Green Apple Hippotherapy, Iliza Muhammed Ikhbal, Founder, Dr Ali Azman Minhaj, Consultant Paediatrician, Irdiyana Idros, Occupational Therapist

Horses are not normally part of the Malaysian cultural landscape, but many of us have read or watched movies featuring these magnificent creatures. Anna Sewell’s Black Beauty and Michael Morpugo’s War Horse are just some that come to mind.

Malaysians may not be familiar with hippotherapy, or horse therapy, which utilises horses as a means to heal both the body and mind. They have an opportunity to discover more for themselves, however, at Green Apple Hippotherapy, the first and currently the only establishment in Malaysia to offer this therapy to children with physical, mental, emotional and social disabilities.

Understanding Hippotherapy

“Hippotherapy,” says consultant paediatrician Dr Ali Azman Minhaj, “is ‘treatment with the help of a horse’, with the ‘hippo’ in hippotherapy meaning ‘horse’ in Greek.”

Hippotherapy is widely recognised as a medical treatment. While the therapeutic benefits of horses had been recorded as early as around 400 BC (by the renowned Greek physician of those days, Hippocrates of Kos), today we see horses used by physical therapists to help patients with disorders affecting their nerves and muscles, such as cerebral palsy and brain injury. This has been practiced in Western countries since the 1960s, and it was only in the last 2 years that hippotherapy finally made its way to Malaysia.

But why use the horse? Why not use, say, the kerbau? Dr Ali Azman’s wife, Iliza Muhammed Ikhbal who is also the founder of Green Apple Hippotherapy, points out that it all lies in the horse’s unique gait. The horse’s gait helps to create movement patterns in the rider that are similar to that of a person walking. No equipment to date can create a similar effect.

“When a child – anybody, actually – sits on the horse,” Iliza explains, “the rhythmic movement of the horse stimulates the learning part of the brain.” The stimulation will lead to neurological changes that can help improve the rider’s posture, strength and coordination. Furthermore, the rider often has to adjust his or her posture while the horse moves, so the riding experience also becomes a rehabilitative activity to reinforce the rider’s efforts to gain better control and coordination over his or her muscles and movement.

Benefits of hippotherapy

Hippotherapy offers improvements in the following areas:

Physical areas

• Strength and control
• Balance, posture and coordination
• Understanding of visual cues
• Integration of senses
• For people with neuromuscular conditions, reduced abnormal muscle tone and better control of limbs.

Cognitive areas

• Improved gross motor skills
• Improved timing and response
• Improved speech and other self-expression abilities.

There are psychological benefits too. Occupational therapist Irdiyana Idros, who is trained to help autistic children as well as to conduct hippotherapy sessions, points out that children view hippotherapy sessions as fun horse-riding times, not a class or a session with the doctor.

Because hippotherapy sessions are fun, most young riders often open up during these sessions, thus improving their social and communication skills. Being able to ride a horse well can build up their confidence to try new things, and bonding with the horse can help them develop a sense of kindness and empathy for other living creatures.

Dr Ali adds that he has personally seen improvements in the behaviour and attention span of children who undergo hippotherapy. Considering the psychological benefits, that is not surprising at all!

Who will benefit from hippotherapy?

Everyone can benefit, says Iliza, but people with the following conditions may find it especially useful:

• Cerebral palsy
• Developmental delay
• Autism spectrum disorder/attention deficit hyperactive disorder
• Learning and/or linguistic disabilities
• Sensory processing disorder
• Down syndrome
• Cerebral (brain) atrophy
• Acquired or traumatic brain injury
• Epilepsy
• Dyspraxia

Green Apple Hippotherapy currently dedicates its resources to helping younger children, so they will be the focus of this article. However, bear in mind that hippotherapy can benefit people of all ages, including as the elderly who are looking for ways to keep their mind sharp.

What happens during a hippotherapy session?

Firstly, a team of paediatricians and therapists – in Green Apple Hippotherapy, that will be Dr Ali and his team comprising a speech therapist, a physiotherapist and an occupational therapist – would evaluate the child’s health and mental status, so that a suitable programme can be tailored to optimise the benefits the child can receive from these sessions. The type of activities and the number of sessions would depend on the result of this evaluation.

Irdiyana explains that a child will then be acquainted with the horse, which is usually picked by the staff as one that would be most compatible with the child (based on size, temperament, etc). The staff would teach the child how to approach and ride the horse.

Once the child and the horse are comfortable and familiar with one another, the session can begin in earnest. Each session typically lasts 30 minutes, and the child will carry out activities while still riding – supervised closely by the therapist and other staff members, of course – to improve coordination and other areas hampered by his or her condition.

Normally, parents can choose to watch by the sidelines, but they cannot enter the riding arena while a session is taking place.

The child will be assessed on his or her progress during the middle and end of the programme. These assessments allow the team to make any necessary adjustments, to ensure that the child is benefitting from these hippotherapy sessions as much as possible.

But is it safe?

Parents may harbour some concerns when it comes to trusting their child to a horse. Will the horse bite or kick? According to Illiza, Green Apple Hippotherapy has established a set of rules for both the parents and the child to ensure the child’s safety.

The child will only be allowed to approach, touch or ride a horse under the supervision of members of the staff.

Bridles and other safety equipment will be used to ensure greater proper control of the horse and prevent unwanted incidents.

The child must not carry any food on him or her.

Throughout the entire session, the child will be closely accompanied by the therapist and usually 2 other staff members.

How much does it cost?

Iliza can only speak for Green Apple Hippotherapy, of course. “A typical programme of 12 sessions and 3 assessments, plus registration, will cost about RM3,500 (for the entire package),” she says.

Interested parents can visit www.greenapplehippotherapy.com to learn more or to arrange for an appointment.

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