Hippotherapy For Multiple Sclerosis Makes Horse Sense
Updated May 2, 2015--Despite its name, hippotherapy has nothing to do with the hippopotamus, which is probably a relief to patients with multiple sclerosis (MS) who want to try this treatment approach. Rather, they will find themselves spending time with horses.
What is hippotherapy?
Hippotherapy is a therapy approach that utilizes the movement of the horse as part of a program to help individuals achieve an improvement in function. The term comes from the Greek word “hippos,” which means horse, and so the literal meaning is “treatment with the help of the horse.”
Hippotherapy is recognized as a form of medical treatment to help children and adults who have mild to severe neuromusculoskeletal issues and/or developmental problems. Therefore it is used as part of a treatment plan for individuals with autism, cerebral palsy, genetic syndromes, learning disability, stroke, MS, and traumatic brain injuries and/or those who suffer with impaired balance, coordination, mobility, sensorimotor function, and muscle tone.
Why does hippotherapy make sense for MS? It’s been shown that the natural variable, repetitive, and rhythmic movements of a horse offer people an excellent platform for improving trunk strength and control, balance, postural endurance, and motor planning.
According to the American Hippotherapy Association (AHA), “Equine movement can be used to facilitate the neurophysiologic systems that support all of our functional daily living skills.” The therapy is provided by specially trained physical and occupational therapists who work with a horse professional.
The AHA explains that the horse is the one who influences the client rather than the person having control of the horse. That is, the therapist directs the horse’s movement and the person on the horse responds to the movement of the horse, which in turn helps to improve neuromuscular function.
Does hippotherapy really work for MS?
Several studies have examined the effects of hippotherapy on MS patients. Here are a few of them.
In 2010, a team from New Zealand reviewed three studies of hippotherapy for MS patients. Although the number of studies was low and the data provided was limited, they reported the following:
- Two studies showed that individuals with primary progressive MS showed the greatest amount of improvement after hippotherapy when compared with other subtypes of MS
- Hippotherapy had a positive impact on balance
- Hippotherapy also improved quality of life
Another study evaluated the impact of hippotherapy on postural stability in MS patients. Fifteen people with MS (ages 24-72) were enrolled in the pilot study.
Nine subjects participated in weekly hippotherapy sessions for 14 weeks while the other six individuals were the controls. At the end of the 14 weeks, those in the hippotherapy group showed significant improvements in two areas: balance and mobility.
The latest study of MS and horses involved therapeutic riding. It should be noted that hippotherapy and therapeutic riding are not exactly the same thing: the former uses the movement of the horse as a treatment tool to improve neuromuscular function while the latter is an umbrella term that encompasses various equine activities for people with disabilities.
In this study, 27 people with MS were assigned to one of two groups: therapeutic riding (12) or traditional physiotherapy (15) for two series of 10 weekly sessions. All the participants were tested before and after the study ended for various functional measures, disability, and mobility as well as a gait analysis.
Participants in the therapeutic riding group showed a significant improvement in mobility scores and in two gait factors: stride time and ground reaction forces, leading the authors to conclude that therapeutic riding can improve gait and balance in people with MS. No significant changes were seen in the control group.
A new (February 2015) randomized, controlled study compared the effectiveness of an internet-based home training program with hippotherapy for individuals with multiple sclerosis. The main goals were to determine the impact on balance and postural control, but the authors also looked at walking capacity, fatigue, strength, and quality of life.
The participants were randomly assigned to one of the two groups. In both cases, training was conducted twice a week for 12 weeks.
Home training included instruction and participation in strength, postural control, and balance exercises. Both the study participants and an exercise therapist were logged onto the study website so the therapist could supervise the training.
The hippotherapy sessions lasted from 20 to 30 minutes each and included a variety of therapeutic riding exercises. Each session was organized individually to meet the patient’s needs.
Overall, both groups showed similar and highly significant improvement in balance. However, only those in the hippotherapy group improved significantly in fatigue and quality of life.
If you are looking for a different approach to treatment for MS, hippotherapy may provide some benefits. Consult with your doctor and look for a certified therapist for hippotherapy on the AHA website.
American Hippotherapy Association
Bronson C et al. Does hippotherapy improve balance in persons with multiple sclerosis: a systematic review. European Journal of Physical and Rehabilitation Medicine 2010 Sep; 46(3): 347-53
Frevel D, Maurer M. Internet-based home training is capable to improve balance in multiple sclerosis: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine 2015 Feb; 51(1): 23-30
Munoz-Lasa S et al. Effect of therapeutic horseback riding on balance and gait of people with multiple sclerosis. G Ital Med Lav Ergon 2011 Oct-Dec; 33(4): 462-67
Silkwood-Sherer D, Warmbier H. Effects of hippotherapy on postural stability, in persons with multiple sclerosis: a pilot study. Journal of Neurologic Physical Therapy 2007 Jun; 31(2): 77-84