Immediate and Sustained Effects of Intensive Equine-Assisted Physiotherapy Based on Neuroproprioceptive “Facilitation and Inhibition” on Psychomotor Development, Clinical Functions, Quality of Life, and Molecular Biological Indicators in Children With Spinal Muscular Atrophy: Protocol for a Crossove
Authors: Katerina Marikova, Jindra Reissigová, M. Vilímek, Marie Černá, Marketa Pokorna, Kamila Řasová
Journal: JMIR Research Protocols
Summary
# Editorial Summary: Equine-Assisted Physiotherapy for Spinal Muscular Atrophy Spinal muscular atrophy (SMA) remains the leading genetic cause of infant mortality, yet pharmacological advances have significantly improved outcomes when combined with comprehensive physiotherapy. A Czech research team has designed a novel crossover randomised controlled trial to evaluate NEUROEQUIP-SMA, an intensive equine-assisted physiotherapy protocol based on neuroproprioceptive facilitation and inhibition principles, against standard land-based physiotherapy using identical neuromuscular facilitation techniques in 20 children aged 2–9 years with SMA types I–III. Both intervention groups will receive equal daily contact time (50 minutes), with the equine-assisted programme delivered in two 15-minute sessions alongside therapeutic grooming, while the control involves a single 30-minute land-based session; researchers will measure changes immediately post-intervention using the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) as the primary outcome, supplemented by 3D motion analysis, spirometry, molecular biomarkers from blood samples, and quality-of-life assessments at 28-day follow-up. The study is powered to detect moderate-to-large effect sizes (Cohen d=0.66) and represents the first rigorous investigation of horse-assisted therapy specifically in SMA populations, with data collection beginning February 2026 and results expected in 2027. For equine and rehabilitation professionals, this protocol signals growing recognition that human–horse interaction may enhance proprioceptive facilitation and motor learning outcomes in paediatric neuromuscular conditions, potentially offering a complementary approach to standard physiotherapy rather than a replacement—particularly valuable as gene therapies transform SMA management trajectories.
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Practical Takeaways
- •This protocol describes a novel equine-assisted physiotherapy method for children with SMA that combines neuroproprioceptive principles with horse interaction; results expected in 2027 will clarify whether this approach offers advantages over standard physiotherapy
- •The study will provide evidence on whether equine-assisted therapy can improve functional outcomes and quality of life in SMA children already receiving gene therapy, potentially informing multimodal rehabilitation strategies
- •Practitioners should monitor for publication of results in 2027 to understand whether equine-assisted physiotherapy represents a viable adjunct to standard care for this rare neuromuscular condition
Key Findings
- •This is a protocol paper; no results are yet available as data collection begins February 2026
- •Study designed to detect moderate-to-large effect sizes (Cohen d=0.66) in CHOP INTEND scores with 80% power
- •Crossover RCT will compare equine-assisted physiotherapy (NEUROEQUIP-SMA) versus standard physiotherapy (SMA-SOC-N) in children aged 2-9 years
- •Primary outcome is motor function via CHOP INTEND; secondary outcomes include motor coordination via 3D motion analysis, muscle fatigue, respiratory function, and quality of life measures