Multiple Sclerosis
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Gencheva, Ivanova, & stefanova
Archives in Physical Education and Sport (2015)
Description
The aim of this pilot study was to evaluate the effect of hippotherapy as a treatment intervention of postural control, balance, chronic fatigue and emotional tension in patients with multiple sclerosis.
Results
The results of this pilot study show that the application of Hippotherapy in patients with Multiple sclerosis has a very beneficial effect on some physical and psycho-emotional symptoms - lower levels of fatigue and tension, improving coordination, balance and muscle strength.
Conclusions
The results of this pilot study show that the application of Hippotherapy in patients with Multiple sclerosis has a very beneficial effect on some physical and psycho-emotional symptoms - lower levels of fatigue and tension, improving coordination, balance and muscle strength.
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Bronson, Brewerton, Ong, Palanca, & Sullivan
European Journal of Physical and Rehabilitation Medicine (2010)
Description
Multiple sclerosis (MS) leads to changes in balance due to the breakdown of a number of neurological processes. Hippotherapy utilizes the movement of the horse to provide sensory feedback and has been used as a therapeutic intervention for different neurological conditions. Little is known about the effects of hippotherapy in MS. The purpose of this study is to systematically review and examine the evidence for hippotherapy as an intervention to improve balance in persons with MS.
Results
All studies examined in this review were either case-control or case-series. Collectively all three studies reported improvements in balance. Pre-test and post-test Berg Balance Scale scores in two studies revealed that primary progressive MS demonstrated the greatest amount of change after hippotherapy compared to other subtypes of MS.
Conclusions
HPOT has a positive effect on balance in persons with MS and has an added benefit of enhancing QOL. More research is needed to strengthen evidence.
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Hammer A, Nilsagard Y, Forsberg A, Pepa H, Skargren E, Oberg B
Physiotherapy Theory and Practice (2005)
Description
The aim of this study was to investigate whether therapeutic riding (TR, Sweden) hippotherapy (HT, United States) may affect balance, gait, spasticity, functional strength, coordination, pain, self-rated level of muscle tension (SRLMT), activities of daily living (ADL), and health-related quality of life.
Results
Results showed improvement for ten subjects in one or more of the variables, particularly balance, and some improvements were also seen in pain, muscle tension, and ADL. Changes in SF-36 were mostly positive, with an improvement in Role-Emotional seen in eight patients.
Conclusion
Balance and Role-Emotional were the variables most often improved, but TR/HT appeared to benefit the subjects differently.
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Lindroth, Sullivan & Silkwood-Sherer
Physiotherapy Theory and Practice (2015)
Description
This case-series study aimed to determine if there were observable changes in sensory processing for postural control in individuals with multiple sclerosis (MS) following physical therapy using hippotherapy (HPOT), or changes in balance and functional gait.
Results
Following the intervention period, all three participants showed improvements in SOT (range 1-8 points), BBS (range 2-6 points), and FGA (average 4 points) scores. These improvements were maintained or continued to improve at follow-up assessment. Two of the three participants no longer over-relied on vision and/or somatosensory information as the primary sensory input for postural control, suggesting improved use of sensory information for balance.
Conclusions
The results indicate that HPOT may be a beneficial physical therapy treatment strategy for some individuals with MS. Post- HPOT intervention, study participants had improved balance, postural stability, and functional gait as witnessed by the improvements in the BBS, SOT and FGA.
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Karla Mendonça Menezes, Fernando Copetti, Matheus Joner Wiest, Cláudia Morais Trevisan, Aron Ferreira Silveira
Fisioter. Pesqui. (2013)
Description
This study intended to identify the effects of hippotherapy on the postural control of multiple sclerosis (MS) patients.
Conclusion
The maintenance of CG scores and the favorable changes in the postural control of the IG suggest that hippotherapy can improve the postural control of MS patients.
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Silkwood-Sherer D & Warmbier H
Journal of Neurologic Physical Therapy (2007)
Description
The purpose of this pilot study was to examine the effectiveness of hippotherapy as an intervention for the treatment of postural instability in individuals with multiple sclerosis (MS).
Results
The group receiving hippotherapy showed statistically significant improvement from pretest (0 week) to posttest (14 week) on the BBS (mean increase 9.15 points (x (2) = 8.82, p = 0.012)) and POMA scores (mean increase 5.13 (x (2) = 10.38, p = 0.006)). The comparison group had no significant changes on the BBS (mean increase 0.73 (x (2) = 0.40, p = 0.819)) or POMA (mean decrease 0.13 (x (2) = 1.41, p = 0.494)). A statistically significant difference was also found between the groups' final BBS scores (treatment group median = 55.0, comparison group median 41.0), U = 7, r = -0.49.
Conclusion
The group receiving hippotherapy showed statistically significant improvement from pretest. Hippotherapy shows promise for the treatment of balance disorders in persons with MS. Further research is needed to refine protocols and selection criteria.
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Vermohlen, Schiller, Schickendantz, Crache, Hussack, Gerber-Grote, Pohlau
Multiple Sclerosis Journal (2017)
Description
To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients.
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.
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