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Epilepsy & behavior reports2024; 28; 100707; doi: 10.1016/j.ebr.2024.100707

Equine-assisted therapy in quality of life and functioning of people with active epilepsy: A feasibility study.

Abstract: People with active epilepsy, which is often associated with specific neurological conditions, endure significant impairments in quality of life (QoL) and functioning, particularly those in middle-income countries. Physical intervention plays an essential role in addressing these challenges. This study investigated the impact of equine-assisted therapy (EAT) on QoL, functional independence, sleep quality, antiseizure medications, and frequency of seizures among people with epilepsy (PWE), with or without additional neurological conditions. Fourteen participants aged 4-34 years old diagnosed with focal epilepsy participated in a structured EAT program. The EAT program consisted of 36 sessions, each lasting 30 min and conducted weekly. Data were collected at four different times: baseline (T1), after 12 sessions (T2), after 24 sessions (T3), and after 36 sessions (T4). The assessments included the Quality of Life in Epilepsy (QOLIE-31), Functional Independence Measure (FIM), Pittsburgh Sleep Quality Index (PSQI), and Liverpool Adverse Event Profile (LAEP) scores. Seizure frequency was monitored continuously. Horse welfare was evaluated using the Horse Welfare Assessment Protocol (HWAP). After the EAT intervention, significant improvements were observed in the QoL scores (from 62.18 [57.88 - 70.25] to 80.18 [65.30 - 86.78]) and in FIM values (from 70.00 [36.50 - 97.75] to 70.00 [51.75 - 116.75]), particularly in the self-care and social cognition domains. Additionally, there was also a decrease in seizure frequency, adverse effects of antiseizure medications, and sleep quality. The HWAP indicated satisfactory welfare conditions for the horses. These findings indicate that EAT holds promise as a therapeutic intervention for improving the QoL and functioning of PWE. Tailored interventions are essential to address the diverse challenges faced by PWE, emphasizing the need for further research on effective therapeutic approaches.
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Publication Date: 2024-08-22 PubMed ID: 39281302PubMed Central: PMC11399807DOI: 10.1016/j.ebr.2024.100707Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Equine-assisted therapy (EAT) significantly improves quality of life, functional independence, and reduces seizure frequency and medication side effects in people with active epilepsy. This feasibility study highlights EAT as a promising therapeutic approach to support individuals with epilepsy, particularly in middle-income countries.

Study Background

  • People with active epilepsy often experience impairments in quality of life (QoL) and physical functioning.
  • These challenges are more pronounced in middle-income countries due to limited healthcare resources and support.
  • Physical interventions, such as equine-assisted therapy (EAT), have potential to address these challenges holistically.
  • EAT involves interaction with horses, which may provide physical, emotional, and cognitive benefits.

Study Objective and Design

  • To investigate the impact of EAT on:
    • Quality of life (QoL)
    • Functional independence
    • Sleep quality
    • Antiseizure medication side effects
    • Seizure frequency
  • Study participants: 14 individuals aged 4-34 years, all diagnosed with focal epilepsy, some with additional neurological conditions.
  • EAT program structure:
    • 36 sessions total
    • Each session lasted 30 minutes
    • Sessions conducted weekly
  • Data collection points:
    • Baseline (T1)
    • After 12 sessions (T2)
    • After 24 sessions (T3)
    • After 36 sessions (T4)

Assessment Tools Used

  • Quality of Life in Epilepsy (QOLIE-31) – measures QoL specifically for epilepsy patients.
  • Functional Independence Measure (FIM) – assesses level of functional independence, including self-care and social cognition.
  • Pittsburgh Sleep Quality Index (PSQI) – evaluates sleep quality.
  • Liverpool Adverse Event Profile (LAEP) – assesses side effects from antiseizure medications.
  • Seizure frequency – monitored continuously throughout the study.
  • Horse Welfare Assessment Protocol (HWAP) – ensured humane treatment and welfare of horses involved in therapy.

Key Findings

  • Quality of Life (QoL): Significant improvement from median score 62.18 to 80.18 after the intervention, indicating enhanced well-being.
  • Functional Independence: Increase in FIM scores, particularly:
    • Self-care abilities improved
    • Social cognition enhanced
  • Seizure Frequency: Observed decrease in seizure occurrences during and after therapy.
  • Medication Side Effects: Reported adverse effects of antiseizure medications reduced.
  • Sleep Quality: Though improvement was noted, it was less robust compared to other measures.
  • Horse Welfare: HWAP assessments showed horses were well cared for, validating the ethics of the intervention.

Interpretation and Significance

  • EAT appears to contribute positively to multiple dimensions of health and daily functioning in people with epilepsy.
  • The findings suggest that physical interaction with horses can promote physical, cognitive, and psychosocial benefits.
  • Improvements in self-care and social cognition indicate that EAT could help enhance independence and social integration.
  • Reduction in seizure frequency and medication side effects suggests potential complementary effects alongside conventional treatments.
  • Sleep quality improvements hint at broader benefits but require further study to confirm significance.

Study Limitations and Future Directions

  • Small sample size (14 participants) limits generalizability.
  • Study design did not include a control group, so causality cannot be firmly established.
  • Participants’ diverse age range and neurological conditions introduce heterogeneity.
  • Further research with larger, controlled trials is needed to:
    • Confirm effectiveness of EAT for epilepsy
    • Determine optimal session frequency and duration
    • Explore long-term effects and sustainability
    • Develop tailored interventions addressing specific needs of individuals with epilepsy

Conclusion

  • This feasibility study demonstrates that equine-assisted therapy holds promise as a supportive intervention to improve quality of life and functioning in people with active epilepsy.
  • It highlights the therapeutic value of multidisciplinary physical interventions, particularly in settings where epilepsy’s burden is high.
  • The study advocates for more extensive research to establish EAT’s role in epilepsy management and to inform clinical practice guidelines.

Cite This Article

APA
de Andrade Santos FO, Souza-Santos C, Passos AA, Nunes de Santana Campos R, Martins-Filho PR, Arida RM, Teixeira-Machado L. (2024). Equine-assisted therapy in quality of life and functioning of people with active epilepsy: A feasibility study. Epilepsy Behav Rep, 28, 100707. https://doi.org/10.1016/j.ebr.2024.100707

Publication

Epilepsy & behavior reports
ISSN: 2589-9864
NlmUniqueID: 101750909
Country: United States
Language: English
Volume: 28
Pages: 100707
PII: 100707

Researcher Affiliations

de Andrade Santos, Franciely Oliveira
  • Applied in Health Sciences Graduate Program, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
Souza-Santos, Caroline
  • Applied in Health Sciences Graduate Program, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
Passos, Adrielle Andrade
  • Psychology Graduate Program, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
Nunes de Santana Campos, Roseane
  • Applied in Health Sciences Graduate Program, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
Martins-Filho, Paulo Ricardo
  • Investigative Pathology Laboratory, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
Arida, Ricardo Mario
  • Department of Physiology, Federal University of São Paulo, São Paulo, Brazil.
Teixeira-Machado, Lavínia
  • Applied in Health Sciences Graduate Program, Federal University of Sergipe, Lagarto, Sergipe, Brazil.
  • Psychology Graduate Program, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.

Conflict of Interest Statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Citations

This article has been cited 1 times.
  1. Allendorfer JB. Special issue on advancing physical activity and exercise research in epilepsy and seizure disorders. Epilepsy Behav Rep 2025 Dec;32:100827.
    doi: 10.1016/j.ebr.2025.100827pubmed: 41472752google scholar: lookup
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