The Effect of Equine-assisted Therapy in Stroke Rehabilitation: A Systematic Review and Meta-analysis
Authors: Moksha Ravi Dadlani, Ravi Dadlani, M. Camargo, Ana Carolina Brun Gudiño, Diana Paola Ariza Perez, Amit Agrawal, LuisRafael Moscote-Salazar
Journal: Indian Journal of Physical Medicine and Rehabilitation
Summary
# Editorial Summary Animal-assisted therapy (AAT) using horses has emerged as a potential complementary approach to conventional stroke rehabilitation, though evidence supporting its integration into standard practice remains limited. Dadlani and colleagues conducted a systematic review and meta-analysis of five international studies comparing equine-assisted interventions with traditional physiotherapy for stroke survivors, examining effects on motor control, balance, spasticity, posture, gait quality and overall quality of life across acute, subacute and chronic phases of recovery. Both live horse-assisted therapy and mechanical horse simulators showed measurable improvements in balance and gait parameters, though the magnitude of benefit varied considerably between studies, suggesting that intervention design and patient selection may significantly influence outcomes. The evidence base indicates AAT holds promise as an adjunctive tool that may address not only neuromotor deficits but also emotional wellbeing and social reintegration—domains often overlooked in conventional rehabilitation—yet the authors emphasise that current research quality remains insufficient to justify widespread clinical adoption without further rigorous investigation. For equine professionals and rehabilitation teams considering AAT implementation, this review suggests potential value in combined multimodal approaches, particularly during chronic phases of recovery, but robust, standardised protocols and high-quality randomised controlled trials are essential before confidently recommending AAT as a standard component of stroke rehabilitation pathways.
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Practical Takeaways
- •Equine-assisted therapy shows promise as a complementary tool alongside conventional physiotherapy for stroke patients, particularly for balance and gait training
- •Both live horses and mechanical simulators demonstrated therapeutic potential, offering options based on accessibility and patient needs
- •Further rigorous research is needed before integrating AAT into standard stroke rehabilitation protocols; clinical adoption should remain cautious until high-quality evidence emerges
Key Findings
- •Five studies met inclusion criteria examining equine-assisted therapy for stroke rehabilitation across diverse international populations
- •Both live horse-assisted therapy and mechanical simulator interventions demonstrated varying degrees of improvement in balance and gait
- •AAT appears to offer benefits across physical, emotional and social domains as adjunct to conventional stroke rehabilitation
- •Current evidence insufficient to confirm efficacy or establish standardized rehabilitation protocols incorporating AAT