Equine Therapy for AADC Deficiency

Emily Malcolm, PhD avatar

by Emily Malcolm, PhD |

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Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder characterized by muscle weakness, uncontrollable movements, and developmental delays. Many patients with the deficiency experience painful “episodes” called oculogyric crises in which muscles cramp or move uncontrollably. Some patients may also experience epileptic seizures.

Physiotherapy can improve strength, coordination, balance, and posture in people with AADC deficiency. However, physical weakness and problems with coordination can make it difficult for patients to exercise safely. One supervised program that has been useful for some patients with developmental and muscular problems is equine therapy, also known as hippotherapy.

What is equine therapy?

Equine therapy is horseback riding under guided and trained supervision. Riding a horse exercises many of the muscles that are also used for walking. People with muscle weakness can ride astride the horse, with one or two assistants on either side to help them balance and ensure they don’t fall off the horse.

One helper guides the horse on a lead and engages the rider in games that help with balance and focus. The assistants walking alongside help the rider to stay balanced and remind them of correct posture.

Is equine therapy safe?

All riders wear protective gear such as boots and helmets. Personnel at equine therapy centers are trained to recognize seizures and to move a patient safely away from the horse when seizures occur. The horses are also trained not to panic if a rider becomes ill. However, children with uncontrolled epilepsy should not participate in equine therapy.

Patients with AADC deficiency should schedule physiotherapy sessions for the mornings — for many patients, symptoms worsen in the afternoon or after physical activity, so make sure to plan time for relaxation after the therapy.

How can I find an equine therapy center?

Your physiotherapist may be able to recommend a certified center near you, and also coordinate with the center to establish guidelines and goals for the therapy, as well as track progress and address any issues or concerns that might arise.


Last updated: Dec. 2, 2019


AADC News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.