Occupational Therapy as Hippotherapy

What is Hippotherapy?

Hippotherapy, according to the American Hippotherapy Association (AHA, Inc.), “refers to how occupational therapy, physical therapy, and speech-language pathology professionals use evidence-based practice and clinical reasoning in the purposeful manipulation of equine movements to engage sensory, neuromotor, and cognitive systems to achieve functional outcomes. In conjunction with the affordances of the equine movement and other treatment strategies, hippotherapy is part of a patient’s integrated plan of care.” 

Why a horse?

A horse’s movement promotes active responses in the client which are intended to impact function. The horse provides multi-modal sensorimotor experiences that are precise, rhythmic, and repetitive, all of which are necessary for most human behavior. 

The horse lends an organized nervous system which allows a client to experience organized multidimensional movement and multisensory input. The horse’s movement provides a repetitive, predictable, and symmetrical dynamic surface on which the patient can develop and practice functional postural control and balance. The horse provides multi-dimensional movement through space, which provides opportunities to experience visual flow and vestibular input within a functional context. 

For most clients, the experience of the horse’s movement is a novel one, allowing for development of movement strategies outside of the habitual patterns. The natural variability of the equine environment is functional and promotes problem solving. 


Medical Precautions:

Hippotherapy inherently involves movement and establishes a human-animal interaction. Therefore, hippotherapy may not be an appropriate treatment strategy for all clients. Please consult with your therapist and physician.


Who Can Benefit?

Hippotherapy is a treatment strategy that is meaningful and can be functionally relevant, specifically addressing impairments in tone, range of motion, timing, attention, arousal, coordination, balance, and postural control. Individuals with a wide variety of disabilities and diagnoses can benefit from the integration of hippotherapy into their current plan of care, along with other therapy tools and/or strategies.

The horse and the equine environment is motivational and encourages the development of relationships while enhancing mobility (AHA Inc). 

Arousal and attention

Mobility of pelvis, spine, and hip joints

Sensorimotor integration


Balance strategies

Muscle strength

Bilateral integration

Neuromotor function

Body awareness

Oral motor function



Dynamic postural stability

Problem solving movement strategies


Respiratory function

Expressive receptive speech and language

Symmetry and alignment

Midline orientation

Timing and motor coordination

Self confidence

Mary Nestor, OTD, OTR/L

Mary is a licensed occupational therapist who is passionate about helping clients achieve functional goals and outcomes utilizing a variety of treatment strategies. 

Mary earned her Doctorate of Occupational Therapy from Belmont University in Nashville, TN. While in Nashville, Mary discovered her interest and passion for hippotherapy when completing her doctoral capstone developing programs for a therapeutic riding and therapy program.  

Mary has experience working with children and adults in a variety of settings. Mary has specialized training in hippotherapy through the American Hippotherapy Association and in evaluating and treating children with Sensory Processing Disorders through the STAR Institute for Sensory Processing Disorder in Denver, Colorado. 

In her free time, you can find Mary hiking, kayaking, reading, cheering on the Kansas City Chiefs, and spending time with family, friends, and pets.