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Laurance Johnston, Ph.D.

Sponsor: Institute of Spinal Cord Injury, Iceland



1) Hippotherapy & Therapeutic Horseback Riding

2) Dolphin-Assisted Therapy


HIPPOTHERAPY: Derived from the Greek word “hippos,” meaning horse, hippotherapy uses equine rhythmic movement to help individuals with a variety of neurological disorders, including SCI. It is not therapeutic horseback riding, which teaches riding skills to people with disabilities. With hippotherapy, the patient doesn’t actively control the horse, but rather is passively influenced neurophysiologically by the horse’s movement while sitting on the animal. A therapist walks beside the horse, staying close to the patient.

In addition to exerting positive psychological influences, hippotherapy may be helpful for muscle tone, posture, balance, and pain. Studies suggest it also reduces spasticity in individuals with cerebral palsy, multiple sclerosis, and SCI. It is theorized that the horse’s rhythmical movement promotes twisting and stretching in the patient’s trunk, which, in turn, lessens spasticity.

SCI-focused studies include the following:

1) Dr. Helga Lechner et al (Switzerland) evaluated the effects of hippotherapy on spasticity in 32 subjects with SCI (1). Subject age ranged from 16 to 72 (average 37) years, all but four were men, and the time from injury varied from one to 60 months (most were injured less than a year). Injuries ranged from the cervical C4 to the thoracic T12 levels and included both complete and incomplete injuries.

On average each subject received 11 half-hour hippotherapy sessions. Before and after each session, lower-extremity spasticity was assessed using the Ashworth Scale. This scale measures the resistance of a muscle being stretched with a five-point scale ranging from 1 (no increase in tone) to 5 (limb rigid in flexion or extension).

In hippotherapy sessions, subjects sat on a sheepskin on a top of an Icelandic horse, a breed known for their easy-to-handle nature. The horse was led at a walking pace by a skilled equestrian with a nearby physical therapist to coordinate posture and repositioning as necessary. A few subjects with higher-level injuries required a second therapist sitting behind them for stabilization.

Of the 351 hippotherapy sessions carried out, spasticity was reduced after 93% of them. The greatest reduction was observed in subjects with high initial spasticity. No difference was noted between subjects with paraplegia and tetraplegia. The reduction was a relatively short-term effect that did not persist over time. The investigators concluded that “hippotherapy is a valuable supplement to the conventional physiotherapy approach in holistic rehabilitation of SCIs.”

2) In 2007, Dr. Lechner and colleagues reported the results of study comparing the effects of hippotherapy on spasticity and mental well being with two other alternative therapies that mimicked aspects of rhythmic horse movement (2). In the first alternative, subjects sat astride a rubber-foam cylinder called a Bobath roll. Feet were on the ground, and hands were resting on the thighs. In the second alternative, subjects sat on a motor-driven rocking board integrated into a wood stool with a cushioned seat. The rhythm of the side-to-side rocking was adjusted to resemble the horse’s walking pace.  

Eleven males were recruited with motor complete injuries. Age ranged from 27 to 68 (average 44) years, and the time since injury varied from 1.5 to 40 (average 13) years. Three subjects had tetraplegia, and eight had paraplegia.

Subjects were divided into the three treatment groups, i.e., hippotherapy, Bobath roll, and rocking board. After a series of baseline evaluations, each group was treated with their assigned intervention for four weeks. After a two-week break, the therapy for each group was switched, and treatment was resumed for another four weeks. Following this, there was another two-week break followed by four weeks of the third treatment. For example, one group would start with hippotherapy, have a break, resume treatment with a Bobath roll, have a break, and finish with the rocking board. Spasticity was assessed throughout the study. This sort of investigation in which all subjects receive all interventions in the course of the study is called a crossover study.

Of the three interventions, only hippotherapy lessened spasticity significantly. As expected given the pleasure many have from interacting with horses, only hippotherapy resulted in an improvement of mental well being. The investigators concluded that “hippotherapy reduces spasticity for a short time and temporarily improves mental well being in persons with SCI.”

THERAPEUTIC HORSEBACK RIDING: In contrast to hippotherapy’s passive involvement by the rider, therapeutic horseback riding provide active training in horsemanship skills. Ms. Glennys Asselin and colleagues (USA) studied the qualitative effects accruing to a 46-year-old male with SCI after 13 weeks of such training. This individual had become an incomplete quadriplegic due to a motor vehicle accident 20-years earlier. During sessions, one rehabilitation nurse led and another walked on the side of the horse. The investigators believed that benefits are, in part, the result of 1) the horse providing a three-dimensional movement which simulates the gait of a human adult, and 2) the riding providing perpetual sensory excitement through receptors in the joints, muscle, tendons, ocular motor skins, and skin. The subject provided a number of positive comments on his experience, including, “since riding my muscles have woke up, and I can feel my legs more, using them to balance with, and I can feel the horse move under me more.”


