Could horseback riding help ease multiple sclerosis symptoms?

One study out of Germany concluded that a horseback riding therapy known as hippotherapy along with standard care significantly improved balance, fatigue, motor function, and spasticity in people with multiple sclerosis (MS).

The primary outcome of the study was the change in the Berg Balance Scale (BBS).

The BBS is a widely used clinical test of a person’s balance abilities, with additional measures including fatigue, pain, quality of life, and spasticity.

The research was initiated by Marion Drache, chair of the executive board of Zentrum für Therapeutisches Reiten Johannisberg e.V., which is a nonprofit organization for hippotherapy focused on high-level scientific studies on therapeutic riding since 2004.

“Hippotherapy is different than regular horseback riding,” Drache told Healthline.

She explained hippotherapy is a physiotherapy treatment based on a neurophysiological approach. It works by “transmitting the three-dimensional movements generated by the horse’s slow gait (walk) to the patient,” she said.

How the riding works

Specially trained horses are guided in a large circle in slow, rhythmic, and methodical gaits as the hippotherapists use the horses’ energy and movement to work with each patient. 

“It relaxes the people,” Andreas Gerber-Grote, director/dean at the School of Health Professions at ZHAW, Zurich University of Applied Sciences, told Healthline. “Patients have to use balance while on a horse, which stimulates muscles and balance using different pathways.”

Gerber-Grote was responsible for the design and application of the study.

The regiment used for this study was provided in accordance by the German Curatorship for Therapeutic Riding (DKThR) and specifically designed to work for those with MS.

The horses used were specifically trained as well.

Patients in the study often expressed how good they felt after their hippotherapy sessions.

Drache shared some comments with Healthline.

One person said, “After a hippotherapy session, everything is much easier for several days.”

Another told her, “My balance is so good after hippotherapy that I can climb the stairs again.”

The study was funded by the Drache Foundation in Germany.

The program was able to work with five clinics and 70 patients. It lasted 12 weeks.

Results a little disappointing

While the study produced positive results, researchers were hoping for more.

“The clinical meaningful difference isn’t as big as hoped for on the Berg Balance Scale,” said Gerber-Grote. “A difference exists, but is it clinically meaningful?”

To find out, more research will need to be done.

In the future, Gerber-Grote advises prolonging the study, or intensifying the horse therapy.

Or, perhaps work with groups with more severe symptoms.

This study involved five horse centers across Germany and hippotherapists who were “not at all familiar with a study or a trial.”

Gerber-Grote commended his team and called them proof that with training and education, “a team can perform a high-level study on non-drug intervention in a real setting.”

Gerber-Grote emphasized the importance of this trial, because it “allowed for a sound, rigorous study to see if hippotherapy, a non-drug intervention, helped MS patients.”

Research elsewhere

Germany is not the only place to look at hippotherapy.

Researchers in Greece recently published a study that the therapy provides cognitive, emotional, and social well-being.

Researchers added that participants who attend such a therapy program have the chance to experience, benefit from, and enjoy this activity outdoors.

More than $19 billion is spent annually in the United States on rehabilitation of people with disabilities associated with multiple sclerosis, stroke, balance deficits, and spinal cord injuries.

Nurses in Missouri found that hippotherapy is attempting to ease functional impairment, pain, balance deficits, and decreased quality of life in people with all of these conditions.

According to the National MS Society website, hippotherapy is the top-listed alternative sport for people with MS, especially those with limited mobility.

Programs are available throughout the country.

Two resources for equestrian-based therapies are American Hippotherapy Association and the Professional Association of Therapeutic Horsemanship.

Editor’s Note: Caroline Craven is a patient expert living with MS. Her award winning blog is, and she can be found @thegirlwithms.