The Effect of Equine-assisted Therapy in Stroke Rehabilitation: A Systematic Review and Meta-analysis

Abstract Animal assisted therapy (AAT) has recently gained attention as a complementary intervention, offering therapeutic benefits through structured interaction with trained animals. This review examines the potential role of AAT in stroke recovery, focusing on its effects on motor function, emotional well being and social reintegration. This study aimed to evaluate the effects of AAT on stroke related neuromotor impairments – including motor function, balance, spasticity, posture, gait and quality of life – compared to conventional physiotherapy. In addition, it sought to address two key questions: (1) Is long term functional recovery achievable following completion of acute or subacute rehabilitation? and (2) Can multimodal interventions such as AAT support sustained recovery in the chronic phase of stroke? Five studies met the predefined inclusion criteria and were selected for analysis. These studies represented diverse international populations. A meta analysis was performed to assess the effects of live horse assisted therapy and mechanical simulator interventions on balance and gait. Both modalities demonstrated varying degrees of improvement in these domains. AAT appears to be a promising adjunct to conventional stroke rehabilitation, with potential benefits extending across physical, emotional and social domains. However, further high quality research is needed to confirm its efficacy and facilitate its integration into standardised rehabilitation protocols.