Hippotherapy and Hand Activities

Special thanks to  Maria Hurley at Divinity Farm and Toby Freeman at Horse Talk   and  Jane-Anne Khalid at Miracles-Sudan for permission to use photos. 


Information on this website should not be construed as medical or therapy advice and is provided only as general information. Please consult your physician and other health professionals for specific advice.
All ideas reflect the creative spirit of the author, Barbara Smith OTR/L and bear no relationship to her current employer. 
Hippotherapy should only be performed by trained and  registered occupational, physical and speech therapists.

Hippotherapy is a treatment tool used to improve strength, postural control, balance and motor planning skills. Riding a horse provides powerful sensory stimulation that effects attention, emotions, language and motor skills.

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Hippotherapy Blog- for therapists, instructors, families, riders and others interested in promoting skills using the horse as a treatment tool. Share your stories and expertise.

Hippotherapy also promotes hand skills

hippotherapy potato head
Photo is property of Horsetalk  and may not be used without permission
Activities such as inserting parts into Mr. Potato Head or connecting pop-it-beads develop hand strength, motor planning and bilateral coordination.

hippotherapy cat toy
Ring stacks develop eye-hand coordination and visual attention. This cat toy with a squeaky mouse is light and easy to hold.

hippotherapy wandStabilizing the toy while placing rings challenges eye-hand coordination and motor planning. This "Princess Wand" vibrates, makes sounds and has flashing lights- making a simple ring stack activity more fun.

hippotherapy fishing

Reaching for toys challenges balance and coordination. This boy is using a magnet wand to reach for a plastic fish with paper clip attached.

hippotherapy trunk rotation
Positioning this ring stack behind the child promotes trunk rotation and visual attention. The ring stack is attached to a door snake used to stop drafts.

hippotherapy objects in basket

A child can reach into a basket to retrieve puzzle pieces. The basket is  attached with a shower clip to the handle.

hippotherapy sword
This  child demonstrates good skills to stabilize the toy sword while reaching to insert plastic rectangular shapes. Positioning the shapes to fit over the sword develops visual perceptual skills.

hippotherapy side sit with toyFacing sideways on the horse provides different sensory stimulation and works the lateral trunk muscles. Playing with this toy is helping this girl rotate her trunk and use both hands together.

hippotherapy velcro bottleRemoving toys attached with velcro from a bottle is very motivating and promotes using both hands together. Children develop eye-hand coordination as they insert them into the enlarged opening on top.

Target Activities

hippotherapy outdoors
Throwing into a basket or playing catch challenges balance and eye-hand coordination.

hippotherapy basket ballChildren can stand with feet supported in stirrups while reaching for a ball held high up. This large folding laundry basket makes it easy to roll the ball into the container.

hippotherapy hoopsShown here is one of the many types of target and toss activities that can be performed while sitting on a horse.

hippotherapy hoops on cone
Hoops can be tossed over cones while the child is different positions such as facing backwards or while over the horse's barrel in prone (on the belly). This activity promotes strong neck, shoulders and arms, bilateral grasping and visual attention.

hippotherapy ring stack
Large ring stacks placed on the ground also develop eye-hand coordination while reaching out of the base of support.

©2008 Barbara Smith           







Some photographs have been altered to protect the
identify of children and facilities

Grasping the handle or reins promotes bilateral hand use
and toleration for touch

hippotherapy grasping handleHandles varies in size and are chosen
according to how much support
the child needs.

This large handle gives much support.

hippotherapy circingle
This circingle has right and left handles.
It promotes
using both hands together.

Photo is property of Horsetalk  and may not be
used without permission

hippotherapy natural rideThe smaller handle on the natural ride provides
less support. It is easier for the rider to bring
her leg over this smaller handle during position

hippotherapy hands on reinsGrasping reins is more challenging since
they do not provide support as a handle

hippotherapy barebackRiders can also work on balance by
using pads that have only a strap to hold
or riding bareback. The rider can grasp
the mane for some support, but needs to
use the trunk and leg muscles to remain
centered with good postural control. The

warmth of the horse's body and greater tactile (touch) stimulation
provided by bareback riding can make it very enjoyable and therapeutic.

hippotherapy barbara smith
Prone on the belly over the horse's barrel provides
a different sensory experience while strengthening
the neck, shoulders and arm muscles. Providng a
large ring promotes bilateral hand use as he engages
in the eye hand coordination task of tossing the ring
over a bucket.

