The Chartered Physiotherapists in Therapeutic Riding and Hippotherapy (CPTRH) is a profession network of the Chartered Society of Physiotherapy (CSP) in the United Kingdom. We are a small but committed group of Physiotherapists specialising in the use of the equine as a treatment modality.
The aim of CPTRH is to utilise and develop the professional skills of its members in the areas of Therapeutic Riding and Hippotherapy treatment and management (please see below for definitions of these terms).
- To provide support and information to members within their working environment.
- To promote and take responsibility for delivering a post-registration course of study, to enable Physiotherapists to work with clients with a range of physical and learning difficulties, through the practice of Hippotherapy and Therapeutic Riding.
- To promote and support research and continuing development within Hippotherapy and Therapeutic Riding.
- To define and promote the highest standards of practice amongst Chartered Physiotherapists in Hippotherapy and Therapeutic Riding.
- To liaise with other organisations which use the equine for riders with physical and learning difficulties including ‘Riding for the Disabled Association’ (RDA), and ‘The Federation of Horses through Education and Training International’ (HETI).
- To develop public and inter – professional awareness of the scope of Hippotherapy and Therapeutic Riding.
A Brief History
CPTRH has evolved over forty years, having been instigated in 1970 by Miss Stella Saywell (FCSP) as “The Chartered Society of Physiotherapy Special Interest Section, Riding for the Disabled” (CSPSISRD). This group was established to provide support and training for Physiotherapists working within this area whilst also recognising the relationship with RDA.
In 1989 the group became a Clinical Interest Group (CIG) of the CSP and had a change of name to “The Association of Chartered Physiotherapists in Riding for the Disabled” (ACPRD).
In 1998 the name was changed to “The Association of Chartered Physiotherapists in Therapeutic Riding” (ACPTR). The change was a reflection of the increased use of the horse as a therapeutic modality and also to encourage Physiotherapists not working within RDA to join the CIG.
In 2012, ACPTR gained Conditional Recognition as a Professional Network (PN) of the CSP and in 2016 our name changed again to Chartered Physiotherapists in Therapeutic Riding and Hippotherapy (CPTRH).
Members of CPTRH utilise the horse as a therapeutic modality within the scope of Therapeutic Riding and Hippotherapy (please see below for definitions of these terms).
Our members have experience of working with adults and children associated with various clinical specialities including but not limited to Learning Disability, Neurology, Mental Health, and Amputees.
Members of CPTRH are given the opportunity to undertake further training specific to Therapeutic Riding and Hippotherapy, and are supported to become fully competent in assessing a client in relation to the treatment and care pathway using the horse in a variety of situations.
1. Therapeutic Riding:
Often undertaken under the auspices of the charity ‘Riding for the Disabled Association’ (RDA), Therapeutic Riding is mainly conducted in a group setting, led by a Riding Instructor and assisted by a Physiotherapist. Working closely together they will use the equine’s movement with the active riding component of the lesson to stimulate the desired responses in a rider. Having initially assessed the rider, the Physiotherapist can further assist with the riding sessions by advising on manual handling issues, optimal mounting/dismounting techniques and riding session content (such as individually tailored exercises and stretches). Different school movements (e.g. straight lines, circles, serpentines) and changes of pace (e.g. walk, halt, trot) can be incorporated into a session to further challenge a rider.
Whilst there are undoubted physical benefits to be had from Therapeutic Riding, it also has strong and positive recreational and psychological elements.
Hippotherapy is a form of physiotherapy treatment which utilises the horse’s movement to achieve the desired responses in a client. It is undertaken by Chartered Physiotherapists who have completed further in-depth post-registration training , and who are fully insured to work within their extended Scope of Practice.
Hippotherapy utilizes the movement generated by the walking equine to replicate the sensory input/motor output of the human pelvis during active walking. The goal is not to teach horse-riding skills, but rather to use the horse as a dynamic base of support upon which the client learns to control and co-ordinate their responses. The Physiotherapist can position the client on the horse in a variety of positions (e.g. astride facing forwards or backwards; sideways sitting; lying supine or prone; kneeling etc.) and the Physiotherapist can apply neuro-developmental and sensory integration techniques to help develop balance and postural reactions.
The Physiotherapist directs and is responsible for a highly trained team: the equine will have been carefully assessed and selected for its temperament and individual movement quality; a horse handler under the Physiotherapist’s guidance will control the speed and direction of the equine; a side walker will walk alongside the client to assist/support as required.
Often specialist equipment will be chosen by the Physiotherapist to maximise the transfer of the horse’s movement and warmth to the client e.g. a soft sheepskin sitting pad will be used in the place of a traditional saddle.
Hippotherapy can benefit many client groups, but children with Cerebral Palsy are a significant group, and benefits such as improvements in gross motor function and enhanced head and trunk control have, in small studies, been shown to occur. Hippotherapy has also been seen to have had positive benefit for people living with Multiple Sclerosis.
Backriding can be undertaken by a Chartered Physiotherapist who has undertaken specialist training and who has been deemed competent to practise this technique.
A client with poor postural/head control may, after assessment, be considered suitable for backriding whereby the Physiotherapist will sit behind the client on the horse and combine the equine’s movement together with facilitation techniques to encourage and develop better postural control. The Physiotherapist will be drawing on her neuro-developmental skills, and she will possess a high degree of horse riding skill.
4. Therapeutic Vaulting:
Vaulting can be defined as ‘gymnastics upon a moving horse’.
By adapting traditional vaulting principles and making goals participant specific, therapeutic vaulting can be used to great effect within physiotherapy treatment programmes. Vaulting is a multi-sensory activity, and it provides many opportunities for a participant to experience, observe, and react. Vaulting can be incorporated both on the ground (rhythm work/warm up) or mounted (using a static barrel or moving horse).