Equoterapia com cavalo versus simuladores de equitação: diferenças nos parâmetros físicos, funcionais e contextuais em distúrbios neurológicos

Abstract

Introduction: Equine-assisted therapy (hippotherapy) is used as a complement to conventional therapy for people with conditions such as neurological injuries. However, it faces high costs and safety issues. Riding simulators were developed to provide a safe, accessible, and economical alternative, however it is not known if they are as effective as hippotherapy. This paper reviews prior literature to test for physical, functional and / or contextual differences between therapy with a real horse when compared to riding simulators. Method: Searches were performed for papers in English or Portuguese in the PEDro, MEDLINE, SciELO, CAPES portal, Cochrane, LILACS, BVS and Sci-Hub databases published between 2010 and May 2020. Papers were only included if they addressed hippotherapy for neurological disorders and included the PICO strategy. Both in the treatment with real horses and with the use of simulators, improvement scans were measured in the physical and functional parameters of the individuals, but the contextual factors have not yet been clarified and the comparison between interventions did not have statistically significant results. Discussion: Both therapies demonstrated improvements in the body structure/function domain, such as increased abdominal muscle activation, improved balance, decreased spasticity, decreased fatigue, trunk control, among others. Few studies have evaluated the activity/participation and environmental factors, but even those that evaluated it are in contradiction with each other. Conclusion: This review summaries the prior research and identifies areas where more research is needed. Most studies show positive results indicating that hippotherapy is a promising treatment for neurological injuries, however few prior studies have directly compared horse and simulator interventions, nor do they show data relevant for clinical practice. Most prior research has been poorly described and lacks consistent dosage, types of intervention and outcome measures. There is a need to develop new research to validate benefits of both horse and simulator therapy and to produce parameters to guide clinical practice in this population.