Effects of hippotherapy on postural balance, functional mobility, self-perceived fatigue, and quality of life in people with relapsing-remitting multiple sclerosis: Secondary results of an exploratory clinical trial

Andréa Gomes Moraes; Silvia G R Neri; Robert W Motl; Carlos Bernardo Tauil; Felipe von Glehn; Éber Castro Corrêa; Ana Cristina de David

doi:10.1016/j.msard.2021.102948

Effects of hippotherapy on postural balance, functional mobility, self-perceived fatigue, and quality of life in people with relapsing-remitting multiple sclerosis: Secondary results of an exploratory clinical trial

Mult Scler Relat Disord. 2021 Jul:52:102948. doi: 10.1016/j.msard.2021.102948. Epub 2021 Apr 20.

Authors

Andréa Gomes Moraes¹, Silvia G R Neri², Robert W Motl³, Carlos Bernardo Tauil⁴, Felipe von Glehn⁵, Éber Castro Corrêa⁶, Ana Cristina de David⁷

Affiliations

¹ Laboratory of Human Motion Analysis, Faculty of Physical Education, University of Brasilia, Brasilia, DF, Brazil. Electronic address: andreafisiounb@gmail.com.
² Laboratory of Human Motion Analysis, Faculty of Physical Education, University of Brasilia, Brasilia, DF, Brazil; Estácio University Center of Brasilia, Brazil.
³ Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Faculty of Medicine, University of Brasília (UnB), DF, Brazil.
⁵ Department of Internal Medicine, Faculty of Medicine, University of Brasilia (UnB), Brasilia, DF and Department of Immunology, University of Campinas (Unicamp), SP, Brazil.
⁶ Clinen, Neurology and Endocrinology Clinic, Brasilia, DF, Brasil.
⁷ Laboratory of Human Motion Analysis, Faculty of Physical Education, University of Brasilia, Brasilia, DF, Brazil.

PMID: 33940496
DOI: 10.1016/j.msard.2021.102948

Abstract

Background: Multiple sclerosis (MS) results in worsening of postural balance, functional mobility, and self-perceived fatigue as influences of quality of life.

Objective: To examine the effects of hippotherapy on postural balance, functional mobility, self-perceived fatigue, and quality of life in people with MS.

Methods: Participants were assigned into a hippotherapy intervention group (n= 17) or a control group (n= 16). The intervention included 16 sessions of 30-minutes of hippotherapy conducted twice a week whereas the control group was maintained their therapeutic routine. Postural balance was evaluated as CoP speed (cm/s) and CoP 95% elliptical area (cm²) using a force platform under 4 experimental conditions: stable surface/ eyes open, stable surface/ eyes closed, foam surface/ eyes open, and foam surface/ eyes closed. Functional mobility was evaluated by the Timed Up and Go (TUG) test. The Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS) measured perceived fatigue, and the Functional Assessment of Multiple Sclerosis (FAMS) measured quality of life. The data were examined using mixed model ANOVA with Bonferroni post hoc.

Results: CoP speed and CoP 95% elliptical area (p < .05) significantly decreased across all testing conditions for the intervention group compared with control. The TUG improved over time in the intervention group (p = .001) as did the FSS (p < .001). In addition, there was also an improvement for the score and all the MFIS domains (p < .005) for the intervention group compared with control and for FAMS improved over time in the intervention group (p < .05).

Conclusion: Hippotherapy improved postural balance, functional mobility, fatigue, and quality of life in people with relapsing-remitting MS. This suggests that hippotherapy may be a useful approach for complimentary treatment among people with MS.

Keywords: Fatigue; Functional mobility; Hippotherapy; Multiple sclerosis; Postural balance; Quality of life.

Publication types

Clinical Trial

MeSH terms

Equine-Assisted Therapy*
Fatigue
Humans
Multiple Sclerosis*
Multiple Sclerosis, Relapsing-Remitting*
Postural Balance
Quality of Life