For a 70-year-old woman with right CVA and left-sided weakness who requires hippotherapy, how would you transition her onto the horse?

• A. Have her crest mount to the right from the near side without a raised platform.
• B. Have her crest mount to the right from the near side with a raised platform.
• C. Have her side sit on the horse from a raised platform and then crest mount to the right from the near side.
• D. Mount from the left side directly without crest mounting.

Answer: (B)

When a rider has left-sided weakness from a right-hemispheric stroke, mounting should prioritize safety and minimizing demand on the weak side. Crest mounting from the near side with a raised platform is the best approach because it allows the rider to use the horse’s neck (crest) as a stable point of contact to assist the ascent, reducing the need to rely on the weaker left leg for lifting and balance. The raised platform provides the necessary height so the rider can initiate the climb with the stronger right leg first and then bring the left leg up, lowering the risk of a fall or loss of balance. Mounting from the right/unaffected side also enables the therapist to provide effective support and control during the transfer. The other options either omit the raised platform, require mounting from the weaker side, or involve additional steps that increase risk or complexity given the left-sided weakness.