Hippotherapy and Everyday Living: Enhancing ADLs

 In this episode, Gina  celebrates April as Occupational Therapy Month by delving into the Occupational Therapy Practice Framework (OTPF) and its application in the unique area of hippotherapy. She explores how hippotherapy promotes the development of activities of daily living (ADLs) and discuss the importance of utilizing equine movement as a therapeutic tool to achieve functional outcomes. Through real-life examples and insights, you learn the ways in which hippotherapy addresses core strength, sensory processing, motor planning, and sequencing—all essential components for enhancing independence in ADLs. This episode provides valuable guidance for occupational therapists seeking to integrate hippotherapy into their practice and effectively communicate its distinct value. 

Transcript

Microphone (3- Logitech USB Headset) & Integrated Camera 0:02

Welcome to our episode this week, we are. Going to be celebrating April as occupational therapy month. And I want to do a little series. Created by taking a deep look at the occupational therapy practice framework. And how we can apply it to the unique areas of practice that we're working in and the benefits that we can gain through using the OTPF to communicate our distinct value. So let's jump in together. Hi, welcome to another episode of animals and aquatics I'm Gina, your cohost and happy to be here with you today. If this is your first time listening. I'm glad to have you here. If you've been listening with us from the beginning. Welcome back. Today, we're going to be taking a look at how do you apply the occupational therapy practice framework to our areas of practice. And I really want to take a look at how we can look at ADL's, our bread and butter, when we're using hippotherapy, as a treatment tool. And I think that slowing down a little bit and really taking a distinct look at one area of practice. And like I said, ADL's are something that occupational therapists are known for. So I think. As a way of celebrating occupational therapy month. Stopping and looking at ADL's in-depth. And how using equine movement can really promote the development of ADL's is a great place to start. So April serves as an opportunity to shine a spotlight on everything that occupational therapy does. We have a chance to educate the public around us, our community and family members. We can look at policies and other healthcare professionals and let them know about what occupational therapy is and what we do such as promoting health, wellbeing, wellness and participation in daily life activities, especially those ADL's. The American occupational therapy association officially designated April as the occupational therapy month to coincide with the founding of the organization. AOTA was established on April 7th in 1917, making April a fitting month to celebrate our history. April is a time to celebrate the achievements and accomplishments of your practice. Occupational therapist, occupational therapy assistance. Our educators, researchers and students who we work with that are there to improve the lives of our clients, of our families and to celebrate all the unique things about occupational therapy. Today again. I said, I wanted to take a really important look at ADL specifically, right. Because a lot of times when other professionals think about occupational therapists, like. Other than where the hand people, which we're not, but that ADL's right. Is what we do. And I wanted to take a little bit of a look into ADL's and the occupational therapy practice framework. Now I'm using the OTPF 4. It defines activities of daily living or ADL's as essential tasks that individuals perform every day to take care of themselves and participate in their communities. So the ADL's that are outlined by OTPF 4 are bathing and showering. Toileting and toilet hygiene. Dressing. Eating and swallowing. Functional mobility. Personal hygiene and grooming and sexual activity. So just putting those out there as we get started with this so you have a reference point to think of when I'm talking about ADL's. Now I'm going to talk about a variety of different areas that we work in, but I'm going to focus on. hippotherapy, today. So let's also get a starting point with that. So according to the American hippotherapy, association or AHA. hippotherapy, is described as a physical occupational and speech language therapy treatment tool. That utilize his equine movement as part of an integrated intervention program to achieve functional outcomes. So, again, we're really focused on that outcome. Of our use of equine movement and not so much maybe what we're seeing within the session or any riding or horsemanship skills. That's not our focus really focused on the therapeutic effects of the horse's movement under the guidance of a skilled therapist. And that the therapist is assessing the client's needs and tailoring the interventions to address specific or discipline specific goals. That have a functional outcome, as well as incorporating hippotherapy, with other treatment tools within our practice. So when we think about. How might that interaction with equine movement or with the horse affect those ADL's that I had talked about or went through the list. Right. I went through the list of ADL's. So how might equine movement impact some of those ADL's? Well, we can think about it through a number of areas. We can look at. Core strength and stability now. And if we think about something like dressing, we need. A certain amount of core strength in order to be able to stand up and put a pair of pants on. Or sit at the edge of the bed in order to reach down and put socks on. So dressing, when we think about it from that core strength and stability. Side of things. There's a number of areas that we need to have enough stability. In order to manage our clothes, as well as the core strength piece. And so one of the things we think about when we think about hippotherapy, is addressing the core strength piece, and we can do that through grading, the equine movement, lengthening the stride. Shortening the stride. We also often introduce. Circles or Serpentini so that we're strengthening