DESCRIPTION
Hippotherapy is used to address functional limitations, impairments, and disabilities in individuals with neuromusculoskeletal dysfunction. Hippotherapy uses the movement of the horse to allow individuals to passively experience the motion of the horse. It is believed that the natural swaying motion of the horse induces a pelvic movement in the rider that stimulates human ambulation. The focal point of the therapy is to develop balance, body awareness, and muscle tone by responding and interacting passively to the horse's movement. Professional therapists use the movement of the horse as a treatment tool. The use of a horse as a treatment tool has been compared to other therapy tools such as balls, scooters, and swings.
Therapeutic horseback riding teaches individuals with physical or mental disabilities the skills and techniques required to ride a horse independently. In addition the goal is for the individual to develop a relationship with the horse while instilling a sense of responsibility and enhancing task concentration. The term hippotherapy and therapeutic riding are not synonymous. Professional therapists generally administer hippotherapy; therapeutic riding merely involves trained riding instructors.
POLICY
Hippotherapy for the treatment of conditions/diseases, including, but not limited to the following: neuromusculoskeletal dysfunction associated with cerebral palsy, cerebral vascular accident, developmental delay, Down syndrome, functional spinal curvature, learning or language disabilities, multiple sclerosis, sensory integrative dysfunction, and traumatic brain injury is considered investigational.
ADDITIONAL INFORMATION
Hippotherapy, used for decades in the treatment of children with cerebral palsy, has no supportive scientific research. No published studies are available addressing long-term efficacy.
SOURCES
American Hippotherapy Association Inc. (2007). Hippotherapy as a treatment strategy. Retrieved January 13, 2009 from http://www.americanhippotherapyassociation.org/.
Benda, W., McGibbion, N. H., & Grant, K. L. (2003). Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). Journal of Alternative and Complementary Medicine, 9 (6) 817-825. (Level 4 Evidence - Independent study)
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2008). Hippotherapy (8.03.12). Retrieved January 13, 2008 from BlueWeb. (9 articles and/or guidelines reviewed)
Cooley, W. C., & the Committee on Children With Disabilities. (2004). Providing a primary care medical home for children and youth with cerebral palsy. Pediatrics, 114 (4), 1106-1113.
Dodge, N. N. (2008). Cerebral palsy: Medical aspects. Pediatric Clinics of North America, 55 (5), 1189-1207.
Goldstein, M. (2004). The treatment of cerebral palsy: What we know, what we don't know. The Journal of Pediatrics, 145 (Suppl. 2), S42-S46.
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EFFECTIVE DATE |
3/12/2009 |
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ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
This document has been classified as public information.