Key words: occupational therapists, occupational therapy, hippotherapy Hippotherapy in occupational therapy practice INTRODUCTION "There is something about the outside of a horse that is good for the inside of a man." Winston ChurchillHippotherapy is a therapeutic intervention strategy in which the movement of a horse is used as part of an intervention plan. It was initially cited in the in the occupational therapy literature approximately thirty years ago 1 . There has been renewed interest in this therapeutic intervention strategy recently given the role that occupational therapists play in hippotherapy. Despite this, research evidence that pertains to hippotherapy and its therapeutic outcomes remains limited in the South African context.It is important to differentiate between the different types of therapies that exist currently with use of the horse. Neill 2 in her article on horse healing, explains the differences between hippotherapy, developmental riding therapy, psycho-educational vaulting and riding, riding as a sport and skill and equine-facilitated therapy. The focus of this paper is on hippotherapy.The word "hippos" is Greek for horse, thus "hippotherapy" literally means therapy with the help of a horse 3 . The American Hippotherapy Association 4 has defined it as "…the use of the movement of the horse as an intervention strategy by physical therapists, occupational therapists, and speech-language pathologists as part of an integrated therapy program to achieve functional outcomes".In South Africa, hippotherapy is mainly offered on a limited basis by a few skilled therapists or riding instructors under the guidance of a therapist where possible, which contributes to the limited public awareness and involvement. LITERATURE REVIEWAlthough initially cited in the early 1980's 1 hippotherapy subsequently received minimal research attention in the field of occupational therapy as the years progressed. Instead studies were carried out by other medical and health professionals largely focussing on the physical effects of hippotherapy. Consequently, recognition grew quickly within the allied health professions and further research studies were undertaken to establish the use of hippotherapy and its physical benefits.Hippotherapy can be an intervention strategy used by therapists within their therapy programmes to enhance overall occupational performance. Research evidence suggests that therapists may use the horse in a variety of therapy approaches including, amongst others, the neurodevelopmental approach and sensory integration, motor learning, motor control as well as through using psycholinguistic principles. The manner in which the horse is used for individual clients depends on their specific needs, the expertise of the therapist and the training of the horse 5 . Despite this, hippotherapy is regarded as one of the areas with the minimal amount of evidence within the rehabilitation professions 6 . Hippotherapy has been established in South Africa with two main accredited organisations, namely ...