Effects of horse-riding therapy and rhythm and music-based therapy on functional mobility in late phase after stroke

Background: Persons with stroke commonly have residual neurological deficits that seriously hamper mobility. OBJECTIVE: To investigate whether horse-riding therapy (H-RT) and rhythm and music-based therapy (R-MT) affect functional mobility in late phase after stroke. Methods: This study is part of a randomized controlled trial in which H-RT and R-MT was provided twice weekly for 12 weeks. Assessment included the timed 10-meter walk test (10 mWT), the six-minute walk test (6 MWT) and Modified Motor Assessment Scale (M-MAS). Results: 123 participants were assigned to H-RT (n = 41), R-MT (n = 41), or control (n = 41). Post-intervention, the H-RT group completed the 10 mWT faster at both self-selected (-2.22 seconds [95% CI,-3.55 to-0.88]; p = 0.001) and fast speed (-1.19 seconds [95% CI,-2.18 to-0.18]; p = 0.003), with fewer steps (-2.17 [95% CI,-3.30 to-1.04]; p = 0.002 and-1.40 [95% CI,-2.36 to-0.44]; p = 0.020, respectively), as compared to controls. The H-RT group also showed improvements in functional task performance as measured by M-MAS UAS (1.13 [95% CI, 0.74 to 1.52]; p = 0.001). The gains were partly maintained at 6 months among H-RT participants. The R-MT did not produce any immediate gains. However, 6 months post-intervention, the R-MT group performed better with respect to time;-0.75 seconds [95% CI,-1.36 to-0.14]; p = 0.035) and number of steps-0.76 [95% CI,-1.46 to-0.05]; p = 0.015) in the 10 mWT at self-selected speed. Conclusions: The present study supports the efficacy of H-RT in producing immediate gains in gait and functional task performance in the late phase after stroke, whereas the effectiveness of R-MT is less clear.