Comparing the effects of core stability training versus hippotherapy on balance dysfunctions in multiple sclerosis patients

Abstract

Overview: Multiple Sclerosis (MS) is a common demyelinating disease where the myelin sheaths of nerves in the central nervous system become damaged, leading to impaired transmission of nerve impulses (Leray et al. 2016, Tafti et al. 2022), resulting in a range of symptoms. Impaired balance affects most patients diagnosed with MS. Balance dysfunctions may be due to generalised muscle weakness apart from other factors. This dissertation attempts to identify whether core-stability training (CST) or hippotherapy is more effective in improving balance in MS patients. Research Question and PICO Elements: ‘Is Core Stability Training superior to Hippotherapy when improving balance levels in MS patients?’ Patients had MS with balance dysfunctions (P). Core-stability training (I) was compared to hippotherapy (C) to determine which therapy is superior at improving balance outcomes (O). Method: Four different search engines were utilised to retrieve relevant literature pertaining to the research question. These were identified through keywords, their synonyms and through the use of Boolean operators. Eligibility criteria comprised of high-quality study designs, having full text, written in the English Language and studies published in the previous twelve years. The PRISMA checklist determined the relevant key articles chosen. The nine key articles chosen were then critically appraised using the Critical Appraisal Skills Programme (CASP) tool as a guideline. Results and Conclusion: A definite answer to the research question could not be given as results from the studies showed that both CST and hippotherapy are effective at improving balance outcomes in MS patients. Implications and Recommendations: Raising awareness on Hippotherapy in order to encourage further research on this area. Possibility of introducing it as a service outside of the physiotherapy department may be considered.