Ren C, Liu T, Zhang J Horse-riding simulators in treatment of chronic low back pain: A meta-analysis. Int J Clin Pract. 2021 Mar 31:e14198. doi: 10.1111/ijcp.14198. (Systematic review)

BACKGROUND: The use of horse-riding simulators in the treatment of chronic low back pain has drawn considerable attention for its efficacy and acceptability to reduce chronic low back pain; because of the similarities in movements provided by equine-assisted therapies and the possible accessibility advantages. However, the results are conflicting. This study aimed to perform a meta-analysis of randomised controlled trials to assess the impact of treatments based on horse-riding simulators on chronic low back pain.

METHODS: A systematic literature search up to January 2021 was performed and 11 studies were detected with 543 subjects with chronic low back pain at the baseline of the study, 257 of them were using horse-riding simulators, and 255 of them were inactive control group who continued their usual care, and similar kind of physical therapy (control). They reported a comparison between horse-riding simulators and control to reduce chronic low back pain. Mean differences (MD) with 95% confidence intervals (CIs) were calculated assessing the impact of treatments based on horse-riding simulators on chronic low back pain using the continuous method with a random or fixed-effect model.

RESULTS: Significantly higher change-from-baseline pain outcomes was observed in Visual Analogue Scale (MD, -4.36; 95% CI, -6.24 to -2.30, P < .001), and Roland Morris Disability Questionnaire change-from-baseline (MD, -2.32; 95% CI, -3.52 to -1.12, P < .001) with horse-riding simulators compared with control.

CONCLUSIONS: Using horse-riding simulators may lower the risk of chronic low back pain. This relationship forces us to recommend the use of horse-riding simulators to avoid any complications that could occur with chronic low back pain.

Discipline Area Score
Physician 4 / 7
Rehab Clinician (OT/PT) 4 / 7
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Comments from MORE raters

Physician rater

I am not clear that the statistically significant score differences are clinically significant. I am also not aware of any local access to such therapy.

Rehab Clinician (OT/PT) rater

Positive findings for the use of horse simulators are interesting, but given the limited availability of such simulators, it is unlikely to have much impact on practice.

Rehab Clinician (OT/PT) rater

The use of horseback riding simulation is not something that is widely available in a therapeutic setting for patients with chronic low back pain.

Rehab Clinician (OT/PT) rater

This is very interesting evidence for CLBP management; although, the access to appropriate equipment for this would be limited for most therapists.
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