# Psychological aspects of hippotherapy for children with severe neurological impairment: An exploratory study

**Authors:** Karin Hediger, Marina Lunzenfichter, Eva Markzoll, Wanda Arnskötter, Martina Schaudek, Gerhard Kluger

PMC · DOI: 10.1371/journal.pone.0320238 · 2025-04-08

## TL;DR

Hippotherapy helps children with severe neurological issues by improving their psychological and social well-being, beyond just physical benefits.

## Contribution

This study explores hippotherapy's psychological and neuropsychological benefits in pediatric neurorehabilitation, going beyond physical outcomes.

## Key findings

- 66.4% of predefined therapeutic goals in hippotherapy sessions were achieved.
- Cognitive functions and social behavior were the most successfully addressed goals.
- 81% of sessions documented that patients had fun, indicating high engagement and motivation.

## Abstract

Neuropediatric hospitalization presents significant psychological challenges that affect quality of life, learning, and treatment adherence. Hippotherapy might address these factors, but its psychological effects are underexplored. This paper explores the psychological and neuropsychological potential of hippotherapy in pediatric neurorehabilitation. Objectives include analyzing (1) patient characteristics, (2) session characteristics, (3) patients’ psychological and neuropsychological reactions, and (4) therapists’ perceptions of the extent to which the therapeutic goals were realized in the sessions.

This retrospective explorative study examines data from 581 children and adolescents (M =  9.01 years, SD =  3.88) with severe neurological disorders who underwent hippotherapy. We used the registration form for each patient and session-documentation forms for each hippotherapy session. We extracted information regarding patient and session characteristics, performed a content analysis on the documented reactions of the patients and the predefined neuropsychosocial goals set by the rehabilitation team, and examined to what extent the goals were met during hippotherapy. The data were analyzed using descriptive statistics.

Patients received an average of 3.47 hippotherapy sessions. During hippotherapy, 66.4% of the predefined goals were reached; cognitive functions and social behavior were the most successfully achieved goals. The most frequently documented patient reaction was had fun (81% of all sessions).

Our study shows that hippotherapy is a feasible and beneficial treatment for neuropediatric patients with severe neurological impairments. The goals of hippotherapy can be much broader than the usually targeted physical functioning and mobility. Hippotherapy might be especially effective in promoting fun and motivation and in addressing patients’ socioemotional needs.

## Full-text entities

- **Diseases:** neurological disorders (MESH:D009461), neurological impairment (MESH:D009422)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC11978075/full.md

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Source: https://tomesphere.com/paper/PMC11978075