One of the activities offered at The Specialized Children’s Home of Nor Kharberd is hippotherapy, which is a form of animal assisted therapy using horses. Hippotherapy is offered to the children at the home, and also to children from the local area who come with their families to take part in hippotherapy, making some days quite busy with quite a lively atmosphere with lots of children and their families. The staff who provide the hippotherapy were part of «Փայտե ձի» Հիպոթերապիա (Wooden Horse Hippotherapy), who worked with the horses. Maga, who ran the hippotherapy, also had her own horse which was stabled at Nor Kharberd, and was very experienced with horses. One of the staff who worked for Wooden Horse had previously lived at the home as a child, and had become adept at guiding the horses during the hippotherapy.

The therapists are licensed by an international licensing body, and the therapy was developed in conjunction with the University of Zurich. Hippotherapy has two major benefits for children. Firstly the act of riding the horse provides a slightly unstable, but comfortable platform, which promotes the development of core muscular strength, helping the children develop balance and coordination. Secondly, the children benefit from being able to socialize with the horses. Horses have evolved in close proximity with humans for a long time, and the horses used in hippotherapy have been specifically bred and trained to be calm and gentle, meaning children can stroke them and interact with them without upsetting the horses. This is similar to therapy dogs, which is another service which has been developed at the Specialized Children’s Home of Nor Kharberd.

The children are carefully given rides on the horses. While the children are being given rides, one of the staff guides the horse while another helps the child balance on the horse. Some of the children who used wheelchairs were carried on the horse by staff as well, which made the hippotherapy accessible to all the children. I did not guide the horses, I was told that this was a very skilled job that needed training, and good temperament with the horses, as well as the licensing. Horses are prey animals which have evolved in close proximity to humans for millennia, as a result careful guidance by human handlers helps to relax the horses, as they feel secure from predators in the presence of humans. However human handlers also have to be careful about the horse's temperament to avoid upsetting or startling the horses, which could be dangerous.

My job during the hippotherapy sessions was to hold the children on the horses. This was an interesting job, because there was a careful balance between making sure the children were safe and didn't fall off the horses, and letting the children balance themselves on the horses to get the benefit of the therapy. Not having a common language with most of the children, I had to pay close attention to read their body language to make sure they had the support they needed. Maya, the girl who I would feed, was very comfortable on the horse and wanted to hi-five me, as she often did other times when I was with her. The horses walked gently around the hippotherapy arena, while relaxing music played, which together made the activity quite relaxing.

While based at the hippotherapy I learned an important safety point about horses. I had only considered horses to be dangerous in terms of falling off the horses; however another important safety point is to not stand, or walk directly behind a horse. Horses can kick behind them with considerable force, so being behind them within their kicking range is very dangerous. Although these horses were tame and relaxed, this is still a hazard that should be avoided. I had to be reminded of this a couple of times, but I was told that the horses had a mild temperament and were unlikely to kick backwards in this manner so I was probably safe, but I should be careful around horses (including even these ones) for this reason!

I also observed horse care. Horses have veterinary needs taken care of by veterinarians, but some of their care was carried out by the hippotherapy staff. Horses hooves require cleaning and occasional filing. The hoof is made of keratin, which is the same material as nail, so this care is like trimming nails and is also why horseshoes can be attached, as the part of the foot that the horse walks on that the shoe is attached to is a fibrous material and not muscle like on a human foot. The horses respond to verbal instructions from the hippotherapy staff as they are trained to do and place their feet on a stool for care. Just like medical devices, it is important for the horses to be taken care of appropriately in order to ensure a safe clinical service, with the additional considerations that the horses are sentient beings whose welfare is important.

During downtime, I had a go at hippotherapy myself as a patient and it was an interesting experience, although I didn't find it particularly relaxing because I was worried about falling off the horse! Though after getting used to riding I began to feel comfortable on the horse and I could feel how the rhythmically undulating motion as the horse walked around the hippotherapy center, and I could feel my core working to keep me balanced. I’ve not had much experience horse riding before, but I found this a very enjoyable experience, and I could see how the children would benefit from it, enjoy the hippotherapy, and spending time around the horses.

Figure 1: Me having a go at hippotherapy. I haven’t had much experience in horse riding, so riding a horse therapeutically was quite an experience for me! But the horse was gentle, and guided carefully by the hippotherapists, so it was an enjoyable experience. I could feel how my core engaged to balance me on the horse and how it felt different to either walking, sitting or paddling a canoe.

From seeing the hippotherapy I learned about how complementary therapies can be used as part of patient care. Animal assisted therapy is one such approach that especially helps children with cognitive and social development. It was interesting to see how such therapies are used in practice, and how they combine with the medical care the children receive at the children’s home. It was interesting to see complementary therapies, as having a background in biochemistry I think in terms of treatment having a mechanistic basis based on chemistry, but that is not the only effective treatment model for all diseases, and I could see at the hippotherapy the benefits of animal assisted therapy in certain contexts.