Therapeutic Horseback Riding for Individuals with Multiple Sclerosis

Background: The complexity of MS challenges rehabilitation specialists to identify and implement optimal treatments to maintain function and improve quality of life. Therapeutic horseback riding is a form of therapy that addresses this need. The 3D motion of the horse resembles human walking, and impacts the rider’s gait and balance. The majority of studies have focused on gait and balance, but few have incorporated a holistic whole-body perspective.

Objectives: The purpose of this study was to investigate the effect of a therapeutic horseback riding intervention on upper and lower extremity impairment, balance, gait, and overall quality of life of an individual living with MS.

Methods: This case study utilized a mixed methods convergent design implementing quantitative and qualitative outcome measures concurrently to gain a complete understanding of the participant’s experiences. Assessments measured participant’s upper and lower extremity function, as well as balance and fatigue. There were four testing periods: baseline, week 4, post and a one month follow-up. Quantitative data were recorded and analyzed across all time points. Qualitative data were captured through the participant’s daily journal entries, and were coded line by line into themes and subthemes.

Results: The participant was a 52 year old female diagnosed with relapsing and remitting MS. Quantitative measures of upper extremity impairment showed overall positive changes. Lower extremity measures varied; the Timed Up and Go gradually improved while the Timed 25 Foot Walk showed a slight decrease until follow-up. Balance measured by the functional reach improved at all time points. Measures of perceived balance showed improvements in performing tasks that were challenging both in the home and community. Perceived fatigue level improved in several areas including maintaining attention, thinking clearly, and completing activities. Qualitative measures yielded two themes of the participant’s experiences: Improvements and Continued Issues. Subthemes of Improvements were comprised of increased standing tolerance, feeling stronger, better posture, increased activity level, better self-management of symptoms, and more sensation. Continued Issues subthemes consisted of balance challenges, tired/weak, and soreness/tightness/spasticity.

Conclusions: Study results demonstrated that therapeutic horseback riding is a beneficial intervention that addresses the unique needs of individuals living with MS.