New Hippotherapy Program Benefits Iowa Children with Disabilities (IA UCEDD)

December 31, 2014

Katie Jo Risma, a physical therapist at the Center for Disabilities and Development (CDD-Iowa's UCEDD) recently completed her first year of providing hippotherapy, serving seven Iowa children with physical disabilities ages 3-13 over the course of three six-week sessions. Hippotherapy is a technique which utilizes the dynamic movement of a horse to assist patients in reaching their therapy goals. It is a billable service under both public and private insurance.

Much of the program's success can be traced to a partnership which Risma and her Rehab Therapies colleagues developed with Miracles in Motion, a therapeutic equestrian center located in eastern Iowa. The partnership resulted in a contractual agreement between University of Iowa Hospitals and Clinics, CDD's administrative home, and Miracles in Motion. The patient-centered approach to matching children with horses illustrates how the partnership was operationalized. While Risma looked primarily at the horses' movement and thought about how each horse's movement (bouncy versus smooth) might impact her patient's ability to work on sitting balance, reaching, and other skills, Miracles in motion staff offered suggestions about the horses' temperament.

Miracles in Motion provides an environment conducive to incorporating physical therapy goals into programming without patients realizing that they are in therapy. While riding a horse on the sensory trail, for example, a patient may bend over to smell an herb or reach out to play a xylophone. While standing in the stirrups, patients develop postural control and improve balance.

Risma explains that the very nature and setting of hippotherapy lead to previously unattainable patient outcomes. The informal, outdoor setting away from clinic encourages children to relax. As children bond with their horse, they begin to take greater control of their therapy by issuing commands and setting goals. The children see a purpose to what they're doing and are therefore motivated to succeed-or, as Risma puts it, "blossom."

Risma explains that as with other CDD clinic-based treatment, the hippotherapy program operates on the World Health Organization's International Classification of Function (ICF) model, which shifts the paradigm from impairment to community participation. She points out that hippotherapy offers a unique opportunity because it is provided in a community-based setting which allows for easy transition to Miracles in Motion's more inclusive programs such as therapeutic riding and a camp scheduled for Summer 2015. Two of this year's seven program participants are already planning to participate in the therapeutic riding program next year.

For more information about CDD's hippotherapy program, contact Katie Jo Risma, To learn more about Miracles in Motion, visit