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Hippotherapy (Therapeutic Horseback Riding)

Physical & MotorModerate Evidence

Uses the movement of a horse to improve posture, balance, coordination, strength, and sensory processing in a therapeutic setting.

What Is Hippotherapy?

Hippotherapy uses the rhythmic, three-dimensional movement of a horse as a therapeutic tool. The horse's walk produces movement patterns in the rider's pelvis that are similar to human walking, stimulating postural responses, balance reactions, and core strength.

Sessions are led by a physiotherapist, occupational therapist, or speech-language pathologist with specialized hippotherapy training. The therapist directs the horse's movement and the rider's position to target specific therapeutic goals.

Therapeutic riding programs may also offer adaptive riding lessons focused on horsemanship skills, social participation, and recreation. Both hippotherapy and adaptive riding have therapeutic benefits, but hippotherapy is specifically treatment-focused.

Who Benefits from Hippotherapy?

cerebral palsy

Improves trunk control, sitting balance, pelvic mobility, and overall posture. The horse's movement provides input that simulates typical walking patterns.

autism

Provides calming sensory input, improves body awareness, builds social engagement with the horse and handler, and increases motivation for therapeutic activities.

down syndrome

Strengthens core muscles, improves balance and coordination, and provides a motivating environment for developing postural control.

multiple sclerosis

Improves balance, core strength, and walking ability. The warm body of the horse and the rhythmic movement can reduce spasticity.

What to Expect in a Session

First Session

An assessment includes evaluation of physical abilities, safety considerations, and rider-horse matching. The therapist explains the program and sets individualized goals.

Ongoing Sessions

The rider sits on the horse while the therapist guides activities — reaching for objects, changing positions, catching/throwing balls — all while the horse walks. A trained horse handler leads the horse.

Your Child's Role

Your child sits on the horse and responds to its movement while engaging in therapeutic activities directed by the therapist. Many children find this highly motivating.

Caregiver's Role

Caregivers observe sessions and may be asked to assist with mounting/dismounting. You'll learn about how the horse's movement targets specific therapeutic goals.

Session length: 30-45 minutesFrequency: 1 time per week (seasonal — typically spring through fall)

When to Start

Early Childhood (0-5)

Children can begin hippotherapy as young as age 2-3, depending on their head and trunk control. The minimum requirement is sufficient head control to safely sit on a horse with support.

School Age (6-17)

Excellent age for hippotherapy as children are more engaged and can participate in more complex activities on horseback.

Adults (18+)

Adults benefit from hippotherapy for core strengthening, balance, and pain management. Therapeutic riding programs welcome riders of all ages.

General guidance: Hippotherapy works best as a supplement to regular physiotherapy or occupational therapy, not a replacement. It provides unique sensory and motor input that land-based therapy cannot replicate.

Typical Costs in Canada
ItemRangeDetails
Initial Assessment$100–$200Equine-assisted therapy intake assessment
Per Session$80–$12030-45 minutes
InsuranceRarely covered by private insurance; may be partially covered if provided by a registered PT or OT
Tax CreditMay qualify for METC if prescribed by a physician and delivered by a registered therapist

Money-Saving Tips

  • Many therapeutic riding centres are registered charities offering subsidized or bursary-funded sessions
  • Some organizations like CanTRA member centres offer financial assistance programs
  • Ask about volunteer-supported group sessions which are often more affordable
Provincial Funding Across Canada
ProvinceStatusProgramDetails
BCNot FundedNot covered by public programs; autism funding may be applied if delivered by a registered health professional.
ABLimitedFSCDMay be funded under FSCD if delivered by a registered physiotherapist or OT as part of a treatment plan.
SKNo data
MBNo data
ONNot FundedNot publicly funded; some families use Passport Program or OAP funding to cover costs at accredited centres.
QCNo data
NBNo data
NSNo data
PENo data
NLNo data
NTNo data
NUNo data
YTNo data

Evidence & Research

Moderate Evidence

Hippotherapy has moderate evidence supporting improvements in balance, posture, and gross motor function, particularly for cerebral palsy. A growing body of research also supports benefits for autism (social engagement, sensory processing) and multiple sclerosis (balance, walking). More large-scale studies are needed.

Red Flags to Watch For

Be cautious of any provider who:

  • The therapist is not a registered health professional (PT, OT, or SLP) with hippotherapy certification
  • Safety equipment (helmets) is not required or properly fitted
  • The horses are not specifically trained for therapeutic work and are unpredictable
  • There is no individualized treatment plan — everyone does the same activities regardless of needs
  • The facility does not have liability insurance or follow Canadian Therapeutic Riding Association (CanTRA) standards

How to Find a Provider

  1. 1

    Search the Canadian Therapeutic Riding Association (CanTRA) directory at cantra.ca for accredited centres

  2. 2

    Ask your physiotherapist or OT if they know of hippotherapy programs in your area

  3. 3

    Contact your local therapeutic riding centre to ask if they have therapist-led hippotherapy (not just adaptive riding)

  4. 4

    Check with your provincial disability organization for a list of therapeutic riding programs

  5. 5

    Ask other parents in your disability support network for recommendations

Conditions That Use Hippotherapy

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