both sides of the body. And this has a direct impact on that ability to manage clothing. To obtain clothing. And to get dressed as independently as possible. Now we could also think about something like functional mobility. So this might sound a little bit PTs. Like moving one from one place to another. But we can also think about it as bed mobility transfers. So that is an area, right? We might all feel a little bit more comfortable in. And again, we need to have that core strength and stability, but we also need to have balance and coordination because in order to do a transfer, we need to be strong, but we also need to be able to coordinate our upper extremities, lower extremities. We need to be able to weight shift. And when we think about equine movement, there is a lot of opportunities to practice coordinating the body. To practice weight shifts. So if I'm choosing a school figure like a figure eight, doing a lot of weight shifts across midline, and often that's an area that our clients might need help with when they're doing a transfer. Another area that I certainly specialize in when I'm using equine movement. Is sensory processing and sensory integration. And when we think about. Sensory processing sensory integration. One of the ADL's that often there's two actually. The one that comes up to me is the personal hygiene and grooming. Feeding and eating. And personal hygiene there are so many sensory aspects to it. And a lot of our clients do struggle with the sensory aspects of feeding and eating. So being able to manage food in their mouth without pocketing. Or being able to have enough sensory input in the mouth to chew something completely, to form a bolus and swallow it, or being able to. Bring the food to the mouth. And get it into their mouth. So they need to have, um, enough tactile discrimination to manage that food. And on the personal hygiene and grooming side of things often, this is an area that can be very problematic for children that are sensory sensitive. So things like caring for their nails on their hands and their feet or brushing their hair. And. Brushing their teeth, right? Applying deodorant, as we get into our adolescents that we're working with, these can all be areas where hypersensitivity to sensory input can be really challenging. So we have the modulation piece, right? So we can be over-sensitive under sensitive, and we can see that with the personal hygiene and grooming. We can also see that in feeding and eating. So in the case that the client is having trouble, knowing what is in the mouth or I'm being really hypersensitive to it, but we can also see it in the discrimination side of things. So they just can't discriminate different textures. They have trouble discriminating where things are at in their mouth. So that could be food or that could also be something like brushing their teeth. So they have a hard time being able to brush all their teeth. Because they have trouble discriminating where the brush is within the mouth. And. As I make that description, you're like, okay. But what in the world does that have to do? With hippotherapy, and I think that's where a lot of times we kind of missed the boat. Or therapist have a harder time. Putting what they're doing together with sensory processing or sensory integration with equine movement, and then tying it back to those ADL's. And in this case, a a little aside here, the American hippotherapy, association, sensory connections course, we are working really hard to get that into a webinar format for you. So that's, a whole treatment course based on this. So if you're interested, let me know, reach out to me. That'll be a great motivator for me and my team to get that finished up. But in this aspect, It's important to look at. Are we treating a modulation issue or are we treating a discrimination issue? And we can work on both of those areas utilizing equine movement. We have lots of opportunities, both with the movement and also in the equine environment to address these sensory issues. And we often see the ability of the client to help with. Personal hygiene and grooming of the horse. Or feeding the horse that can help them overcome their own sensory sensitivities and challenges. The last part I want you to think through is the motor planning and sequencing needed for ADL's and whether that's dressing or bathing and showering. There's a lot of components that go into sequencing. And planning out how we're going to bathe and shower or. What do we need to do to use the toilet? So one of my children is beginning potty training right now. And just the sequencing of everything. In enough time not to have an accident, right. Is a big piece. And the motor planning of when you're little, how do you get up on a stool? And then turn around to sit down is really quite complex. So a lot of the kids that I work with have trouble with motor planning. They have trouble with sequencing. And when we think about dressing there's. A lot of components that go into both undressing and dressing in a sequential fashion. As well as then fasteners that go along with it. So. In all of these activities, right? There's a number of areas where motor planning and sequencing is really important. And if we want to look at. Some of the ways that we might address that. If we're doing our transfers on and off the horse. That's a great time to work on motor planning and sequencing because a lot of our clients that are really struggling with this will have trouble with that transition. And so thinking about is it ideational Praxis that they're having trouble with? Is it the sequencing piece? And that will depend on how we're going to break it down for them to help them be successful. And the more times they have to practice the skill and practice some novel motor planning. The really nice thing about the equine environment and that transfer on and off the horse is it is novel. And particularly if we're only seeing our clients. Once a week it's a novel experience pretty much every week. And sometimes we think of that often as like a downside that we're like, we're only able to see them once a week and they really do need a lot more practicing of the motor planning and