Effects of horse-riding therapy and rhythm and music-based therapy on functional mobility in late phase after stroke.

Only adults 50 to 75 years with moderate disability (Modified Rankin Scale grade 2 or 3) and 10 months to 5 years after stroke were included, so it does not apply to more dependent stroke survivors or people outside that age and time window. Participants had to live at home, travel to the intervention, and have no fear of horses, allergy, heart condition, uncontrolled seizures or other issues that would make riding or testing unsafe, so the sample was selected for safety and feasibility. Participants and therapists were not blinded, and data analysts were not blinded. The mobility outcomes were secondary; the trial's primary outcome was perceived recovery, reported previously. There was a baseline trend toward greater mobility impairment in the horse-riding group, and the authors say this could have affected comparisons. The 6-minute walk test was added after the first group had been enrolled. Horse-riding was a multimodal programme with motor, sensory, cognitive and social stimulation, so the effect cannot be separated from any single component. The immediate functional task gain was not sustained at 6 months, and the paper reports no cost-effectiveness data.

No competing interest declaration is included in the supplied text. Funding came from Sten A Olsson foundation for Research and Culture, the Swedish Brain Foundation, the Swedish Arts Council, LUA/ALF Gothenburg, AFA Insurance, The Swedish Stroke Association, and Rune and Ulla Amlöv's Foundation.

Do not conclude that horse-riding therapy is proven better than rhythm and music therapy for overall stroke recovery. This paper reports secondary mobility outcomes, the primary outcome was perceived recovery reported elsewhere, and the horse-riding programme was a multimodal intervention, so the effect cannot be separated from its sensory, cognitive and social elements.