Whether it’s swim, horseback or occupational, Isabelle Lisboa, 5, is taken by her mother, Alessandra, to a different therapy session every Monday through Friday.

Isabelle has Dubowitz syndrome, a genetic disorder defined by slow growth, combined with other neurological deficits due to bleeding in her brain at birth.

Much like a stroke in an older person, crucial centers of her brain — mainly the parts dealing with coordination and balance — were deprived of their life source, oxygen. Except Isabelle lost these functions at one of the earliest stages of development.

She didn’t want to walk and plopped quietly on the ground with a look of discontent when Alessandra lowered her out of the car at Buckaroo Barn off County Road 104 June 3, something she has done every week for the last nine months.

She seemed small, even for a 5-year-old, but her deep, brown eyes suggested a strong sense of awareness. Her curly, brown locks almost created the serene image of a halo when she passed through the sunlight, and her pink shirt was surely the gentle touch of her feminine mother.

After a little coaxing, Isabelle, still with a hold on both Alessandra’s hands, made gradual, wide steps toward the barn. After realizing where she was, she let go and walked with only verbal persuasion toward Kristye Chastang, physical therapist and founder of Buckaroo Barn.

“This is definitely her favorite therapy,” said Alessandra, a native of Brazil who moved to Orange Beach seven years ago. “No matter if she’s sick or whatever, this is the only therapy she always wants to come to.”

It’s called hippotherapy. “Hippos” is the greek word for horse.

Neuromusculoskeletal dysfunctions — such as cerebral palsy, developmental delay, down syndrome, functional spinal curvature, multiple sclerosis, sensory integrative dysfunction and others caused by strokes and traumatic brain injuries are the main focus of the therapy.

These conditions generally cause problems with a person’s gross motor skills, the big muscle groups used in everyday activities like sitting, standing and walking.

Physical therapists have myriad tools at their disposal to combat these issues of balance and muscle memory. They use rubber balls, scooters and swings, but there’s nothing quite like the three-dimensional motion provided by the gradual trot of the horses, according to Chastang.

As soon as Isabelle got on the horse, her face lit up with a smile and she clapped feverously. It was the first sound she made since arriving.

When Chastang began to lead the mounted Isabelle around the barn and the outside trail, she couldn’t help but periodically emit shrill yells of joy and excitement; another aspect of the therapy useful for patients with speech problems, according to Chastang.

The benevolent therapist had Isabelle sit, crouch, lean forward and stand in the saddle. When walking, her balance is too wide, according to Chastang, and these exercises were meant to correct it.

They “played” with plastic rings and rubber balls for Isabelle to develop coordination. She tossed the balls into baskets and the rings onto poles, but always with praise and one set of hands holding her to the horse.

While the patients are saddled in, they move their pelvises much like the movement required of walking. The balance used to hold themselves with the horse generates core stability from the pelvis to the shoulders.

So, by strengthening the gross motor skills and balance, the repetitious rocking of the horses’ stroll slowly rounds off the asymmetrical movement a patient might have.

“The horse is always moving and that makes it more challenging,” Chastang said. “A challenge I can’t reproduce on the ground.”

Making the therapy proportionally difficult equates to the body builders’ cliche, “no pain, no gain,” and Chastang isn’t afraid to take her patients up and down hills creating more challenges in balance.

The result is an accelerated process for developing motor skills. The horse does all the walking around and the patient is focused on balance, which is a catalyst for development, according to Chastang.

It was only a few months after Isabelle started hippotherapy when she started walking, according to Alessandra.

“She always had therapy but after the hippotherapy she really broke out,” she said. “After that, she wasn’t scared to move anymore.”

At the end of the session, Isabelle walked between Alessandra and Chastang much faster than before. She even made turns of independence toward more of the horses.

However, the most noticeable difference between Isabelle before and after the therapy was her subtle grin, which grew as she walked with encouragement.

Brian Lackey, a physical therapist at North Baldwin Infirmary, thinks the only drawback to hippotherapy may be that the families could have difficulty reproducing it at home.

“I have referred patients there,” he said. “And I haven’t heard anything but positive reviews.”

John Pickard, a 6-year-old with cerebral palsy, and his father, Perry, have travelled from Grovehill for the riding therapy every week for nearly two years.

“We’ve made strides here that would’ve taken several years,” Perry said. “A year ago he stood up in the saddle for the first time, and when I brought the pictures home nobody could believe it.”

The normally timid John shows a different side of himself while on one of the horses.

“The other day we had a dog with us that he normally didn’t want to be around,” Perry said. “But that day he had the dog up on the horse with him.”

Lackey said the horses definitely produce a “calming effect.”

Full of hope, Perry is looking forward to discarding John’s newest walker, which Chastang predicts will be his last.

“We’re going to hold her to it,” Perry said with an anxious, ear-to-ear smile as his exhausted son rested in his arms.

Chastang has recently discharged her first graduate, too. A 5-year-old girl who first showed up 1 1/2 years ago barely able to crawl and stand up.

Children without developmental delays usually take their first steps around 1 year old.

“It was so awesome to be a part of her first step because her family had been waiting five years for it,” Chastang beamed.

From cowgirl to therapist, then both.

Back in college, Chastang was stagnate with a sprained ankle and no idea what to do with her life.

Then the efforts of her personal physical therapist inspired her to follow the same path to help others.

“That’s when I knew what I wanted to do,” she said.

She was seeing several physical trainers who couldn’t seem to help her, but the physical therapist provided her with what she needed to “get over the hump” and heal.

After following through with the required degree, Chastang learned about hippotherapy on her way to a master’s degree in physical therapy. She also learned there weren’t any similar therapies in Baldwin County.

She’d always owned and loved horses, and her husband is a competition team roper, where two men or women on horses lasso a calf and try to tie it up the quickest.

She uses the same horses for the therapy.

“These horses travel, wide-open at 100 miles an hour (for the competitions),” she exaggerated. “But when a kid gets on his back, (the horse) just knows how to walk. They have their play time with me.”

After becoming a physical therapist, she went on to the variety of courses required by the American Hippotherapy Association to be a certified hippotherapist.

In July 2005, she outfitted her family’s five-acre plot of land on the outskirts of Bay Minette to become a full-functioning therapeutic clinic and horse ranch. With the help of her husband and three daughters, she now works with more than 40 children a week.

“To me, it was a perfect fit and everything has fallen into place,” she said. “It’s been so much fun and I thank God everyday I should be so blessed.”