Multiple Sclerosis (Neurological Modality)
- Jaithra Kakarla
- May 6, 2020
- 4 min read
Updated: Aug 2, 2020
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system) which causes communication problems between the brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease, and manage symptoms.
Therapeutic riding can be a great source of exercise in which people with multiple sclerosis may choose to participate. They can participate in riding within their limits of strength and energy and still enjoy an active recreational activity or sport. Riding may help people with multiple sclerosis stay limber and active. Both the shape of the horse’s back and the horse’s movements make it ideal for therapy. Sitting on the horse can stretch hip joints and reduce pain and spasticity in leg muscles. The horse’s pelvis moves like a human pelvis – up and down, back and forth, and side to side. Therefore, the movement of the horse stimulates the way we walk. While riding, the movement of the rider’s hips can increase limberness and muscle tone in the legs.
Riding can also improve coordination, balance, and posture, as well as strengthen core and leg muscles. Learning a new skill can build self-esteem, create a sense of well-being, and improve self-control. Another positive element is the social interaction among other riders and between the rider and the horse. For instance, activities can include the participant pushing their body off the saddle and then sitting down when the horse stepped over the beam. Lifting off the saddle by pushing into the stirrups works the muscles of the thigh and leg. Another exercise for leg strengthening is the two-point position, which involves grabbing the horse’s mane, leaning forward over its neck, and pushing the body off the saddle into a position similar to a jockey’s.
For those with MS who can engage in hippotherapy safely, it has been found to provide improvements in balance, although most studies of hippotherapy have been small. A systematic review of studies published in September 2010 in the European Journal of Physical and Rehabilitation Medicine concluded that hippotherapy has a positive effect on balance in people with MS and has the added benefit of improving quality of life.
A more recent study, published in October 2015 in the journal Physiotherapy Theory and Practice, found that three people with MS who engaged in horseback riding twice a week for a six-week period, under the supervision of rehabilitation therapists, showed improvements in posture control, gait, and balance.
“Senses help map our motor responses, and we’ve found that by having people with MS get on a horse and move through space, perhaps at a faster pace than they can walk normally, we can effectively re-map and enhance their motor responses,” says Debbie Silkwood-Sherer, the director of the doctoral program in physical therapy at Central Michigan University in Mount Pleasant and a physical therapist who uses hippotherapy in her practice.
“Plus, the horse’s movement forces the rider to use his muscles to maintain balance, which strengthens the core. Typically, when people think about hippotherapy, they think about it in connection to children with movement disorders. But we’ve seen incredible benefits for adults with diseases like MS as well,” Silkwood-Sherer says. Those benefits, says the AHA's executive director, Jacqueline Tiley, is why more and more neurologists who treat people with MS are turning to equine-assisted therapy.
Hippotherapy is effective, says Silkwood-Sherer, because it enables therapists to incorporate activities that they simply can’t replicate in the clinic. For example, Silkwood-Sherer says she has had her MS patients ride with their eyes closed to “engage their other senses in balance” and has even had patients carry weights in their hands while riding. She has also played catch with her patients while they are on horseback. “That activity forces them to maintain their balance while moving,” she explains. “We call that dynamic balance, and we find that as your dynamic balance improves, your static balance goes off the charts.”
Although practitioners such as Silkwood-Sherer recommend that people with MS interested in incorporating equine movement into their treatment consult their neurologists first, she admits that not all physicians are as open to the approach.
RISKS
It’s still a good idea to check with your doctor to make sure you are healthy enough to use — and benefit from — hippotherapy. Silkwood-Sherer says people who have advanced or severe stages of MS, or who have gained too much excess weight, may not be a good fit for the approach.
I implore any individual considering any form of EAA* or EAT** to consult with their physician or any related doctor before beginning this form of therapy. It is highly important that you are well aware of the risks of participating in this form of therapy, which sometimes may be entirely related to the health issue too. If you have any queries or suggestions please leave a comment below or reach out to me through the Contact Form on the Home page.
*Equine-Assisted Activities
**Equine-Assisted Therapy
Visit the "Current medical use of horses" post to gain more clarity about the interventions for specific modalities: https://www.equineinsight.info/post/current-medical-use-of-horses
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