Hippotherapy provides great opportunities for weight bearing on hands to help decrease muscle tone and strengthen shoulders. (sorry, I did a lot of smudging with photoshop to protect the identity of my little friend and where I work). In the top photo, he is facing backwards and you can see that he does not have much weight on his hands. But in the photo below while he is facing forwards using the pillow- a lot of weight is on his hands. His fingers are open and his chest is also more open with shoulders less rounded. Use of the stirrups helped him to maintain this position for several minutes. I am working toward holding this position with some flexion in elbows and knees, so that they aren't locked. I typically hold his feet back to get knee flexion, but I am busy with the camera here.
Sitting side facing with forearm bearing weight on pillow is also excellent to decrease spasticity. I love this position so that I can look right into the child's face while encouraging speech and singing. It's one of the best positions for this type of emotional bonding, but also very insecure for the child because he can't grasp the handle. So you may need to build trust first with some kids before doing this.
Barbara Smith, M.S., OTR/L author of, The Recycling Occupational Therapist
Horseot.com
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