Effects of Equine-Assisted Therapy on Recovery after Stroke – A Systematic Review

Abstract

Background Equine−Assisted Therapy (EAT) can boost well−being and recovery of patients with neurological or psychiatric disorders. Objective The goal of this systematic review is to gain a better understanding of the effects of EAT on recovery after stroke. Methods A systematic literature search was performed in the following databases: PubMed, Web of Science and Scopus. Furthermore, reference lists from the articles included were screened. English-written articles published between 2000−2023 that reported on health-related effects of EAT (applied with both horses and riding simulators) on stroke recovery in patients aged between 18 and 85 were included. Methodological quality was assessed by the Mixed Methods Appraisal Tool. Results Following the screening of 2030 and retrieval of 33 articles respectively, 17 reports were included in this systematic review (437 patients, mean age range: 40−70 years). Since several of these studies lacked important methodological information, the overall methodological quality varied. Fourteen of the articles reported physical (balance, gait, postural coordination, activities of daily living (ADL), lower extremity motor impairment, motor function and hand strength), while six studies reported psychological (cognition, quality of life (QoL), depression and perception of the intervention) findings. Only two studies reported physiological findings (muscle thickness and trunk muscle activity). In general, the findings suggest positive effects of EAT on stroke recovery in each domain, whereas the most consistent beneficial effects were reported for balance and gait. Conclusion EAT appears to be a promising multimodal intervention for the recovery of different functions after stroke. However, evidence is sparse and methodological quality limited. Future research should investigate the effects of EAT on stroke recovery more systematically.