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

BackgroundEquine-Assisted Therapy (EAT) can boost well-being and recovery of patients with neurological or psychiatric disorders. ObjectiveThe goal of this systematic review is to gain a better understanding of the effects of EAT on recovery after stroke. MethodsA 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. ResultsFollowing the screening of 2030 and retrieval of 33 articles respectively, 14 studies 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. Thirteen studies reported physical findings (balance, gait, postural coordination, activities of daily living, lower extremity motor impairment, motor function and hand strength), and seven studies reported further health-related outcomes (cognition, quality of life, depression and perception of the intervention, muscle thickness and trunk muscle activity). The findings suggest positive effects of EAT on stroke recovery in different health-related outcomes, whereas the most consistent beneficial effects were reported for balance and gait. ConclusionEAT 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.