Effectiveness of hippotherapy and therapeutic horseback riding on balance in hemiparetic patients after stroke: a systematic review and meta-analysis

Stephanie Bruna Carlos Azevedo Silva, Anna Carolina Corrêa Bicca Hruschka, Andrea Gomes Moraes, Josevan Cerqueira Leal, Marianne Lucena da Silva, Leonardo Petrus da Silva Paz


INTRODUCTION: Stroke is one of the leading causes of disability and death worldwide. Individuals who suffered stroke present numerous functional limitations. It proposed Hippotherapy as capable of promoting the recovery of postural balance in patients with neurological impairment. OBJECTIVE: To analyze published articles, seeking the effects of hippotherapy on changes in postural balance, through the Berg Balance Scale (BSE). METHODS: We conducted a systematic review of studies published on the electronic databases: PubMed, VHL, SCIELO, Cochrane, SCOPUS, Web of Science, and Cinahl. Keywords: "hippotherapy", "horseback riding" and "stroke" linked by the OR and AND boolean operators. The research was restricted to clinical trials in an adult population with a history of stroke. RESULTS: Four articles were included in this meta-analysis, which used hippotherapy as an intervention to improve postural balance. Three studies used a mechanical device (horseback riding), and one used the horse. The age ranged from 61 to 71 years, being more predominant than the male sex. Sessions ranged from 6 to 12 weeks of 20 to 30 minutes per session. Quality analysis using the PEDro scale demonstrated scores ranging from 6 to 8 points in the selected studies. As compared with conventional therapy just studies with horseback riding was superior to conventional therapy to improve postural balance in hemiparetic stroke patients. CONCLUSION: There are few studies of high quality; then, it is not possible to evaluate the effectiveness of hippotherapy using a horse or a mechanic simulator in patients with stroke when compared with conventional therapy.


Mechanical horseback riding. Equine-assisted therapy. Hippotherapy. Stroke. Postural balance.

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DOI: https://doi.org/10.1590/fm.2021.34201


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