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Physical Therapy Intervention With Hippotherapy (HPOT) Affects Balance Control in the Elderly: A Randomized Controlled Trial.
Abstract: Aging is characterized by a decline in functional abilities, strength, balance, flexibility, agility, and coordination due to neurological and muscular changes. Hippotherapy (HPOT) has been recognized for its physical and psychological benefits for older adults. Hence, this study aimed to investigate the effects of hippotherapy on balance in elderly individuals. The novelty lies in using the Biodex Balance System SD for dynamic balance assessment in healthy elderly without neurological disorders. Unassigned: We recruited elderly men aged 60 to 70 who had independent mobility and medical clearance for hippotherapy, ensuring they met criteria such as consistent participation and the absence of pertinent diseases, orthopedic issues, recent surgeries, or medications that could influence outcomes. The dependent variables measured with the Biodex Balance System SD included (I) fall risk, (II) stability index, (III) balance index, (IV) anterior-posterior deviation, and (V) mediolateral deviation. The intervention consisted of 16 sessions of hippotherapy over 8 weeks, with two 30-min sessions each week, during which participants rode a horse. Unassigned: The main findings derived from this study indicate that the intervention significantly reduced Fall Risk in the training group compared to the control ( = 0.000, η = 0.77). Hippotherapy also significantly improved Stability index ( = 0.041, η = 0.15), Anterior-Posterior Sway ( = 0.013, η = 0.39), mediolateral sway ( = 0.002, η = 0.54), and Balance index ( = 0.008, η = 0.43). This suggests a noteworthy distinction across all measured variables. Unassigned: The findings demonstrate that hippotherapy significantly enhances balance in physically active elderly individuals, potentially improving their quality of life. These results will inform professionals working with this population.
© 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC.
Publication Date: 2026-05-03 PubMed ID: 42088665PubMed Central: PMC13136507DOI: 10.1002/hsr2.72349Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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Physical therapy intervention using hippotherapy—therapeutic horseback riding—significantly improves balance control in elderly men aged 60 to 70, as measured by dynamic balance assessments. This randomized controlled trial provides evidence that hippotherapy can reduce fall risk and enhance various balance parameters in healthy older adults.
Background and Purpose
- Aging commonly results in decreased functional abilities such as strength, balance, flexibility, agility, and coordination due to neurological and muscular changes.
- Hippotherapy (HPOT), which involves therapeutic horseback riding, has established physical and psychological benefits for older adults but has been understudied in terms of objective balance improvements.
- The study aimed to determine the effects of hippotherapy on balance control in elderly individuals without neurological disorders, using the Biodex Balance System SD to quantitatively assess dynamic balance.
- This investigation is novel for applying sophisticated balance measurement tools in a healthy elderly population engaged in hippotherapy.
Participants and Methodology
- The study recruited men aged 60 to 70 who met inclusion criteria:
- Independent mobility and medical clearance for hippotherapy.
- No neurological disorders, relevant diseases, orthopedic problems, recent surgeries, or medications affecting balance or study outcomes.
- Consistent participation agreement.
- Participants were randomly assigned to either the hippotherapy intervention group or a control group.
- The intervention comprised 16 sessions over 8 weeks—two 30-minute horseback riding sessions per week.
- Balance-related dependent variables were measured pre- and post-intervention using the Biodex Balance System SD:
- Fall Risk
- Stability Index
- Balance Index
- Anterior-Posterior Deviation (sway)
- Mediolateral Deviation (sway)
Main Findings
- Hippotherapy led to a statistically significant reduction in Fall Risk compared to the control group (p = 0.000, large effect size η = 0.77), indicating less likelihood of falls.
- Significant improvements were seen in:
- Stability Index (p = 0.041, η = 0.15) – indicating enhanced postural stability.
- Anterior-Posterior Sway (p = 0.013, η = 0.39) – showing reduced forward-backward balance deviations.
- Mediolateral Sway (p = 0.002, η = 0.54) – showing reduced side-to-side balance deviations.
- Balance Index (p = 0.008, η = 0.43) – reflecting overall improved balance performance.
- The effect sizes ranged from small to large, reflecting meaningful clinical impact on balance control measures.
Implications and Conclusion
- The study demonstrates that hippotherapy is an effective intervention for improving multiple balance parameters in physically active elderly men.
- Improved balance control has direct relevance to reducing fall risk, a major health concern in the aging population.
- These findings support incorporating hippotherapy into physical therapy programs aiming to preserve or enhance balance function among older adults.
- The quantitative use of the Biodex Balance System SD highlights the utility of objective measures in monitoring therapeutic progress.
- Professionals working with aging populations can consider hippotherapy as a viable modality to improve quality of life through better balance and stability.
Cite This Article
APA
Gholami BB, Fatahi A, Boroushak N, Molavian R.
(2026).
Physical Therapy Intervention With Hippotherapy (HPOT) Affects Balance Control in the Elderly: A Randomized Controlled Trial.
Health Sci Rep, 9(5), e72349.
https://doi.org/10.1002/hsr2.72349 Publication
Researcher Affiliations
- Department of Physical Education and Sports Sciences CT.C, Islamic Azad University Tehran Iran.
- Department of Physical Education and Sports Sciences CT.C, Islamic Azad University Tehran Iran.
- Department of sports biomechanics Sport Science Research Institute Tehran Iran.
- Department of Physical Education and Sports Sciences CT.C, Islamic Azad University Tehran Iran.
Conflict of Interest Statement
The authors declare no conflicts of interest.
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