Children develop motor planning skills as they pull the
reins to turn left or right.

hippotherapy steering reins
I teach the children to pull the reins to stop
at junctions and then we discuss which
direction they would like to go. Weaving around
cones provides another opportunity to steer the
reins and learn the association between pulling
to turn in the same direction.
Controlling the
reins to steer also encourages crossing midline
and discriminating left and right.




hippotherapy lacing board
After riding for 10-15 minutes children are often
more focused and ready for a challenging fine-motor
activity such a lacing board.

This lacing board is made from cardboard with a picture of a horse
attached with clear contact paper. Four large wholes were cut for lacing.

hippotherapy closing zipper
This girl is opening a zipper to remove
sunglasses from a case. She likes helping
her therapist get her sunglasses.

hippotherapy scratch ballThis Velcro Scratch ball is placed inside
a mesh bag and attached with string to the mitt.
Children with difficulty grasping can simply
pull the ball off the mitt. This adapted hand activity
can be use to motivate the rider to reach in
different directions and heights.

hippotherapy towel
A towel is placed across the horse's rump.
It has pockets sewn to each side to insert
or remove objects.

hippotherapy opening buttons
This child is opening "button squares". These
are made by sewing a large piece of plastic
(with punched holes) to a blue square cloth.
The red square cloth has a button hole cut.
Tape is attached to the button hole to prevent
unraveling. This child will open the squares, place the red square
in the red pocket and the blue square in the blue pocket. He can
do this while the horse is moving.

hippotherapy buttons
Close up of button squares
The red and blue halves can be opened
and sorted by color.

hippotherapy folding basket
Folding and opening the basket used for
insertions tasks is a great motor planning

hippotherapy hanging up horse strap
Children can work on fine-motor skills by
performing horse related tasks while
the horse. In this picture a girl is hanging
up the horse's neck strap on a hook. 
Children may be able to clip or unclip the
reins, brush the horse, put away toys and
hang up the gait belt and helmet,

Lotto cards are attached with velcro to a
board. Children pull them off and insert them
into the can. This activity encourages reaching
out of the base of support, language as children
name the pictures and motor planning to fit
the card into the slit.

hippotherapy vibrating canMany tasks can be made more exciting by
making them motorized. In this case the
brush from an electric toothbrush was
removed and inserted inside the can. The
sound and slight vibration holds children's
attention. Squiggly writer pens with the
points removed also work well.  These

can be inserted into the "Velcro bottle" shown at left and
inside ring stacks.

hipotherapy red conesCones or other fine-motor toys can be
hidden in the arena so that children
need to say "whoa", pull the reins or
indicate in a different way that they
want to stop the horse to retreive
the toy.

Pictures and puzzles can be used for communication and visual
discrimination activities.

hippotherapy puzzle animals
Puzzles than have pictures in the board
are ideal so that children know what
to look for as they scan the arena looking
for the needed puzzle piece.

hippotherapy puzzleCompleting a puzzle or peg board develops
eye-hand coordination. This is most easily
done while the child sits facing backwards.
The puzzle pieces are attached to the box
lid with Velcro so that children can reach
and balance while pulling them off.

hippotherapy animal board
This activity involves removing the named animal
picture (attached with velcro) or matching it to
the picture on the board.

hippotherapy photo bookA child chooses an animal and then finds
the matching picture hanging on the wall in
the arena. The child might be asked to make
the horse stop in front of the picture, reach
up high to grasp it or simply make the
corresponding animal sound when passing

the picture. These activities teach the child to attend, scan the room,
identify matching pictures and follow multi-step directions.

Occupational therapists may use picture cards to provide directions
or ask the child to point to or remove a picture to choose an activity
such brushing the horse, playing with toys, going outside or trotting.

hippotherapy brushing horse small hippotherapy toys small  hippotherapy outdoors small  hippotherapy trotting horse