title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Universidad Complutense, Dept. de Medicina Física y Rehabilitación, Madrid, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Muñoz-Lasa
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ferriero
authors.forename: Raquel
authors.initials: R
authors.lastname: Valero
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomez-Muñiz
authors.forename: Alessia
authors.initials: A
authors.lastname: Rabini
authors.forename: Enrique
authors.initials: E
authors.lastname: Varela
mesh_terms: D000328:Adult; D056147:Equine-Assisted Therapy; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D004856:Postural Balance