Horseback riding for MS, a randomized controlled trial

[ActiveMSers]

Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO)

Vanessa Vermöhlen, Petra Schiller, Sabine Schickendantz
First Published August 3, 2017 Research Article

Abstract

Background:

Evidence-based complementary treatment options for multiple sclerosis (MS) are limited.

Objective:
To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients.

Methods:
A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity.

Results:
Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54).

Conclusion:
Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

[cl3me]

This quantifies what I have experienced. I was a horse person before I was diagnosed and getting back into riding has been such a blessing. I had to use elastic to keep my feet in the stirrups, but have developed enough coordination I no longer need them even though I have abnormal reflexes and some numbness.

[hscott72]

riding is my healthy addiction

I ride obsessively. Before and after my MS diagnosis it has been my most important source of exercise and mental well being and I think its part of the reason I'm doing as well as I am. Specifically I train dressage horses where proprioception is key and the exercise is primarily isometric.

6 months before my life went sideways I had purchased 2 young horses. They are the last 2 I will start because its definitely been an extra tough road now that my coordination is not what it was. My goal had been to get at least one of them to Grand Prix. Not so sure that is going to be possible now which has been emotionally one of the tough blows. Its not just the riding but everything else it take to make it happen that makes me think its a stretch. Trying though at least gets me moving every single day. They need to be fit enough to do the work which means I must get my butt in the saddle. I used to work full time, ride 3 horses a day and coach a few students but now I'm struggling to ride 2 and I've dropped all my students. I know most people thinks its alot but its not compared to the old me. Like I said though, they are the reason I'm as good as i am. They have taught me to be strategic in how to get things done. I've come off a few times I anyway but it has made me a better trainer. I now rarely take a problem head on but try to find non confrontational solutions (not that I was ever harsh but I'm better at heading an issue off before it starts). You can't ride well if you are in the past or the future you need to be in the present.

For me horses are crucial to my well-being!

[ibartist]

Ohh to ride!

This is absolutely thrilling to discuss. I miss learning dressage.
I live in Palm Beach County FL --- lots of horses... but I never thought to ask a stable to help me take lessons.
Does anyone have advice as to how to approach a stable as a person with MS?
I used to be quite capable and was really, really loving riding. I miss it terribly - but with medical expenses and knowing Im not exactly up for mount/dismount - I erased this from my list of things I would love to keep doing...
I believe my level of joy would hit the overload meter if I were able to 'get back in the saddle' ... pun quite intended! Thanks so much for bringing this up. A true lesson in - not x-ing out all I thought I had to... yes!!!!!

[cl3me]

Start by checking to see if any stables near you offer a therapeutic riding program, they will be better prepared to help and will likely have some specialized equipment like sturdy mounting blocks and horses that are quieter.

[hscott72]

Just got talk to coaches

Hi Ibartist,

If you can find a therapeutic riding center then great. If not then go ahead and talk to coaches at riding schools. You may need to help educate them but some of them may be open to teaching you what they can. Years ago I taught a blind boy riding lessons even though I have no training in teaching the disabled. He taught me as much as I taught him. Watch some lessons before you take one (make sure they are super safety conscious and have suitable horses). Then don't be shy about taking a trial lesson or 2. Not every coach is suitable for every riding regardless of ability. When I was teaching my criteria for students was that they genuinely wanted to learn and that their goals were aligned with the effort they wanted to put in. This means I was willing to take on weekend warriors sometimes as long as they didn't then expect to then go to the Olympics. My point in all this is that I can't be the only coach who feels this way. Go talk to them and see what the options are in your area.

Good luck!

[Suebee]

This is a great post! I got very intetested in horse therapy after reading about Mitt Romney's wife using dressage for her MS therapy. I located a stable that has theraputic riding available, but sadly it was too much for me to do on a regular basis. Maybe $30-50 a visit??? Yay for you all horse lovers who can ride often. I'm envious. I think too that horses, like our pets, understand us so well and know when an MS warrior is on their back. Best wishes, happy riding!

[cl3me]

Sue, my horse absolutely adjusts to me. Years ago during a dressage competition, we had a good ride in the morning, but the afternoon heat and humidity had me weak. During the test, were supposed to do an "extended trot" which is a more powerful longer stride, and my horse Slew normally excelled at this, being an ex racehorse he loved moving out and being expressive, but this time when I tried to ask him to move out, he did not change his rhythm, tempo, or cadence. A friend afterward said it wasn't our usual test. Pretty sure my horse could feel I wasn't together enough to go with him and the bigger movement, pretty sure he was looking after me.

He older now, so competition days over but we still go for trail rides.

when I'm riding well, he will give a playful hop n skip before we settle in for a gallop.

And then there's days like today where we walked the whole way along the trail.

Some days I only have the strength to give him a groom and some treats.

He is my physio, shrink, fitness and joy all wrapped into one.