Dolphins appear to facilitate healing through mechanisms not readily reconciled with modern medical precepts (3-4). People frequently report that they become euphoric after swimming with these loving, graceful, and joyous creatures. In turn, an uplifted spirit seems to infuse beneficial healing effects into the mind and body. Numerous people who have serious illnesses and depression have reported dramatic, long-term, favorable changes in their emotional state.

Scientists now know that these emotional changes (which last much longer than the “high” experienced from the release of endorphins, the body’s natural opiates) can initiate a cascade of health-enhancing hormonal and physiological changes. Children with a variety of developmental disabilities have shown remarkable improvements after dolphin-assisted therapy. Learning, cognitive abilities, concentration, communication, and ability to relate to others all improve.

In addition to possessing a direct therapeutic effect, dolphins appear to enhance other therapies. For example, the Upledger Institute has treated individuals with a variety of disorders, including SCI, with dolphin-assisted, craniosacral therapy (See Bodywork Section). The therapy was completed in the water with, and in near proximity to, the dolphins. Many beneficial effects were observed beyond levels normally realized, including pain reduction, increased ease in breathing, muscle relaxation, enhanced strength and flexibility, increased appetite, and better sleep.

John, an individual with chronic paraplegia, participated in this pilot program and recorded his experiences in a journal:

“Dolphin Therapy this morning, my Lord, what a morning!  First we went for a "structured swim” with two pregnant dolphins.  The regular stuff, dorsal pulls, imitative games, kisses, and pets.  Then into a pool with a dolphin named Tina, a young female, and a very strong girl.  Tina would go to my feet and blast energy up from there; it was completely powerful. Suddenly my feet came alive with a pulsing energy. That pulsing energy went through my body and into my lower spinal cord. Every time Tina would blast from my feet, I would get a "therapeutic earthquake" from my first lumbar vertebrae down into my sacrum. All my tissues in the lower part of my body were literally shaking with energy. Talk about sending a shiver up the spine, this was the ultimate.”  

Next Day: “Starting at my feet, there is a constant flow and movement of impulse, a indescribable gyration of synergy that rotates and pulsates, ebbs and flows, buzzes and beats, vibrates and harmonizes with a myriad of sensations that move up and down my legs. This is more than I've felt down there since the night I fell out of that tree.  And the location is different too… this morning, the energy web has moved all the way down into my feet and pulsating upward from there. It is warm, I would say an almost glowing awareness of my feet and legs, tissues and bone.  It feels so fine.”

Although no one really knows how and to what degree dolphins heal, a number of speculations have been put forth.

Scientists believe that the dolphin’s ultrasound emissions have considerable healing potential from an energy and informational perspective. Clinically, ultrasound has been used to promote healing, for diagnostic imaging, and to destroy cataracts and kidney and gallstones. Throughout history, sound - such as music, drumming and chanting - has been used to promote health. Physiologically, we now know that these sounds can influence heart rate, breathing, muscle contractions, memory, and immune function. In terms of energy, the dolphin’s ultrasound blast is four times stronger than therapeutically used in hospitals.

Furthermore, this blast is delivered through water, which is 60 times more efficient than air for sound transference, to a body that is three-quarters fluid. It is believed that ultrasound resonance within the cerebrospinal fluid is especially important due to the fluid’s key influence on the brain and spinal cord.

Second, it has shown that human brain waves shift from high-frequency beta to low-frequency theta waves after a dolphin encounter. Beta waves are associated with increased concentration, alertness, and enhanced memory function. In contrast, theta waves are associated with enhanced creativity, sensory integration, and altered states of consciousness. Scientists believe that a brain-wave shift of this nature strengthens the human immune system. Furthermore, after a dolphin encounter, research has shown a synchronization of brain-wave activity between the logical, analytical left brain and the intuitive, imaginative right brain. These brain-wave alterations may explain why people view swimming with the dolphins as a transcendental experience.

These brain-wave alterations are facilitated by sonar-induced cavitation. Basically, the dolphin’s intense sound waves create alternating regions of compression and expansion that form small bubbles in the cell membrane.  In turn, these bubbles facilitate the transport of key neurological molecules from outside to inside neurons.

Third, scientists also speculate that the dolphins’ therapeutic energy is mediated through human energy fields (see discussion elsewhere). According to speculation, dolphins can sense human-energy-field imbalances and adjust their ultrasonic emanations. The dolphin’s powerful energy may initiate an appropriate alteration in the human electromagnetic field, which, in turn, will facilitate healing.