title: Does hippotherapy effect use of sensory information for balance in people with multiple sclerosis?
abstract: OBJECTIVE
  This case-series study aimed to determine if there were observable changes in sensory processing for postural control in individuals with multiple sclerosis (MS) following physical therapy using hippotherapy (HPOT), or changes in balance and functional gait.
  
  
  METHODS
  This pre-test non-randomized design study, with follow-up assessment at 6 weeks, included two females and one male (age range 37-60 years) with diagnoses of relapse-remitting or progressive MS. The intervention consisted of twelve 40-min physical therapy sessions which included HPOT twice a week for 6 weeks. Sensory organization and balance were assessed by the Sensory Organization Test (SOT) and Berg Balance Scale (BBS). Gait was assessed using the Functional Gait Assessment (FGA).
  
  
  RESULTS
  Following the intervention period, all three participants showed improvements in SOT (range 1-8 points), BBS (range 2-6 points), and FGA (average 4 points) scores. These improvements were maintained or continued to improve at follow-up assessment. Two of the three participants no longer over-relied on vision and/or somatosensory information as the primary sensory input for postural control, suggesting improved use of sensory information for balance.
  
  
  CONCLUSIONS
  The results indicate that HPOT may be a beneficial physical therapy treatment strategy to improve balance, functional gait, and enhance how some individuals with MS process sensory cues for postural control. Randomized clinical trials will be necessary to validate results of this study.
authors.affiliation: a Menominee Tribal Clinic , Keshena , WI , USA .
authors.forename: Jodi L
authors.initials: JL
authors.lastname: Lindroth
authors.affiliation: b MidMichigan Medical Center, Harrison , MI , USA , and.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Sullivan
authors.affiliation: c Graduate Program in Physical Therapy, Central Michigan University , Mt. Pleasant, MI , USA.
authors.forename: Debbie
authors.initials: D
authors.lastname: Silkwood-Sherer
mesh_terms: D000328:Adult; D003463:Cues; D004185:Disability Evaluation; D056147:Equine-Assisted Therapy; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004856:Postural Balance; D011187:Posture; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014796:Visual Perception
keywords: Balance; functional gait; hippotherapy intervention; multiple sclerosis; physical therapy; postural control; sensory processing