the sequencing piece. But in this case, we can think of it as an asset because they're not planning this particular motor plan over and over and over again. And they have an opportunity to do some novel motor planning. We get to see, is there more fluidity? Are they able to start to link the sequence together? Do they have an idea of how to initiate the sequence for the transfer? And this is a great opportunity. We can do it. And static, that transfer of statically going from a static. Ramp platform. Stairs mounting block on to the horse. But we can also do some of those same transitions dynamically if the horse is moving. So that's another way to look at that. We've talked about equine movement and client positioning. So if we are doing. A transition from a forward sitting to side sitting, we have that opportunity again, to do the motor planning piece and sequencing. How am I going to move my body from this forward sitting position to a side sitting position. Once we're in that side sitting position, then we have a different weight shift right now. We're often weight shifting anterior posterior because the client is, is in a different position in relationship to equine movements. So very hard sometimes to explain this. In just words. And I'm used to either explaining it with my hands. And so thinking about, we've now changed the clients access and re. Access in relationship to the equine movement. And then we have the engagement in grooming and care activities with the horse, which I was just talking about as far as the sensory piece, but also. With the grooming and care of the horse, often there's motor planning components to that. And there's also sequencing to that. So those are all areas where it's really nice to be able to slow down a little bit, work on that motor planning and sequencing. To target specific ADL's and. It's really nice to have a real focus that we are working on. ADL's no. What we want to do and bring in as far as whether it's the transfers, the motor planning. In grooming or addressing sensory issues with horse care tasks or whether we're really just focused on that equine movement piece. But those are all ways that we can adapt. hippotherapy, or the equine environment for the individual client's needs. Now, when we're looking at goals, we're still setting our typical client goals. So maybe that the client can dress. Independently, what set up assistance. And we're then going to be targeting our interventions in how that will be done. So there may be a component of a home program. We might be doing some parent training. We're going to be incorporating sequencing. We're going to be incorporating the equine movement. Right? There's a lot of components that might be going into why that client is not currently able to dress. Independently, just with some setup assistance. So when we think about this, We need to have a plan in place for. Our assessment. Writing our goals. Designing our treatment plan. And then communicating all of this to. Other care providers to the client and family. And when we think about how we're going to put all that together. That's a big part of delivering effective occupational therapy services in a non-traditional environment. And one of the things I really like for looking at ADL's is the PEDI cat. So that's a assessment that looks at a number of areas. And one of the things I really like about it is it scaffolds the skills. And I can look when a parent fills it out, can be done as a parent interview. It can also be done in more independently by the parent. And when I look, I can see if there's missing skills or like what's the last skill that the client has left off as achieved. And what would be the next step that they would need to achieve. And so that w is usually one of the assessments that I'm going to use when I'm focused on ADL skill development. Then I'm working collaboratively with the family to develop the goals and often I'll use the COPM. So that's the Canadian occupational performance measure. And I will do that in an interview format with the parent. So that way we can go through what ADL's and goals are most important to them. Then I'm going back to my treatment planning phase and I want to know. All the tools that I'm going to use and bring in. For this particular client and I'm going to write that into the plan of care. And so it's going to say, occupational therapy plan of care includes, but it's not limited to, and maybe that's another area I'll address with this OTPF series because. I definitely use the OTPF to scaffold my evaluations and how I write up my evals and plan of care. So they incorporate that in there. And then I'm sharing that with the family so that they have an understanding of, where are the areas that their child is developing in? What are the goals that we've set together? And then what are the tools that I'm going to use to help us get there? Right. So we can go together. So, if you're interested in learning more about this, I definitely encourage you to go to the American hippotherapy associations website. You can find additional information there about courses about upcoming courses. Look up the occupational therapy practice framework. Again, I'm using version four. So if you would like to, you can look that up and download a copy. There are free PDFs out there. So if you want to follow along with what we're doing this month. Go ahead and download that. And if you're looking really for a clinical mentorship, certainly reach out to me. I run trailblazers quest and that's a clinical mentorship that really helps clinicians in unique practice areas put what they know as an occupational therapist into practice in their unique setting. So I'm really excited that you joined us today for one of our April as occupational therapy month episodes focused on the occupational therapy practice framework and applying it in a unique setting. This week, we focused on the value of hippotherapy, and occupational therapy practice to address ADL's. And as we get ready to wrap up, they hope that you'll leave us a review, subscribe and share our podcast with other OTs who are interested in animals or aquatics. Have a fantastic occupational therapy month.