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What is Hippotherapy? Defines the use of horse movements as a treatment strategy. Hippotherapy; It is a successful type of treatment that aims to work the body muscles thanks to the exercises performed on horseback. One of the most important reasons why horses are used in therapy; rhythmic movements of the horse are very close to human movements. The word "hippotherapy" is formed by the combination of the word "hippo", which means "horse" in Greek, and the word "therapy". Historically, the benefits of horse in treatment BC. It was noticed around 460 years. It has been used intensively since the 1950s. Today, there are over 1000 "Hippotherapy Centers" in the USA, Canada and England alone. Hippotherapy, which is applied under the control of Physiotherapists in private Hippotherapy centers abroad, is a very popular treatment method in our country. HORSE RIDING STIMULATOR DEVICE Developing technology; It has presented the hippotherapy device, which imitates the movements of a real horse, to the use of physical therapy in clinics. With the horse riding stimulator, all major muscle groups of the body are exercised. This is an event that develops at the reflex level, because while on the horse, the rider moves with him, instinctively trying to maintain balance, so that both healthy and damaged muscles are activated. The main benefits of hippotherapy; The development of muscles is flexibility, strength, balance, coordination, self-confidence, discipline, control, adaptation, social interaction, stronger mobility and mental relaxation. It is fun and useful for all age groups. Hippotherapy has become an enjoyable method that makes their lives worth living for all disabled people who do not accept their disabilities to limit their lives. Facilitation of postural tone. Adequate postural tone is required in the antigravity muscles to support the trunk and limbs in an upright position. Improvement in postural tone can be associated with vestibular, visual sensory input and central nervous system and arousal mechanisms, as well as a strong somato-sensory and proprioceptive input from the pelvis, hip, and spine. General Indications of Hippotherapy: Target audience - children and adults with moderate to severe neuromotor dysfunction. Common problems: Abnormal muscle tone Abnormal reflexes Balance disorders Coordination disorders Communication disorders Oral motor dysfunction Sensorimotor dysfunctions Postural asymmetry Medical conditions with postural control impairment: • Autism • Chromosomal abnormalities or losses • Cerebral palsy Cerebrovascular incident / stroke Growth retardation Functional spinal curvatures: Scoliosis, kyphosis, and lordosis Multiple Sclerosis / Neuromuscular dysfunction Sensory perception disorders Acquired brain injuries Contraindications of Hippotherapy: • Active mental disturbances that may cause security problems (setting fire, suicidal tendency, maltreatment of animals, aggressive attitude, etc.) Acute disc herniation (nerve root depressed or uncompressed) Chiari II Malformation with neurological symptoms • Atlantoaxial instability - Neurological findings evaluated by the physician - C1 vertebra displaced according to C2; It can sometimes be seen in individuals with juvenile rheumatoid arthritis or Down syndrome. • Coxarthrosis - Degeneration of the hip joint; the femoral head is flattened; the socket functions like a hinge joint rather than a joint. Sitting on a horse puts an excessive strain on the joint. Down Syndrome - less than two years old Gran Mal Seizures - not controlled with medication Hemophilia with a recent history of bleeding Permanent catheters (women) • Medical conditions during acute exacerbation (RA, nucleus pulposus hernia, MS, Diabetes, etc.) • Open wounds on the weight bearing surface. • Pathology of untreated pathological fractures, severe osteoporosis, osteogenesis imperfecta, bone tumor, etc. Spinal canal stenosis with symptoms Unstable spinal cord and sinkers Many scientific studies have been conducted on hippotherapy. McGibbon et al. (1998) showed that after 8 weeks of hippotherapy, children with Spastic Cerebral Palsy decreased their energy consumption during walking and gross motor functions. In another study, Benda et al. (2003) concluded that hippotherapy increases muscle symmetry in their study on 15 children with cerebral palsy between the ages of 4-12. This evidence-based and similar applications show us that hippotherapy is a good supportive treatment method that can be used alongside classical treatments.