BlueCross BlueShield of Tennessee Medical Policy Manual

Hippotherapy

DESCRIPTION

Hippotherapy, also referred to as equine movement therapy, describes a treatment strategy that uses equine movement to engage sensory, neuromotor and cognitive systems to achieve functional outcomes.  Hippotherapy has been proposed as a type of therapy for individuals with impaired walking or balance.

Hippotherapy uses the movement of the horse to allow individuals to passively experience the motion of the horse. The natural swaying motion of the horse purportedly induces a pelvic movement in the rider that stimulates human ambulation and develops balance, body awareness and muscle tone. Professional therapists compare hippotherapy to other therapy tools such as balls, scooters, and swings.

POLICY 

IMPORTANT REMINDERS  

ADDITIONAL INFORMATION    

Literature on hippotherapy is limited, consisting primarily of small uncontrolled case series, and anecdotal evidence. It is not known if hippotherapy has clinically significant treatment impact. No published studies are available addressing long-term efficacy.

SOURCES  

BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2016). Hippotherapy (8.03.12). Retrieved April 17, 2017 from BlueWeb. (20 articles and/or guidelines reviewed)

Champagne, D. Corriveau, H. and Dugas, C. (2017, February) Effect of hippotherapy on motor proficiency and function in children with cerebral palsy who walk. Physical & Occupational Therapy in Pediatrics. 2017 Feb; 37(1):51-63. Abstract retrieved April 17, 2017 from PubMed database.

Kim, S., & Lee, C. (2014). The effects of hippotherapy on elderly persons’ static balance and gait. Journal of Physical Therapy Science, 26. 25-27. (Level 3 evidence)

Kwon, J., Chang, H., Yi, S., Lee, J., Shin, H., & Kim, Y. (2015). Effect of hippotherapy on gross motor function in children with cerebral palsy: a randomized controlled trial. Journal of Alternative & Complementary Medicine, 21 (1), 15-21. Abstract retrieved July 19, 2016 from PubMed database.

Lee, C., Kim, S., & Yong, M. (2014). Effects of hippotherapy on recovery of gait and balance ability in patients with stroke. Journal of Physical Therapy Science, 26, 309-311. (Level 3 evidence)

Lindroth, J., Sullivan, J., & Silkwood-Sherer, D. (2015). Does hippotherapy affect use of sensory information for balance in people with multiple sclerosis? Physiotherapy Theory and Practice, 31 (8), 575-581. Abstract retrieved July 20, 2016 from PubMed database.

Rigby, B., & Grandjean, P. (2016). The efficacy of equine-assisted activities and therapies on improving physical function. Journal of Alternative & Complementary Medicine, 22 (1), 9-24. Abstract retrieved July 20, 2016 from PubMed database.

Rigby, B., Gloeckner, A,, Sessums, S., Lanning, B., and Grandjean, P. (2017, March) Changes in cardiorespiratory responses and kinematics with hippotherapy in youth with and without cerebral palsy. Research Quarterly: Exercise & Sport. 2017 Mar; 88(1):26-35. Abstract retrieved April 17, 2017.

Sunwoo, H., Chang, W., Yi Kwon, J., Kim, T., Young Lee, J., & Kim, Y. (2012). Hippotherapy in adult patients with chronic brain disorders: a pilot study. Annals of Rehabilitation Medicine, 36 (6), 756-761. (Level 4 evidence)

Tseng, S., Chen, H., & Tam, K. (2013). Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy. Disability and Rehabilitation, 35 (2), 89-99. Abstract retrieved July 19, 2016 from PubMed database.

Zadnikar, M., & Kastrin, A. (2011). Effects of hippotherapy and therapeutic horseback riding on posture control or balance in children with cerebral palsy: a meta-analysis. Developmental Medicine & Child Neurology, 53 (8), 684-691. (Level 2 evidence)

ORIGINAL EFFECTIVE DATE:  9/11/2005

MOST RECENT REVIEW DATE:  6/8/2017

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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.

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