATEGIES FOR REMEDIATION IN REHABILITATION

11.7 Read the text and write the annotation to it (all in all 5-8 sentences).

Affolter Method

Dr. Felicie Affolter, a Swiss language pathologist, has developed a treatment approach involving Guiding as a Perceptual Cognitive Approach to functional development of persons with motor disorders. This approach is based on Piagetian theories of development. It assumes that perception is a prerequisite for interaction, tactile-kinesthetic information is necessary for interaction to occur and interaction is always goal-directed. The technique, as described by Affolter, requires a hands-on approach in which the therapist assists the client in performing a task. The therapist puts her arms and hands over the client's arms and hands and guides the client through the performance of a task. The client learns to register sensation of touch and movement in the process of performing the task.

Alexander Method

Gerda Alexander, a German, calls her method Eutony. "Eu" in Greek means “good, well, harmonious”, and "tomis" means “tension”. This method involves focusing on the unity of the total person. It increases one's awareness of his bodily systems and influences the way he functions.

Conductive Education System

This is a method of learning called "rhythmic intention". In it, each task to be learned is broken down into component parts; each part is practiced separately until success is reached. Rhythmic intent as a method of learning claims to involve the client's motor, linguistic, perceptual and cognitive abilities. When several clients are working together, the group provides further motivation.

Cranio-Sacral Therapy

It involves the understanding of the cranio-sacral system and the specific techniques used by those who have been trained in this method. This modality is used with persons with neuromuscular dysfunction and helps to identify and reduce accumulated pain and stress, calm down the autonomic system, lower blood pressure and fevers, remove transient and minor restrictions, relax muscles, improve fluid exchange and blood flow, lengthen the spine, and promote general relaxation and a balancing of the body system.

Feldenkrais Method

The Feldenkrais method is an educational, neuromuscular approach to improve function. It strives toward ease of movement and improved coordination. This is accomplished through increased awareness, sensitivity and coordination. The entire sensory-motor system is involved in order to unravel habitual patterns and replace them with better motor function through changing the person's perception of movement.

Feldenkrais Awareness through Movement is based on several concepts: that one needs to learn at one's own rate, that movement is the vehicle for learning and that one need to have alternative ways of moving. Learning must be pleasurable and it must be easy. These two elements increase relaxed breathing. He felt that emphasis should be on the action of learning the movement, not the goal to be obtained; one needs to be aware of the learning process.

Handling Techniques

Any hands-on technique, which can be used to manipulate the posture or limbs of a client for therapeutic reasons, is called a "handling technique." Facilitatory techniques are special handling techniques used by the therapist to increase the ease in carrying out a functional action or to inhibit neural responses. They assist the client by enhancing function. Handling techniques are used by caregivers and therapists to handle a person at key points in such a way as to maintain normal or near normal posture and are used when moving a person from one position to another. Inhibitory techniques are also handling techniques which inhibit (restrain or interfere with) an action or a process. Therapists use inhibitory techniques to reduce spasticity, or to relax or slow down undesirable actions.

Holistic Treatment

Holistic refers to treatment of the whole or consideration of all functional aspects of a person. Holistic treatment deals with all aspects of a person's function and dysfunction and usually encompasses many different approaches.

Myofacial Release

Myofacial release relates to the fascia of the body. The facial is a three-dimensional connective tissue, which runs from thehead to the foot throughout the body. Its purpose is to support structures by holding tissues together as well as separating structures so that they can move without friction. Myofacial Release is the lengthening of superficial and deep body tissue through' a gentle and sustained stretch.

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