This is Kentucky Derby week, the time each year when everyone is focused on horses that run fast for a living. So I thought I would write about horses whose job it is to walk slowly.
T-Ball and Wanda are hefty Norwegian Fjords who work at Central Kentucky Riding for Hope at the Kentucky Horse Park. They help heal the clients of Lisa Harris and Becky Johnson, two therapists at Cardinal Hill Rehabilitation Hospital.
It is called hippotherapy — hippo is Greek for horse — and it is a relatively new method of therapy that is struggling for recognition with the insurance companies and government agencies that pay most medical bills in America.
Hippotherapy is not the same as therapeutic riding. In hippotherapy, a patient sits or lies on a horse's back and does movements under the direction of a therapist as the horse is led around slowly by a handler and a side walker.
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"The horse's pelvis creates a movement that is very similar to our walking," said Harris, who has been on the board of the American Hippotherapy Association. "Its motion is our strategy."
The horse stimulates movement by the patient on its back. Hippotherapy helps many patients improve balance, flexibility and strength, especially in the neck, chest and abdomen. Core strength is important not only in helping patients walk, but in speech therapy, Harris said. The hippotherapy environment also can help improve sensory perception in children who struggle with it.
"It can be very helpful as part of a full treatment plan," Harris said. "We have seen some adults and kids who haven't walked before take their first steps, or haven't spoken before say their first words."
Harris has ridden horses since she was a child. Her mother, Nancy Herring, was the first executive director of Central Kentucky Riding for Hope, which since 1981 has offered other healing-related activities involving horses, including work with military veterans disabled while serving in Iraq and Afghanistan. (Her father is George Herring, a noted historian and author at the University of Kentucky.)
In addition to a master's degree in physical therapy, Harris has a master's in equine biomechanics and a bachelor's in animal science. So she naturally became interested in hippotherapy after it was introduced in this country from Germany and Austria in the 1990s.
Harris began offering hippotherapy in Lexington in 2002 after Cardinal Hill formed a partnership with Central Kentucky Riding for Hope, the state's only premium accredited therapeutic riding center. She and Johnson, an occupational therapist, use the methods with about 25 clients a week.
Many of Harris' clients are children. Hallie Adams, 7, of Paris, was born with cerebral palsy. Her mother, Ginger Adams, said the sessions have helped make her daughter much stronger. Once around Wanda, Hallie becomes more motivated to work her muscles.
"She's super engaged on the horse, so anything the therapists ask her to do, she will do," Adams said.
Carlos Taylor, 34, of Winchester, is using hippotherapy to help recover from a 2005 construction accident. He was helping to build a log house when scaffolding collapsed and injured his spine, causing him to lose feeling in his lower legs.
"I never thought I would get on a horse again," Taylor said with a laugh. He said he twice tried horseback riding before his injury and was thrown off both times.
Taylor receives several kinds of therapy, but he said that after he began hippotherapy last year, he quickly noticed improvement in core strength and muscle control.
"It has helped a lot," he said. "I never thought I would be where I am today."
The American Hippo therapy Association is trying to increase awareness of its methods so more insurance companies and other health care reimbursement agencies will pay for patients to get it.
"There's a lot of confusion out there about hippotherapy and how it is different from therapeutic riding, which is done by a riding instructor and not a therapist," Harris said.
She said about half the insurance companies in Kentucky will reimburse for hippotherapy, but unlike many other states, Medicare and Medicaid in Kentucky will not.
"This is the horse capital of the world," Harris said. "Not saying yes to this treatment strategy is kind of crazy."