Effect of therapeutic horseback riding on balance and gait of people with multiple sclerosis.

Abstract

BACKGROUND: Exercise therapy is an important part of symptomatic and supportive treatment in patients with multiple sclerosis (PwMS). According to the literature, equine-assisted therapies--such as therapeutic horseback riding (THR) and hippotherapy (HT)--are exercise therapies that can have positive physical effects on coordination, muscle tone, postural alignment, stiffness/flexibility, endurance and strength, correcting abnormal movement patterns and improving gait and balance. While HT is known to have a positive effect on balance in PwMS, data about THR are limited. OBJECTIVE: The aim of the present work was to determine the effect of THR on the balance and gait of ambulatory PwMS. METHODS: Twenty-seven PwMS were included in the study. Patients were divided into two groups: 12 underwent THR and 15 traditional physiotherapy (for both groups, two series of 10 weekly sessions were performed). Before and after the study period, the following outcome measures were applied: Extended Disability Status Scale (EDSS), Barthel Index, Tinetti Performance-Oriented Mobility Assessment (POMA). In addition, patients of the THR group underwent a gait analysis to assess spatiotemporal gait parameters and ground reaction forces. RESULTS: The THR group showed a significant improvement in POMA scores (p<0.005) and two gait parameters: stride time (p<0.04) and ground reaction forces (p<0.01). No statistically significant change was found in the control group. CONCLUSION: The results of the study show that THR can improve balance and gait of ambulatory PwMS. Findings are preliminary, but promising and in line with the recent literature.