Study: Horse -based therapy seems to improve balance in people with multiple sclerosis

Reference

Bronson C, Brewerton K, ONG J, Palanca C, Sullivan SJ. Improves hippotherapy balance in people with multiple sclerosis: a systematic review. EUR J Phys Rehabil Med . 2010; 46: 347-353.

Design

Systematic literature research

Study methods: Case control or case series

background

Multiple sclerosis (MS) is a chronic disease based on a progressive demyelinization of axons in the central nervous system. The symptoms can vary from patient to patient and the disease can be recurrent and remitting or progressive. In view of the great variety of clinical symptoms, various treatments are available, the primary goal of which is to improve the balance of everyday activities. In this regard, movement training has proven to be an effective strategy.

Hippotherapy means a systematic program of physiotherapy on horseback under the direction of a certified hippotherapy specialist who is also licensed physiotherapist, occupational therapist or speech therapist. It uses the movement of the horse to make continuous dynamic changes in balance, in the attitude and proprioceptive input of the rider, which leads to current compensatory motor reactions that finally train the neuromuscular system.

hippotherapy is used as a therapeutic intervention in a number of neurological diseases, including cerebral palsy, spinal cord injury, traumatic brain injury and Ms.

hippotherapy is used as a therapeutic intervention in a number of neurological diseases, including cerebral palsy, spinal cord injury, traumatic brain injury and Ms.

materials and methods

The specific research question for this systematic review was: "Does hippotherapy as an intervention improve balance in people with MS?" In 2009 the authors searched the databases of Mdlin, Amed, Embase, Eric, Scopus, ISI Web of Science, Cinahl, Psychinfo, Science Direct and Pedro according to the terms: hippotherapy, horse, riding, riding, riding therapy, movement therapy, horse -based therapy, therapeutic riding and balance, balance, balance, posture, posture, Home reactions, attitude, dynamic balance and multiple sclerosis. Due to the restricted access to translation options, only articles were recorded in full length or translated into English.

results

From the 13 generated articles on hippotherapy, balance and MS 3 met the inclusion criteria and were evaluated. The average time and duration of hippotherapy intervention was 7.75 hours (range 5.0–13.5) over 11.2 weeks (area 9–14), and the interventions were carried out both outside and inside. In total, all three studies on improvements in balance reported, whereby a study suggested the greatest improvement in patients with primarily progressive MS compared to other subtypes of the disease. The restrictions of the study included very small sample sizes and the lack of a random selection of the subjects, which is important due to the variable nature of MS.

discussion

The published research in the areas of animal -assisted therapy, horse -based therapy and hippotherapy is relatively small, but has increased exponentially in the past decade. Methods such as the randomized controlled study are very difficult to use, since these interventions depend on a constantly changing therapeutic input on a multifactorial source (the horse) to a recipient with a variant of a multifactorial disability (cerebral paresis, traumatic brain injury, MS). .

Despite the broad search strategy, only three articles met the inclusion criteria. ^{6,7,8 Nonetheless, all three indicate an improvement in equilibrium after hippotherapy sessions, and it is relevant for this discussion that there are significant observation verification for the value of the hippotherapy of therapists, patients and family members, but in particular in the area of ​​the area Cerebral palsy and the traumatic brain /spinal cord injury.}

There are more than 700 therapeutic riding clinics in the United States, and there are thousands abroad. The North American Riding for the Handicapped Association (NARHA) monitors the certification of therapeutic riding stairs, and the American Hippotherapy Association (AHA) ensures the certification of qualified therapists to carry out hippotherapy interventions.

effects on practice

Although therapeutic riding in general and hippotherapy in particular do not have the abundance of well -founded research results of conventional therapies, numerous centers have treated tens of thousands of patients with very positive observation results for decades. The risk for the patient is very low and there is no documented side effects of these interventions except the occasional allergy to horses or other environmental sources such as hay. In view of the lack of effective therapies and the absence of known remedies, patients who suffer from these severe neurological disabilities should be transferred to a therapeutic riding clock.