Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery—A Randomized Controlled Clinical Trial

Abstract

Background: Breast cancer is the most diagnosed women’s cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient’s challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care. Methods: We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6 month program included, in the treated group, an initial 1 week daily hippotherapy session, followed by three short 2 day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life, and cognitive performances, fatigue, anxiety and depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. Results: We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation. Conclusions: We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments’ efficiency and promotes the reconstruction of the patient’s life and their ecosystem. This work reveals a layer of complexity that needs to be broadly considered. Trial registration: ClincalTrials.gov NCT04350398. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.

Effects of Equine-Assisted Therapy on Recovery after Stroke – A Systematic Review

“…Benefits of EAT following severe neurological disability or illness have previously been reported (Viruega et al ., 2022); usually in children with cerebral palsy (Deutz et al ., 2018; Guindos-Sanchez et al ., 2020; Heussen and Häusler, 2022), but also in patients with multiple sclerosis (Stergiou et al ., 2017), spinal cord injury (Lechner et al ., 2007), ADHD (Hyun et al ., 2016; Yoo et al ., 2016), chronic pain (Collado-Mateo et al ., 2020), Down syndrome (Portaro et al ., 2020), cancer (Viruega et al ., 2023), or stroke (Beinotti et al ., 2013, Bunketorp-Käll et al ., 2017 b ). EAT was found to benefit physical function, i.e., improved gait, balance, or gross motor function, as well as to decrease spasticity.…”

“…(Guindos-Sanchez et al ., 2020; Badin et al ., 2022) In addition, psychological factors, such as quality of life and depression were found to be improved in various cohorts. (Badin et al ., 2022; Viruega et al ., 2023)…”