Rosenburg and Donald (1995) describe evidence based medicine as "a process of turning clinical problems in to questions and then systematically locating appraising, and using contemporaneous research finding as the basis of clinical decisions".

The evidence based Medicine Working Group (1992) stated that a new paradigm for medical practices was emerging. Thomas Kuhn (1970) defined the scientific paradigm as: "Ways of looking at the world that define both the problems that can be legitimately be addressed and the range and admissible evidence that may be on the solution".

Dr Jean Ayres (1975) stipulates that the vestibular system plays a major role in the functioning of the whole brain. The spinal column, brain stem, cerebellum and cerebral hemispheres are particularly responsible for sensory reception and it influences perception, movement, posture, co-ordination and academic learning. The vestibular core receives information from the muscles, joint's skin, visual and auditory interceptors and from other sensory areas in the brain. The inhibition and facilitation of vestibular impulses occur simultaneously. If the latter does not function correctly, it results in a confusion of stimuli which in turn causes disorganised reactions and behaviour. If there is another area in the brain itself that does not function correctly, for e.g. an area where brain impulses are disorganised then the result is almost like a plug, that prevents brain impulses from going up into the higher area's of the brain. Where brain functions like reading and spelling are situated.

When looking at physiotherapy or occupational therapy one may ask what is the main therapeutic goal when working with a challenged patient? Would it not be to improve the patients' movement range and cognitive ability, and so their ADL or QL functions, (Activities for Daily Living - brushing their hair and teeth, Quality of Life - toileting)?

Now considering hippotherapy, the main goal is similar - the application of "movement". All three-therapy strategies basically carry different but complementary applications of movement.

"Movement is the door to learning. To live is to move". (P. Dennison)

Taking this a step further it has been the norm for many years to give children various forms of mechanical or gymnastic exercise to develop their general physique but very little consideration was given to how the mind should develop. This is now all changing, and it would cause many people astonishment to be told, that educators world-wide are recognising horse riding as a very valuable educational medium. By talking about the development of the mind I need to stress that the psychological development of the rider is taken from the horses' body language and character, while the riders cognitive development is taken from the application of its movement.

We don't need to tell any body that in essence the development of human physique and personality is influenced by the motor activity learning process. Posture, balance, body image, laterality, directionality, locomotion and motor-visual perception are all-important aspects of harmonious child development.

Which means that normal growing pre-school children will be given a better chance at additional cognitive development if they are exposed to riding therapy from as younger age as possible. (Porcelli, 1988).

The effects of the use of the horse as a therapeutic aid can all be related to the neuro-, senso-, psycho- and sociomotoric development of all developing children regardless of whether they are challenged or not. Most disabled people find participation in sports or recreational activities difficult, but horse riding can be achieved with very little adjustment. (Heipertz,1989) Therapeutic horse riding can be the solution to gain optimal function. It is where the horse becomes a drug free facilitator to solve many problems facing of our children in a happy and disciplined manner.

If a child is not standing & ambulation has not been achieved by the age of 4 strong stimuli is required to maintain motivation. By this time the child will be aware of their problem and in many cases will have grown tired of therapy on the "mat" that appears not to be working. In most cases these children will be suffering from therapy burn-out making it difficult to keep them motivated, but we must remember that in every sensorimotor dysfunction we find some normal components, when these are identified and activated goals can be achieved. With exposure to a new experience we find inner drive improving, with functional physical gain being made and so resulting in motivation, psychological bonding, self-esteem, self-confidence and so personality changes.

Well we would basically say that the horse would do hip mobilisation, gross motor stimulation of especially the trunk, and co-ordination of postural adaptations in response to the horse's movements to complement the NDT treatments given by the physiotherapist or the occupational therapist on the mat, in addition it also creates attention and concentration.

Can the "Hippo or Equitherapist" achieve the best for the potential rider without the intervention of a physio, occupational, speech and psychotherapist?

In South Africa hippotherapy is offered mainly by riding instructors under the guidance of either a physiotherapist or an occupational therapist and so testing of potential riders needs to be done by a trained physio or occupational therapist.

Our sessions are structured to compliment the physiotherapy or occupational therapy offered to the client by either their own or our consulting professionals.