After a stroke, hippotherapy appears to improve balance, but its everyday benefits remain unclear

A review of trials in adults after a stroke

The researchers examined randomized trials assessing the effects of hippotherapy on balance in adults who had experienced a stroke. Ten trials met the systematic review’s criteria. Seven were included in the meta-analysis, covering 389 participants.

The review compares outcomes from hippotherapy with those from conventional exercise programs. Only the Europe PMC abstract was consulted in the supplied dossier. It specifies neither the duration of the interventions nor detailed participant characteristics, limiting the ability to identify which patients these findings apply to.

Measured improvements, without direct evidence of greater independence

On the Berg Balance Scale, the reported mean difference is 1.72 points in favor of hippotherapy, with a 95% confidence interval of 1.38 to 2.07 points. On the Timed Up and Go mobility test, completion time is 2.97 seconds shorter on average, with a confidence interval ranging from 1.11 to 4.83 seconds shorter.

These differences are statistically significant. However, the abstract does not establish whether their magnitude represents a noticeable and meaningful improvement for patients. It reports no results on falls and does not establish whether these improvements persist after the intervention.

Data on quality of life and psychological outcomes remain limited and inconclusive. The benefits observed in the tests should therefore not be extended to these areas.

Real horse or simulator: no demonstrated equivalence

An exploratory analysis found no statistically significant difference between hippotherapy using a real horse and hippotherapy using a mechanical device. This lack of a detected difference does not demonstrate that the two approaches are equivalent.

The authors present hippotherapy as a potential complement to conventional rehabilitation, not a replacement. The abstract does not detail adverse effects, contraindications or supervision requirements. It is therefore insufficient to establish the safety of this approach for an individual patient.

What we can take away

Hippotherapy appears to improve performance on some balance and mobility tests after a stroke. This review supports its potential value as a complement to rehabilitation, without establishing a lasting improvement in independence.