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

Abstract

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.

The Effectiveness of Music Therapy on Hand Function in Patients With Stroke: A Systematic Review of Randomized Controlled Trials

“…The items' random sequence generation, allocation concealment, incomplete outcome data, and other sources of bias were assessed as low risk of bias in most of the included studies ( 9 , 12 , 16 , 17 , 19 , 21 – 24 ). Blinding of participants and personnel scored high risk of bias or unclear risk in half of the included studies, which is inherent to the intervention ( 15 – 20 , 22 , 24 ). There are some studies that the blinding of outcome assessment was not described clearly so that they were scored unclear in the detection bias ( 12 , 19 , 20 , 22 ).…”

“…The included studies had the gender distribution as follows: 253 females and 345 males. The mean age of the participants was 61.09 years old (SD = 11.43), ranging from 48.6 to 76.02 years old (9,12,16,17,19,(21)(22)(23)(24). All subjects suffered from stroke from 1.7 months to 3 years before exposed to the MST intervention.…”

“…The items' random sequence generation, allocation concealment, incomplete outcome data, and other sources of bias were assessed as low risk of bias in most of the included studies (9,12,16,17,19,(21)(22)(23)(24). Blinding of participants and personnel scored high risk of bias or unclear risk in half of the included studies, which is inherent to the intervention (15-20, 22, 24).…”

“…To determine effectiveness, musical interventions were compared with blank control group (9,16), standard of care, regular activities (15,18,20,21,23), conventional rehabilitation treatments (12,17,22,24), and mute music training (19,24). Conventional rehabilitation treatments such as passive mobilization, stretch and progressive resistance exercises, and task-specific training (17,22), mute music training such as using a sponge or custom-made pad on the musical instrument to inhibit or delay patients from hearing sounds during the training (19,24). Nine trials required participants played rhythmical-melodic musical instruments or digital music equipment, such as xylophones, glockenspiels, drums, bongos, ethnic percussion, piano, iPads with touch screen musical instruments (9, 12, 15-19, 22, 23).…”

Motor Function in the Late Phase After Stroke: Stroke Survivors’ Perspective

“…We have previously found that horse-riding therapy (H-RT) and rhythm- and music-based therapy (R-MT) helps promote subjective and objective functional recovery in the late phase after stroke [ 10 , 11 ], including gains in motor function. Additional in-depth analyses of data derived from the randomized controlled trial (RCT) supported the observed efficacy of H-RT in producing immediate and sustained gains in gait and functional mobility in the late phase after stroke, whereas the effectiveness of R-MT in this respect was less convincing [ 12 ].…”