Rehabilitation Services


Physical Therapy, Occupational Therapy, Speech and Language Pathology

Equine movement is a powerful treatment tool that can be utilized by a licensed and specially trained physical therapist, occupational therapist, or speech and language pathologist. The therapists use the movement of a horse as a strategic intervention to address a variety of dysfunctions. Our Rehabilitation Services do not teach riding skills; instead the goals are functional goals to improve independence at school, the community, and in the home.

During a treatment session the movement of the horse, position of the client, and types of activities used, are constantly monitored and modified by the therapist to promote the best functional outcomes. Equine movement may be one of many treatment tools used by the therapist. This movement creates a pattern that is similar to normal walking in the patient that cannot be duplicated in traditional clinical settings. Treatment off the horse is incorporated in the on-site therapy room or the natural environment of the barn to either prepare the patient for the movement of the horse, or to address functional goals after the movement of the horse has prepared the patient’s body.

For more information, please refer to the Rehabilitation Services Handbook and the HIPAA Patient Privacy Notice.

Medical Conditions & Diagnoses

There are many medical conditions and diagnoses that can benefit from equine movement. These include:

  • Autism
  • Cerebral Palsy
  • Down Syndrome
  • Developmental Delays
  • Social/Communication Delays
  • Speech/Language Disorders
  • Sensory Integration Disorders
  • Traumatic Brain Injuries
  • Multiple Sclerosis
  • Genetic Disorders

[The Rehabilitation Services team] gave me back a sense of myself that I never thought I would get back after my traumatic brain injury. They gave me back my identity.


Benefits of Equine Movement

Research has shown that equine movement can help improve:

  • Core Trunk Strength
  • Postural Control
  • Joint Mobility
  • Communication
  • Balance
  • Muscle Tone
  • Sensory Integration
  • Coordination
  • Cognitive Skills
  • Endurance

Precautions or Contraindications

The following conditions, if present, may represent PRECAUTIONS or CONTRAINDICATIONS for our Rehabilitation Services Team. Therefore, when completing this form, it is important to note whether these conditions are present, and to what degree.


  • Spine
    • Fusion
    • Instabilities/Abnormalities, including Atlantoaxial Instability (common with Down Syndrome, JRA)
    • Scoliosis/Kyphosis/Lordosis
    • Spinal Orthoses
    • Internal Spinal Stabilization Devices (such as Harrington Rods)
  • Hip
    • Hip Subluxation and Dislocation
    • Coxarthrosis
  • General
    • Pathologic Fractures
    • Heterotopic Ossification
    • Osteogenesis Imperfecta
    • Osteoporosis
    • Cranial Deficits
    • Joint instabilities


  • Hydrocephalus/shunt
  • Spina Bifida
  • Tethered Cord
  • Chiari II Malformation
  • Hydromyelia
  • Paralysis due to Spinal Cord Injury (above T-6)
  • Seizure disorder or history of seizures


  • Allergies to Grasses, Animals, and Dust
  • Cancer
  • Poor Endurance
  • Recent Surgery
  • Diabetes
  • Peripheral Vascular Disease
  • Varicose Veins
  • Hemophilia
  • Hypertension
  • Serious Heart Condition
  • Stroke (Cerebrovascular Accident)
  • Acute exacerbation of chronic disorder (Rheumatoid Arthritis, Herniated Disk, Multiple Sclerosis, etc)
  • Open wound over weight bearing surface
  • Indwelling urethral catheter


  • Mental/behavioral disorders that would be unsafe (fire setting, animal abuse, violent behavior, etc)
  • Weight over 190 lbs.

Insurance & Cost

If your insurance includes physical, occupational or speech therapy you may be covered. Our Rehabilitation Services is a type of physical, occupational, and speech therapy and is billed under traditional physical therapy, occupational therapy, and speech and language pathology diagnoses and treatment codes.

Forward Stride is a fee for service program. This means that the client is responsible for paying for each service at the time the service is performed. Clients will be given a detailed statement or “Superbill” which contains all the information needed to submit to their insurance companies for reimbursement. Forward Stride does not do direct billing.

Rehabilitation Services Evaluation $250
Rehabilitation Services Session $180

More information can be found on our FAQs About Equine Assisted Therapy.

I see so much benefit in what you do for mental health disorders, physical rehabilitation and health maintenance. So often in my medical career, all I could do was hold hands with the suffering. At Forward Stride you have a gift and programs that translates holding hands into an improvement in wellness.

James Gajewski, MD, MACP

Forward Stride Therapists

  • Sheila Stahl Butler PT, Director of Rehabilitation Services
  • Camille Robinson PT – seasonal
  • Valery Sampson OTR/L

Medical Advisory Council

  • James Gajewski MD, Physician
  • Dean Moshofsky MD, Pediatrician
  • Ellen Raney MD, Orthopedic Surgeon
  • Mary Englert LPC, Licensed Professional Counselor
  • Joe Gallegos PhD, Professor

Registration Form

To sign up for Rehabilitation Services please fill out the form below. For questions regarding this therapy, please contact our Director of Rehabilitation Services, Sheila Stahl Butler, at (503) 217-2186, or email

Please note: a helmet and gait belt are required for any animal related interaction, regardless of age and ability.