Lavín-Pérez Ana Myriam, Collado-Mateo Daniel, Caña-Pino Alejandro, Villafaina Santos, Parraca Jose Alberto, Apolo-Arenas María Dolores
Centre for Sport Studies, Rey Juan Carlos University, 28943 Fuenlabrada, Madrid, Spain.
Department of Medical Surgical-Therapy, Medicine Faculty, Extremadura University, 06006 Badajoz, Spain.
Evid Based Complement Alternat Med. 2022 Apr 27;2022:9656503. doi: 10.1155/2022/9656503. eCollection 2022.
This systematic review aimed to provide an up-to-date analysis of the effects of equine-assisted therapies (EAT) in people with multiple sclerosis (PwMS). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review. PubMed and Web of Science databases were employed in the search, which ended in February 2022. The risk of bias analysis was performed using the Evidence Project tool. After removing duplicates, thirty-nine studies were identified. However, only ten fulfilled the inclusion criteria and were included in this systematic review. Therefore, a total of 195 PwMS, aged between 40.3 and 51.3, were included in this systematic review. EAT-based interventions had a mean length of 13.6 weeks with a session´s frequency ranging from ten to once a week. All sessions involved real horses and lasted a mean of 34.4 min. Among the included articles, four were randomized controlled trials (RCT), four did not perform randomization, and two employed a prepost design without a control group. RCTs showed positive effects on quality of life, fatigue, balance, spasticity, and gait speed. Furthermore, non-RCT showed improvements in balance, spasticity, and postural control (postural control was not assessed in RCT studies). Importantly, significant effects were only observed when the comparison group was inactive or followed usual care. Therefore, EAT is a promising and effective therapy to improve quality of life, fatigue, balance, spasticity, and gait speed in PwMS. However, since comparison groups are heterogeneous, results could vary depending on the research design. Moreover, the inclusion of noncontrolled studies (in order to have a wide perspective of the state of art) could increase the risk of bias and make the results be taken with caution.
本系统评价旨在对马辅助疗法（EAT）对多发性硬化症患者（PwMS）的影响进行最新分析。本系统评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。检索使用了PubMed和科学网数据库，检索截止到2022年2月。使用证据项目工具进行偏倚风险分析。去除重复项后，共识别出39项研究。然而，只有10项符合纳入标准并被纳入本系统评价。因此，本系统评价共纳入了195例年龄在40.3至51.3岁之间的PwMS患者。基于EAT的干预平均时长为13.6周，每周疗程频率从一次到十次不等。所有疗程均涉及真马，平均持续34.4分钟。在所纳入的文章中，4篇为随机对照试验（RCT），4篇未进行随机分组，2篇采用了无对照组的前后对照设计。RCT显示对生活质量、疲劳、平衡、痉挛和步态速度有积极影响。此外，非RCT显示平衡、痉挛和姿势控制有所改善（RCT研究中未评估姿势控制）。重要的是，只有当对照组不活动或接受常规护理时才观察到显著效果。因此，EAT是一种有前景且有效的疗法，可改善PwMS患者的生活质量、疲劳、平衡、痉挛和步态速度。然而，由于对照组存在异质性，结果可能因研究设计而异。此外，纳入非对照研究（以便全面了解当前技术水平）可能会增加偏倚风险，结果应谨慎对待。
