The effect of hippotherapy on people with multiple sclerosis, a systematic review.

Overview

• This systematic review investigates the effects of hippotherapy—a therapeutic horseback riding intervention—on various symptoms and functional abilities in people with Multiple Sclerosis (MS).
• It summarizes evidence from randomized controlled trials to understand whether hippotherapy improves clinical outcomes such as balance, fatigue, spasticity, pain, muscle strength, gait, endurance, and quality of life in MS patients.

Background

• Multiple Sclerosis (MS) is a neurodegenerative disorder that progressively impairs neurological function, causing severe symptoms that negatively impact daily living.
• Standard treatments aim to slow symptom progression and improve patient function, but innovative therapies are being explored for additional benefits.
• Hippotherapy involves using horse riding movements as a therapeutic approach, previously found effective in various neurological conditions.
• This review focuses on evaluating the impact of hippotherapy specifically on individuals with MS and their clinical symptoms.

Methods

• Database Search: Articles were sourced from PubMed, Scopus, Cochrane Library, and EBSCO databases.
• Keywords Used: Multiple sclerosis, MS, hippotherapy, therapeutic horseback riding/ride, equine assisted therapy, equine therapy.
• Selection Process: Articles were screened based on pre-defined inclusion and exclusion criteria, independently reviewed by two examiners.
• Quality Assessment: The PEDro scale, which rates the methodological quality of clinical trials, was used to assess the included studies.
• Initial Screening: 428 original articles were found, 5 randomized controlled trials (RCTs) met the criteria and were analyzed in depth.

Results

• The review found evidence that hippotherapy positively affects multiple symptoms in MS patients:
• Improvement in impaired balance
• Reduction in fatigue levels
• Decreased spasticity (muscle stiffness)
• Lowered pain intensity
• Enhancement of muscle strength
• Improved gait and walking ability
• Increased endurance
• Enhanced quality of life
• These effects suggest that hippotherapy can be a beneficial complementary therapy for addressing both physical symptoms and overall well-being in MS.

Conclusions and Future Directions

• Hippotherapy demonstrates promising therapeutic benefits for people with MS across a range of clinical symptoms.
• The intervention appears to improve motor functions and reduce symptom severity, leading to better quality of life.
• However, the number of high-quality randomized controlled trials is limited, restricting definitive conclusions.
• Future research with larger sample sizes and rigorous methodologies is necessary to validate and strengthen the evidence base.
• Further studies could explore optimal program duration, frequency, and long-term effects of hippotherapy in MS populations.

Summary

• This systematic review synthesizes current evidence on hippotherapy as an intervention in MS, showing encouraging results for symptom management and functional improvement.
• It provides a foundation for clinicians and researchers interested in incorporating equine-assisted therapies into MS rehabilitation strategies.