Hippotherapy — therapeutic horse riding under supervision — is a recognised rehabilitation method for people with disabilities, and adaptive horse riding additionally offers a unique recreational sports context. Both work on strength, balance, muscle tone, self-confidence and social contact — for children with CP through to adults with spinal cord injury or neurological impairment.
🐎 Hippotherapy vs adaptive horse riding
Hippotherapy (therapeutic)
- Medical-therapeutic context — supervised by a certified hippotherapist (physiotherapist with specialisation)
- Physical effects: improved balance, muscle symmetry, trunk control
- Cognitive/emotional effects: self-confidence, focus, social contact
- Target groups: cerebral palsy (CP), autism, intellectual disability, spinal cord injury (T6+), MS, ADHD
- Usually on prescription — some health insurers reimburse
Adaptive horse riding (recreational/sport)
- Sports context — learning to ride with adapted aids
- For wheelchair users: adapted mounting hoist, adapted saddle, footrests
- For visual/hearing impairment: adapted communication, guide rider
- For intellectual disability: adapted pace, more supervision
- Para-equestrian sport: Paralympic discipline since 1996 (dressage specifically)
🏛️ Certified Belgian stables with adaptive programme
Flanders
- National stables with G-riding programme — check via Vlaamse Ruiterbond or G-sport Vlaanderen
- Several provincial therapy farms with equine therapy: Antwerp, Limburg, East Flanders, West Flanders
- Hippotherapy practices often linked to rehabilitation centres (UZ Leuven, UZ Gent, UZ Antwerpen)
Wallonia
- Ligue Handisport Francophone (LHF) has a para-equestrian section
- Certified Walloon stables — check via LHF member list
- Hippotherapy centres often linked to rehabilitation centres
German-speaking Community
- Smaller offering, usually via LHF or via the German cross-border context (Aachen)
🎯 For which target groups?
Children (largest target group)
- CP (cerebral palsy) — strongly proven effect on muscle tone
- Autism (ASD) — sensory integration + social context
- Down syndrome — balance, coordination, muscle strengthening
- ADHD — focus, structure
Adults
- Post-stroke rehabilitation — balance + muscle symmetry
- MS (multiple sclerosis) — muscle maintenance
- Spinal cord injury (T6+) — trunk control under supervision
- Chronic pain — general movement
Seniors
- Mild Parkinson's — coordination
- General mobility maintenance — low-impact movement
🛒 Adapted aids
Mounting aid
- Adapted mounting hoist — critical for wheelchair users
- Wheelchair-to-horse transfer platform — often at horse height
Saddle adaptation
- Standard saddle for milder impairment
- Specially adapted saddle with back support, safety belts, adapted footrests for more severe impairment
- Tandem saddle — supervisor sits behind (for younger children)
Communication aid
- Voice command via supervisor for blind riders
- Visual signals for deaf riders
💰 Funding — VAPH, AVIQ, health insurer
VAPH (Flanders)
- Hippotherapy possible via RTH certification (Directly Accessible Help) — limited offer
- PAB can cover hippotherapy sessions as part of individual budget
- See financial allowances deepdive
AVIQ (Wallonia)
- BAP — comparable to PAB
- AVIQ certification for some therapeutic practices
Health insurer
- Some health insurers partially reimburse hippotherapy (via supplementary insurance)
- Christian Mutuality, Independent Health Insurers, Neutral Health Insurer — check adapted supplementary coverage
Tax benefits
- Tax deduction for extraordinary medical costs (if physician's prescription)
🏆 Para-equestrian sport — competitive
Paralympic discipline
- Dressage only — since Atlanta 1996
- Grade I to V classification (I = heaviest impairment, V = lightest)
- Belgium Paralympic: has historically fielded several dressage athletes at Paralympic Games
Belgian championships
- Belgian Championship Para-equestrian Dressage — annually
- Flemish and Walloon regional championships
🎯 Beginner flow
Step 1: determine goal
- Therapy (medical)? Contact rehabilitation physician + hippotherapist
- Sport/recreation? Contact G-sport Vlaanderen / LHF for stable referral
Step 2: trial session
- Usually 1-3 free or reduced-price trial sessions
- Stable checks adapted equipment
Step 3: intake interview
- For therapy: multidisciplinary (physiotherapist, hippotherapist, physician)
- For sport: sport-specific goal setting
Step 4: regular sessions
- Therapy: usually 1x/week, 30-45 min per session
- Sport: own pace, group or individual
🎯 Our top recommendations
For children with CP or ASD: hippotherapy via certified hippotherapist — strong effects demonstrated in scientific literature. Ask your rehabilitation physician for a referral.
For adults post-stroke or MS: hippotherapy combined with regular physiotherapy — reinforces balance + muscle symmetry.
For sporty wheelchair users: para-equestrian dressage programme via LHF or the G-sport branch of Vlaamse Ruiterbond.
For families seeking a unique sport: adaptive horse riding at a certified therapeutic farm — combines sport, nature and animal context.
Combine with other pillars
- G-sport clubs per province
- Adaptive sport & recreation overview
- Financial allowances — hippotherapy funding
- Post-stroke rehabilitation & tourism — post-rehab sport
- Families with a child with a disability — family context
- Autism-friendly tourism — ASD hippotherapy context
In closing
Hippotherapy and adaptive horse riding in Belgium are recognised but underused rehabilitation and sports options. Especially for children with CP or ASD the effect is scientifically well-substantiated. Also very valuable for adults post-stroke or with MS.
Our recommendation for first-time hippotherapy: contact a rehabilitation physician or hippotherapist in your region for a referral. For a sport context: contact the Vlaamse Ruiterbond G-programme or LHF.
Are you a user or professional in hippotherapy/para-equestrian with experience to share? Let us know.
For medical fitness for hippotherapy (contraindications for certain types of spinal cord injury, epilepsy, severe spasticity): always consult your rehabilitation physician before the first session.