Spinal cord injury and equine therapy

Spasticity is known as an accompanying phenomenon of spinal cord injuries and was defined by Lance as an increased reflex activity, as well as a velocity-dependent increase in muscle tone elicited by passive stretching. Not every patient suffering from spasticity necessarily requires treatment. However, depending on the severity of spasticity it may interfere with activities of daily life. In the Stockholm spinal cord injury study, for example, more than 41% of subjects with spastic paralysis reported excessive spasticity associated with additional functional impairment and/or pain, and 2/3 of the subjects with spastic paralysis took medication to treat their spasticity. What other possibilities besides medication are there to reduce high muscle tone?

 

For several years hippotherapy has been used in rehabilitation of spinal cord injured patients (SCIs) and positive effects on spasticity have been reported. Unfortunately, only few studies assessing the effect of hippotherapy on spasticity have been conducted, and most of the existing literature is not in the English language. Studies that aim at explaining the mechanisms underlying the positive effect of hippotherapy on spasticity are even more scarce. Unlike therapeutic horseback riding, which teaches riding skills to individuals with disabilities, hippotherapy is a neurophysiological treatment that uses the movement of the horse. The hypothesis is that the rhythmical side flexion and extension of the patient's trunk combined with trunk torsion have a beneficial effect on spasticity. The working mechanism of hippotherapy on spasticity may be complex. According to neurophysiological standards, an inhibition of the spasticity is achieved through the saddle position in hip flexion – abduction – external rotation as well as through rhythmical and three-dimensional equine movements communicated to the patients' pelvis and trunk.A further impact on spasticity is also attributed to the psychosomatical effects. According to Strauss hippotherapy gains its unique effect through a neural facilitation, sensorimotor stimulation and psychosomatic influence.