Equine-assisted therapeutic activities and their influence on the heart rate variability: A systematic review.
Abstract: To examine the effect of equine-assisted therapeutic interventions on users' heart rate variability, using this said variability as an objective biological variable related to stress levels. Methods: A systematic review has been carried out using the methodology suggested in the PRISMA declaration following systematic searches in academic databases. Results: 432 registers were initially identified; however, in the screening and suitability process, nine papers were included in the review. With one exception, all of them reported that equine-assisted therapeutic activities had a favourable effect on users' heart rate variability as such activities favour a state of relaxation by activating the Parasympathetic Nervous System. The analysis of the quality of the evidence and the confirmation of the bias in the works indicate that these results must be considered with caution. Conclusions: Although these preliminary results are promising, more rigorous clinical trials are necessary to overcome the methodological limitations of the works.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Publication Date: 2020-04-06 PubMed ID: 32379693DOI: 10.1016/j.ctcp.2020.101167Google Scholar: Lookup
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- Journal Article
- Systematic Review
Summary
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This research examines the influence of equine-assisted therapeutic activities on the heart rate variability of individuals, suggesting a possible reduction in stress levels. However, the findings demand careful interpretation due to inherent study biases, and further detailed, rigorous clinical trials are required for better understanding.
Introduction
- The primary aim of this systematic review is to investigate the effects of equinotherapy, specifically equine-assisted therapeutic interventions, on a person’s heart rate variability (HRV). This HRV is used as an objective biological variable that can gauge the stress levels of the individual.
Methodology
- The researchers conducted a systematic review using the procedure outlined in the PRISMA declaration.
- Academic databases were exhaustively searched for studies pertaining to the topic at hand. The detailed methodology used for the review was not defined, but is likely to have involved thoroughly assessing the design, sample size, methodology, and findings of each study included.
Results
- Initially, 432 records were identified from the database searches. These were subsequently refined for inclusion based on their relevance, validity, and quality, resulting in nine papers for the final review.
- The majority of these papers, eight in total, reported positive effects of equine-assisted therapy on HRV. These therapeutic activities appeared to encourage relaxation by activating the Parasympathetic Nervous System, which typically serves to slow heart rate and decrease blood pressure. Only one study did not report a favorable effect.
- The quality of evidence and potential bias in the studies were also analyzed. This analysis indicated that the conclusions must be interpreted cautiously due to possible biases in the reviewed studies.
Conclusions
- The preliminary results showing a favorable influence of equine-assisted therapy on HRV are promising. However, due to the methodological limitations of the available studies, these results cannot be considered definitive.
- The researchers conclude that more rigorous clinical trials need to be conducted to validate these findings. This will help overcome the limitations encountered in the initial works, enhancing the credibility and generalizability of results on the effectiveness of equine-assisted therapy on stress reduction.
Cite This Article
APA
García-Gómez A, Guerrero-Barona E, García-Peña I, Rodríguez-Jiménez M, Moreno-Manso JM.
(2020).
Equine-assisted therapeutic activities and their influence on the heart rate variability: A systematic review.
Complement Ther Clin Pract, 39, 101167.
https://doi.org/10.1016/j.ctcp.2020.101167 Publication
Researcher Affiliations
- Department of Educational Sciences, University of Extremadura, Spain.
- Department of Psychology and Anthropology, University of Extremadura, Spain.
- Department of Psychology and Anthropology, University of Extremadura, Spain.
- Department of Psychology and Anthropology, University of Extremadura, Spain. Electronic address: martarodriguez@unex.es.
- Department of Psychology and Anthropology, University of Extremadura, Spain.
MeSH Terms
- Animal Assisted Therapy / methods
- Animal Assisted Therapy / statistics & numerical data
- Animals
- Autonomic Nervous System / physiology
- Heart Rate / physiology
- Horses
- Humans
- Stress, Psychological / therapy
Conflict of Interest Statement
Declaration of competing interest None.
Citations
This article has been cited 8 times.- Marchand WR. Potential Mechanisms of Action and Outcomes of Equine-Assisted Services for Veterans with a History of Trauma: A Narrative Review of the Literature. Int J Environ Res Public Health 2023 Jul 16;20(14).
- Amado-Fuentes M, Gozalo M, Garcia-Gomez A, Barrios-Fernandez S. Impact of Equine-Assisted Interventions on Heart Rate Variability in Two Participants with 22q11.2 Deletion Syndrome: A Pilot Study. Children (Basel) 2021 Nov 22;8(11).
- Lanning BA, Smith CM, Ugale C, Nazarenko E, Marchand WR. Using Functional Near-Infrared Spectroscopy to Elucidate Neurophysiological Mechanism of Action of Equine-Assisted Services: Proof-of-Concept Study. Int J Environ Res Public Health 2025 Aug 19;22(8).
- Wienhold S, Bär L, Ringleb Z, Zirpel V, Gomolla A, Denk BF, Volkmer N, Gaertner RJ, Klink ESC, Pruessner JC. The relationship of early life adversity and physiological synchrony within the therapeutic triad in horse-assisted therapy. J Neural Transm (Vienna) 2025 Sep;132(9):1291-1312.
- Smith CM, Weimann K, Widick M, Merritt T, Christensen H, Siegel M, Pan Z, Gabriels RL. Best practices for physiological data collection in youth with autism and co-occurring mental health diagnoses: Implications for human-animal intervention research. MethodsX 2025 Jun;14:103284.
- Visser EK, Jens AL, Nieuwe Weme LE, Spaapen AA, Maarleveld KN, Enzerink KH, Tromp PN, Haven-Pross SC. Assessing Equine Behavioural Responses in Equine-Assisted Services: A Field Study Analysis. Animals (Basel) 2025 Feb 25;15(5).
- Potier JF, Louzier V. Evaluation of stress markers in horses during hippotherapy sessions in comparison to being ridden by beginners. Anim Welf 2023;32:e10.
- Rigby BR. Characterizing stress during animal interaction: a focus on the human endocrine response during equine-assisted services. Front Vet Sci 2023;10:1303354.
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