Hippotherapy, or horse therapy, is an innovative form of physical therapy that involves the use of a horse as a therapeutic tool in order to effectively challenge a rider's core muscles. The rhythm of the horse's gait continuously engages the client's balance and posture, while the supervising physical therapist seeks to improve the client's overall coordination and fine motor skills through various activities. This combination of movement and therapist-directed activity can have significant impacts on the client's postural control and physical function. Eight children between the ages of 2-12 years that had been previously diagnosed with a variety of different developmental delays or disorders participated in 8-12 weeks of hippotherapy. Subjects were tested before, during, and at the completion of their therapy. The physical function measures included a timed level and unlevel walking test, a coordination-based reach test, and were scored using the Gainesville Riding through Equine Assisted Therapy (G.R.E.A.T.) Postural Scale to measure quality of posture. Psychological changes were also evaluated based on the physical therapists' notes and on parent questionnaires given pre-and post-study. Results indicated that 62.5% (5/8) of the subjects improved in their Postural Scale score, 87.5% (7/8) decreased their time to complete the level and unlevel distances, and 50% (4/8) of the subjects showed better coordination-based reach results from pre-to post-. Physical therapists' notes and preliminary parent report analyses suggest improvements in subjects' self-esteem and overall quality of life. These results indicate that hippotherapy sessions are a very effective way to improve physical function, specifically postural control, strength, and coordination in children who have been diagnosed with any type of developmental delay or disorder. Additionally children showed improvements in confidence, self-esteem, and quality of life as observed by their therapist and measured by the parent questionnaires, which may be directly related to the interaction with the horse and therapists or indirectly related to the improvements in motor function. This research has implications for the benefits of hippotherapy for the pediatric population for both function and quality of life.

A case is presented of an individual with Down's syndrome and multiple personality disorder. No such cases were found in a review of the literature. Three other individuals with Down's syndrome are also discussed whose symptoms range from experiencing imaginary friends to experiencing borderline multiple personality disorder. In all these cases the imaginary friends became more evident and resistive of diversion as the levels of stress increased. We speculate that experiencing imaginary friends progresses to experiencing multiple personality disorder in some individuals as personal stress increases. These cases also indicate that limited cognitive development does not preclude individuals from presenting with imaginary friends or multiple personality disorder.

No abstract

No abstract