Physical activities incorporating horseback riding can help to
improve strength, balance, and other outcomes for children and adults
with a range of neuromotor, developmental, and physical disabilities,
according to a report in the American Journal of Physical Medicine & Rehabilitation, the official journal of the Association of Academic Physiatrists.
"Such equine-assisted activities and therapies - using the horse as a
therapeutic tool - are clearly a viable intervention option for
participants with impairments in balance, gross and fine motor function,
gait, spasticity, and coordination," write Alexandra N. Stergiou and
colleagues of Medical School of Ioannina, Greece. But they emphasize
that further evidence is needed to demonstrate the clinical benefits of
‘Equine-assisted activities are a viable intervention option for people with impairments in balance, gross and fine motor function, gait, spasticity, and coordination.’
Evidence Supports Benefits of Therapeutic Riding and Hippotherapy
The researchers reviewed and analyzed previous studies of
horseback riding interventions for patients with various types of motor
(movement) dysfunction - for example, cerebral palsy, multiple sclerosis,
and stroke. A comprehensive review identified 16 studies evaluating two
types of interventions: therapeutic riding, defined as some type of
adaptive or modified horseback riding with a therapeutic goal; or
hippotherapy, which uses the movement of the horse for therapeutic
Eight studies assessed the effects of equine-assisted therapies for
children with cerebral palsy, including a total of 434 patients. Four
studies evaluated the use of these interventions to improve mobility in
older adults with multiple health problems and disabilities, 90
patients; and three studies addressed patients with multiple sclerosis,
52 patients. One study, including 20 patients, assessed the use of
hippotherapy for patients after a stroke.
The results suggested that therapeutic riding or hippotherapy had a
"significant positive impact" in all groups of patients studied.
Individual studies reported small but significant improvements in
outcomes such as balance, motor function, posture, gait, muscle
symmetry, pelvic movement, psychosocial factors, and quality of life.
Eight studies provided sufficient data for pooled analysis
(meta-analysis) of specific measures of balance and gross motor
function. On a measure of balance, the effects of therapeutic riding
were not significantly greater than for other types of therapy. There
was evidence of positive effects on several dimensions of gross motor
function, but no statistically significant effect on the overall motor
Mrs. Stergiou comments, "The evidence for therapeutic riding and
hippotherapy is encouraging, but with gaps in that there are very few
studies of these interventions in the international literature." She
notes that the ability to perform meta-analysis is limited by the small
size of the studies and the different measurements used.
Within these limitations, the available evidence suggests that
therapeutic riding and hippotherapy can be beneficial for patients with
neuromotor disabilities. The studies show improvement on measures of
walking and gross motor function in children with cerebral palsy. The
research also provides evidence of increased balance and leg muscle
strength in older adults, including stroke survivors.
Further studies will be needed to examine how horseback riding
interventions affect other important outcomes, such as daily activity
levels and patient self-competence. "Equine-assisted therapies
potentially provide advantage for cognitive, emotional, and social
well-being," Dr. Stergiou and coauthors write. "Individuals who
participate have the opportunity to simultaneously experience, benefit
and enjoy the outdoors, which might not otherwise be readily available."