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How effective is horseback riding as a form of therapy for MS?

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  • How effective is horseback riding as a form of therapy for MS?

    Multiple Sclerosis and Related Disorders

    Available online 23 July 2021, 103161
    In Press, Journal Pre-proofWhat are Journal Pre-proof articles?
    Effectiveness of equine-assisted therapies for improving health outcomes in people with multiple sclerosis: a systematic review and meta-analysis

    David Suárez-Iglesias, Iraia Bidaurrazaga-Letona, et al

    •Scientific evidence on the effects of equine-assisted therapies on people with multiple sclerosis (PwMS) mainly comes from hippotherapy
    •Scant research exists regarding the impact of therapeutic horseback riding on PwMS
    •Hippotherapy can be an effective complement to other available therapies in PwMS


    Scientific evidence has shown that equine-assisted therapies (EAT) lead to improvements in the physical function and the quality of life (QoL) of people with disabilities through the practice of hippotherapy or therapeutic riding (TR). There is a need to confirm whether people with multiple sclerosis (PwMS) can also benefit from its practice. This review aimed to systematically evaluate and meta-analyze the available data on the potential health benefits of EAT in PwMS.

    Four electronic databases (MEDLINE/PubMed, Web of Science, SPORTDiscus, and Scopus) were searched systematically from their inception until June 2021 for randomized controlled trials (RCTs) and comparative studies that provided information regarding the effects of EAT on PwMS. The studies' methodological quality assessment was performed using the PEDro and the MINORS scales. For the meta-analysis, heterogeneity across studies was quantified using the I2 statistic. Fixed-effect or random-effects models were applied to obtain the pooled results in the case of low (I2<30%) or high (I2 >30%) heterogeneity values, respectively. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated to assess the change in each outcome.

    After removing duplicated studies, 234 results were retrieved by the literature search and 11 were eligible for full text search. Finally, 9 studies with a methodological quality ranging from good to low quality met the inclusion criteria. Six of them focused on hippotherapy and 4 of them were included in the quantitative analysis. Totally, 225 PwMS patients were evaluated. Findings from the meta-analysis indicated that this therapy improved static (SMD = 0.42; 95% CI: 0.05, 0.78) but not dynamic balance (SMD=0.51; 95% CI: -0.04, 1.06), while significant benefits were observed on the patients’ QoL (SMD=0.37; 95% CI: 0.00, 0.73). Hippotherapy showed effectiveness for reducing self-perceived fatigue (SMD=0.70; 95% CI: 0.33, 1.07), while TR showed mixed effects on balance and QoL.

    The actual evidence on the effectiveness of EAT in PwMS is mainly limited to hippotherapy. This rehabilitation approach seems to have beneficial effects on static balance, QoL and fatigue, but not directly on gait and dynamic balance. Altogether, the findings suggest that hippotherapy could be incorporated as a complementary therapy when developing comprehensive care plans for PwMS.
    Dave Bexfield