Departments: Letters to the Editor
To the Editor:
I am responding to the letter written to the editor, on September 24, 2008 by Barbara Cunningham from the American Hippotherapy Association about our article, “The Effects of Hippotherapy on Functional Outcomes for Children with Disabilities—A Pilot Study.”1
It is a complex world with rapidly developing advances locally, nationally, and globally, requiring common language that is easily understood and focuses on the primary issues.
Therapeutic programs using horses have advanced in scope, program development, and terminology. I acknowledge and appreciate the author’s point highlighting the need for consistent terminology. There is indeed a lack of consensus of the terminology at different local programs, various national and international professional organizations regarding the use of horses for improving function. In addition to therapeutic riding and hippotherapy, the terminology Equine-Assisted Activity is another umbrella term which has also been used to capture therapeutic riding and hippotherapy terminology.
For the purpose of clarification, the authors used the term therapeutic horseback riding once in the body of the text under the methods section in brackets. The authors used the term specifically in the text at that point to reflect the farm’s terminology of the intervention used for the children in the study. Certainly, this validates your point that there is a lack of consensus of terminology throughout the field and local programs.
The term modality is defined in Stedman’s Dictionary as “a form of application or employment of a therapeutic agent or regimen.”2 The term modality is used in the article in the broad sense of a therapeutic regimen. Most recently in 2007, Sterba3 uses the term modality to refer to horseback riding as therapy in his review article.
American Physical Therapy Association has joined the World Health Organization in supporting the International Classification and Functioning, Disability and Health (ICF) model. The language of the ICF is neutral as to etiology, placing the emphasis on function rather than condition or disease. The ICF model framed the methods, design, and functional outcomes of our study. The ICF model describes individuals according to their function, rather than disease or illness. The study focused on the broad view of health related status versus concentrating on the effects of hippotherapy at the cellular level.
The common language of the ICF provides a conversation about function.4 Using common language narrows the gap between health care providers and professional organizations, while optimizing functional outcomes for patients.
Deirdra Murphy, DT, DPT, MS, MHA
University of Massachusetts Lowell
1. Murphy DA, Kahn-D’Angelo L, Gleason J. The Effects of hippotherapy on functional outcomes for children with disabilities—a pilot study. Pediatr Phys Ther
2. Stedman’ Medical Dictionary for the Health Professions and Nursing, Illustrated. 6th ed. Lippincott Williams & Wilkins; 2007.
3. Sterba, J. Does horseback riding therapy or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Dev Med Child Neurol
4. Van Sant A. Pediatr Phys Ther