International Journal of Human Movement and Sports Sciences Vol. 12(4), pp. 653 - 662
DOI: 10.13189/saj.2024.120406
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The Effect of Hippotherapy on Fatigue, Dynamic Balance, Walking Capacity and Energy Expenditure in Multiple Sclerosis: A Case Study

Christina Koutra ^1,*, Maria Liga ², Katerina Daskalaki ¹, Manos Stefanakis ³, Georgios Godolias ¹, Paraskevi Malliou ^1,3, Thomas Kourtesis ^4
1 Department of Physical Education and Sports Science, Democritus University of Thrace, Greece
² Hellenic Therapeutic Riding Center of Serres, Greece
³ Department of Health Sciences, School of Life and Health Sciences, University of Nicosia, Cyprus
⁴ Department of Early Childhood Education and Care, International Hellenic University, Greece

ABSTRACT

Background: Secondary Progressive Multiple Sclerosis (SPMS) is a neurological disease of the central nervous system which presents a complex array of symptoms, including severe fatigue, compromised balance, diminished walking capacity, and increased energy expenditure. Although the positive effect of hippotherapy on aspects like balance and self-perceived fatigue in MS patients in a resting state has already been proved, research papers examining its effect on dynamic balance in both rest and fatigue states are lacking. Objective: The aim of the present case study was to investigate the effectiveness of hippotherapy in a male patient with SPMS and to examine its impact on dynamic balance in resting and fatigue states. Secondary outcomes include walking capacity, energy expenditure of walking and subjective perception of fatigue. Methods: A 38-year-old male with SPMS participated in 16 hippotherapy sessions, lasting 30-40mins each. Measurements included a baseline and a final measurement regarding dynamic balance in rest and fatigue states (mini-BESTest), walking capacity (distance and speed at Modified 6-Minute Walk Test), energy expenditure (Physiological Cost Index) and subjective perception of fatigue (MFIS). Results: Improvements were seen in the dynamic balance in rest (+8points) and fatigue state (+7points), walking distance (pre: 290m vs. post: 367m) and speed (pre: 48,3m/min vs. post: 61,33m/min), and self-perceived fatigue (pre: 33points vs. post: 22points). The energy cost of walking remained constant. Conclusion: Hippotherapy is shown to have positive effects on dynamic balance at rest and at fatigue, thus improving performance fatigability which is an objective measurement of fatigue in people with MS. Improvements in walking capacity and subjective perception of fatigue were also noteworthy. These findings mark an initial exploration of hippotherapy's impact on performance fatigability in MS, prompting further research inquiries.

KEYWORDS
Equine Assisted Physiotherapy, Performance Fatigability, Self-perceived Fatigue, Physiological Cost Index, Mini-BESTest, 6-Minute Walk Test

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Christina Koutra , Maria Liga , Katerina Daskalaki , Manos Stefanakis , Georgios Godolias , Paraskevi Malliou , Thomas Kourtesis , "The Effect of Hippotherapy on Fatigue, Dynamic Balance, Walking Capacity and Energy Expenditure in Multiple Sclerosis: A Case Study," International Journal of Human Movement and Sports Sciences, Vol. 12, No. 4, pp. 653 - 662, 2024. DOI: 10.13189/saj.2024.120406.

(b). APA Format:
Christina Koutra , Maria Liga , Katerina Daskalaki , Manos Stefanakis , Georgios Godolias , Paraskevi Malliou , Thomas Kourtesis (2024). The Effect of Hippotherapy on Fatigue, Dynamic Balance, Walking Capacity and Energy Expenditure in Multiple Sclerosis: A Case Study. International Journal of Human Movement and Sports Sciences, 12(4), 653 - 662. DOI: 10.13189/saj.2024.120406.