Horseback Riding Plus Standard Care Can Help MS Patients Improve Balance, Other Symptoms

Therapeutic horseback riding, also known as hippotherapy, when combined with standard care regimens significantly reduces fatigue and muscle contraction (spasticity) in multiple sclerosis. It also improves balance and quality of life, according to a German study.

The study, “Hippotherapy for patients with multiple sclerosis: A multicenter randomized controlled trial (MS-HIPPO),” appeared in the Multiple Sclerosis Journal.

Hippotherapy takes advantage of a horse’s natural movements to develop a patient’s muscle tone and improve breathing, while strengthening the torso muscles. Horseback riding also improves balance control, coordination and gait, while boosting a patient’s social communication skills, which can benefit self-esteem.

“Hippotherapy as a complementary treatment can be defined as one-patient-one-horse physiotherapy treatment with and on the horse,” researchers wrote.

Team leaders Vanessa Vermöhlen and Petra Schiller of the University of Cologne evaluated the benefits of half-hour weekly sessions of hippotherapy in combination with standard care. They randomly assigned 70 MS patients with lower limb spasticity to either an intervention group that did 12 weeks of hippotherapy, or a control group that received only standard therapy.

The team evaluated the impact therapeutic horseback riding had on balance, measured by the Berg Balance Scale (BBS). They also measured its effect on other multiple sclerosis symptoms and signs, including fatigue, quality of life, pain, and spasticity.

Overall, the team found that those who received hippotherapy plus standard care improved their BBS scores by 4.8 points after six weeks of therapy, and 6.4 by the trial’s end. These increases were significantly higher than those achieved by the control group (2.9 points at six weeks and 3.1 points at 12 weeks).

Although this represents a difference of only 3.3 points after 12 weeks, it still reflects a relevant change in patients’ balance control capabilities, the authors said.

In addition, the researchers also recognized significant improvements in fatigue, spasticity and quality of life of those undergoing hippotherapy plus standard care compared to those on the control group.

The observed beneficial effects of hippotherapy validate previous reports that showing that activities with horses could help adults and children improve their balance, gait and psychomotor abilities.

“The results of this first randomized controlled multicenter trial in the field of hippotherapy for MS patients indicate the positive effect of this therapy on balance and other relevant functions,” the team wrote. “For the benefit of patients, we encourage health professionals and independent foundations to be more proactive regarding research in non-pharmacological interventions.”

For more information about hippotherapy programs or places to access to therapeutic horseback riding, consult the American Hippotherapy Association or the Professional Association of Therapeutic Horsemanship.