Acta Neurol Taiwan. 2026 Oct 1;35(4):216-226. doi: 10.4103/ant.ANT-D-25-00092. Epub 2026 Oct 29.
ABSTRACT
BACKGROUND: Stroke frequently leads to balance and mobility impairments, significantly affecting patients' independence and quality of life. Hippotherapy, a therapy involving horse-based movements, has gained attention as a potential intervention for balance rehabilitation.
OBJECTIVES: This study evaluates the effectiveness of hippotherapy in improving balance and mobility in stroke patients.
MATERIALS AND METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines through PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Physiotherapy Evidence Database for randomized controlled trials (RCTs) assessing hippotherapy's effects on balance in adult stroke patients (Prospero registration number: CRD42024552688). Effect sizes were pooled using RevMan software.
RESULTS: Ten RCTs met the inclusion criteria, with seven included in the meta-analysis (n = 389 participants). Hippotherapy significantly improved balance outcomes compared to conventional exercise programs, as measured by the Berg Balance Scale (BBS) (mean difference [MD] =1.72; 95% confidence interval [CI] [1.38, 2.07], P < 0.00001) and the timed up and go (TUG) test (MD = -2.97 s; 95% CI [-4.83, -1.11], P = 0.002). Exploratory subgroup analysis showed no statistically significant difference between mechanical and real-horse hippotherapy (P = 0.64).
CONCLUSIONS: Stroke patients may benefit from hippotherapy as an effective adjunct to conventional rehabilitation. Hippotherapy significantly improves balance and functional mobility, as demonstrated by improvements in the BBS and TUG test. However, evidence regarding quality of life and psychological outcomes remains limited and inconclusive, underscoring the need for further high-quality RCTs.
PMID:42954441 | DOI:10.4103/ant.ANT-D-25-00092